Fetal small bowel simulating an abdominal mass at sonography

1986 ◽  
Vol 14 (5) ◽  
pp. 404-407 ◽  
Author(s):  
Lawrence G. Manco ◽  
Francis A. Nunan ◽  
Howard Sohnen ◽  
Edward J. Jacobs
Keyword(s):  
Small Bowel ◽  
Abdominal Mass

scholarly journals A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Aghyad K Danial ◽  
Ahmad Al-Mouakeh ◽  
Yaman K Danial ◽  
Ahmad A Nawlo ◽  
Ahmad Khalil ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Medical History ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Past Medical History ◽  
Abdominal Symptoms ◽  
Diaphragm Disease ◽  
History Of ◽  
Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of NSAID use.

scholarly journals Fetal Midgut Volvulus with Meconium Peritonitis Detected on Prenatal Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Emanuelle J. Best ◽  
Cecelia M. O’Brien ◽  
Wendy Carseldine ◽  
Aniruddh Deshpande ◽  
Rebecca Glover ◽  
...  
Keyword(s):  
Small Bowel ◽  
Abdominal Mass ◽  
Uneventful Recovery ◽  
Team Approach ◽  
Midgut Volvulus ◽  
Meconium Peritonitis ◽  
Third Trimester ◽  
Bowel Necrosis ◽  
Threatening Condition ◽  
Life Threatening

Background. Fetal volvulus is a rare, yet life-threatening condition that requires skilful diagnosis and management. Volvulus occurs when bowel loops become twisted and the twisting of the mesenteric artery leads to congestion, impaired venous return, and bowel necrosis. Case Description. We present a case of fetal ileal volvulus suspected on third trimester ultrasound, complicated by premature labour, small bowel necrosis, and meconium peritonitis. Progressive dilatation and decreased peristalsis of echogenic bowel were noted in the early part of the third trimester. Daily surveillance ultrasound was performed and spontaneous labour occurred at 32 weeks’ gestation. A proactive postnatal approach guided by prenatal sonographic findings allowed prompt treatment and an urgent laparotomy was performed for an ileal volvulus with necrosis and meconium peritonitis. A segment of small bowel volvulus was resected and an end-to-end anastomosis was performed with uneventful recovery. Discussion. Clinically signs of fetal midgut volvulus are not pathognomonic, such as intestinal dilatation, abdominal mass, ascites, peritoneal calcifications, or polyhydramnios; thus, the diagnosis is often challenging. Complications reported in the literature include perforation and haemorrhagic ascites, which may lead to anaemia, hypovolemia, heart failure, and fetal demise. Conclusion. This case highlights the importance of assessing the fetal bowel as a part of routine third trimester ultrasound. The case describes the complexity of diagnosis in the fetus, important considerations along with multidisciplinary team approach to management.

scholarly journals Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease

2019 ◽  
Author(s):  
Zihan Huang ◽  
Xiang Liu ◽  
Fei Yang ◽  
Guoxin Wang ◽  
Nan Ge ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Abdominal Mass ◽  
Video Capsule Endoscopy ◽  
Small Intestinal Mucosa ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Abstract Background Due to the development of double-balloon enteroscopy and video capsule endoscopy, direct visualization of the entire small intestinal mucosa has been achieved. Compared with video capsule endoscopy, double-balloon enteroscopy has the advantages of biopsy samples and endoscopic treatment. The aim of this research was to explore the value of double-balloon enteroscopy for isolated small bowel Crohn’s disease. Methods This study included patients with suspected isolated small bowel Crohn’s disease who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients with symptoms of chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic Crohn’s disease were excluded from this cohort. Patients with suspected isolated small bowel Crohn’s disease underwent double-balloon enteroscopy. Results With clear endoscopic images and histological support, 14 patients were diagnosed with isolated small bowel Crohn’s disease. Three patients who were diagnosed with small bowel Crohn’s disease by double-balloon enteroscopy showed improved morphological features of the small bowel when the double-balloon enteroscopy was reviewed after medical treatment. Conclusions The diagnosis of Crohn’s disease is usually based on the patient’s clinical history and related examinations. Double-balloon enteroscopy provides imaging support and histological support for the definitive diagnosis of Crohn’s disease and can be considered as a useful tool to evaluate the therapeutic efficacy in the future.

scholarly journals Difficult to Diagnose the Cause of Intestinal Obstruction due to Abdominal Cocoon Syndrome

2021 ◽  
Author(s):  
Cemal Ulusoy ◽  
Andrej Nikolovski ◽  
Nazım Öztürk
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Abdominal Mass ◽  
Clinical Signs ◽  
Rare Condition ◽  
Abdominal Cocoon ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis ◽  
Palpable Abdominal Mass

Abdominal cocoon syndrome (sclerosing encapsulating peritonitis) is a rare condition associated with clinical signs of intestinal dysfunction, episodes of small bowel obstruction and sometimes a palpable abdominal mass. We present the case of a 46-year-old male patient with clinical signs of intestinal obstruction caused by primary sclerosing encapsulating peritonitis.

Gastrointestinal Stromal Tumors: Actin Expression, a New Prognostic Factor?

2010 ◽  
Vol 76 (11) ◽  
pp. 1244-1250 ◽  
Author(s):  
Jaime Ruiz-Tovar ◽  
María Diez-Tabernilla ◽  
Gada Housari ◽  
Enrique Martinez-Molina ◽  
Alfonso Sanjuanbenito
Keyword(s):  
Prognostic Factors ◽  
Small Bowel ◽  
Gastrointestinal Stromal Tumors ◽  
Abdominal Mass ◽  
Disease Free Survival ◽  
Gastric Gist ◽  
Free Survival ◽  
Stromal Tumors ◽  
Actin Expression ◽  
Disease Free

The aim of this study is to analyze the clinical outcome of gastrointestinal stromal tumors (GISTs) and to determine new prognostic factors. We perform a retrospective study of all the patients diagnosed with GIST in any location and operated on between 2000 and 2008 at our institution. We analyzed 35 patients, 16 males (45.7%) and 19 females (54.3%), with a mean age of 64 ± 13.8 years. The tumors were located in the stomach in 22 patients (62.9%), in the small bowel in 10 (28.6%), and the retroperitoneum in three (8.6%). Referring to gastric GIST, endoscopy revealed an ulceration in the mucosa in five cases, suggesting an epithelial neoplasm. In all these cases, pathology of the biopsy specimen was nonconclusive. Survival rate at 1 and 5 years was 94.3 and 88.6 per cent, respectively. Disease-free survival at 1 and 2 years was 91.4 and 88.6 per cent, respectively. Analyzing prognostic factors, a lower disease-free survival was observed among patients with constitutional syndrome at diagnosis ( P = 0.000), small bowel GIST ( P = 0.037), and tumors not expressing actin ( P = 0.015). A lower global survival was observed among men ( P = 0,036), patients with an abdominal mass ( P = 0.033) or with constitutional syndrome ( P = 0.007) at diagnosis and tumors at a retroperitoneal location ( P = 0.0002). Gastric GIST may be confused with epithelial neoplasms, modifying the surgery. In our patients, masculine gender, constitutional syndrome and abdominal mass at diagnosis, small bowel and retroperitoneal location, and actin negative tumors are bad prognostic factors.

Spontaneous resolution of fetal ascites secondary to gastrointestinal abnormality

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Alison Wiles ◽  
Melissa Yannetti ◽  
Cheryl Dinglas
Keyword(s):  
Small Bowel ◽  
Neonatal Outcome ◽  
Abdominal Mass ◽  
In Utero ◽  
Spontaneous Resolution ◽  
Meconium Peritonitis ◽  
Case Presentation ◽  
Favorable Prognosis ◽  
Normal Neonate ◽  
Gastrointestinal Abnormalities

Abstract Objectives Isolated fetal ascites carries an uncertain prognosis and broad differential diagnosis. When detected on prenatal sonography, a thorough evaluation is warranted to exclude development of hydrops and search for an underlying condition. While gastrointestinal abnormalities account for approximately 20% of cases of fetal ascites, surgical correction is commonly required postnatally. While there have been reports of isolated fetal ascites resolving in utero, spontaneous resolution of the causative gastrointestinal abnormality is unusual. Case presentation We report a case of a multiparous 33-year-old found to have moderate fetal ascites and a complex fetal abdominal mass near the small bowel detected by ultrasound at 32 weeks with spontaneous resolution of both ascites and mass by 37 weeks. Following the delivery of a normal neonate, we suspect the mass and ascites to have been produced by a small bowel rupture resulting in meconium peritonitis. Conclusions When fetal ascites with late gestational onset has spontaneous resolution in utero and hydrops never develops, there is generally a favorable prognosis and normal neonatal outcome.

scholarly journals SMALL BOWEL DIVERTICULAR DISEASE;

2013 ◽  
Vol 20 (05) ◽  
pp. 776-782
Author(s):  
ANSAR LATIF ◽  
ANILA ANSAR ◽  
MUHAMMAD QASIM BUTT
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Teaching Hospital ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Study Patient ◽  
Military Hospital ◽  
Study Results ◽  
Bleeding Per Rectum

Objectives: 1). To see the prevalence of small bowel diverticulosis in patients presenting with acute abdomen. 2). To knowpresentation and complications of diverticulosis in teaching hospital in Sialkot region of Pakistan. Introduction: Small bowel diverticulardisease may be complicated by small bowel obstruction. Multiple diverticulosis represents an uncommon pathology of the small bowel.Related complications such as diverticulitis, perforation, bleeding or intestinal obstruction, and acute pancreatitis appear in 10-30% ofthe patients, increasing the morbidity and mortality rates. This pathology which is uncommon is much higher in our study in patientsundergoing exploratory laparotomy in district level hospitals in Sialkot region of Pakistan. Study Design: Prospective and observational.Setting and duration: Combined Military Hospital, Sialkot (June 2005 to August 2010). Islam teaching hospital, Sialkot (September 2010to September 2012). Methods: 260 consecutive patients undergoing exploratory laparotomy for obstruction, peritonitis, pain and massabdomen were included in the study. Patient with established cause of obstruction were excluded. The data including demographicinformation, presentation, operative findings, complications and follow up were entered in structured proforma. Patients with less thanthree months of followup were also excluded from study. Results: Small bowel diverticuli were encountered in 24 (9%) out of 260 patientsincluding; 8 (3%) Meckel's, 9 (3.5%) jejunal, 3 (1.2%) duodenal and 4 (1.5%) Ileal diverticuli. These patients with diverticuli presented asintestinal obstruction, peritonitis, mass abdomen, vague abdominal pain and one patient with fresh bleeding per rectum. The indicationsof surgery were peritonitis 6 (25%), intestinal obstruction 13 (54.2%), abdominal mass 3(12.5%), nonspecific abdominal pain 1 (4.2%)and fresh bleeding per rectum of obscure origin 1 (4.2%). Complications encountered as Intestinal obstruction due to adhesion formationin 8; obstruction due to congenital bands attached to diverticuli in 3; diverticular perforation in 2; peritonitis due to diverticulitis in2,bleeding from arteriovenous malformation within the jejuna diverticuli in 1 and mass formation due to volvulus in 1. Three duodenaldiverticuli and 4 jejunal diverticuli were found as silent pathologies synchronous with other active pathologies.

scholarly journals Diagnostic efficacy of double-balloon enteroscopy in patients with suspected isolated small bowel Crohn’s disease

2020 ◽  
Author(s):  
Zihan Huang ◽  
Xiang Liu ◽  
Fei Yang ◽  
Guoxin Wang ◽  
Nan Ge ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Abdominal Mass ◽  
Experimental Treatment ◽  
Small Intestinal Mucosa ◽  
Double Balloon Enteroscopy ◽  
Diagnostic Efficacy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Abstract Background: Owing to the development of double-balloon enteroscopy (DBE) and video capsule endoscopy (VCE) in recent years, direct visualization of the entire small intestinal mucosa has become possible. Because of the nonspecific symptoms and the anatomic location of the small bowel, diagnosis of isolated small bowel Crohn’s disease (CD) remains a challenge. The aim of this research was to explore the value of DBE for isolated small bowel CD in situations where routine tests cannot confirm the diagnosis.Methods: This study included patients with suspected isolated small bowel CD who were hospitalized in Shengjing Hospital from April 2014 to June 2018. We included patients presenting with chronic diarrhea, abdominal pain, abdominal mass, perianal lesions, and systemic symptoms including weight loss, fever, and anemia after excluding infection factors. Patients with purely colonic CD were excluded from this cohort. Patients with suspected isolated small bowel CD underwent DBE.Results: In 16/18 patients, pathological findings were detected by DBE. In 12 of the cases, small bowel CD was confirmed. The remaining four patients were diagnosed with small bowel inflammation, duodenal carcinoma, ileum inflammation and small bowel ulcers. However, the diagnosis of CD was confirmed in 14/18 (78%) patients by taking into account the clinical presentation, endoscopic and histological results as well as the experimental treatment. DBE assisted in the diagnosis in 86% (12/14) of the patients.Conclusions: In the diagnosis of small bowel CD, DBE is a helpful tool. Before assessment with DBE, clinical features, colonoscopy, and CT were used to initially assess the intestine. According to the lesions indicated by CT, we chose the most appropriate endoscope insertion route, and combined the endoscopic characteristics and pathological results of DBE to confirm the diagnosis.

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