205 Internal Herniation of The Caecum and Ascending Colon Through the Foramen of Winslow: A Case Report

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Lasheen ◽  
A Amin

Abstract Introduction An internal hernia occurs when part of the bowel protrudes through a mesenteric or a peritoneal orifice which could be either normally present or acquired. These hernias usually represent a challenge to diagnose. Of the natural anatomical orifices is the Foramen of Winslow through which the caecum and the ascending colon could herniate. Case Report An 85-year-old gentleman presented with a one-day history of abdominal pain. His pain had a sudden onset, an intermittent course and was limited to the epigastric region. He was nauseated but not vomiting. He had opened his bowels a day before presenting to the hospital. CT scan of the revealed herniation of the caecal pole through the foramen of Winslow and into the lesser sac. The decision was made to perform a laparotomy where it was revealed that the caecum and part of the ascending colon had herniated through the foramen of Winslow. Content of the hernia, which was viable, was carefully reduced and right hemicolectomy was performed. Conclusions With the scarcity of similar cases, we currently have no consensus of management. Dealing with the hernia at laparotomy would be usually the choice of the surgeon depending on tissue viability and other operative findings.

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
S. Casiraghi ◽  
P. Baggi ◽  
P. Lanza ◽  
A. Bozzola ◽  
A. Vinco ◽  
...  

This is the case report of a 45-year-old woman affected by HIV, who was hospitalized for diffuse abdominal pain, constipation, and weight loss present for over one month. A colonoscopy showed the presence of a nontransitable stenosis of the ascending colon. A right hemicolectomy was performed. The histological examination reports CD with outbreaks of endometriosis. CD and the HIV infection may coexist in the same individual and it seems that HIV reduces the relapse rate in IBD patients. CD and intestinal endometriosis can also occur simultaneously. The diagnosis is often only made after surgical resection of the diseased segment. These patients were more likely to have stricturing CD but endometriosis does not seem to impact the natural history of CD.


2021 ◽  
Vol 51 (3) ◽  
Author(s):  
Germán Brito Sosa ◽  
Ana María Iraizoz Barrios

Cecal volvulus is a rare disease responsible for 1% of the cases of intestinal occlusion, whose main etiology is due to a mobile cecum. A 73-year-old male patient with a history of constipation is presented. He had a clinical picture of abdominal pain and distention, nausea, vomiting, and absence of stool or gas expulsion. A Cecal volvulus with lesion in the ascending colon was found. The surgical technique most frequently performed by surgeons for cecal volvulus is right hemicolectomy with transverse ileus anastomosis, but if the volvulus caused intestinal necrosis and the patient is hemodynamically unstable, it is safer to perform intestinal resection and ileostomy. Ascending ileus anastomosis performed at a higher level of the ascending colon is a safe alternative for the restitution of intestinal transit in patients with cecal volvulus.


Author(s):  
Faisal Albaqami ◽  
Feras Alsannaa ◽  
Reem Bin Saleem ◽  
Nahla Arab

37-year-old man presented to the emergency department with a three-hour history of severe, generalized abdominal pain. Computed tomography of abdomen revealed two distal ileoileal intussusceptions with high suspicion of 3 cm mass within the intussusception around the ileocecal region. Laparoscopic right hemicolectomy with extracorporeal ileocolic anastomosis which showed Meckel


2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
P. K. B. S. C. Bandara ◽  
A. M. Viraj Rohana ◽  
Aloka Pathirana

Abstract Background Intestinal obstruction due to internal herniation of the bowel is a rare clinical entity which is often overlooked in the differential diagnosis of patients with abdominal pain who have no previous history of abdominal surgery. Several sites of bowel internal herniation have been described, amongst which internal herniation through the foramen of Winslow accounts for about 8% of cases. These patients present with nonspecific abdominal pain associated with symptoms of gastroesophageal reflux disease, and hence the diagnosis is often overlooked. The usual symptoms of intestinal obstruction can be delayed, which results in a delay in diagnosis and gangrene of the herniated bowel segment. Abdominal radiographs and computed tomography are helpful in the diagnosis. Open reduction is the management of choice; however, laparoscopic reduction has also been attempted, with good results. Case presentation We report a case of a middle-aged Sri Lankan man who presented with features of gastroesophageal reflux disease, developed features of intestinal obstruction and was found to have a gangrenous small bowel loop which had herniated through the foramen of Winslow. Following needle aspiration and reduction of the herniated small bowel loop, the gangrenous part of the small bowel was resected and an ileoileal anastomosis performed. The large foramen of Winslow was partially closed with interrupted stitches. The patient made an uneventful recovery. Conclusion Since delayed diagnosis of bowel obstruction is detrimental, it is of utmost importance to diagnose it early. Because internal herniation of the small bowel through the foramen of Winslow presents with nonspecific symptoms including features of gastroesophageal reflux disease, as documented in several cases worldwide and also presented by our patient, there should be a high degree of suspicion of internal herniation of the bowel causing bowel obstruction and low threshold for extensive investigation of patients presenting with symptoms of gastroesophageal reflux disease which does not resolve with usual medication.


2013 ◽  
Vol 79 (11) ◽  
pp. 1140-1141 ◽  
Author(s):  
Ann A. Albert ◽  
Tracy L. Nolan ◽  
Bryan C. Weidner

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CTwas consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.


2003 ◽  
Vol 40 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Carlos Augusto Real Martinez ◽  
Rogério Tadeu Palma ◽  
Jaques Waisberg

BACKGROUND: Retroperitoneal lipoma is an extremely rare neoplasm. AIMS: The authors report a case of giant retroperitoneal lipoma in a 32-year-old white female, with a history of pain and an abdominal mass over a 2-year period. Total abdominal ultrasonography and barium enema showed a large mass located in the retroperitoneal space behind the ascending colon. Laparotomy showed a large encapsulated tumor measuring 20 x 13 x 10 cm and weighing 3.400 g. The histological study revealed a benign neoplasm of fatty cells. CONCLUSION: The patient remains well 17 years after surgery, without recurrentce of the disease.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 321-323
Author(s):  
Ballal Mamatha ◽  
Shetty Vignesh ◽  
Agarwal Manali ◽  
Nayal Bhavna ◽  
Umakanth Shashikiran

A case report of a healthy, immunocompetent male,an international traveller from Germany who had visited India for a short trip,presented at our OPD with a history of loose stools, fever and abdominal pain,for two months. After thorough investigations, he was diagnosed to have an infection withGiardia lambliaacute gastroenteritis (AGE) along witheosinophilic ascites with peripheral eosinophilia, withassociatedPlesiomonasshigelloidesdiarrhoea. He was then treated with metronidazole and cotrimoxazole, which resulted in complete resolution of the symptoms.


2021 ◽  
Vol 15 (3) ◽  
pp. 129-136
Author(s):  
Nesrin Mwafi ◽  
Ali Alasmar ◽  
Monther Al-Momani ◽  
Sattam Alazaydeh ◽  
Omar Alajoulin ◽  
...  

Abstract Background Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.


Author(s):  
Rashid Hameed ◽  
Noshine Irrum ◽  
Subodhini P. Arachchige ◽  
Edwin Tan ◽  
Jacinta Tobin

In genetically susceptible individuals, gluten ingestion triggers and immune infiltration and bowel damage in the classical pattern of coeliac disease, with variable symptoms. Intussusception is a condition where one segment of intestine ‘telescopes’ inside of another portion of intestine, which may cause symptoms of abdominal pain due to obstruction. Intussusception has been associated with coeliac disease. We report a 4-year-old girl presented with recurrent abdominal pain of variable severity and found to have intussusception on two occasions, which on both occasions reduced spontaneously during ultrasound examinations. She was later diagnosed with coeliac disease. This case highlights the importance of considering coeliac screening in patients with a history of recurrent abdominal pain and intussusception.


Sign in / Sign up

Export Citation Format

Share Document