scholarly journals 1568 A Case of Small Bowel Intussusception Occurring Six Years After Laparoscopic RYGB

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M N A Abusheikha ◽  
A Arman ◽  
W A Al Natsheh ◽  
R M A A Ayoub ◽  
R I Addasi
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Case Reports ◽  
Rare Complication ◽  
Postnatal Period ◽  
Oral Contrast ◽  
Delay In Diagnosis ◽  
First Case ◽  
Small Bowel Intussusception ◽  
Laparoscopic Rygb

Abstract Introduction We present a case of small bowel intussusception occurring in a female who had previously undergone Laparoscopic RYGB. Few case reports of retrograde intussusception occurring in pregnant patients with a history of LRYBG have been published. Up to our knowledge, this is the first case of this rare complication presenting in the postnatal period. Case report Our patient, a female in her thirties, gave birth to a healthy baby via caesarian section six years after her LRYGB. On the day following her operation, she experienced epigastric severe, progressive abdominal pain associated with nausea and vomiting. Abdominal examination showed epigastric and left upper quadrant tenderness, hypoactive bowel sounds and no palpable masses. Small bowel obstruction was suspected. A nasogastric tube was inserted and an abdominal CT scan with oral contrast was ordered. The CT scan showed multiple concentric segments of small bowel loops representing the intussusceptum pulled into the intussuscipiens, giving the classic doughnut sign. The patient was subsequently taken to theatre for a laparotomy. The mass was comprised of the biliopancreatic limb which was dilated as the common limb was retrogradely intussuscepting into it. The bowel was ischemic and remained so after manual reduction. A 45cm ischemic segment was resected and then primary re-anastomosis was done. Her postoperative course was unremarkable. Discussion Intussusception can present years after the original surgery, and imaging is not always reliable. Seeing as bariatric surgery is getting more popular, physicians should be well aware of this serious complication as delay in diagnosis increases morbidity and mortality.

scholarly journals Two Case Reports of Varicocele Rupture during Sexual Intercourse and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Chalil Arif ◽  
Konstantinos Kotoulas ◽  
Chrysostomos Georgellis ◽  
Konstantinos Frigkas ◽  
Athanasios Bantis ◽  
...  
Keyword(s):  
Sexual Intercourse ◽  
Spermatic Cord ◽  
Case Reports ◽  
Rare Complication ◽  
Traumatic Rupture ◽  
Male Population ◽  
First Case ◽  
Key Points ◽  
General Male Population ◽  
Scrotal Hematoma

Varicocele is characterized by the dilatation of the veins of the spermatic cord. Its prevalence in general male population is 15% while in the infertile population the prevalence rises up to 25%. The varicocele is considered an etiological factor for male infertility. Although different pathophysiological patterns have been proposed, there is no consensus in the urological society to date. In most of the cases varicocele is asymptomatic but sometimes gives mild symptoms as dull pain at the scrotal region. A rare complication of this condition is the spontaneous or traumatic rupture and hematoma formation, either as spermatic cord hematoma or as scrotal hematoma. We are presenting two cases of varicocele rupture, presented with acute painful swelling of the left inguinal and scrotal region during sexual intercourse. Imaging studies revealed a scrotal hematoma in the first case and a spermatic cord hematoma in the second case, without signs of active bleeding. Both patients were treated conservatively and recovered uneventfully. Subsequently, we reviewed the literature in an effort to find the key points for the diagnosis and treatment of this condition.

scholarly journals A rare complication of small bowel intussusception: Report of a case and review of literature

2013 ◽  
Vol 10 (4) ◽  
pp. 381 ◽  
Author(s):  
Impellizzeri Pietro ◽  
BorrutoFrancesca Astra ◽  
MontaltoAngela Simona ◽  
Romeo Carmelo
Keyword(s):  
Small Bowel ◽  
Rare Complication ◽  
Review Of Literature ◽  
Small Bowel Intussusception

scholarly journals Intramucosal esophageal dissection after esophagogastroduodenoscopy: two case reports

2021 ◽  
pp. 198
Author(s):  
Keyword(s):  
Ct Scan ◽  
Subcutaneous Emphysema ◽  
Case Reports ◽  
Upper Gastrointestinal Endoscopy ◽  
Conservative Approach ◽  
First Case ◽  
Esophageal Dissection ◽  
Dental Arcade ◽  
Sharp Foreign Body ◽  
Upper Gastrointestinal

Introduction: Intramucosal esophageal dissection (IED) is an uncommon disorder, described as the separation of the mucosa and/or submucosa from deeper muscular layers due to abrupt increase in intraesophageal pressure. Case presentation: The first case il that of a 52 – years old female patient who underwent an esophagogastroduodenoscopy for control. After the procedure an extensive subcutaneous emphysema of the neck and a massive pneumomediastinum occurred. The patient was successfully treated with a conservative approach. The second case is that of a 43-years old male patient affected by Down’s Syndrome, who underwent an esopagogastroduodenoscopy because of persisting dysphagia. The endoscopic showed the presence of a serrated stricture at 20 centimeters from dental arcade. After the procedure he fell dysphagia. A neck-chest TC-SCAN showed superior and posterior pneumomediastinum and subcutaneous emphysema, without signs of mediastinitis. The patient was successfully treated with conservative approach. After a few days, a new chest CT-SCAN showed the presence of an anomalous right subclavian artery arising from the descending part of the aortic arch, causing dysphagia lusoria. Discussion: The causes of IED include iatrogenic instrumentation, hemostatic applications, mucosal injuries from ingestion of sharp foreign body, or spontaneous. A fluoroscopic upper gastrointestinal series or upper gastrointestinal endoscopy has been widely used to diagnose IED. CT and magnetic resonance are useful for differential diagnosis. In the absence of signs of mediastinitis management is conservative. Conclusion: CT SCAN should be the first exam to perform in the suspicion of IED. The first line treatment should be conservative. In case of the onset of complications and in patients who are refractory to conservative management, endoscopic or surgical treatment are indicated.

scholarly journals Intussusceptions in Adults: A Retrospective Interventional Series of Cases

1970 ◽  
Vol 8 (3) ◽  
pp. 158-165 ◽  
Author(s):  
Rakesh Kr Gupta ◽  
Chandra Shekhar Agrawal ◽  
Rohit Yadav ◽  
Amir Bajracharya ◽  
Panna Lal Sah
Keyword(s):  
Small Bowel ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Clinical Features ◽  
Retrospective Review ◽  
Large Bowel ◽  
Ct Scanning ◽  
Adult Intussusception ◽  
Small Bowel Intussusception ◽  
Intestinal Obstructions

Background: Intussusception is a different entity in adults than it is in children and is usually secondary to a definable pathology. Objective: To review adult intussusception: clinical features, diagnosis and their management. Subjects and methods: A retrospective review of 38 cases of intussusception in individuals older than 18 years of age presenting to BPKIHS Dharan, Nepal from January 2003 to December 2009 was done. Results: In six years, there were thirty-eight patients of surgically proven adult intussusception. The patients. mean age was 49.6 ± 16.2 years, M: F ratio was 1.3:1. Intestinal obstructions of various extents were the commonest presentation in twenty-seven patients (71%). There were 42% enteric, 32% ileocolic and 26% colonic AI. The diagnostic accuracy of the ultrasonography was 78.5%, CT scan was 90% and colonoscopy was 100%. The pathological lesions were found in 94% of AI. Among the pathological lesion, enteric have 62% benign, 38% malignant, ileocolic have 50% benign, 50% malignant, and in colocolic 70% malignant, 30% benign. In enteric AI, 68% were reduced successfully, 25% reduction was not attempted. Of ileocolic AI, 58.3% were reduced successfully, 41.6% had resection without reduction. Of colocolic AI, 30% of them were reduced successfully before resection, 70% had resection without reduction. Conclusion: CT scanning is the most useful diagnostic radiologic method in AI. Colonoscopy is the most accurate in ileocolic and colonic AI. Small-bowel intussusception should be reduced before resection if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant. Keywords: Adult intussusception (AI); Bowel obstruction; CT scan DOI: 10.3126/hren.v8i3.4208Health Renaissance, September-December 2010; Vol 8 (No.3);158-165

scholarly journals De novo AVM formation following venous sinus thrombosis and prior AVM resection in adults: report of 2 cases

2018 ◽  
Vol 128 (2) ◽  
pp. 506-510 ◽  
Author(s):  
Siyu Shi ◽  
Raghav Gupta ◽  
Justin M. Moore ◽  
Christoph J. Griessenauer ◽  
Nimer Adeeb ◽  
...  
Keyword(s):  
De Novo ◽  
Sinus Thrombosis ◽  
Case Reports ◽  
Individual Case ◽  
Postnatal Period ◽  
Adult Patients ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
First Case ◽  
Congenital Origin

Brain arteriovenous malformations (AVMs) are traditionally considered congenital lesions, arising from aberrant vascular development during the intrauterine period. Rarely, however, AVMs develop in the postnatal period. Individual case reports of de novo AVM formation in both pediatric and adult patients have challenged the traditional dogma of a congenital origin. Instead, for these cases, a dynamic picture is emerging of AVM growth and development, initially triggered by ischemic and/or traumatic events, coupled with genetic predispositions. A number of pathophysiological descriptions involving aberrant angiogenic responses following trauma, hemorrhage, or inflammation have been proposed, although the exact etiology of these lesions remains to be elucidated. Here, the authors present 2 cases of de novo AVM formation in adult patients. The first case involves the development of an AVM following a venous sinus thrombosis and to the authors' knowledge is the first of its kind to be reported in the literature. They also present a case in which an elderly patient with a previously ruptured AVM developed a second AVM in the contralateral hemisphere 11 years later. In addition to presenting these cases, the authors propose a possible mechanism for de novo AVM development in adult patients following ischemic injury.

Spontaneous Microguidewire Extrusion From the Foot Following Cerebral Aneurysm Treatment: First Case Report

2017 ◽  
Vol 15 (2) ◽  
pp. 213-216
Author(s):  
Kurdow Nader ◽  
Saleh Lamin ◽  
Joseph Leyon ◽  
Swarupsinh Chavda ◽  
Allan Thomas ◽  
...  
Keyword(s):  
Case Reports ◽  
Rare Complication ◽  
Family Doctor ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Her Family ◽  
First Case ◽  
Subsequent Fracture ◽  
Femoral Puncture ◽  
The Wire

Abstract BACKGROUND AND IMPORTANCE Microguidewire entrapment and failure related to endovascular therapy is a rare complication with limited case reports available, most of which are from cardiac endovascular intervention. Migration of the microguidewire has been reported in coronary intervention with some resulting in severe complications, but there are no reported cases of spontaneous extrusion of wire fragment following a neurointerventional procedure. We report the first case of a microguidewire entrapment with subsequent fracture, followed by spontaneous extrusion of the wire fragment. CLINICAL PRESENTATION A 40-yr-old woman was admitted for an elective flow-diversion stent treatment of an unruptured paraophthalamic aneurysm. Microguidewire entrapment occurred during an attempted balloon-aided dilatation of the partially opened stent. Careful attempts failed to retrieve the wire; hence, the decision was made to leave it behind. She presented to her family doctor 6 mo later with spontaneous extrusion of a 60-cm fragment of the retained wire, from her heel ipsilateral to the femoral puncture site. This had not resulted in any further vascular or non-vascular complications. CONCLUSION Fracture with extrusion is a potential consequence of a retained microguidewires. While this is an extremely rare complication, it is important to alert clinicians and patient about the possibility of wire migration and extrusion. Early follow-up with clinical assessment, and targeted imaging should lead to identification of this occurrence.

scholarly journals COVID-19 and Pulmonary Mycobacterium Tuberculosis Coinfection

2021 ◽  
Vol 36 (5) ◽  
pp. e298-e298
Author(s):  
Redha Al Lawati ◽  
Nasser Al Busaidi ◽  
Rashid Al Umairi ◽  
Merah Al Busaidy ◽  
Hanan Hamed Al Naabi ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Case Reports ◽  
World Health ◽  
Delay In Diagnosis ◽  
Global Pandemic ◽  
First Case ◽  
Appropriate Treatment ◽  
The World ◽  
Health Organization ◽  
High Index Of Suspicion

The Coronavirus disease-2019 (COVID-19) outbreak was classified as a global pandemic by the World Health Organization on 11 March 2020. It is caused by the novel severe acute respiratory syndrome coronavirus 2. The virus affects mainly the human respiratory system. Mycobacterium tuberculosis (TB) is another respiratory infection known to affect humans and may share joint clinical presentations and risk factors with COVID-19 infection. Therefore, clinicians must have a high index of suspicion that the two infections might coexist so that there is no delay in diagnosis and starting the appropriate treatment. There are few case reports about TB and COVID-19 coinfection. The first case report ever was from China and there have been a few others around the world. Here, we report two cases of coexisting COVID-19 and newly diagnosed pulmonary TB infection in Oman.

scholarly journals Haemolymphangioma of the small bowel mesentery in adults: two case reports and a literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yao Du ◽  
Jiang Nan Zhang ◽  
Lu Lu Zhu ◽  
Yi Wang ◽  
Wei Ping Li
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Case Reports ◽  
Abdominal Cavity ◽  
Final Diagnosis ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Small Bowel Mesentery ◽  
Enhanced Ct

Abstract Background Haemolymphangioma arising from the small bowel and its mesentery is extremely rare in the clinical setting. To date, only 8 cases of small bowel haemolymphangioma have been reported, and there have been no previously reported cases of haemolymphangioma in the small bowel mesentery (PubMed). The formation of this tumour is mostly congenital, but the exact mechanism is still unclear. As a benign tumour, the presentation of the disease may vary from a simple well-defined cystic lesion to an aggressive ill-defined lesion mimicking malignancy. However, there are no typical symptoms, and preoperative diagnosis is difficult. Case presentation We present two cases of haemolymphangioma in the small bowel mesentery in a 54-year-old man and a 52-year-old woman. Both of them came to the hospital due to an abdominal mass. In the first case, a cystic teratoma in the left abdominal area was considered after abdominal plain computed tomography (CT) and magnetic resonance imaging (MRI) scans. After taking an enhanced CT scan, a lipoma was considered based on the images. In the second case, cystic masses of the left upper and middle abdomen were observed on abdominal ultrasonography. An abdominal plain CT scan showed an irregular low-density mass in the left upper and middle abdomen. With an enhanced CT scan, haemolymphangioma was considered based on the images. After complete surgical removal, the masses were found to originate from the small bowel mesentery and had not invaded into the peripheral lymphatic tissue. In case 1 in this study, the routine pathology diagnosis was lymphangioma, while in case 2, the diagnosis was haemangioma. The final diagnosis was confirmed to be haemolymphangioma by immunohistochemistry in both cases. No recurrence was evident during 4 months of follow-up. We review the previous case reports of haemolymphangioma in the abdominal cavity and discuss their clinical features, diagnosis, treatment and prognosis. Conclusions The clinical manifestations of abdominal haemolymphangiomas can vary for both location and size. Abdominal CT examination has important clinical value for haemolymphangioma in the abdominal cavity. The final diagnosis of haemolymphangioma depends on a postoperative pathological examination. In addition, postoperative regular follow-up is necessary.

scholarly journals Mixed Adenocarcinoma and Squamous Cell Carcinoma of Duodenum: A Case Report and Review of the Literature

2017 ◽  
Vol 11 (2) ◽  
pp. 402-410 ◽  
Author(s):  
Muhammad Bader Hammami ◽  
Anuj Chhaparia ◽  
Jinhua Piao ◽  
Yihua Zhou ◽  
Christine Hachem ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Small Bowel ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Case Reports ◽  
Exploratory Laparotomy ◽  
Duodenal Mucosa ◽  
Management Guidelines ◽  
First Case ◽  
History Of

Despite being the largest part of the human gastrointestinal (GI) tract, the small intestine accounts for only 1–1.4% of all GI malignancies. Adenocarcinoma is the most common primary small bowel malignancy, with the most common site being the duodenum. On the other hand, squamous cell carcinoma (SCC) of the duodenum is extremely uncommon. We report the first case of mixed adenocarcinoma and SCC occurring in the third part of duodenum (D3). Our patient, a 64-year-old female with history of GERD, hypertension, and IDDM presented with 4 weeks of nausea, vomiting, and abdominal pain. Tomographic imaging of her abdomen demonstrated a distended stomach and a proximal duodenum with narrow caliber changes at the level of D3. An EGD revealed a tight stricture at D3 that could not be traversed. Stricture biopsies revealed duodenal mucosa with two small foci of SCC (positive for p63 and CK5/6) and adenocarcinoma (positive for CK7 and Moc31). Peritoneal metastases were detected on exploratory laparotomy, making the tumor surgically incurable. As she progressively declined and with worsening liver enzymes and general debility, she was not a candidate for chemotherapy and was eventually discharged on home hospice. Small bowel SCC/adenocarcinoma is an exceedingly uncommon cancer, making further case reports such as ours important to understand the nature of this entity and establish management guidelines.

scholarly journals Spontaneous Pneumomediastinum Associated with COVID-19 Pneumonia

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Hamza Mimouni ◽  
Soufiane Diyas ◽  
Jamal Ouachaou ◽  
Ilyas Laaribi ◽  
Younes Oujidi ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Ct Scan ◽  
Male Patient ◽  
Rare Complication ◽  
Therapeutic Management ◽  
Fourth Case ◽  
Spontaneous Pneumomediastinum ◽  
Global Pandemic ◽  
First Case

The first case of coronavirus disease 2019 (COVID-19) was declared in December in Wuhan, before becoming a global pandemic in a few weeks. Several complications of this infection have been reported. However, a spontaneous pneumomediastinum has rarely been described. We report the fourth case of this extremely rare complication in a 65-year-old male patient with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia, discovered during his therapeutic management by a CT scan control.

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