scholarly journals Jejunojejunal intussusception: an unusual case of postoperative intestinal obstruction

2018 ◽  
Vol 100 (7) ◽  
pp. e165-e167 ◽  
Author(s):  
S Madhavan ◽  
A Augustine
Keyword(s):  
Intestinal Obstruction ◽  
Unusual Case ◽  
Single Layer ◽  
Early Postoperative Period ◽  
Uneventful Recovery ◽  
Anastomotic Site ◽  
Proximal Jejunum ◽  
Lead Point ◽  
Free Jejunal Transfer ◽  
Postoperative Intestinal Obstruction

Intussusception is a rare cause for postoperative intestinal obstruction. We report a case of intussusception in the early postoperative period following resection of proximal jejunum and end to end anastomosis. Computed tomography showed jejunal intussusception, which was confirmed on exploration. The anastomotic site was acting as the lead point, which was resected after reduction and reanastomosed in a single layer. The patient had uneventful recovery. Very few similar cases are reported in the literature and all the reported cases are following free jejunal transfer for pharyngo-oesophageal reconstruction.

Crohn’s disease associated adenocarcinoma of ileocaecal region: a miscalculated approach

2020 ◽  
Vol 13 (4) ◽  
pp. e234512
Author(s):  
Royson Dsouza ◽  
Gigi Varghese ◽  
Deepa Rebecca Korula ◽  
Amit Kumar Dutta
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Obstruction ◽  
Histopathological Examination ◽  
Palliative Therapy ◽  
Uneventful Recovery ◽  
Resected Specimen ◽  
Anastomotic Site ◽  
Oncological Safety ◽  
Contrast Ct

Adenocarcinoma of the bowel is a dreadful sequelae of inflammatory bowel disease that can be difficult to diagnose and has been shown to have poor prognosis. The diagnosis is often made on histopathological examination of the resected specimen for what is suspected to be an exacerbation of the underlying intestinal Crohn’s. A 39-year-old woman who was being treated for small bowel Crohn’s disease for 4 years presented with features of intermittent intestinal obstruction that was refractory to medical therapy. A contrast CT of the abdomen was suggestive of ileocaecal Crohn’s disease, and colonoscopy revealed a stricture at proximal transverse colon with multiple superficial ulcers. She underwent a mesentery sparing right hemicolectomy and had an uneventful recovery. The biopsy, however, was reported to be moderately differentiated adenocarcinoma stage T3N0 with a harvest of four pericolic nodes. Adjuvant chemotherapy was advised, which she deferred. Ten months later, she presented to the emergency room with features of intestinal obstruction. Contrast CT of the abdomen showed thickening at the anastomotic site with intestinal obstruction. On exploratory laparotomy, tumour recurrence was noted at the site of the anastomosis and diffuse peritoneal metastasis. A palliative diversion ileostomy was done due to inoperable obstructing disease. She was then given palliative therapy and subsequently succumbed to the illness. The inclusion of mesentery with the resected specimen in Crohn’s disease has been a debate over many years. Since the preoperative diagnosis of carcinoma of the bowel in Crohn’s disease is challenging, all ileocolic resections should be radical as done in oncological resections. This would yield better oncological safety and may improve survival rates.

scholarly journals Inverted Meckel’s diverticulum: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Lovenish Bains ◽  
Rahul Bhatia ◽  
Rohit Kaushik ◽  
Pawan Lal ◽  
Gayatri Rajpaul ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intestinal Obstruction ◽  
Meckel’S Diverticulum ◽  
Rare Condition ◽  
Meckel's Diverticulum ◽  
Uneventful Recovery ◽  
Lead Point ◽  
Computed Tomography Images ◽  
Recurrent Intussusception ◽  
Inverted Meckel’S Diverticulum

Abstract Background Inverted Meckel’s diverticulum refers to the condition in which the diverticulum inverts on itself. The reasons for such an inversion are poorly understood due to the rarity of the condition. We present a case of inverted Meckel’s diverticulum, an uncommon finding, as a cause of recurrent intussusception. Case presentation A 30-year old Indian woman presented with complaints of pain in the central abdomen for 3 days, accompanied with vomiting and loose stools. Computed tomography images were suggestive of intussusception with intestinal obstruction. Intra-operative findings were suggestive of an intussuscepted segment of ileum measuring 10 cm in length, proximal to ileocecal junction. Ileo–ileal anastomosis was performed after appropriate resection. Upon opening the specimen, we were surprised to find an inverted Meckel diverticulum with lipoma at one end causing the intussusception. The patient made an uneventful recovery and was discharged after 5 days. Conclusion The reasons for inversion include abnormal peristalsis around the diverticulum and non-fixity of the diverticulum itself. The inverted diverticulum itself can cause luminal compromise and acts as a lead point for intussusception leading to obstruction. Computed tomography remains the diagnostic tool of choice for identifying intestinal obstruction and intussusception. Although pathological signs, such as lipoma, can be identified, the identification of any inversion will require a proficient radiologist. Inverted Meckel’s diverticulum is a rare condition which is difficult to diagnose preoperatively. Treatment is surgical, whether diagnosed pre-operatively or intra-operatively, and includes segmental resection and anastomosis. This uncommon condition should be noted as one-off differential diagnosis for intussusception and intestinal obstruction.

scholarly journals Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 73-75
Author(s):  
R Hamid ◽  
AH Shera ◽  
NA Bhat ◽  
A Baba ◽  
A Rashid
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Transverse Colon ◽  
Late Onset ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Colonic Stenosis ◽  
Colonic Atresia ◽  
Mucous Fistula

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446   J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75  

scholarly journals SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Obturator Hernia ◽  
Uneventful Recovery ◽  
Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

scholarly journals Transverse colon volvulus in a patient with sickle cell disease

2019 ◽  
Vol 12 (3) ◽  
pp. e228863 ◽  
Author(s):  
Hussain Adnan Abdulla ◽  
Eman Hamza ◽  
Ali Dhaif
Keyword(s):  
Sickle Cell Disease ◽  
Intestinal Obstruction ◽  
Sickle Cell ◽  
Transverse Colon ◽  
Unusual Case ◽  
Large Bowel Obstruction ◽  
Cell Disease ◽  
Postoperative Course ◽  
Colon Volvulus ◽  
High Index Of Suspicion

Although colonic volvulus is a relatively rare cause of large bowel obstruction, accounting for up to 5% of all cases of intestinal obstruction, transverse colon volvulus is extremely uncommon compared with volvulus of the sigmoid colon or caecum and is responsible for only 3% of all reported cases. We report an unusual case of spontaneous volvulus of the transverse colon in a young man with sickle cell disease who underwent resection with primary anastamosis. Having a high index of suspicion and early operative intervention allowed for this patient to have an uneventful postoperative course.

Cecal volvulus causing postoperative intestinal obstruction

2001 ◽  
Vol 44 (6) ◽  
pp. 893-895 ◽  
Author(s):  
Carl W. Konvolinka ◽  
Richard A. Moore ◽  
Kulvinder Bajwa
Keyword(s):  
Intestinal Obstruction ◽  
Cecal Volvulus ◽  
Postoperative Intestinal Obstruction
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