scholarly journals 1228 Massive Gastrointestinal Bleeding Secondary to Bleeding Jejunal Diverticulum

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A. Mukhtar A Mukhtar ◽  
B.A. Abdalaziz Alshareif ◽  
M. Gareeballah Yousif Hijazi ◽  
M Y Ibrahim
Keyword(s):  
Histopathological Examination ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Intestinal Bleeding ◽  
Upper Gastrointestinal Endoscopy ◽  
Jejunal Diverticulum ◽  
Massive Gastrointestinal Bleeding ◽  
Blood Clots ◽  
Lower Endoscopy ◽  
Upper Gastrointestinal

Abstract Usually, the Jejunal diverticula appeared multiple and vary in size. These false diverticula lack the muscular coat of the normal intestinal walls, and most patients presented with it were asymptomatic. Although 10% of all patients develop complications such as perforation, obstruction, or bleeding, which then requires surgical intervention, but bleeding is relatively rare among these complications. A case of 74 years old lady was referred to our hospital because of persistent hematemesis and fresh melena. Her previous and recent upper gastrointestinal endoscopy both revealed only gastric erosions without any active bleeding. Also, previous, and recent colonoscopy was done but not completed due to the presents of fresh blood and blood clots along the colon, which led to improper visualization. Her selective mesenteric angiography was done together with upper and lower endoscopy, but none of them revealed the source of bleeding. Emergency exploratory laparotomy was undertaken, and a prominent single jejunal diverticulum with a prominent vessel entering it was noted, and no bleeding from other sites detected. Enterotomy was performed, and enteroscopy confirmed ulceration at the jejunal diverticulum site. Resection of the portion containing the diverticulum and primary anastomosis was done, and this cured the patient. The histopathological examination of the specimen showed an ulcerative lesion with an exposed vessel suggestive of the source of bleeding. Although jejunal diverticula incidence is rare, it is important to look for such lesions in patients with intestinal bleeding. Keywords: jejunal diverticulum, small intestine, intestinal bleeding.

scholarly journals Perforated Jejunal Diverticulum - an Unusual Presentation

2015 ◽  
Vol 1 (1) ◽  
pp. 43-45
Author(s):  
Kamal Koirala ◽  
Mahesh Khakurel ◽  
Reeta Barai
Keyword(s):  
Abdominal Pain ◽  
Histopathological Examination ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Health Sciences ◽  
Unusual Presentation ◽  
Jejunal Segment ◽  
Acute Peritonitis ◽  
Jejunal Diverticulum ◽  
Acute Complications

Jejunal diverticula are rare and usually asymptomatic. Acute complications may include haemorrhage, diverticulitis, obstruction, abscess formation and perforation. Here we report a case of 61 years lady who presented with generalized abdominal pain, vomiting and fever. There were features of acute peritonitis on examination. Exploratory laparotomy revealed a perforated jejunal diverticulum. Resection of the jejunal segment containing the perforated diverticulum and primary anastomosis was done. Histopathological examination revealed jejunal diverticulum with pinhole perforation. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13016   Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):43-45

scholarly journals Clinical Practice Recurrent Severe Obscure Gastro Intestinal- Bleeding in a 20 Year Old Man

2014 ◽  
Vol 11 (1) ◽  
pp. 81-85
Author(s):  
M Breidert ◽  
A Mandal ◽  
A Koller ◽  
N Huellebrand ◽  
B Malla
Keyword(s):  
Gastrointestinal Bleeding ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Intestinal Bleeding ◽  
Gi Bleeding ◽  
Double Balloon Enteroscopy ◽  
Morbus Osler ◽  
Massive Gastrointestinal Bleeding ◽  
Time Of Admission

Morbus Osler-Weber-Rendu syndrome also known as Hereditary hemorrhagic telangiectasia (HHT) and Meckel’s diverticulum is a rare combination disorder. Our case presented with the recurrent obscure gastrointestinal (GI) bleeding for several years. He came with a massive active lower gastrointestinal bleeding. Ultimatively, he underwent an exploratory laparotomy along with intraoperative colonoscopy. A Meckel’s diverticulum in combination with multiple erosions was found as a probable cause of the massive gastrointestinal bleeding. An ileo-caeacal resection had been performed and by the pathologist multiple telangiectasias in the resected ileum were established. Blood was sent for genetics and was negative for ENG, ALK-1, and SMAD-4 genes. The patient was discharged after 10 days from time of admission and is under regular follow up without any further bleeding. In this case, despite sophisticated techniques for investigations the cause of the GI-bleeding with several esophagogastroduodenoscopies and colonoscopies, mesenteric angiography and finally an oral double balloon enteroscopy was misdiagnosed till the intra operative endoscopy showed a middle GI-bleeding. The management for obscure GI-bleeding is discussed for countries with lower medical facilities like Nepal in our case with Morbus Osler-Weber-Rendu syndrome. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11034 Kathmandu University Medical Journal Vol.11(1) 2013: 81-85

Mesenteric Cystic Lymphangioma “Intra-abdominal Catastrophe”

2020 ◽  
pp. 1-5
Author(s):  
R. S. Kiran ◽  
S. Sarmukh ◽  
H. Azmi
Keyword(s):  
Intestinal Obstruction ◽  
Histopathological Examination ◽  
Primary Anastomosis ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Small Bowel Resection ◽  
Cystic Lymphangioma ◽  
Co Morbidity ◽  
Mesenteric Mass ◽  
Life Threatening

Lymphangioma is a benign tumour of lymphatic origin. Lymphangioma in peritoneal cavity is extremely rare (5%), particularly in adults. Hereby, we are reporting a case of a Malay gentleman with no co morbidity presented with sign and symptoms of intestinal obstruction. We proceeded with exploratory laparotomy with small bowel resection with primary anastomosis. Intraoperatively, revealed soft mesenteric mass measuring around 5X5 cm and it was 80 cm from duodenum-jejunum flexure. Histopathological examination showed mesenteric cystic lymphangioma (MCL). Cystic intra-abdominal mass should be included MCL as a diagnosis although it’s rare. Surgical management is still a mainstay of treatment due to its potential to invade vital structures and develop life threatening complication such as intestinal obstruction and bleeding. The surgical outcome after a complete clear margin resection can avoid recurrence.

scholarly journals A surgically treated case of severe upper gastrointestinal hemorrhage with gastritis cystica polyposa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaaki Yoshikawa ◽  
Hiroki Kinoshita ◽  
Naoki Nishimura ◽  
Rieko Takai ◽  
Takuya Matsuda ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Postoperative Recovery ◽  
Endoscopic Hemostasis ◽  
Resected Specimen ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Glands ◽  
Duodenal Ulcers ◽  
Billroth Ii Reconstruction ◽  
Severe Hemorrhage ◽  
Upper Gastrointestinal

Abstract Background Gastritis cystica polyposa (GCP) is a recently recognized entity histologically characterized by hyperplasia and cystic dilatation of the gastric glands spreading through the submucosal layer. Its symptoms include those affecting the upper gastrointestinal tract, such as upper abdominal pain, nausea, and anorexia, although some patients might be asymptomatic. GCP rarely causes severe hemorrhage. Recently, we encountered a GCP case that exhibited severe hemorrhage. Case presentation A 53 year-old man visited the emergency department complaining of hematemesis. He underwent distal gastrectomy and Billroth II reconstruction for duodenal ulcers 32 years ago. Upper gastrointestinal endoscopy detected bleeding from the reddened mucosa at the anastomosis; thus, tentative endoscopic hemostasis was conducted. Despite medical treatment with transfusion, melena with significant hemodynamic impairment persisted. He was treated again with endoscopic hemostasis and interventional radiology (IVR) but remained unresponsive to these procedures. He eventually underwent partial resection of the anastomosis site with Roux-en-Y reconstruction and finally achieved excellent postoperative recovery. Histopathological examination of the resected specimen suggested a GCP bleeding. Conclusions GCP can indeed cause severe hemorrhage. Hemorrhage caused by GCP may not respond to endoscopic hemostasis or IVR; therefore, surgical treatment should be decided without delay.

scholarly journals Comparative Study of Clinico-Pathological Profiles of Patients with Proximal Versus Distal Gastric Adenocarcinoma

2020 ◽  
pp. 107-113
Author(s):  
Ashwini Krishnamoorthy ◽  
Shreya Rajkumar ◽  
K. Kuberan
Keyword(s):  
Gastric Adenocarcinoma ◽  
Gastrointestinal Endoscopy ◽  
Histopathological Examination ◽  
Clinical Pathology ◽  
Western Hemisphere ◽  
Upper Gastrointestinal Endoscopy ◽  
Medical College ◽  
Gastric Adenocarcinomas ◽  
Stomach Adenocarcinoma ◽  
Upper Gastrointestinal

Background: Stomach adenocarcinoma has been a major source of malignant development through the greater part of the 20th century. In different parts of the world, the prevalence of this disease has decreased, mostly due to changes in diet and some other natural constituents. Aim: To examine the clinical pathology of patients with proximal and distal gastric adenocarcinomas. Methodology: This was the prospective work carried out with gastric adenocarcinoma patients treated at Sree Balaji Medical College and Hospital (SBMCH), Chennai, Tamilnadu, India. All patients were undergone upper gastrointestinal endoscopy and an imaging. In endoscopy, biopsies will be taken from the lesion and biopsies were subjected to histopathological examination. Results: The most striking epidemiologic perceptions were the increasing frequency of adenocarcinomas of the proximal stomach and distal throat. We found that the occurrence of proximal gastric adenocarcinomas isn't expanding in our populace when contrasted with the rising rate of such proximal tumors in the Western Hemisphere. Conclusion: In our investigation distal gastric adenocarcinomas were a more incessant finding than the proximal gastric adenocarcinomas.

scholarly journals Intramural duodenal haematoma with mucosal prolapse causing intestinal obstruction

2019 ◽  
Vol 12 (4) ◽  
pp. e228276
Author(s):  
Arun Kumar Loganathan ◽  
Harshjeet Singh Bal
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Gastrointestinal Endoscopy ◽  
Histopathological Examination ◽  
Vascular Malformations ◽  
Duplication Cyst ◽  
Upper Gastrointestinal Endoscopy ◽  
Proximal Jejunum ◽  
Upper Gastrointestinal ◽  
Duodenal Haematoma

Intramural small bowel haematoma is a rare cause of intestinal obstruction in children. Coagulation disorders or anticoagulant therapy are the most common cause followed by blunt trauma. A one and half-year-old boy, with known case of gastro-oesophageal reflux disease had undergone upper gastrointestinal endoscopy and biopsy. Four days later, he presented to us with clinical features of small bowel obstruction. CT of the abdomen showed features suggestive of haemorrhagic duplication cyst. Explorative laparotomy revealed 15–20 cm of bowel from the third part of the duodenum to proximal jejunum filled with clotted blood and thinned out serosa. There was no evidence of intraluminal blood in the distal bowel loops. Resection of the involved bowel with primary anastomoses was done. Histopathological examination of bowel revealed intramural haematoma associated with prolapse of the mucosa. There was no evidence of duplication cyst or vascular malformations. Postoperative period was uneventful.

scholarly journals Diagnostic utility of imprint cytology of endoscopic gastric biopsy: A cyto-histo correlation study

2019 ◽  
Vol 9 (2) ◽  
pp. 1542-1544
Author(s):  
Prabesh Kumar Choudhary ◽  
Niraj Nepal ◽  
Rishab Shrestha ◽  
Utsav Adhikari
Keyword(s):  
Diagnostic Tool ◽  
Histopathological Examination ◽  
Correlation Study ◽  
Gastric Biopsy ◽  
Upper Gastrointestinal Endoscopy ◽  
Imprint Cytology ◽  
Kappa Score ◽  
Common Procedure ◽  
Sensitivity Specificity ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal endoscopy is a common procedure done for suspected cases of gastric malignancies. Histopathological examination of gastric tissue has been a gold standard for the diagnosis. Imprint smears of the gastric biopsy specimen is a useful and rapid alternative diagnostic tool. This study was conducted to assess the accuracy of gastric biopsy imprint cytology as compared to the histopathology. Materials and Methods: Imprint smears were made from all cases of gastric biopsy specimens taken from suspected cases of gastric malignancies. They were evaluated by three pathologists and categorized in to negative for malignancy, suspicious of malignancy and positive for malignancy. The diagnosis given by imprint smears was compared with histopathology. With the help of sensitivity, specificity & accuracy and Kappa score, the agreement between the imprint smear and histopathology was determined. Results: Among the total 79 cases, 49 cases were chronic non specific gastritis and 22 were adenocarcinoma. The sensitivity, specificity, and overall accuracy of gastric biopsy imprint smear were 92.0%, 98.11% and 94.93% respectively. Kappa core was 0.88. Conclusions: The gastric biopsy imprint smears is a rapid diagnostic tool and can be used routinely as an adjunct to histopathology in the diagnosis of gastric malignancies.

scholarly journals Mixed adenoneuroendocrine carcinoma of proximal stomach; a rare but sinister pathology

2020 ◽  
Vol 10 (2) ◽  
pp. 1772-1775
Author(s):  
Deepshikha Gaire ◽  
Daisy Maharjan ◽  
Nisha Sharma
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Histopathological Examination ◽  
Gastroesophageal Junction ◽  
Upper Gastrointestinal Endoscopy ◽  
Radiological Findings ◽  
Proximal Stomach ◽  
History Of ◽  
Adenocarcinoma Component ◽  
Physical Findings ◽  
Upper Gastrointestinal

Mixed adeno-neuroendocrine carcinoma is a rare tumor of the gastrointestinal tract comprising of both epithelial and neuroendocrine components, each representing at least 30% of the tumor. Diagnosis is based on clinical evaluation, radiological findings, histopathological features in conjunction with immunostaining with specific neuroendocrine markers such as chromogranin, synaptophysin, CD56, and markers of epithelial differentiation such as cytokeratin, CDX2, and carcinoembryonic antigen. A 50-year-old female presented with a history of dysphagia, chest pain, anorexia, and significant weight loss with normal physical findings and baseline investigations. Upper Gastrointestinal endoscopy showed growth at the gastroesophageal junction involving cardia of the stomach. Histopathological examination of the resected mass showed both adenocarcinoma and neuroendocrine carcinomatous components each involving more than 30% of total mass examined. Identifying adenocarcinoma component admixed with a high-grade neuroendocrine component is significant as the prognosis and survival of patients differ from pure adenocarcinoma.

scholarly journals Síndrome de Rapunzel. Reporte de un caso

2020 ◽  
Vol 50 (3) ◽  
Author(s):  
Vanessa Durán Becerra ◽  
Laura Tatiana Padilla Pinzón ◽  
Jean Andre Pulido Segura ◽  
Luis Felipe Cabrera Vargas ◽  
Mauricio Pedraza Ciro ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Gold Standard ◽  
Gastrointestinal Endoscopy ◽  
Clinical Manifestations ◽  
Exploratory Laparotomy ◽  
Upper Gastrointestinal Endoscopy ◽  
Rapunzel Syndrome ◽  
Difficult Diagnosis ◽  
Upper Gastrointestinal

Bezoars are accumulations of non-digestible material in the gastrointestinal tract; classified according to the material that it is composed. They are called trichobezoars to those who are formed by the hair, and when are extended to the gastric chamber are called Rapunzel syndrome. It presents mainly in teenagers associated with psychiatric disorders. It has different clinical manifestations and the upper gastrointestinal endoscopy is the gold standard for its diagnosis. We present a case of a Rapunzel Syndrome in an 18 years old patient who was admitted due to abdominal pain, emesis and absence of stools. The initial diagnosis was a difficult diagnosis because of an intestinal obstruction. By this reason it was decided to perform an exploratory laparotomy where it was found a trichobezoar which was extended over the pylorus. According to literature, Laparotomy is the most successful procedure for the resolution of this disease.

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