scholarly journals The value of the erect abdominal radiograph for the diagnosis of mechanical bowel obstruction and paralytic ileus in adults presenting with acute abdominal pain

2018 ◽  
Vol 65 (4) ◽  
pp. 259-266 ◽  
Author(s):  
Wendy Z. M. Geng ◽  
Michael Fuller ◽  
Brooke Osborne ◽  
Kerry Thoirs
Keyword(s):  
Abdominal Pain ◽  
Bowel Obstruction ◽  
Paralytic Ileus ◽  
Acute Abdominal Pain ◽  
Abdominal Radiograph ◽  
Mechanical Bowel Obstruction

scholarly journals TOURNIQUET APPENDIX: RARE ETIOLOGY OF ORGANIC ACUTE INTESTINAL OBSTRUCTION

2021 ◽  
Vol 9 (08) ◽  
pp. 834-836
Author(s):  
Bicane Ma. ◽  
◽  
Malaaynine Mf. ◽  
Rabbani K. ◽  
Louzi A. ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Paralytic Ileus ◽  
Rare Case ◽  
Acute Intestinal Obstruction ◽  
Ileal Loop ◽  
Surgical Emergency ◽  
Mechanical Bowel Obstruction

Acute appendicitis is the most common surgical emergency. A bowel obstruction due to the appendicitis is in most cases functional with a paralytic ileus mechanical bowel obstructions are rare or exceptional. We describe a rare case of a mechanical bowel obstruction due to a strangulation of the last ileal loop by the appendix.

scholarly journals Prevalence of pneumonia in children under 12 years of age who undergo abdominal radiography in the emergency department

CJEM ◽  
2007 ◽  
Vol 9 (05) ◽  
pp. 347-351 ◽  
Author(s):  
Valérie Homier ◽  
Colette Bellavance ◽  
Marianne Xhignesse
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Chest Radiograph ◽  
Chest Radiography ◽  
Acute Abdominal Pain ◽  
Tertiary Care ◽  
Abdominal Radiograph ◽  
Upper Respiratory Tract ◽  
Abdominal Radiography ◽  
X Ray

ABSTRACT Objective: Pneumonia is a well-known cause of acute abdominal pain in children. However, the utility of chest radiography in this setting is controversial. We sought to determine the prevalence of pneumonia in children under 12 years of age who had abdominal pain and underwent abdominal radiography when visiting an emergency department (ED). We also aimed to describe the signs and symptoms of children diagnosed with pneumonia in this context. Methods: We conducted a retrospective analysis of electronic data from ED visits to a tertiary care centre by children 12 years of age and under who were seen between June 1, 2001, and June 30, 2003, and who underwent both an abdominal and a chest radiograph during the same visit, or an abdominal x-ray at a first visit as well as a chest x-ray in the 10 days following the initial visit. Results: Of 1584 visits studied, 30 cases of pneumonia were identified, for a prevalence of 1.89% (95% confidence interval 1.22%–1.56%). If chest radiography had been limited to children who presented with fever, cough and symptoms of an upper respiratory tract infection (URTI), the diagnosis of pneumonia would have been missed in only 2/1584 visits (0.13%). Conclusion: Children aged 12 years and under presenting to the ED with acute abdominal pain and in whom an abdominal radiograph is requested need only undergo a chest radiograph in the presence of cough, fever or other symptoms of a URTI.

scholarly journals Gallstone ileus managed with enterolithotomy

2019 ◽  
Vol 12 (10) ◽  
pp. e231581 ◽  
Author(s):  
Louise Dunphy ◽  
Ihsan Al-Shoek
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Clinical Presentation ◽  
Gallstone Ileus ◽  
Gallstone Disease ◽  
Abdominal Radiograph ◽  
Ileocaecal Valve ◽  
History Of ◽  
Mechanical Bowel Obstruction ◽  
Pacemaker Insertion

Although gallstone disease is classically associated with the inflammatory sequela of cholecystitis, other presentations include gallstone ileus, Mirizzi syndrome, Bouveret syndrome and gallstone ileus. Gallstone ileus occurs when a gallstone passes from a cholecystoduodenal fistula into the gastrointestinal tract and causes obstruction, usually at the ileocaecal valve. It represents an uncommon complication of cholelithiasis, accounting for 1%–4% of all cases of mechanical bowel obstruction and 25% of all cases in individuals aged >65 years. It has a female predilection. Clinical presentation depends on the site of the obstruction. Diagnosis can prove challenging with the diagnosis rendered in 50% of cases intraoperatively. The authors present the case of a 79-year-old woman with a 10-day history of abdominal pain, nausea, vomiting and episodes of loose stools. An abdominal radiograph showed mildly distended right small bowel loops. Further investigation with a CT of the abdomen and pelvis demonstrated small bowel obstruction secondary to a 3.3 cm calculus within the small bowel. She underwent a laparotomy and a 5.0×2.5 cm gallstone was evident, causing complete obstruction. An enterolithotomy was performed. Her postoperative course was complicated by Mobitz type II heart block requiring pacemaker insertion. This paper will provide an overview of the clinical presentation, investigations and management of gallstone ileus. It provides a cautionary reminder of considering gallstone ileus in the differential diagnosis in elderly patients presenting with bowel obstruction and a history of gallstone disease.

scholarly journals Acute Abdominal Pain Secondary to Chilaiditi Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
David Kang ◽  
Andrew S. Pan ◽  
Michael A. Lopez ◽  
Jessica L. Buicko ◽  
Miguel Lopez-Viego
Keyword(s):  
Abdominal Pain ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Symptomatic Treatment ◽  
Conservative Surgery ◽  
Chilaiditi Syndrome ◽  
Clinically Significant ◽  
The Right

Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. Diagnosis is best achieved with CT imaging. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. If the patient is symptomatic, treatment is usually conservative. Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.

scholarly journals Colonic Diverticulosis: From Asymptomatic Form to Major Complications

2018 ◽  
Vol 15 (2) ◽  
pp. 27-30
Author(s):  
Ana Maria Miulescu ◽  
Alexandru Ispas
Keyword(s):  
Computed Tomography ◽  
Bowel Obstruction ◽  
Medical Records ◽  
Acute Abdominal Pain ◽  
Geographical Area ◽  
Secondary Peritonitis ◽  
Abdominal Radiograph ◽  
Colonic Diverticulosis ◽  
Different Types ◽  
Surgery Department

AbstractIntroduction This pathology is rare in patients younger than 40 years old (5%) and, in those older than 70 years old, almost 50% exhibit colonic diverticulosis. Most cases have mild symptoms and only 20% presents complications as: bleeding, bowel obstruction, abscess and secondary peritonitis.Aim. The aim is to analyse different types of complications in colonic diverticulosis and compare the data from literature to those in Argeș geographical area.Material and method. The medical records of 120 patients out of which 101 were admitted in gastroenterology department and 19 in general surgery department were analysed. Diagnosis methods: colonoscopy, computed tomography with contrast dye, simple abdominal radiograph for acute abdominal pain.Results. 40 patients (33.33%) with asymptomatic colonic diverticulosis, 28 patients (23.33%) moderate diverticulitis, 25 patients (20.83%) with moderate anorectal bleeding, 25 patients (20.83%) with secondary peritonitis, and 2 (1.68%) cases with complications.Conclusions. All the patients were older than 50 years old, 44 % of diverticulitis cases led to complications (almost half with bleeding and the rest with peritonitis). No bowel obstruction. In 99% of the cases, the localisation of the diverticula was at the level of sigmoid and descending colon.

scholarly journals Point-of-care ultrasonography for the diagnosis of small bowel obstruction in the emergency department

CJEM ◽  
2015 ◽  
Vol 17 (2) ◽  
pp. 206-209 ◽  
Author(s):  
Joshua Guttman ◽  
Michael B. Stone ◽  
Heidi H. Kimberly ◽  
Joshua S. Rempell
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Plain Radiography ◽  
Common Cause ◽  
Point Of Care Ultrasonography

AbstractSmall bowel obstruction (SBO) is a common cause of acute abdominal pain presenting to the emergency department (ED). Although the literature is limited, point-of-care ultrasonography (POCUS) has been found to have superior diagnostic accuracy for SBO compared to plain radiography; however, it is rarely used in North America for this. We present the case of a middle-aged man who presented with abdominal pain where POCUS by the emergency physician early in the hospital course expedited the diagnosis of SBO and led to earlier surgical consultation. The application of POCUS for SBO is easily learned and applied in the ED. POCUS for SBO may obviate the need for plain radiography and expedite patient care.

scholarly journals A Surprising Finding of Ileal Intussusception Caused by Pleural Mesothelioma Metastases

2020 ◽  
pp. 1-3
Author(s):  
Stefania Tamburrini ◽  
Antonella Pesce ◽  
Ester Marra ◽  
Giuseppe Mercogliano ◽  
Giuseppe Militerno ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Malignant Pleural Mesothelioma ◽  
Bowel Obstruction ◽  
Clinical Condition ◽  
Acute Abdominal Pain ◽  
Pleural Mesothelioma ◽  
History Of

Background: Malignant pleural mesothelioma is an aggressive form of cancer originating in the pleural mesothelioma. It generally appears as a local disease in the affected hemithorax, and metastasis are rare. It is unusual for malignant pleural mesothelioma to manifest with gastrointestinal complications due to metastatic implants, but clinicians should be careful to take into consideration this hypothesis in patients with a history of malignant pleural mesothelioma referring to the Emergency Department with acute abdominal pain. Case Presentation: A 65-year-old man, with a medical history of pleural mesothelioma, presented to our emergency department for acute abdominal pain. The patient underwent abdominal ultrasound and abdominal Computed Tomography with intravenous contrast. At US examination a small bowel obstruction diagnosis was made, CT confirmed a mechanical small bowel obstruction due to an intussuscepted multiloculated mass in the terminal ileum, with CT’s signs of parietal damage; another peritoneal mass was reported adjacent to the posterior wall of the cecum and in contiguity with the iliopsoas muscle. Considering the acute medical presentation, the patient underwent surgery, with segmental bowel resection and a stapled side-by-side bowel anastomosis. Histopathology revealed metastasis of sarcomatoid pleural mesothelioma. The post-operative course was complicated by anastomotic leak treated with a conservative approach. The patient was discharged on the 24th post-operative day. Conclusion: Our case highlights the potential of pleural mesothelioma to metastasize within abdominal viscera, causing bowel obstruction. In presence of the patient’s critical clinical condition and advanced state of local disease, a surgical approach based on damage control procedure consisting in exploration, biopsies and ileostomy upstream the obstruction or, exploration and resection without anastomosis, carry on several advantages, solving the acute clinical condition, staging the disease and offering the possibility to proceed rapidly with supportive care (chemotherapy and/or surgery).

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