scholarly journals Management of Patent Vitellointestinal Duct in Infants

2021 ◽  
Author(s):  
Rajendra K. Ghritlaharey
Keyword(s):  
Intestinal Obstruction ◽  
Wedge Resection ◽  
Acute Intestinal Obstruction ◽  
Paediatric Surgery ◽  
Single Institution ◽  
Acute Small Bowel Obstruction ◽  
Considerable Morbidity ◽  
Gangrenous Bowel ◽  
Delay In Seeking Treatment ◽  
Patent Vitellointestinal Duct

Abstract Objectives This study was undertaken to investigate and review the clinical presentation, surgical procedures executed, and the final outcome of infants managed for the patent vitellointestinal duct. Materials and Methods This is a single-institution, retrospective study and included infants who were operated for the patent vitellointestinal duct. This study was conducted at author’s Department of Paediatric Surgery during the last 20 years; from January 1, 2000 to December 31, 2019. Results A total of 24 infants were operated for the patent vitellointestinal duct during the study period and comprised 20 (83.3%) boys and 4 (16.6%) girls. The age of infants ranged from 7 days to 10 months, with a mean of 88.41 ± 64.9 days. Twenty-three (95.8%) infants were operated within 6 months of the age, 17 (70.8%) of them were operated within 3 months of the age. Only one (4.1%) infant was operated at the age of 10 months. Among 24 infants, 13 (54.1%) were presented with features suggestive of acute intestinal obstruction and remaining 11 (45.8%) were presented with fecal discharges through the umbilicus without intestinal obstruction. Among 13 infants who presented with acute intestinal obstruction, 12 had prolapsed bowel and 6 of them also had gangrenous bowel. Operative procedures were executed (n = 24) in the following order of frequency: (1) resection of patent vitellointestinal duct, wide wedge resection of ileum,and ileal repair (n = 13, 54.1%); (2) resection of patent vitellointestinal duct, small segment of ileum, and ileoileal anastomosis (n = 9, 37.5%); and (3) resection of patent vitellointestinal duct, segment of ileum, and an ileostomy (n = 2, 8.33%). Postoperatively, two (8.3%) infants developed anastomotic leak and peritonitis one each, later on, both of them died. Conclusion Patent vitellointestinal duct not only present with fecal discharges through the umbilicus but half of the infants presented with prolapsed bowel and with features of acute small bowel obstruction. Delay in seeking treatment for such cases was associated with considerable morbidity and mortality and therefore the patent vitellointestinal duct should be excised at the earliest.

scholarly journals Mesenteric lipoma: a rare cause of acute small bowel obstruction

2021 ◽  
Vol 8 (10) ◽  
pp. 3214
Author(s):  
Debarghya Chattarjee ◽  
Vijay Raina ◽  
Rajeev Sharma
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Human Body ◽  
Surgical Intervention ◽  
Acute Intestinal Obstruction ◽  
Abdominal Symptoms ◽  
Clinical Literature ◽  
Multiple Imaging ◽  
Acute Small Bowel Obstruction ◽  
Mesenteric Lipoma

Lipomas, also known as universal tumors, can be found almost anywhere in the human body. However mesenteric lipomas are rare entities, with less than 100 cases reported in clinical literature. Patients may present with chronic non-specific abdominal symptoms, or rarely acute intestinal obstruction. Multiple imaging modalities are available for pre-operative diagnosis. Surgical intervention is required for treatment of symptomatic mesenteric lipomas.

scholarly journals Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases

2021 ◽  
Author(s):  
Rajendra K. Ghritlaharey
Keyword(s):  
Intestinal Obstruction ◽  
Surgical Procedures ◽  
Bowel Resection ◽  
Bowel Perforation ◽  
Primary Objective ◽  
Acute Intestinal Obstruction ◽  
Perforation Peritonitis ◽  
Bowel Gangrene ◽  
Gangrenous Bowel ◽  
Infants And Young Children

Abstract Objectives The primary objective of this study was to analyze and review the demographics of children operated upon for intussusception. Secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and outcome. Materials and Methods It is a single-institution, retrospective study and consists of children below the age of 12 years. This study was conducted at the author’s department of pediatric surgery for the past 21 years, from January 1, 2000 to December 31, 2020. Results During the study period, 212 children were operated upon for intussusceptions and included 146 (68.86%) boys and 66 (31.13%) girls. This review consisted of infants 158 (74.52%), and children of 1 to 5 years of age (30; 14.15%), and 6 to 12 years of age (24; 11.32%). Clinically, 177 (83.49%) children presented with the features of acute intestinal obstruction, and the remaining 35 (16.5%) presented with features of perforation peritonitis. Primary (idiopathic) intussusception was documented in 188 (88.67%) of the cases. Gangrenous bowel was evident in 98 (46.22%) children. Sixty-two percent of the cases required bowel resection. Surgical procedures were executed in children for intussusception in the following order of frequency: (1) operative reduction with or without serosal tear/bowel perforation repair, n = 81 (38.2%); (2) resection of diseased ileum and ileoileal anastomosis, n = 52 (24.52%); (3) resection of diseased ileum ± part of colon and an ileostomy, n = 36 (16.98%); and (4) resection of diseased ileum, cecum, part of colon, and ileocolic (ileo-ascending or ileo-transverse) anastomosis, n = 43 (20.28%). Postoperatively, 9 (4.24%) children required reexploration for the management of their complications. Twenty-one (9.9%) children died during the postoperative period. Conclusion Intussusception remains the most common cause of acute intestinal obstruction in infants and young children. Delay in the referral, diagnosis, and seeking treatment were significantly associated with bowel gangrene, required bowel resection during the surgical therapy, and also culminated in significantly higher mortalities.

scholarly journals Morphofunctional changes of the hemocirculatory bed of the liver in different types of acute small bowel obstruction

2018 ◽  
Vol 17 (3) ◽  
pp. 92-101
Author(s):  
V. E. Milyukov ◽  
V. G. Motalov ◽  
H. M. Sharifova
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Unit Area ◽  
Clinical Manifestations ◽  
Acute Intestinal Obstruction ◽  
Vascular Bed ◽  
Different Types ◽  
Acute Small Bowel Obstruction

The purpose of the work - to identify patterns of changes in the morphofunctional organization of the vascular bed of the liver at different stages of development of strangulational and obturating acute small bowel obstruction (ASBO). Material and methods. The study was performed on 33 adult mongrel dogs of both sexes weighing 17-20 kg. The morphology of the liver in normal was studied on 2 (two) of those dogs. Twelve animals were simulated with a strangulational ASBO. In 12 animals, a low obturating ASBO was simulated. A morphometric method was used to assess the change in the volume of the vascular bed in terms of the degree of change in the area of the vessels per unit area. Results. In the dynamics of the development of the disease, we revealed patterns of changes in the morphofunctional organization of the vascular bed of the liver. Conclusions. In the process of formation of obturating ASBO, in spite of the absence of clinical manifestations of acute intestinal obstruction, the emergence of a basis for the development of polyorganic insufficiency has already been observed from 2 days.

scholarly journals Acute small bowel obstruction caused by phytobezoar Meckel diverticula

2019 ◽  
pp. 118-121
Author(s):  
S. V. Tarasenko ◽  
A. A. Natal`skij ◽  
O. D. Peskov ◽  
A. Yu. Bogomolov ◽  
P. V. Tarakanov
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Adult Population ◽  
Rare Condition ◽  
Acute Intestinal Obstruction ◽  
Meckel Diverticulum ◽  
Surgical Department ◽  
Acute Small Bowel Obstruction

Introduction. Meckel diverticulum-is a residue of not completely reduced yolk duct. Among the occurring complications of Meckel’s cuticle in the adult population, acute intestinal obstruction prevails. In this case, the most common intussusception and inversion of the intestines. The occurrence of small bowel obstruction due to phytobesoar in the Meckel diverticulum is a rare condition and has been described in the literature in isolated cases. Materials and methods. The patient of 29 years entered the surgical Department with complaints of abdominal pain of a permanent nature, violation of the discharge of stool and gases, vomiting up to 4 times. Sick for about 2 days. Fluoroscopy of the abdomen showed multiple arches with small bowel fluid levels, single bowl kloybera. The man was operated on urgently with a diagnosis of acute mechanical small bowel obstruction. Results. During the operation, Meckel’s phytobezoar diverticula was detected, which caused acute small bowel obstruction, for which the fragmentation of the bezoar was performed with its relegation to the cecum. The postoperative period proceeded without complications, the patient was discharged on the 10th day after surgery. After 6 weeks, the patient underwent laparoscopic diverticulectomy as planned. Discharged for 5 days. Conclusion. A clinical case of treatment of a patient with phytobezoar Meckel diverticulum complicated by acute mechanical small bowel obstruction is presented. The use of delayed diverticulectomy can reduce the risk of anastomosis failure in acute intestinal obstruction, and if proper diet is observed, it reduces the risk of recurrent intestinal obstruction before re-planned hospitalization.

scholarly journals Management of Intussusceptions Secondary to Pathological Lead Points in Infants and Children

2021 ◽  
Vol 57 (01) ◽  
pp. 53-57
Author(s):  
Rajendra K. Ghritlaharey
Keyword(s):  
Surgical Procedures ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Infants And Children ◽  
Paediatric Surgery ◽  
Single Institution ◽  
The Mean ◽  
Terminal Ileostomy ◽  
Gangrenous Bowel ◽  
In Infants And Children

Abstract Objectives This study was undertaken to investigate and review the age, sex, clinical presentation, surgical procedures done, major postoperative complications, and the final outcome of infants and children operated for intussusceptions secondary to pathological lead points (PLPs). Materials and Methods This is a single-institution, retrospective study and included infants and children below the age of 12 years who were operated for the secondary intussusceptions. This study was conducted at author’s Department of Paediatric Surgery during the last 20 years; from January 1, 2000 to December 31, 2019. Results During the study period, 200 infants and children were operated for the intussusceptions, and 23 (11.5%) of them were operated for the intussusceptions secondary to PLPs. This review comprised 18 (78.26%) boys and 5 (21.73%) girls, and consisted of infants (n = 9, 39.13%) and children of 1 to 5 years of age (n = 7, 30.43%) and 6 to 12 years of age (n = 7, 30.43%). The age at presentation ranged from 3 months to 10 years, with the mean age of 41.47 ± 40.06 months. Clinically, all the children presented with features of acute intestinal obstruction. Ultrasonography (USG) examination of the abdomen revealed the diagnosis of intussusception in all of them but not able to document the PLPs as a cause for it. During the exploratory laparotomies, gangrenous bowel was detected in 15 (65.21%) cases. PLPs causing intussusceptions were Meckel’s diverticulum (n = 17, 73.91%), begin ileal growth (n = 4, 17.39%), benign ileal polyp (n = 1, 4.34%), and caecal lymphoma (n = 1, 4.34%). Surgical procedures were executed in the following order of frequency: (1) resection of segment of ileum including PLP, and ileoileal anastomosis (n = 13, 56.52%); (2) resection of segment of ileum including PLP, caecum and part of ascending colon, and ileoascending anastomosis (n = 5, 21.73%); (3) Meckel’s diverticulectomy (n = 3, 13.04%); and (4) resection of segment of ileum including PLP and terminal ileostomy (n = 2, 8.69%). This study documented two (8.69%) deaths in postoperative period. Conclusion Meckel’s’ diverticulum was the commonest pathology for the secondary intussusceptions in infants and children and documented most frequently during infancy. Half of the secondary intussusceptions occurred within 24 months of age. Bowel resection was required in more than 85% of the cases during the surgical procedures.

scholarly journals The state of endogenous intoxication and the dynamics of changes of trace element homeostasis in experimental acute small bowel obstruction

2013 ◽  
Vol 17 (1 (65)) ◽  
pp. 122-125
Author(s):  
V. D. Skrypko
Keyword(s):  
Trace Elements ◽  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Trace Element ◽  
Biochemical Parameters ◽  
Acute Intestinal Obstruction ◽  
Experimental Conditions ◽  
Endogenous Intoxication ◽  
Acute Small Bowel Obstruction

The author has generalized the results of an investigation of an impaired function of the small intestine, depending on the time of the development of acute intestinal obstruction in the pathogenesis of the formation of the indicators of endogenous intoxication and trace element homeostasis in an experiment on 40 pigs of the Vietnamese breed. It has been established that the course of the disease under the experimental conditions is accompanied with essential changes of the biochemical parameters and trace elements homeostasis in the organism that were dependent on the duration of intestinal obstruction.

Acute intestinal obstruction : an unusual cause

2020 ◽  
Vol 41 (4) ◽  
pp. 231-234
Author(s):  
M Tarchouli ◽  
M Essarghini ◽  
A El Kharras
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction

CHANGES IN SMALL INTESTINE MICROFLORA IN PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

2020 ◽  
pp. 16-18
Author(s):  
V. M. Lykhman ◽  
O. M. Shevchenko ◽  
Ye. O. Bilodid ◽  
Igor Vladimirovich Volchenko ◽  
I. A. Kulyk ◽  
...  
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Species Composition ◽  
Intestinal Obstruction ◽  
Bacterial Flora ◽  
Anaerobic Bacteria ◽  
Acute Intestinal Obstruction ◽  
Gram Positive ◽  
Mechanical Intestinal Obstruction ◽  
Facultative Anaerobic Bacteria

Among urgent surgical diseases of abdominal cavity, an acute intestinal obstruction is the most difficult to be diagnosed and treated. Leading factor, determining the development of pathophysiological processes is considered to be the progressive manifestations of enteric insufficiency syndrome, resulting in intestinal barrier impairment, negative changes in ecology of intestinal flora, increased endotoxins. To identify the small intestine microflora in acute intestinal obstruction and determine the role of dysbiotic disorders in clinical manifestations of main pathological process, a study was conducted in 60 patients with mechanical intestinal obstruction. The small intestine has a relatively rare microflora, consisting mainly of gram−positive facultative aerobic microorganisms, streptococci, lactobacilli. The distal ileum in nearly 30−55 % of healthy people contains scanty microflora, and yet the flora of this area differs from the microbial population of the higher gastrointestinal tract due to higher concentration of gram−negative bacteria. Optional−anaerobic coliform bacilli, anaerobic bifidobacteria and fusobacteria, bacteroids, the number of which starts exceeding the one of gram−positive species, are presented in significant quantities. Distal to the ileocecal valve there are significant changes in the microflora quantitative and species composition. Obligatory anaerobic bacteria become the predominant part of microflora, exceeding the number of aerobic and facultative anaerobic bacteria. The bacterial flora in different parts of gastrointestinal tract has its own specifics and is quite constant, as a result of the interaction of many factors, regulating the bacterial population in small intestine. The most important among them are: acidity of gastric juice, normal peristaltic activity of the intestine, bacterial interactions and immune mechanisms. Disorders of the intestine motor and evacuation function with its obstruction lead to slow passage of the chyme and contamination of the upper gastrointestinal tract with new types of microbes. There is a syndrome of small intestine excessive colonization, which means an increased concentration of bacterial populations in it, similar in species composition to the colon microflora. Pathological intra−intestinal contents become a source of endogenous infection and re−infection of the patient, leads to internal digestive disorders, which is manifested by syndrome of malabsorption of proteins, carbohydrates and vitamins. Key words: acute intestinal obstruction, small intestinal microflora, conditionally pathogenic microorganisms, intestinal biocenosis.

Acute Intestinal Obstruction

BMJ ◽  
1926 ◽  
Vol 2 (3422) ◽  
pp. 275-275
Author(s):  
J. O'Conor
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction
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