scholarly journals Internal double omental hernia: a rare cause of acute abdomen

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
André C Pacheco ◽  
Maria J Jervis ◽  
Joana Pimenta ◽  
Ricardo Escrevente ◽  
Fátima Caratão
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Internal Hernia ◽  
Acute Abdominal Pain ◽  
Epigastric Pain ◽  
Sudden Onset ◽  
Postoperative Adhesions ◽  
Common Causes

Abstract Small bowel obstruction is one of the most common causes for acute abdominal pain leading to surgical admissions, occurring most frequently due to postoperative adhesions. Although less common, internal hernia is also a possible etiology, in which a delay on its therapy may lead to a not so dismal morbidity and mortality. Here, we report the case of a 24 year old Caucasian man that was admitted in our emergency department with an inaugural episode of sudden-onset epigastric pain associated with vomiting. After observation and diagnostic workup, the patient underwent urgent laparotomy that revealed an ischemic small bowel due to a double omental hernia, being successfully treated without enteric resection.

scholarly journals Point-of-care ultrasonography for the diagnosis of small bowel obstruction in the emergency department

CJEM ◽  
2015 ◽  
Vol 17 (2) ◽  
pp. 206-209 ◽  
Author(s):  
Joshua Guttman ◽  
Michael B. Stone ◽  
Heidi H. Kimberly ◽  
Joshua S. Rempell
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Plain Radiography ◽  
Common Cause ◽  
Point Of Care Ultrasonography

AbstractSmall bowel obstruction (SBO) is a common cause of acute abdominal pain presenting to the emergency department (ED). Although the literature is limited, point-of-care ultrasonography (POCUS) has been found to have superior diagnostic accuracy for SBO compared to plain radiography; however, it is rarely used in North America for this. We present the case of a middle-aged man who presented with abdominal pain where POCUS by the emergency physician early in the hospital course expedited the diagnosis of SBO and led to earlier surgical consultation. The application of POCUS for SBO is easily learned and applied in the ED. POCUS for SBO may obviate the need for plain radiography and expedite patient care.

scholarly journals A Surprising Finding of Ileal Intussusception Caused by Pleural Mesothelioma Metastases

2020 ◽  
pp. 1-3
Author(s):  
Stefania Tamburrini ◽  
Antonella Pesce ◽  
Ester Marra ◽  
Giuseppe Mercogliano ◽  
Giuseppe Militerno ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Malignant Pleural Mesothelioma ◽  
Bowel Obstruction ◽  
Clinical Condition ◽  
Acute Abdominal Pain ◽  
Pleural Mesothelioma ◽  
History Of

Background: Malignant pleural mesothelioma is an aggressive form of cancer originating in the pleural mesothelioma. It generally appears as a local disease in the affected hemithorax, and metastasis are rare. It is unusual for malignant pleural mesothelioma to manifest with gastrointestinal complications due to metastatic implants, but clinicians should be careful to take into consideration this hypothesis in patients with a history of malignant pleural mesothelioma referring to the Emergency Department with acute abdominal pain. Case Presentation: A 65-year-old man, with a medical history of pleural mesothelioma, presented to our emergency department for acute abdominal pain. The patient underwent abdominal ultrasound and abdominal Computed Tomography with intravenous contrast. At US examination a small bowel obstruction diagnosis was made, CT confirmed a mechanical small bowel obstruction due to an intussuscepted multiloculated mass in the terminal ileum, with CT’s signs of parietal damage; another peritoneal mass was reported adjacent to the posterior wall of the cecum and in contiguity with the iliopsoas muscle. Considering the acute medical presentation, the patient underwent surgery, with segmental bowel resection and a stapled side-by-side bowel anastomosis. Histopathology revealed metastasis of sarcomatoid pleural mesothelioma. The post-operative course was complicated by anastomotic leak treated with a conservative approach. The patient was discharged on the 24th post-operative day. Conclusion: Our case highlights the potential of pleural mesothelioma to metastasize within abdominal viscera, causing bowel obstruction. In presence of the patient’s critical clinical condition and advanced state of local disease, a surgical approach based on damage control procedure consisting in exploration, biopsies and ileostomy upstream the obstruction or, exploration and resection without anastomosis, carry on several advantages, solving the acute clinical condition, staging the disease and offering the possibility to proceed rapidly with supportive care (chemotherapy and/or surgery).

Small Bowel Adenocarcinoma Complicating Crohn's Disease

1992 ◽  
Vol 37 (2) ◽  
pp. 54-55 ◽  
Author(s):  
H.E. Ellamushi ◽  
I.S. Smith
Keyword(s):  
Small Intestine ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Small Bowel Obstruction ◽  
Medical Therapy ◽  
Acute Abdominal Pain ◽  
Fistula Formation ◽  
Small Bowel Adenocarcinoma

Crohn's disease of the small intestine is usually managed by medical therapy with surgery being reserved for obstruction or fistula formation. A patient is described who developed small bowel obstruction due to an adenocarcinoma of the ileum after over twenty years of medical therapy for Crohn's disease, originally diagnosed at a laparotomy for acute abdominal pain. The possibility of malignancy in such long-standing disease should be considered.

scholarly journals Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen

2019 ◽  
Vol 12 (7) ◽  
pp. e230496 ◽  
Author(s):  
Joseph Do Woong Choi ◽  
Michael Yunaev
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Oestrogen Receptor ◽  
Surgical Intervention ◽  
Prior History ◽  
Good Recovery ◽  
History Of

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

scholarly journals Etiologies of abdominal pain emergencies in pediatrics

2021 ◽  
Author(s):  
Hala Atta Youssef ◽  
Aishah Mohammad Alkhaldi ◽  
Manar Mohammed Alshahrani ◽  
Abdullah Tariq Almalki ◽  
Amjad Ali Alahmari ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Acute Abdominal Pain ◽  
Clinical Importance ◽  
Healthcare Settings ◽  
Common Causes ◽  
The Common ◽  
Attending Physicians

Reports showed that children usually complained of acute abdominal pain, which indicated the presence of severe underlying conditions and can have significant clinical importance. Serious challenges have been reported in healthcare settings where an urgent evaluation of the cases was necessary to adequately manage the patient before developing serious complications that might even end up with death. Some of these conditions included intussusception, appendicitis, volvulus and adhesions. Although estimates indicated that only around 1% of pediatric patients with acute abdominal pain usually required surgical intervention, concerns regarding the overlooking and misdiagnosis of significant conditions that might have severe prognostic outcomes were aroused among the different emergency departments. This study reviewed the common causes of acute abdominal pain among children admitted to the emergency department. Our results indicated that various etiologies can develop acute abdominal pain and therefore, establishing an adequate diagnosis by differentiating between the different etiologies should be done by the attending physicians to enhance the outcomes and adequately manage the admitted patients. Gastrointestinal causes of acute abdominal pain were the commonest to cause admissions to the emergency department. However, care should also be provided to the less common conditions, which might include genitourinary and pulmonary disorders and therefore, a thorough examination of children should be provided not to conduct a misdiagnosis of the underlying condition.

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.

Abdominal Pain

2018 ◽  
pp. 124-128
Author(s):  
Ali Kamran
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Key Management ◽  
Abdominal Ultrasound ◽  
Unclear Etiology

Small bowel obstruction is an important diagnosis to consider in an adult presenting with abdominal pain with previous risk factors. Abdominal pain of unclear etiology in the Emergency Department has an exhaustive differential, but key historical and physical exam findings can help narrow the differential considerably. Key management steps for a bowel obstruction include obtaining an appropriate history and physical examination, ordering necessary laboratory studies to exclude other diagnoses, making the patient nil per os, addressing any serious electrolyte derangements, obtaining necessary imaging and a surgical consult. Multidetector computed tomography of the abdomen provides the highest sensitivity for the diagnosis of a small bowel obstruction, but an abdominal X-ray or an abdominal ultrasound can be utilized to help make the diagnosis.

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