scholarly journals Primary ileal volvulus: a rare cause of small intestinal obstruction

2020 ◽  
Vol 7 (4) ◽  
pp. 1304
Author(s):  
Syed Faizan ◽  
Amit Kumar C. Jain ◽  
Durganna Thimmappa
Keyword(s):  
Intestinal Obstruction ◽  
Iliac Fossa ◽  
Significant Risk ◽  
Exploratory Laparotomy ◽  
Small Bowel Volvulus ◽  
The Past ◽  
Risk Of Mortality ◽  
History Of ◽  
Abdominal Examination ◽  
Small Intestinal

A 50-year-old lady presented to us in the emergency department with history of acute abdominal pain and vomiting since the past 24 hours. Abdominal examination showed tenderness and guarding in the hypogastrium, lumbar and right iliac fossa region. Initial diagnosis of ruptured appendicitis was considered but exploratory laparotomy gave us an intra-operative surprise. Small bowel volvulus is extremely rare in clinical practice and their symptoms are usually nonspecific. The diagnosis is typically confirmed at surgery most of the time just like in this case. No etiology of this volvulus was found in this patient. Ileal volvulus carries a significant risk of mortality. Awareness of this condition among surgeons will help to reduce the morbidity and mortality associated with this unusual form of intestinal obstruction.

scholarly journals Intestinal Obstruction in a Child with Massive Ascariasis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Munanura Turyasiima ◽  
Paul Matovu ◽  
Gloria Kiconco ◽  
Walufu Ivan Egesa ◽  
Phillip Sunday ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Postoperative Management ◽  
Soft Mass ◽  
History Of ◽  
Abdominal Examination ◽  
The Tropics

Soil-transmitted helminths are so prevalent in the tropics and low developing countries. Pediatric clinical presentation of ascariasis, the most common helminth, as the intestinal obstruction is not only rare but also less described. We present a case of a 4-year-old girl with massive ascariasis. She presented with a 3-day history of acute abdominal pain associated with vomiting and an episode of passing long white roundworms, about 5 cm in length, through the nose. The child had mild constipation and passed pellets of hard stool once in the last 72 hours. She was in fair general condition at the examination but had significant findings on abdominal examination. On palpation, there was a soft mass localized in the left paraumbilical area and no tenderness, with normal bowel sounds on auscultation. Exploratory laparotomy was sanctioned where roundworms (Ascaris lumbricoides), saucepan full, were delivered through a 2.5 cm enterotomy incision. Postoperative management was carried out, and the child discharged on the 7th day of treatment including a 3-day course of albendazole 400 mg daily.

scholarly journals A Rare Case of Pseudotumoral Ureteric Tuberculosis Causing Forniceal Rupture

2021 ◽  
Vol 15 (7) ◽  
pp. 1449-1449
Author(s):  
M. Hajri ◽  
W. Ferjaoui ◽  
S. Baccouche ◽  
L. Gharbi ◽  
H. Mestiri ◽  
...  
Keyword(s):  
Iliac Fossa ◽  
Exploratory Laparotomy ◽  
Retroperitoneal Mass ◽  
Reactive Protein ◽  
Inflammatory Phase ◽  
History Of ◽  
Abdominal Examination ◽  
The Right ◽  
Protein Cell ◽  
Segmental Ureterectomy

A 55-year-old woman, with no medical history, presented with acute right flank pain. She had no history of other urinary complaints. On physical examination, the patient was tachycardic (pulse rate: 100bpm) and tachypneic (respiratory rate: 24 breaths/min), blood pressure was11/6 and temperature was 37.4°. The abdominal examination showed severe tenderness in the right flank and the right iliac fossa. All blood reports were normal, including C-reactive protein, cell blood count and serum creatinine. Computed Tomography of the abdomen revealed a right hydronephrosis with delayed phase contrast leak and a retroperitoneal mass of 48x36mm of unknown nature, enhanced after contrast injection, which seemed to compress the right ureter causing the forniceal rupture. A double J ureteral stent was insterted into the right renal cavities with favorable evolution and immediate resolution of pain. Surgical management of the mass was scheduled one month later after the inflammatory phase and resorption of the urinoma. The patient underwent an exploratory laparotomy. Intraoperatively, a tissular retroperitoneal mass of 4 cm was discovered which invadedthe right proximal ureter as well asthe duodenum and the ileocecal pedicle (Figure 1). Resection of the tumor was performed as well as a segmental ureterectomy, right colectomy, and resection of a small portion of the duodenum. Both ureteric and colic anastomosis were then performed along with duodenal suture. The post operative course was uneventful.

scholarly journals Ileal Trichobezoar Causing Small Intestinal Obstruction: A Rare Variant

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 82-85
Author(s):  
Binod Kumar Rai ◽  
MD Shahid Alam ◽  
Elina Dangol ◽  
Rishi Karki ◽  
K N Singh
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Fruits And Vegetables ◽  
Exploratory Laparotomy ◽  
Rare Entity ◽  
Foreign Material ◽  
X Ray ◽  
History Of ◽  
Small Intestinal ◽  
Psychiatric Problems

Bezoars are conglomerate mass of ingested foreign material commonly found in stomach and small intestine in patients with psychiatric problems. On the basis of composition bezoars are classified into many variants. Trichobezoar and phytobezoar are most common composed of hair and fibers of fruits and vegetables, respectively. Bezoar itself is a rare entity and the bezoar solely present in small intestine causing intestinal obstruction is rarer, so we present a case report of 7 years old girl presented in our emergency with the feature of intestinal obstruction. Diagnosis was made on the basis of clinical examination, x-ray finding and history of trichophagia. On exploratory laparotomy the cause of obstruction was found to be ileal trichobezoar.

scholarly journals 186. Risk Factors for Extended Spectrum β-Lactamase Bacteremia and External Application of a Clinical Prediction Tool

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S113-S114
Author(s):  
Jacqueline Burnell ◽  
Rebecca Fallis ◽  
Peter Axelrod ◽  
Daniel Mueller
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Klebsiella Oxytoca ◽  
Significant Risk ◽  
University Hospital ◽  
Prediction Tool ◽  
External Application ◽  
The Past ◽  
Extended Spectrum ◽  
History Of

Abstract Background Extended spectrum β-lactamase (ESBL) bacteria are resistant to many antibiotics, which increases the risk of inadequate early antibiotic therapy. A previous single-center study had created a prediction tool to assist clinicians in identifying patients at risk for ESBL bloodstream infections. The purpose of our research project was to assess validity of this tool while also identifying risk factors for ESBL bacteremia within our own institution, which would allow for assessment of alternative prediction tools. Methods We performed a retrospective chart review of adult patients admitted to an urban university hospital who were found to have bacteremia with Escherichia coli, Klebsiella pneumoniae, and/or Klebsiella oxytoca between October 2016 and April 2018. Demographics and comorbidities were assessed, along with other potential risk factors including exposure to antibiotics and hospitalizations within the past 6 months. Results A total of 214 instances of bacteremia were identified and 14% were due to ESBL organisms. Risk factors for ESBL bacteremia in our cohort included history of positive culture for ESBL (RR = 5.9) or MRSA (RR = 3.5) and antibiotic usage in the past 6 months (RR = 2.3). Patients with ESBL bacteremia were hospitalized longer (mean 16 days vs. 6 days for non-ESBL), received longer durations of antibiotic therapy (11.7 days vs. 5.3 days), and were exposed to greater numbers of different antibiotics (1.9 vs. 0.7) in the previous 6 months. Multivariate logistic regression showed that history of prior ESBL infection (OR 14.7, CI 1.8–120) and increasing number of different antibiotic classes administered in the prior 6 months (OR 4.3, CI 1.7–11.2) were significant risk factors for ESBL bacteremia. The previously created prediction tool did not sufficiently differentiate higher and lower risk for ESBL bacteremia in our cohort. Conclusion Although risk factors were similar, the previously derived stepwise prediction tool did not predict ESBL bacteremia in our external cohort. Point-based prediction modeling might better assess risk across institutions. Additionally, the number of different antibiotics received was associated with risk for ESBL bacteremia and should be investigated further. Disclosures All authors: No reported disclosures.

Malignant Brenner tumour of the ovary manifesting as distal intestinal obstruction and perforation

2020 ◽  
Vol 13 (6) ◽  
pp. e235394
Author(s):  
Brijesh Kumar Singh ◽  
Sudipta Saha ◽  
Shilpi Agarwal ◽  
Yashwant Singh Rathore
Keyword(s):  
Present Report ◽  
Iliac Fossa ◽  
Colonic Obstruction ◽  
Exploratory Laparotomy ◽  
Abdominal Radiograph ◽  
Palpable Mass ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
History Of

A rare case of malignant Brenner tumour of ovary manifesting with intestinal perforation due to colonic infiltration is elaborated in the present report. Brenner’s tumour accounts for 1%–2% of all ovarian neoplasms and malignant Brenner tumour is even rarer and only about 5% of Brenner tumours are malignant. A 62-year-old woman came to surgical emergency with 1-month history of abdominal pain, vomiting and constipation with a palpable mass in right iliac fossa. Abdominal radiograph was suggestive of colonic obstruction. Contrast-enhanced CT of the abdomen revealed cystic right ovarian mass of 10.2×8.8 cm2 with pneumoperitoneum. Exploratory laparotomy was done, which revealed mass arising from right ovary involving terminal ileum, cecum and ascending colon. Possibility of ovarian malignancy was kept. Patient underwent debulking surgery along with ileostomy and descending colon mucous fistula was created. Histology was compatible with malignant Brenner tumour of the ovary.

scholarly journals T-shaped Meckel’s diverticulum: a rare anatomical variant complicating small bowel volvulus

2018 ◽  
Vol 5 (8) ◽  
pp. 2929
Author(s):  
Vergis Paul ◽  
Ramu R. ◽  
Kocheril Sheryl Mathews ◽  
Ashly Thomas ◽  
Reesha P. A. ◽  
...  
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Anatomical Variant ◽  
Small Bowel Volvulus ◽  
Common Presentation ◽  
Congenital Diverticulum

The Meckel's diverticulum is a congenital diverticulum arising from the terminal ileum and is the unobliterated proximal portion of the vitellointestinal duct. Intestinal obstruction due to Meckel’s diverticulum is the most common presentation in adults and is the second most common presentation in children. We present a case of a 58-year-old gentleman presented with acute abdomen who was later found to have Giant T- shaped Meckel’s Diverticulum complicating small bowel volvulus on exploratory laparotomy. A T-shaped Meckel's diverticulum has not yet been described.

scholarly journals Spontaneous Transmural Migration of a Retained Surgical Mop into the Small Intestinal Lumen Causing Sub-Acute Intestinal Obstruction: A Case Report

2011 ◽  
Vol 19 (1) ◽  
pp. 34-37
Author(s):  
Md Moniruzzaman Sarker ◽  
AKM Golam Kibria ◽  
Md Manzurul Haque ◽  
Kali Prosad Sarker ◽  
Md Khalilur Rahman
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
College Hospital ◽  
Medical College ◽  
Transmural Migration ◽  
History Of ◽  
Small Intestinal ◽  
The Right ◽  
Surgery Department

A case of sub-acute intestinal obstruction due to spontaneous complete transmural migration of a retained surgical mop into the small intestinal lumen has been treated surgically in surgery department of Rajshahi Medical College Hospital. The patient presented with colicky abdominal pain, nausea, occasional abdominal distention and vomiting. She had history of abdominal operation twice previously. Abdominal examination revealed a mobile lump in the right side of abdomen. Diagnosis could be made only at laparotomy.   doi: 10.3329/taj.v19i1.3167 TAJ 2006; 19(1): 34-37

scholarly journals A STUDY OF INTESTINAL OBSTRUCTION CONSERVTIVE VERSUS SURGICAL MANAGEMENT

2020 ◽  
Vol 1 (2) ◽  
pp. 10-16
Author(s):  
MA Oyinlola ◽  
OA Omisakin
Keyword(s):  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Exploratory Laparotomy ◽  
Related Factors ◽  
Previous Abdominal Surgery ◽  
Intestinal Contents ◽  
History Of ◽  
Obstructed Hernia

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.

scholarly journals Posterior Gastric Perforation – Rare Surgical Emergency: A Case Report

2021 ◽  
pp. 143-146
Author(s):  
Tushar Nagtode ◽  
Y. R. Lamture ◽  
Venktesh Rewale ◽  
P. Tanveer ◽  
Aditya Mundada
Keyword(s):  
Case Report ◽  
Gastric Perforation ◽  
Care Center ◽  
Central India ◽  
Exploratory Laparotomy ◽  
Posterior Wall ◽  
Delayed Presentation ◽  
Health Care Center ◽  
History Of ◽  
Abdominal Examination

Background: Incidence of perforation on posterior wall of stomach is rare throughout world; its occurrence has not been found till now in literature of central India. diffuse symptoms with delayed presentation to health center and poorly skilled faculty with facilities make a way to raise in total number of deaths associated with posterior gastric perforation. Objective: To report a rare case of posterior gastric perforation at a tertiary health care center in Central India, which would be first to be documented. Case Presentation: A 74-year-old male patient was referred to Department of General Surgery, AVBRH, with chief complaint of acute abdominal pain for two days. He had a history of alcohol consumtion which was stopped 2 years back A moderately distended, distinctly tender abdomen accompanied by guarding, rigidity and excluded bowel sounds was unveiled by abdominal examination. Patient has been resuscitated with intravenous fluids, antibiotics and analgesics. Consequently, an emergency exploratory laparotomy revealed a significant collection of purulent peritoneal fluid, 1x1 cm sized perforation on posterior wall of stomach. Perforation was repaired and thus patient recovered in a satisfactory way. Conclusion: And since posterior gastric perforation is extremely uncommon and expected to worsen, associated with increased morbidity and mortality leading to missed presence, this case report indicates that evaluation of patients with gastric perforation, identify risk factors and ability to repair perforations right away along with resuscitation will greatly enhance clinical outcome.

Foreign body perforation of the distal ileum: an unusual cause of right iliac fossa pain managed via single incision laparoscopic surgery (SILS) approach

2021 ◽  
Vol 14 (2) ◽  
pp. e238563
Author(s):  
Matthew R Bonomaully ◽  
Zia Haque ◽  
Milind Rao
Keyword(s):  
Foreign Body ◽  
Single Incision ◽  
Iliac Fossa ◽  
Exploratory Laparotomy ◽  
Distal Ileum ◽  
Emergency Setting ◽  
Single Incision Laparoscopic Surgery ◽  
Single Incision Laparoscopy ◽  
History Of ◽  
Right Iliac Fossa Pain

A 61-year-old woman was seen by the emergency general surgical team with a 2-week history of right iliac fossa pain. Imaging revealed the possibility of a distal ileum perforating foreign body. Using a single incision laparoscopy surgery (SILS) approach, this diagnosis was confirmed at operation. This emerging technique meant a much smaller incision could be used than traditional exploratory laparotomy, with the benefit of less postoperative pain and a faster recovery. This case highlights an uncommon cause for abdominal pain and the importance of close liaison with radiologists and the low threshold for use of laparoscopy as a diagnostic tool. We advocate the use of SILS in the emergency setting for appropriate cases.

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