scholarly journals P53 First Reported Case of Successful Non-Surgical Management for Acute Small Intestinal Obstruction Caused by Enterolith as A Rare Complication of Jejunal Diverticulosis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Fang Fang Quek ◽  
Andrew Tanase ◽  
Fang Fang Quek
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
Acute Intestinal Obstruction ◽  
Jejunal Diverticulosis ◽  
Jejunal Diverticulum ◽  
Life Threatening

Abstract Introduction Enterolith ileus is a rare complication of jejunal diverticulosis, which in itself is a rare entity. Here we report a rare case of enterolith ileus as a complication of jejunal diverticulosis which is successfully managed conservatively. Case Report A 75-year-old female presented with a 7- day history of “gripey” abdominal pain with intermittent vomiting. She was able to pass flatus and had open bowel with small amount of loose stool. Patient was previously fit and well with no significant past medical history and had not undergone previous abdominal surgery. On admission, patient was in no acute distress and was afebrile. On examination, she had a very distended tympanic abdomen with left-sided tenderness but no palpable mass. Bowel sounds were present. Laboratory investigations revealed a white cell count of 22.6 x109/L, C-reactive protein of 26 mg/L and haemoglobin of 144 g/L. Abdominal X-rays revealed distended loops of small bowel indicating small bowel obstruction. CT images did not reveal pneumobilia which would be suggestive of gallstone ileus but showed intraluminal small bowel obstruction secondary to an enterolith in the terminal ileum. The scan also showed an inflamed jejunal diverticulum with fat stranding around but no perforation nor abscess was seen. The working diagnosis was acute intestinal obstruction caused by jejunal enterolith expulsed from jejunal diverticulum. Since no perforation nor abscess was noted, this patient was treated conservatively. Patient recovered uneventfully and was discharged with an MRI scheduled in 4-6 weeks for follow-up. The follow-up MRI was completely normal and patient has recovered uneventfully with conservative management. Discussion Acute intestinal obstruction caused by jejunal enterolith expulsed from jejunal diverticulum is rare. However, it is important to diagnose jejunoileal diverticulosis timely as they may lead to acute complications which can be life- threatening and may even cause death. Conclusion Many cases have reported jejunoileal diverticulosis being overlooked or misdiagnosed for other acute abdominal conditions. It is important to have a clinical awareness of this condition as although rare, it can lead to life-threatening complications.

scholarly journals Ruptured Jejunal Diverticulum Due to a Single-Band Small Bowel Obstruction

2008 ◽  
Vol 8 ◽  
pp. 934-940 ◽  
Author(s):  
Rajaraman Durai ◽  
Ashish Sinha ◽  
Mihir Khan ◽  
Happy Hoque ◽  
Rajab Kerwat
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Single Band ◽  
Spontaneous Perforation ◽  
Jejunal Diverticulosis ◽  
Jejunal Diverticulum ◽  
Distal Obstruction

Jejunal diverticulosis is rare and often goes unnoticed until complications occur. The diverticula are true, acquired diverticula and often asymptomatic. Jejunal diverticulosis can be associated with diverticulosis of the duodenum, ileum, and colon. Here we describe a patient with known severe diverticular disease of the large bowel, who presented acutely with abdominal pain and signs of generalised peritonitis. Laparotomy showed ruptured jejunal diverticulosis with a single band over the terminal ileum, causing small bowel obstruction. Spontaneous perforation of a jejunal diverticulum is rare and is usually an intraoperative finding. One should exclude a precipitating cause, such as coexisting distal obstruction, stricture, or a foreign body.

scholarly journals Acute intestinal obstruction due to appendicular tie syndrome: a rare case report

2019 ◽  
Vol 6 (9) ◽  
pp. 3446
Author(s):  
Akash Agrawal ◽  
Palak Vora
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Surgical Emergencies ◽  
Common Causes ◽  
Rare Case Report

Acute intestinal obstruction is one of the most common surgical emergencies encountered by surgeons on daily bases. Most common causes for small bowel obstruction includes postoperative adhesions and hernia. One of the rarest cause of intestinal obstruction is appendicular band syndrome. Here we report a case of small bowel obstruction due to appendicular tie syndrome in a 70 years old male patient at GMERS hospital, Dharpur, Patan, Gujarat, India.

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 Small Bowel Obstruction due to Mesodiverticular Band of Meckel's Diverticulum: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Aziz Sumer ◽  
Ozgur Kemik ◽  
Aydemir Olmez ◽  
A. Cumhur Dulger ◽  
Ismail Hasirci ◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Small Intestine ◽  
Case Report ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum

Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include haemorrhage, intestinal obstruction, and inflammation. Small bowel obstruction due to mesodiverticular band of Meckel's diverticulum is a rare complication. Herein, we report the diagnosis and management of a small bowel obstruction occurring due to mesodiverticular band of a Meckel's diverticulum.

EP.FRI.798 Emergency surgery: Acute intestinal obstruction – how are we doing three years post NASBO guidelines?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Guillaume Lafaurie ◽  
James Butterwoh ◽  
Angeliki Iakovou ◽  
Alec Engeldow
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Holistic Approach ◽  
District General Hospital ◽  
Operative Management ◽  
Acute Intestinal Obstruction ◽  
Water Soluble ◽  
Average Hospital

Abstract Aims 10% of emergency surgical admissions are due to acute intestinal obstruction. If surgery is required, the mortality is raised to 10%. The latest 2017 National Audit of Small Bowel Obstruction (NASBO) has identified several key investigative and therapeutic targets. Our aim is to look into our clinical practice and compare it to the NASBO standards.  Methods In a district general hospital (DGH), we prospectively collected data of 30 patients coming consecutively with acute small bowel obstruction looking into imaging, conservative management, surgical management and outcomes.  Results 30 patients were included in this study with mean age of 69 years (24-88 years old), with an average hospital stay of 7 days (1 - 46 days). Bowel obstruction aetiology included: 15 secondary to adhesions, 5 hernias, 4 crohns strictures and others. 28 patients had AXR on admission as well as CT with average time to CT of 13.4 hours from admission. A third received water soluble contrast, on average 32.9 hours after admission. A third patients required surgery, undertaken on average 60 hours from admission. The outcomes showed 25 recovering well and going home and a 30-day mortality of 13% (4/30). Seven patients received dietician input, two patients were reviewed by geriatricians before surgery and none post-operatively.  Conclusion From a previous review of our practice we improved in terms of instigating timely investigations and prompt decision to surgery. However, we need to clearly work towards a more holistic approach including dietician and geriatrician input within the complex post-operative management of these patients. 

scholarly journals Case of combination of acute intestinal obstruction and acute myocardial infarction

2019 ◽  
Vol 178 (3) ◽  
pp. 47-50
Author(s):  
D. A. Smirnov ◽  
A. V. Birjukov ◽  
R. D. Ivanchenko ◽  
D. A. Vaulina ◽  
A. Ju. Korolkov
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Female Patient ◽  
Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Adhesive Small Bowel Obstruction

The case of combination of acute myocardial infarction and acute adhesive small bowel obstruction in 70-years old female patient was reported.

scholarly journals Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Song Liu ◽  
Qiongyuan Hu ◽  
Lihua Shao ◽  
Xiaofeng Lu ◽  
Xiaofei Shen ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Gut Dysfunction ◽  
Gut Function

Abstract Background Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO. Methods All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well. Results Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery. Conclusions This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.

META-ANALYSIS ON ETIOPATHOGENESIS OF SMALL BOWEL OBSTRUCTION IN THE DEPARTMENT OF GEN. SURGERY P.M.C.H. & K.M.C.H., BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Abhishek Chaudhary ◽  
Kanchan Sone Lal Baitha ◽  
Yasir Tajdar
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Meta Analysis ◽  
Ileocaecal Valve ◽  
Time Period ◽  
Ligament Of Treitz

Background:The small intestine is the longest and convoluted portion in the digestive tract. It starts from pylorus and ends at ileocaecal valve. The small bowel consists of three parts measuring about 5 to 6 meters. The rst 25cm is the duodenum. Out of the rest part of small gut, jejunum th th. constitute the proximal 2/5 and ileum distal 3/5 The jejunum and ileum extend from the peritoneal fold that supports the duodeno-jejunal junction (Ligament of Treitz) down to ileocaecal valve. Material and Methods:All the patients admitted to PMCH, Patna and KMC, Katihar as intestinal obstruction was included for the study. The time period of study was from October 2014 to November 2016 in PMCH and December 2016 to January 2019 in KMC, Katihar. Out of all Intestinal obstruction 59 cases only of adult small gut obstruction were recorded for comparison and conclusive study.Conclusion: Small bowel obstruction remains a frequently encountered problem in abdominal surgery. Although modern day surgical management continues to focus appropriately on avoiding delayed operation, whatever surgery is indicated, not every patient is always best served by immediate operation

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