scholarly journals Intraluminal Meckel’s Duplication Cyst Causing Bowel Obstruction in an Infant: A Role for Laparotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mitchell R. Ladd ◽  
Alejandro V. Garcia ◽  
Derek B. Allison ◽  
Jeffrey R. Lukish
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Ileocecal Valve ◽  
Signs And Symptoms ◽  
Duplication Cyst ◽  
Ectopic Gastric Mucosa ◽  
Lower Quadrant ◽  
Intraluminal Mass ◽  
Enteric Duplication ◽  
Right Lower Quadrant

This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel’s diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.

Spontaneous Resolution of Small Bowel Obstruction in a Child following Rupture of a Small Bowel Duplication Cyst

Ultrasound ◽  
2011 ◽  
Vol 19 (4) ◽  
pp. 221-223
Author(s):  
K Patel ◽  
J Jacob ◽  
J Flavill ◽  
M Sellars
Keyword(s):  
Differential Diagnosis ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Paediatric Population ◽  
Duplication Cyst ◽  
Spontaneous Resolution ◽  
Enteric Duplication

Duplication cysts are rare congenital malformations that can present with a variety of symptoms that may change during the course of an acute admission. We report a case in which a four-year-old boy presented with signs of small bowel obstruction that following imaging were found to be secondary to bowel compression by a large duplication cyst. The symptoms changed when the cyst ruptured. We highlight the importance of ultrasound in establishing the diagnosis of enteric duplication cysts in the symptomatic paediatric population. We also explore the differential diagnosis and complications that can be caused by these congenital anomalies.

Concurrent Spigelian and Grynfeltt-Lesshaft Hernias

2021 ◽  
pp. 000313482110562
Author(s):  
Ryan M. Huttinger ◽  
Matthew S. Kazaleh ◽  
Dylan J. Skinner ◽  
Marsha C. Nelson
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Synthetic Mesh ◽  
Accurate Diagnosis ◽  
Spigelian Hernia ◽  
Lower Quadrant ◽  
Superior Lumbar Triangle ◽  
Lumbar Triangle ◽  
Right Lower Quadrant

Only 0.12% to 2% of diagnosed hernias are Spigelian type. Even less frequently encountered—Grynfeltt-Lesshaft hernias—hernias have unknown incidence. A Spigelian hernia is encountered along the Spigelian fascia and Grynfeltt-Lesshaft hernias are bounded by the superior lumbar triangle. These unique hernias can both be intermuscular, given their anatomical borders which allow concealment and preclusion of accurate diagnosis. Here, an 86-year-old male presented with symptoms consistent with small bowel obstruction. On physical exam, a right lower quadrant hernia and right posterior flank mass were appreciated. Computed tomography revealed obstruction secondary to bowel incarceration within Spigelian hernia and additional Grynfeltt-Lesshaft hernia. The patient underwent reduction and repair of Spigelian hernia with synthetic mesh, while repair of asymptomatic hernia was deferred. These unusual hernias are difficult to distinguish, given their negligible occurrence and unreliable exam findings. Clinicians must remain cognizant of their features to aid in diagnosis and mitigate potential sequelae.

scholarly journals Small bowel transit of a bran meal residue in humans: sieving of solids from liquids and response to feeding

Gut ◽  
1998 ◽  
Vol 42 (5) ◽  
pp. 685-689 ◽  
Author(s):  
J M Hebden ◽  
P E Blackshaw ◽  
A C Perkins ◽  
M D’Amato ◽  
R C Spiller
Keyword(s):  
Gastric Emptying ◽  
Small Bowel ◽  
Small Bowel Transit ◽  
Motor Patterns ◽  
Solid Meal ◽  
Lower Quadrant ◽  
Distal Small Bowel ◽  
Proximal Small Bowel ◽  
Indium 111 ◽  
Right Lower Quadrant

Background—Ileal motor patterns are adapted to the propulsion of viscous meal residue, such as bran, which accumulates in the distal ileum postprandially.Aims—To examine the effects of a second liquid/solid meal on ileal emptying.Subjects and methods—Eleven healthy fasting subjects consumed a 1.47 MJ pancake containing 15 g bran and 5 MBq Technetium-99m labelled amberlite resin (meal A). Gastric emptying and transit through the left upper quadrant (proximal) and right lower quadrant (distal) small bowel regions and colon were assessed scintigraphically. Transit was compared with and without a second Indium-111 liquid/solid DTPA labelled 2.28 MJ meal (B) given three hours after the first meal.Results—Gastric emptying of meal A was slower than meal B (the time for 50% of the activity to leave the stomach (T50) being 113 (11) minutes versus 48 (3) minutes respectively, p<0.01, n=11). Both meals passed rapidly through the proximal small bowel (T50 meal A = 57 (14) minutes versus T50 meal B = 42 (11) minutes). Transit of meal A through the distal small bowel was much slower (T50 more than 390 minutes versus 176 (29) minutes for meal B, p<0.01), resulting in meal B overtaking meal A and entering the colon earlier. Ingestion of the second meal (B) resulted in significantly less meal A marker entering the colon (5 (3)%) at 11 hours than when meal A was taken alone (18 (4)%) (p<0.05, n=8).Conclusions—The distal small bowel selectively retains bran, allowing liquid phase markers through to the colon. Consuming a second liquid/solid meal does not stimulate ileal transit of bran which seems to be propelled quicker by fasting motor patterns.

scholarly journals Anomalous Vascular Peritoneal Band Causing Small Bowel Obstruction in an Adult

2020 ◽  
Vol 17 (2) ◽  
pp. 85-87
Author(s):  
Suzanne Nyakirugumi ◽  
Mathenge Nduhiu
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Mesenteric Artery ◽  
Signs And Symptoms ◽  
Sub Saharan Africa ◽  
Definitive Treatment ◽  
Anomalous Artery ◽  
History Of ◽  
Sub Saharan

Peritoneal bands resulting in small bowel obstruction in adults are rare. We present a case study of a 39-year-old male who presented with a 10-day history of signs and symptoms of intestinal obstruction. The patient had no history of abdominal trauma or surgery. Intraoperatively, the small bowel obstruction was caused by a vascularized peritoneal band that had a membrane. The band formed a closed loop and caused the small bowel to herniate and lead to mechanical obstruction. In the band was an anomalous artery that connected the ileocolic artery to the descending branch of the left colic artery. The mainstay for diagnosis is an exploratory laparoscopy or laparotomy. The definitive treatment is transection of the band. This is the first reported case in Sub-Saharan Africa. Keywords: Small bowel obstruction, Congenital bands, Peritoneal bands, Vascular bands, Inferior mesenteric artery, Superior mesenteric artery

scholarly journals Gallstone Ileus Decades after Cholecystectomy and Pylorus-Preserving Whipples

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Miho Mugino ◽  
Takako Eva Yabe ◽  
Bruce Ashford
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Literature Review ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Transition Point ◽  
Gallstone Ileus ◽  
Whipple Procedure ◽  
Stone Analysis ◽  
Intraluminal Mass

We report a case of small bowel obstruction due to gallstone ileus found in a patient with previous pancreaticoduodenectomy (Whipple procedure). Investigation by computed tomography of the abdomen showed a transition point in the midjejunum due to a radioopaque intraluminal mass. Following resuscitation, the patient underwent laparotomy to remove the offending mass from the midjejunum. Subsequent stone analysis confirmed a cholesterol-rich gallstone. This is thus the first description of gallstone ileus following Whipple procedure. The rarity of this presentation and a literature review is presented.

scholarly journals Sudden Unexpected Death Associated with Ileocecal Duplication Cyst and Clinical Review

2010 ◽  
Vol 4 ◽  
pp. CMPed.S4850 ◽  
Author(s):  
Y Kashiwagi ◽  
S. Suzuki ◽  
K. Watanabe ◽  
S. Nishimata ◽  
H. Kawashima ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Duplication Cyst ◽  
Multiple Organ ◽  
Watery Diarrhea ◽  
Abdominal Radiograph ◽  
Unexpected Death ◽  
Plain Abdominal Radiograph ◽  
Abdominal Symptoms

Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.

SMALL INTESTINAL CARCINOID TUMOR-A CASE REPORT

2021 ◽  
pp. 36-37
Author(s):  
B. Santhi ◽  
S. Savitha ◽  
V. G. Vikraman
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Wall Thickening ◽  
Lower Quadrant ◽  
Polypoidal Lesion ◽  
Contrast Enhanced ◽  
Intraluminal Mass ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Carcinoid tumors are neuroendocrine tumours, the most common tumour of the small bowel and its incidence is rising. Most carcinoid tumours grow slowly and mostly asymptomatic or may present with nonspecic abdominal pain or carcinoid syndrome. We had a 38 year old, female patient presented with generalized, intermittent, dull aching abdominal pain accompanied with distension and obstipation for 2 days with associated vomiting. She complained of weight loss and constipation during this period. On examination abdomen showed deep tenderness in periumbilical, right lower quadrant regions. No guarding, rigidity, mass or free uid. On per-rectal examination, there was no tenderness and the rectum was empty. Contrast enhanced computed tomography scan showed enhancing polypoidal lesion noted in distal ileum causing proximal dilatation of small bowel with air uid levels and circumferential wall thickening in dilated ileum proximal to polypoidal lesion, strongly enhancing nodal mass with specs of calcication, multiple mesentric lymph nodes and no liver metastasis. As the conservative management for 48 hours showed no improvement in symptoms, an emergency exploratory laparotomy was performed, and an intraluminal mass was identied from ileocecal junction causing obstruction with dilated loops of ileum and jejunum. Local resection of terminal ileum was performed and a side to side anastomoses was done using GI stapler. Histopathology showed diagnosis of neuroendocrine tumor

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