scholarly journals A clinicopathologic study of intussusception in Nepalese adults

2020 ◽  
Vol 23 (1) ◽  
pp. 9-13
Author(s):  
Vikal Chandra Shakya ◽  
Bikram Byanjankar ◽  
Rabin Pandit ◽  
Anir Ram Moh Shrestha ◽  
Saurav Karki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Retrospective Study ◽  
Bowel Resection ◽  
Adult Intussusception ◽  
Rare Entity ◽  
Recommended Treatment ◽  
Generalized Peritonitis ◽  
Clinicopathologic Study ◽  
Primary Reduction ◽  
The Mean

Introduction: Intussusception is rate in adults and is usually secondary to a definable pathology. This study was designed to review adult intussusception, including presentation, diagnosis, and pathology. Methods: A retrospective study of 18 cases of intussusception in individuals older than 18 years of age visiting the department of surgery of Civil Service Hospital from 2010 to 2018 was done. Results: There were 18 cases of adult intussusception. The mean age was 49.2 years (range 19-84 years). Abdominal pain and vomiting were the commonest symptoms. The median duration of presentation was 5 days (range 20 hours to 10 months). Three patients (16.6%) presented with generalized peritonitis. There were eight ileocolic, seven ileoileal, and three colocolic intussusceptions. Two patients (11.1%) settled spontaneously. Twelve out of the 18 patients (66.6%) had leading lesions. Benign pathologies were seen in seven cases (38.8%) and malignant in five patients (27.7%). All malignancies were in the large bowl Conclusions: Adult intussusception is a rare entity, nearly one-third of their causes are malignant. Surgery is the best recommended treatment, with or without a primary reduction of the intussusception; the latter can result in more limited bowel resection.

scholarly journals Adult intussusception as rare anomaly: case reports and management

2019 ◽  
Vol 6 (10) ◽  
pp. 3856
Author(s):  
Kirti Savyasacchi Goyal ◽  
Tejinder Pal Singh Sodhi ◽  
Maneshwar Singh Utaal ◽  
Nitish Dhawan ◽  
Mani Garg
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Emergency Surgery ◽  
Bowel Resection ◽  
Case Reports ◽  
Adult Intussusception ◽  
Laparoscopic Management ◽  
Diagnosis And Management ◽  
Feasible Option ◽  
Specific Symptoms

Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, aetiology, and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms and most cases are diagnosed at emergency surgery. Use of computed tomography in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial. Laparoscopic management has been reported to be a safe and feasible option regardless of the etiology. This paper presents the diagnosis and management of two cases of adult intussusception, their presentation and management.

scholarly journals An Unusual Presentation of Small Bowel Intussusception

2021 ◽  
pp. 9-11
Author(s):  
Yinglin Gao ◽  
Cheikh Talal El Imad ◽  
Hai Song Kim ◽  
Vivek Gumaste
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Rare Case ◽  
Recurrent Abdominal Pain ◽  
Nausea And Vomiting ◽  
Adult Intussusception ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Small Bowel Intussusception ◽  
Intestinal Obstructions

Adult small bowel intussusception is a very rare entity that accounts for 5% of all cases of intussusception and 1%–5% of intestinal obstructions. It is more common in children but can occur in adults. It is an important etiology to consider when a patient presents with recurrent abdominal pain. The diagnosis can be challenging as symptoms are nonspecific and include abdominal pain, nausea and vomiting. This paper presents a rare case of duodenal intussusception, followed by a review of the literature discussing the diagnosis and treatment of adult intussusception.

scholarly journals Crohn’s disease triggering ileoileal intussusception in an adult

2021 ◽  
Vol 8 (8) ◽  
pp. 2498
Author(s):  
Praveen Gnanadev ◽  
Mukund . ◽  
Hariprasad Ramachandra Naidu Taluru ◽  
Rohit Krishnappa ◽  
Vinayak Hiremath ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Clinical Presentation ◽  
Recurrent Abdominal Pain ◽  
Adult Intussusception ◽  
Lead Point ◽  
Rare Entity ◽  
History Of ◽  
Supply Reduction

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract (intussusceptum) into an immediately adjacent distal bowel (intussuscipiens), causing venous congestion, edema, and blood supply reduction. Adult intussusception is a rare entity which can be with or without lead-point. Cases without lead-point frequently occurs in children or adults with celiac disease and Crohn’s disease and with lead point is caused by an underlying neoplasm, benign or malignant frequently presenting with bowel obstruction and acute abdomen. A 41-years-old male presented to our outpatient clinic with a history of recurrent abdominal pain. The clinical presentation and CT scan findings led to the diagnosis of ileoileal intussusception. Subsequently he underwent laparotomy which revealed an ileal intussusception, which was investigated and was found to be of Crohn’s etiology.

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

THE PRELIMINARY RESULTS OF OPERATION COLORECTAL ADENOMATOUS POLYPOSIS BY LAPAROSCOPY

2017 ◽  
pp. 63-68
Author(s):  
Quoc Phong Le ◽  
Nhu Hiep Pham
Keyword(s):  
Laparoscopic Surgery ◽  
Bowel Resection ◽  
Right Hemicolectomy ◽  
Adenomatous Polyposis ◽  
Operative Indication ◽  
Surgical Department ◽  
Colorectal Polyposis ◽  
Segmental Bowel Resection ◽  
The Mean ◽  
Bloody Stools

Objective: To study the clinical characteristics, paraclinic, the operative indication and treatment outcomes operation of colorectal polyposis by laparoscopic. Marterials: 12 patients with colorectal polyposis, is surgically the subtotal colectomy, and the total colorectomy by laparoscopic from 11/2012 to 4/2015 at Digestive Surgical Department of Hue Central Hospital. Method: Prospective study, all patients were examined clinically, endoscopic colorectal, operative indication, the type of surgery, lengh of post-operative stay, complications, and pathology. Results: From 11/2012 to 4/2015. We had overalled 12 patients: 8 males and 4 females, the mean patient was 36.33 ± 19.5 years of age (15-71). Dyspepsia 66.7%, bloody stools 100%. Laparoscopic segmental bowel resection in four (33,3%) cases: right hemicolectomy in one (8.3%), resection of transverse colon in one (8.3%), left hemicolectomy in two (16.7%), and totally colorectomy in eight (66.7%) by laparoscopic surgery. The mean post-operative hospital stay was 10.1 ± 3.8 days. The early complication: fistula anastomosis in one (8.3%), patients recovered after conservative treatment, no bleeding and no wound infection. The pathology is adematous polyps 91.7% and hyperplasia polyps 8.3%. Conclusion: Laparoscopic surgery is currently the technique of choice. The resection of colorectal polyposis is the method safe, effective, high success, low rate complications. Key words: laparoscopic, polyposis, colo-rectal polyposis, hemicolectomy

Pathogenic potential of Parabacteroides distasonis revealed in a splenic abscess case: a truth unfolded

2020 ◽  
Vol 13 (12) ◽  
pp. e236701
Author(s):  
Anitha Gunalan ◽  
Rakhi Biswas ◽  
Balamurugan Sridharan ◽  
Thirthar Palanivelu Elamurugan
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Antimicrobial Therapy ◽  
Splenic Abscess ◽  
Rare Entity ◽  
Normal Flora ◽  
Pathogenic Role ◽  
Pathogenic Potential ◽  
Open Splenectomy

Splenic abscess is a rare entity, however if unrecognised or left untreated, it is invariably fatal. We herein report a case of splenic abscess in a 40-year-old man presenting with fever, left-sided abdominal pain, altered sensorium and vomiting. On clinical examination, hepatosplenomegaly was noted and the ultrasound of the abdomen showed multiple hypoechoic regions in the upper pole of spleen, and the diagnosis of splenic abscess was made. The patient received antimicrobial therapy and underwent an open splenectomy with full recovery. Pus aspirated from the splenic abscess grew an unusual organism named Parabacteroides distasonis. In the literature, there are only a few recorded cases of P. distasonis causing splenic abscess. Through this case report, we would like to emphasise the pathogenic role of P. distasonis in causing clinical disease, as this organism is typically known to constitute a part of the normal flora.

scholarly journals The design of RIP belts impacts the reliability and quality of the measured respiratory signals

2021 ◽  
Author(s):  
Kristofer Montazeri ◽  
Sigurdur Aegir Jonsson ◽  
Jon Skirnir Agustsson ◽  
Marta Serwatko ◽  
Thorarinn Gislason ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Sleep Apnea ◽  
Automatic Assessment ◽  
Signal Reliability ◽  
Respiratory Airflow ◽  
Flow Quality ◽  
The Mean ◽  
Home Sleep Apnea Testing ◽  
Apnea Testing

Abstract Purpose Evaluate the effect of respiratory inductance plethysmography (RIP) belt design on the reliability and quality of respiratory signals. A comparison of cannula flow to disposable cut-to-fit, semi-disposable folding and disposable RIP belts was performed in clinical home sleep apnea testing (HSAT) studies. Methods This was a retrospective study using clinical HSAT studies. The signal reliability of cannula, thorax, and abdomen RIP belts was determined by automatically identifying periods during which the signals did not represent respiratory airflow and breathing movements. Results were verified by manual scoring. RIP flow quality was determined by examining the correlation between the RIP flow and cannula flow when both signals were considered reliable. Results Of 767 clinical HSAT studies, mean signal reliability of the cut-to-fit, semi-disposable, and disposable thorax RIP belts was 83.0 ± 26.2%, 76.1 ± 24.4%, and 98.5 ± 9.3%, respectively. The signal reliability of the cannula was 92.5 ± 16.1%, 87.0 ± 23.3%, and 85.5 ± 24.5%, respectively. The automatic assessment of signal reliability for the RIP belts and cannula flow had a sensitivity of 50% and a specificity of 99% compared with manual assessment. The mean correlation of cannula flow to RIP flow from the cut-to-fit, semi-disposable, and disposable RIP belts was 0.79 ± 0.24, 0.52 ± 0.20, and 0.86 ± 0.18, respectively. Conclusion The design of RIP belts affects the reliability and quality of respiratory signals. The disposable RIP belts that had integrated contacts and did not fold on top of themselves performed the best. The cut-to-fit RIP belts were most likely to be unreliable, and the semi-disposable folding belts produced the lowest-quality RIP flow signals compared to the cannula flow signal.

scholarly journals Minimal Invasive Surgery for Gastroesophageal Reflux Disease and Hiatus Hernia—Our Experience: A Case Series with Review of Literature

2021 ◽  
Author(s):  
Rafique Umer Harvitkar ◽  
Abhijit Joshi
Keyword(s):  
Retrospective Study ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Operating Time ◽  
Type I ◽  
Type Ii ◽  
The Mean ◽  
Gerd Symptoms

Abstract Introduction Laparoscopic fundoplication (LF) has almost completely replaced the open procedure performed for gastroesophageal reflux disease (GERD) and hiatus hernia (HH). Several studies have suggested that long-term results with surgery for GERD are better than a medical line of management. In this retrospective study, we outline our experience with LF over 10 years. Also, we analyze the factors that would help us in better patient selection, thereby positively affecting the outcomes of surgery. Patients and Methods In this retrospective study, we identified 27 patients (14 females and 13 males) operated upon by a single surgeon from 2010 to 2020 at our institution. Out of these, 25 patients (12 females and 13 males) had GERD with type I HH and 2 (both females) had type II HH without GERD. The age range was 24 to 75 years. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy). A total of 25 patients had various degrees of esophagitis. Two patients had no esophagitis. These patients were analyzed for age, sex, symptoms, preoperative evaluation, exact procedure performed (Nissen’s vs. Toupet’s vs. cruroplasty + gastropexy), morbidity/mortality, and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications, and recurrent symptoms on follow-up. Symptoms were assessed objectively with a score for six classical GERD symptoms preoperatively and on follow-up at 1-, 4- and 6-weeks postsurgery. Further evaluation was performed after 6 months and then annually for 2 years. Results 14 females (53%) and 13 males (48%) with a diagnosis of GERD (with type I HH) and type II HH were operated upon. The mean age was 46 years (24–75 years) and the mean body mass index (BMI) was 27 (18–32). The range of duration of the preoperative symptoms was 6 months to 2 years. The average operating time dropped from 130 minutes for the first 12 cases to 90 minutes for the last 15 cases. The mean hospital stay was 3 days (range: 2–4 days). In the immediate postoperative period, 72% (n = 18) of the patients reported improvement in the GERD symptoms, while 2 (8%) patients described heartburn (grade I, mild, daily) and 1 (4%) patient described bloating (grade I, daily). A total of 5 patients (20%) reported mild dysphagia to solids in the first 2 postoperative weeks. These symptoms settled down after 2 to 5 weeks of postoperative proton-pump inhibitor (PPI) therapy and by adjusting consistency of oral feeds. There was no conversion to open, and we observed no perioperative mortality. There were no patients who underwent redo surgeries in the series. Conclusion LF is a safe and highly effective procedure for a patient with symptoms of GERD, and it gives long-term relief from the symptoms. Stringent selection criteria are necessary to optimize the results of surgery. Experience is associated with a significant reduction of operating time.

scholarly journals High Dose of Lamivudine and Resistance in Patients with Chronic Hepatitis B

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hamid Ullah Wani ◽  
Saad Al Kaabi ◽  
Manik Sharma ◽  
Rajvir Singh ◽  
Anil John ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Retrospective Study ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Standard Dose ◽  
High Dose ◽  
Lamivudine Therapy ◽  
Daily Dose ◽  
The Mean ◽  
Emergence Of Resistance

Background. Lamivudine is the most affordable drug used for chronic hepatitis B and has a high safety profile. With the daily dose of 100 mg there is progressive appearance of resistance to lamivudine therapy. In our study we used 150 mg of lamivudine daily as a standard dose which warrants further exploration for the efficacy of the drug. Aims of the Study. To assess the efficacy of lamivudine 150 mg daily on resistance in patients with chronic hepatitis B. Methods. This retrospective study consists of 53 patients with chronic hepatitis B treated with 150 mg of lamivudine daily. The biochemical and virological response to the treatment were recorded at a 1-year and 2-, 3-, 4-, and 5-year period and time of emergence of resistance to the treatment was noted. Results. The mean age of the patients was 54 years with 80% being males. The resistance to lamivudine 150 mg daily at 1 year and 2, 3, and 5 years was 12.5%, 22.5%, 37.5%, and 60%, respectively, which is much less compared to the standard dose of 100 mg of lamivudine. Conclusions. Lamivudine is safe and a higher dose of 150 mg daily delays the resistance in patients with chronic hepatitis B.

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