A case report of retrograde intussusception 3 years post Roux-en-Y gastric bypass

Abstract Retrograde jejuno-jejunal intussusception is a rare complication of bariatric surgeries. It causes acute sudden symptoms that require immediate surgical intervention. We report a case of a 46-year-old female who underwent Roux-en-Y gastric bypass (REYGP) 3 years prior. The patient presented to the emergency department with acute sudden abdominal pain, nausea and vomiting. Laparoscopically, intussuscepting small bowel segment was found gangrenous, and it was resected and end-to-end anastomoses were fashioned. The postoperative course was uneventful, and the patient remained asymptomatic for the 12 months of follow-up. Patients with retrograde intussusception experience an intolerable severe pain that necessitates surgical intervention. The etiology of intussusception as a complication after REYGP is unclear, yet theoretically some possible etiologies exist. The initial diagnosis of retrograde intussusception is made based on abdominal computed tomography. Early intervention significantly reduces morbidity and mortality.

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Management of a pseudo-aneurysm in the hepatic artery after a laparoscopic cholecystectomy

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0182 ◽

2016 ◽

Vol 98 (7) ◽

pp. 456-460 ◽

Cited By ~ 5

Author(s):

MP Senthilkumar ◽

N Battula ◽

MTPR Perera ◽

R Marudanayagam ◽

J Isaac ◽

...

Keyword(s):

Computed Tomography ◽

Laparoscopic Cholecystectomy ◽

Hepatic Artery ◽

Computed Tomography Angiography ◽

Rare Complication ◽

Artery Pseudoaneurysm ◽

Pseudo Aneurysm ◽

High Index Of Suspicion ◽

Time Of Presentation

Introduction Symptomatic hepatic-artery pseudoaneurysm (HAP) after bile-duct injury (BDI) is a rare complication with a varied (but clinically urgent) presentation. Methods A prospectively maintained database of all patients with BDI at laparoscopic cholecystectomy (LC) referred to a tertiary specialist hepatobiliary centre between 1992 and 2011 was searched systematically to identify patients with a symptomatic HAP. Care and outcome of these patients was studied. Results Eight (6 men) of 236 patients with BDI (3.4%) with a median age of 65 (range: 54?6) years presented with symptomatic HAP. Median time of presentation of the HAP from the index LC was 31 (range: 13?16) days. Bleeding was the dominant presentation in 7 patients. One patient presented late (>2 years) with abdominal pain alone. Computed tomography angiography was the most useful investigation. Angioembolisation was successful in 7 patients. One patient died, and another patient developed liver infarction. Three patients (38%) developed biliary strictures after embolisation. Seven patients are alive and well at a median follow-up of 66 months. Conclusions Presentation of HAP is often delayed. A high index of suspicion is necessary for the diagnosis. Computed tomography angiography is the first-line investigation and selective angioembolisation can yield successful outcomes.

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Rectosigmoid prolapse - a case report

Vojnosanitetski pregled ◽

10.2298/vsp140706001j ◽

2015 ◽

Vol 72 (12) ◽

pp. 1118-1121

Author(s):

Vasilije Jeremic ◽

Srdjan Mijatovic ◽

Slobodan Krstic ◽

Sanja Dragasevic ◽

Tamara Alempijevic

Keyword(s):

Emergency Department ◽

Case Report ◽

Sigmoid Colon ◽

Severe Pain ◽

Clinical Presentation ◽

Surgical Intervention ◽

Preoperative Management ◽

Perianal Region ◽

Rectosigmoid Colon ◽

Possible Cause

Introduction. Many factors have been indentified as a possible cause of rectal prolaps. Despite the fact that it is not a lifethreating condition, its clinical presentation varies, and sometimes it can present as an emergency. We presented a patient with prolapse of an unusually large segment of the rectosigmoid colon caused by chronic constipation, as an incarcerated segment repaired surgically. Case report. A 62-year-old female patient was referred to the Emergency Department in bad condition with severe pain in the perianal region. On examination a complete rectal prolaps as well as a part of sigmoid colon were found. Macroscopically, the prolapsed segment appeared edematous, livid, with ulcerations. An attempt to manually reduce prolapse failed, therefore resection of 50 cm of sigmoid colon with rectopexy had to be performed. No complications occurred and the patient was without symptoms six months later. Colonoscopy did not reveal any abnormality. Conclusion. Although the preoperative management and preparation of the patient was limited, emergancy surgical intervention for such a case was the strategy of choice due to magnitude of the prolapsing segment. It provided a successful and permenant solution.

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Management of pancreaticoduodenal artery aneurysm associated with coeliac artery stenosis

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0020 ◽

2019 ◽

Vol 101 (4) ◽

pp. e105-e107

Author(s):

SK Kamarajah ◽

S Kharkhanis ◽

M Duddy ◽

J Isaac ◽

RP Sutcliffe ◽

...

Keyword(s):

Computed Tomography ◽

High Risk ◽

Surgical Intervention ◽

Artery Aneurysm ◽

Gastroduodenal Artery ◽

Pancreaticoduodenal Artery ◽

Computed Tomography Angiogram ◽

Pancreaticoduodenal Artery Aneurysm ◽

Radiological Intervention

Pancreaticoduodenal and gastroduodenal artery aneurysms are rare but require early radiological or surgical intervention due to a high risk (61%) of rupture. A 71-year-old woman presented with an incidental 30-mm aneurysm arising from the inferior pancreaticoduodenal artery associated with coeliac axis stenosis. She underwent embolisation of the pancreaticoduodenal aneurysm, but the coeliac axis stenosis was not amenable to radiological intervention. She remained well at six months of follow-up and a repeat computed tomography angiogram six months later reported stable appearances. The management of pancreaticoduodenal aneurysms is discussed.

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Cavernous Hemangioma of the Gallbladder Masquerading as a Carcinoma

Case Reports in Gastroenterology ◽

10.1159/000500079 ◽

2019 ◽

Vol 13 (1) ◽

pp. 219-224

Author(s):

Naotake Funamizu ◽

Yukio Nakabayashi

Keyword(s):

Computed Tomography ◽

Cavernous Hemangioma ◽

Benign Tumors ◽

Low Density ◽

Vascular Endothelial ◽

Postoperative Course ◽

Follow Up Study ◽

Abdominal Computed Tomography ◽

Extended Cholecystectomy

Cavernous hemangioma arising from the gallbladder is extremely rare. Here, we report a cavernous hemangioma of the gallbladder masquerading as a carcinoma. A 75-year-old man was referred to our institution for a follow-up study after gastrectomy. Abdominal computed tomography revealed that the gallbladder was filled with a low-density mass with calcification of the wall. The patient underwent extended cholecystectomy. Histologically, the tumor consisted of vascular endothelial cellular elements and hematomas. The postoperative course was uneventful without complications. Presently, only 7 cases of cavernous hemangioma of the gallbladder have been previously reported. This case serves as an important reminder to consider benign tumors including cavernous hemangioma when investigating all possible causes of a gallbladder tumor.

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Extra-thoracal migration of the Nuss Bar in corrective surgery for pectus excavatum: a very rare late complication

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa388 ◽

2020 ◽

Vol 2020 (10) ◽

Author(s):

Natalie Simon ◽

Shyam Kolvekar ◽

Amir Khosravi

Keyword(s):

Pectus Excavatum ◽

Surgical Intervention ◽

Rare Complication ◽

Late Complication ◽

Nuss Procedure ◽

Corrective Surgery ◽

Chest Wall Deformity ◽

X Ray ◽

First Case

Abstract Pectus excavatum is a chest wall deformity with an incidence of around 1 in 400 live births. The Nuss procedure is a surgical intervention that aims to restore functional integrity in these patients. We report the first case of bar migration into the stomach necessitating further surgical intervention for removal. Our case presents a rare complication of pectus excavatum repair and highlights the importance of vigilant follow-up in these patients. If bar migration does occur, imaging in the form of X-ray and CT scans may be of use in early detection in order to expedite management.

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Computed tomography for non-traumatic headache in the emergency department and the impact of follow-up testing on altering the initial diagnosis

Emergency Radiology ◽

10.1007/s10140-015-1314-9 ◽

2015 ◽

Vol 22 (5) ◽

pp. 521-525 ◽

Cited By ~ 4

Author(s):

Jeffrey S. Quon ◽

Rafael Glikstein ◽

Christopher S. Lim ◽

Betty Anne Schwarz

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Initial Diagnosis ◽

The Impact

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The radiologic roadmap for treatment of an acute appendicitis patient who tested positive for coronavirus disease 19

BJR|case reports ◽

10.1259/bjrcr.20210102 ◽

2021 ◽

Author(s):

Şeref Barbaros Arik ◽

Elif Gunaydin ◽

Celal İsmail Bİlgiç ◽

İnanç Güvenç

Keyword(s):

Emergency Department ◽

Acute Appendicitis ◽

Standard Treatment ◽

Surgical Intervention ◽

Ultrasound Examination ◽

Bridging Therapy ◽

Emergency Surgical Intervention ◽

Pelvic Ct Scan

Objective: In this study, we aimed to emphasize the role of radiological imaging in determining the treatment of a patient, who tested positive for COVID-19 and diagnosed with acute appendicitis during the pandemic. Methods: A 31-year-old patient presented to the emergency department due to abdominal pain. Ultrasound examination, thoracic and pelvic CT scan were performed. Results: Non-complicated appendicitis can be treated conservatively with antibiotics. Treatment can be maintained by starting with IV antibiotics and bridging therapy with oral antibiotics. Conclusion: This study aims to summarize how radiological follow-up can be used to decide on the suitability of the patient for appropriate medical treatment as an alternative to surgery in a patient, whose gold standard treatment is emergency surgical intervention, which is frequently encountered in the emergency department during the COVID-19 pandemic.

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Computed tomography as primary postoperative follow-up after laparoscopic Roux-en-Y gastric bypass

World Journal of Radiology ◽

10.4329/wjr.v10.i1.1 ◽

2018 ◽

Vol 10 (1) ◽

pp. 1-6

Author(s):

Tarik Delko ◽

Diana Mattiello ◽

Thomas Koestler ◽

Urs Zingg ◽

Silke Potthast

Keyword(s):

Computed Tomography ◽

Gastric Bypass

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Emergency presentation of retrograde intussusception as a late complication of gastric bypass

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2012.94.3.e116 ◽

2012 ◽

Vol 94 (3) ◽

pp. e116-e117 ◽

Cited By ~ 3

Author(s):

R Pande ◽

I Fraser ◽

C Harmston

Keyword(s):

Gastric Bypass ◽

Rare Complication ◽

Late Complication ◽

Emergency Presentation ◽

Retrograde Intussusception ◽

First Case ◽

History Of ◽

The Uk

Retrograde intussusception is a rare complication of a Roux-en-Y gastric bypass. With the rising number of gastric bypass operations being performed in the UK, the incidence of retrograde intussusception is likely to increase. We report the first case in the UK and highlight its insidious presentation and the importance of considering intussusception in any patient with a history of a Roux-en-Y gastric bypass.

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