scholarly journals Laparoscopic Management of Mechanical Small Bowel Obstruction Secondary to Meckel's Diverticulum with a Double Basis. A Rare Anatomic Presentation

2020 ◽  
Vol 08 (01) ◽  
pp. e59-e61
Author(s):  
Aurora Mariani ◽  
Mohammed Siddiqui ◽  
Nicolas Boulard ◽  
Dominique Berrebi ◽  
Arnaud Bonnard
Keyword(s):  
Acute Abdominal Pain ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Computed Tomography Scan ◽  
Rebound Tenderness ◽  
Intestinal Occlusion ◽  
First Case ◽  
Intestinal Segments ◽  
Double Base ◽  
Tomography Scan

AbstractMeckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Intestinal occlusion due to MD is a commonly observed consequence of intussusception or volvulus. Here, we report a case of an 11-year-old boy who presented to the emergency department with acute abdominal pain, bilious vomiting, and abdominal rebound tenderness. Computed tomography scan concluded a diagnosis of intestinal occlusion with no apparent cause. The patient was submitted to diagnostic laparoscopy, and mechanical occlusion by the permeable Meckel with double base was identified. A diverticulectomy by staplers was performed, and occlusion was alleviated. MD is a rare disease (for only 0.3–2.9% of the general population), and only 4.2 to 9% of patients diagnosed with MD have associated complications. MD can be a large base or a narrow base, with a mesodiverticular band but the diverticulum is usually a blind recess. In our case, the tube connected two intestinal segments. To the best of our knowledge, we have reported the first case of an MD-like permeable tube with a double basis.

scholarly journals Successful treatment of pyopneumothorax secondary to Streptococcus constellatus infection with linezolid: a case report and review of the literature

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhaorui Zhang ◽  
Binbin Xiao ◽  
Zhixin Liang
Keyword(s):  
Computed Tomography ◽  
Rare Event ◽  
Good Choice ◽  
Penicillin G ◽  
Computed Tomography Scan ◽  
Streptococcus Constellatus ◽  
First Case ◽  
Drug Sensitivity Test ◽  
Lung Condition ◽  
Tomography Scan

Abstract Background Pyopneumothorax secondary to Streptococcus constellatus infection is a clinically rare event, and few cases have been reported. Case presentation We report the case of a 55-year-old Han Chinese man with underlying diabetes who presented with fever of 17 days duration. A pulmonary computed tomography scan revealed right-sided massive pyopneumothorax. A culture of the pleural effusion and blood grew S. constellatus. A drug sensitivity test showed that the isolate was sensitive to linezolid, penicillin G, cefotaxime, vancomycin, and cefuroxime. Our patient was treated with linezolid for a total of 6 weeks. Subsequently, his chest computed tomography scan showed improved lung condition. Conclusion To the best of our knowledge, this is the first case of pyopneumothorax secondary to S. constellatus to be treated with linezolid. Pyopneumothorax may be caused by streptococcal infection, and linezolid is another good choice for treatment.

scholarly journals A Triad of Congenital Diaphragmatic Hernia, Meckel’s Diverticulum, and Heterotopic Pancreas

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Parkash Mandhan ◽  
Amer Al Saied ◽  
Mansour J. Ali
Keyword(s):  
Case Report ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Chromosomal Abnormalities ◽  
Meckel’S Diverticulum ◽  
Pancreatic Tissue ◽  
Meckel's Diverticulum ◽  
Developmental Anomaly ◽  
Heterotopic Pancreatic Tissue ◽  
First Case

Congenital diaphragmatic hernia is a common developmental anomaly encountered by paediatric surgeons. It is known to be associated with extradiaphragmatic malformations, which include cardiac, renal, genital, and chromosomal abnormalities. Herein, we report a newborn born with concurrent congenital diaphragmatic hernia, Meckel’s diverticulum, and heterotopic pancreatic tissue. This is the first case report of such a triad with description of possible mechanisms of the development.

scholarly journals Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Giovanni Aluisio ◽  
Ercole Mazzeo ◽  
Frank Lohr ◽  
Federica Fiocchi ◽  
Stefania Bettelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Mismatch Repair ◽  
Checkpoint Inhibitors ◽  
Locally Advanced ◽  
Computed Tomography Scan ◽  
Altered Expression ◽  
First Case ◽  
Repair Deficiency ◽  
Tomography Scan

Abstract Background Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors. Case presentation We report a 76 year-old Italian male patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a computed tomography scan showed stable disease. After palliative RT (30 Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up computed tomography scan at 8 weeks revealed an impressive response that remained stable at computed tomography after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in high-MSI LAPC. Conclusions Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm.

scholarly journals Radiologic Findings of Splenic Abscess: A Report of Two Cases

2021 ◽  
Vol 5 (5) ◽  
pp. 01-03
Author(s):  
Sule M.B ◽  
Umar A.U ◽  
Gele I.H ◽  
Ribah M.M ◽  
Aliyu A.Z
Keyword(s):  
Computed Tomography ◽  
Mortality Rate ◽  
Antimicrobial Agents ◽  
Splenic Abscess ◽  
Rare Entity ◽  
Computed Tomography Scan ◽  
Radiologic Findings ◽  
First Case ◽  
Post Traumatic ◽  
Tomography Scan

Splenic abscess is a very rare entity with an incidence of about 0.14-0.7% in autopsy studies. Splenic abscess has been reported to have a mortality rate of about47%, it has various causes but usually associated with trauma and infections of the spleen. We report two cases of splenic abscess; a child with post traumatic cause and a middle aged lady with an unknown cause. Both cases were diagnosed of having the abscess following imaging; the first case had abdominopelvic ultrasound that showed an abscess cavity with a volume of about 11mls and subsequently resolved following medical treatment with intravenous antimicrobial agents. The second case however had an abdominopelvic computed tomography scan that showed a huge splenic abscess with a volume of about 1400mls; she had a successful splenectomy. We report the radiologic findings of these cases due to the rare nature of splenic abscess as reported in the literature.

scholarly journals Large Enterolith Complicating a Meckel Diverticulum Causing Obstructive Ileus in an Adolescent Male Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Constantinos Nastos ◽  
Dimitrios Giannoulopoulos ◽  
Ioannis Georgopoulos ◽  
Christos Salakos ◽  
Dionysios Dellaportas ◽  
...  
Keyword(s):  
Male Patient ◽  
Bowel Obstruction ◽  
Meckel’S Diverticulum ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Adolescent Male ◽  
Unique Case ◽  
First Case ◽  
Obstructive Ileus

We present a unique case of a 16-year-old male patient who was eventually diagnosed with a large enterolith arising from a Meckel’s diverticulum. The enterolith had caused intermittent intestinal symptoms for three years before resulting in small bowel obstruction requiring surgical intervention. Meckel’s enterolith ileus is very rare with only few cases described in the literature. To our knowledge, this is only the second case of Meckel’s enterolith which had caused intermittent symptoms over a period of time, before resulting in ileus, and the first case where the intermittent symptoms lasted several years before bowel obstruction. The patient had been evaluated with colonoscopy, computerized tomography (CT), and magnetic resonance imaging enterography (MRIE); a calcified pelvic mass had been found, but no further diagnosis other than calcification was established. The patient presented at our emergency department, with symptoms of obstructive ileus and underwent exploratory laparotomy, where a large enterolith arising from a Meckel’s diverticulum (MD) was identified, causing the obstruction. A successful partial enterectomy, enterolith removal, and primary end-to-end anastomosis took place; the patient was permanently relieved from his long-standing symptoms. Consequently, complications of Meckel’s diverticulum and enterolithiasis have to be included in the differential diagnosis of abdominal complaints.

scholarly journals A Rare Case of Acquired Transthoracic Littre's Hernia

2019 ◽  
Vol 05 (04) ◽  
pp. e150-e153
Author(s):  
Arthur Curmi ◽  
Anthony P. Dimech ◽  
Rebecca Dalli ◽  
Ayman Mostafa ◽  
Joseph Debono
Keyword(s):  
Motor Vehicle ◽  
Meckel’S Diverticulum ◽  
Lower Abdominal Pain ◽  
Rib Fractures ◽  
Meckel's Diverticulum ◽  
First Case ◽  
History Of ◽  
Littre’S Hernia ◽  
The Right ◽  
Littre Hernia

Abstract Introduction The Littre hernia is a rare complication of Meckel's diverticulum. Meckel's diverticulum is vestigial remnant of the omphalomesenteric duct occurring in approximately 2% of the general population with an estimated 4 to 16% risk of complications. Usual sites of the Littre hernia include inguinal (50%), umbilical (20%), and femoral (20%). We report a case of an acquired transthoracic Littre's hernia occurring through the left part of the diaphragm triggered by a history of traumatic rib fractures associated with alcohol abuse. Case Report A 71-year-old man presented with 4-day history of worsening shortness of breath, colicky lower abdominal pain, and inability to open bowels despite passing flatus, without nausea or vomiting. His past medical history was remarkable for multiple traumatic rib fractures caused by falls which were associated with excessive alcohol consumption. A noncontrast computed tomography (CT) scan of the abdomen and pelvis showed distended jejunal loops containing air/fluid levels likely resulting from herniated jejunum between the left chest wall and left diaphragm. An urgent laparotomy was performed which revealed small bowel and omentum herniating through a small defect in the left posterior hemidiaphragm. The contents of the sac were reduced and a Meckel's diverticulum was found inside the sac, characteristic of Littre's hernia. The diaphragmatic defect was closed and the Meckel diverticulum stapled and excised. Discussion Herniation of Meckel's diverticulum through the diaphragm most commonly occurs in the pediatric population. Acquired transthoracic Littre's hernia is rare and may arise following thoracobdominal trauma caused by surgery, motor vehicle accidents, and falls from height. Left-diaphragmatic tears are characteristically more clinically apparent and symptomatic than the right since the liver often has a protective effect on the right part of the diaphragm. Herniation of abdominal contents in the chest cavity causes respiratory distress and requires urgent surgical correction. Diagnosis is often delayed since diaphragmatic hernia tends to present very late after the initial trauma, subjecting the patient to possible life-threatening complications. While it is easier to reduce the herniated contents and repair the diaphragm via a thoracic approach, laparotomy is often preferred in cases of acute trauma associated with intra-abdominal injuries. Repair of Littre's hernia then consists of resection of the diverticulum and herniorraphy. Conclusion Internal Littre's hernia is usually of congenital origin. This is the first case of a transthoracic Littre's hernia caused by traumatic rib fractures. Hence, it is of utter importance that a clinician is aware of such uncommon pathology.

scholarly journals Perforated Meckel’s Diverticulum with Pancreatic and Gastric Heterotropia and Acute Peritonitis - A Case Report

2022 ◽  
Vol 12 (2) ◽  
pp. 115-118
Author(s):  
Monika Mehjabin ◽  
Mohammed Kamal ◽  
Md Abdus Sabur Talukder ◽  
Mizanur Rahman ◽  
Md Mozzamel Hoque ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Wedge Resection ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Acute Onset ◽  
Meckel's Diverticulum ◽  
Midline Incision ◽  
Acute Peritonitis ◽  
First Case ◽  
Meckel’S Diverticulitis

Meckel’s diverticulum, the most common congenital anomaly of small bowel although usually silent, can cause complications like intestinal obstruction, bleeding, diverticulitis, perforation etc. We report a case, which presented with acute onset of severe pain in right iliac fossa which was clinically and sonographically diagnosed as acute appendicitis. Histopathological report of appendix was non specific findings. Four days after appendectomy patient again came with features of acute abdomen. X-ray abdomen showed free gas under diaphragm. Abdomen was explored with a midline incision, a perforated Meckel’sdiverticulum was found which was managed by wedge resection and repair of the ileum. Histopathological examination of specimen revealed diverticular wall with normal appearing intestinal mucosa and muscle coat which showed two heterotrophic tissues (pancreatic and gastric ) in the wall.These also showed features of perforation and acute peritonitis. This is probably the first case of Meckel’s diverticulitis with heterotropic pancreatic and gastric tissue in Bangladesh. J Shaheed Suhrawardy Med Coll 2020; 12(2): 115-118

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