scholarly journals Vaginal evisceration of small bowel

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Peter Rogers ◽  
Hong Lee ◽  
Kedar Jape ◽  
Zi Qin Ng ◽  
David Koong
Keyword(s):  
Emergency Department ◽  
Small Bowel ◽  
Mortality Rate ◽  
Rare Condition ◽  
Vaginal Prolapse ◽  
Vaginal Vault ◽  
Vaginal Evisceration ◽  
Vaginal Repair ◽  
Midline Laparotomy ◽  
Surgical Emergency

Abstract Evisceration of bowel through the vaginal vault is an extremely rare condition and is considered to be a surgical emergency. We present the case of an 83-year-old female who was brought to the emergency department with a vaginal prolapse complicated by evisceration of small bowel. A midline laparotomy was performed for reduction of the bowel with a subsequent vaginal repair. We present this case due to its rarity and high-reported mortality rate.

scholarly journals A rare case of intestinal obstruction as a result of phytobezoar

2013 ◽  
Vol 94 (1) ◽  
pp. 134-135 ◽  
Author(s):  
D V Bolshakov ◽  
N Z Valiullin ◽  
R R Burganov
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Good Effect ◽  
Midline Laparotomy ◽  
Colon Cleansing ◽  
Peritoneal Drainage ◽  
Set Up ◽  
Fluid Levels

Intestinal obstruction (ileus) due to bezoar is a rare condition. Its combined prevalence among all cases of intestinal obstruction varies from 0.5 to 1%. An observed case is reported. A patient was admitted at the emergency ward with abdominal pain,nausea, bloating, and constipation. At examination - bloating, abdominal distention, moderate abdominal muscular defense at palpation, paraumbilical tenderness. Colon cleansing was started with a good effect. Gastrointestinal fluoroscopy: at 4 and 8 hours after introduction of barium contrast it is located in the dilated loops of small bowel with persisting air fluid levels. The diagnosis of unresolved intestinal obstruction was set up. The midline laparotomy, small bowel decompression by Abbott-Miller, peritoneal drainage with two tubes were performed. Final diagnosis: «Intestinal obstruction (phytobezoar), non-infected peritonitis».

scholarly journals Small Bowel Evisceration through the Vaginal Vault: A Rare Surgical Emergency

Cureus ◽  
2019 ◽  
Author(s):  
Abdullah M Rana ◽  
Abdul Ahad Rana ◽  
Yasser Salama
Keyword(s):  
Small Bowel ◽  
Vaginal Vault ◽  
Surgical Emergency

scholarly journals Intersigmoid Hernia: A Forgotten Diagnosis—A Systematic Review of the Literature over Anatomical, Diagnostic, Surgical, and Medicolegal Aspects

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Stella Chiarini ◽  
Paolo Ruscelli ◽  
Roberto Cirocchi ◽  
Vito D’Andrea ◽  
Beatrice Sensi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Small Intestine ◽  
Surgical Treatment ◽  
Small Bowel ◽  
Acute Abdomen ◽  
Clinical Presentation ◽  
Rare Condition ◽  
Review Of The Literature ◽  
Medicolegal Aspects

Introduction. Intersigmoid hernia is a hernia of the small bowel into the intersigmoid fossa. It is well known to be a rare condition. Recent reports reveal that the preoperative differentiation of intersigmoid hernias is difficult and the diagnosis is often confirmed during the laparotomic exploration. Due to the vague clinical manifestation in most cases, the surgical treatment is frequently delayed. Materials and Methods. In this study, we systematically reviewed the literature up to 2019 covering 114 studies and 124 patients with an intersigmoid hernia. The purpose of this work is to improve the understanding of the anatomical aspects, clinical presentation, diagnosis, and treatment of intersigmoid hernia so as to assist the preoperative differentiation of these hernias when presented as acute abdomen in the emergency department. Results. The diameter of the intersigmoid recess was reported with mean 2.65 cm (range 1–10 cm, SD 1.15 cm) and the length of the incarcerated small intestine was between 3 cm (min) and 150 cm (max): mean 25.25 cm, SD 35.04 cm. The diameter of the sigmoid recess was greater in patients who underwent resection due to strangulation (mean 3.31 cm, SD 1.53 cm) compared to those who underwent only reduction of the hernia (mean 2.35 cm, SD 0.74 cm). The time from onset to operation was less in patients undergoing resection surgery due to throttling (mean 3.03 days, SD 3.01 days) compared to those who underwent only a reduction of hernia incarceration (mean 8.49 days, SD 6.83 days). Conclusion. Intersigmoid hernia is often a forgotten diagnosis and a clinical challange due to its anatomical characteristics.

Subtle Vaginal Evisceration Resulting in Small Bowel Evisceration: A Case Report

2012 ◽  
Vol 43 (2) ◽  
pp. e125-e128 ◽  
Author(s):  
Kar-mun C. Woo ◽  
Judith A. Linden ◽  
Robert A. Lowenstein ◽  
Jose C. Varghese ◽  
Miguel A. Burch
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Vaginal Evisceration

scholarly journals Concurrent Spontaneous Sublingual and Intramural Small Bowel Hematoma due to Warfarin Use

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Gül Pamukçu Günaydın ◽  
Hatice Duygu Çiftçi Sivri ◽  
Serkan Sivri ◽  
Yavuz Otal ◽  
Ayhan Özhasenekler ◽  
...  
Keyword(s):  
Emergency Department ◽  
Small Bowel ◽  
Warfarin Therapy ◽  
International Normalized Ratio ◽  
Fresh Frozen Plasma ◽  
Close Monitoring ◽  
Observation Unit ◽  
Fresh Frozen ◽  
Tomography Scan ◽  
Frozen Plasma

Introduction. We present a case of concurrent spontaneous sublingual and intramural small bowel hematoma due to warfarin anticoagulation.Case. A 71-year-old man presented to the emergency department complaining of a swollen, painful tongue. He was on warfarin therapy. Physical examination revealed sublingual hematoma. His international normalized ratio was 11.9. The computed tomography scan of the neck demonstrated sublingual hematoma. He was admitted to emergency department observation unit, monitored closely; anticoagulation was reversed with fresh frozen plasma and vitamin K. 26 hours after his arrival to the emergency department, his abdominal pain and melena started. His abdomen tomography demonstrated intestinal submucosal hemorrhage in the ileum. He was admitted to surgical floor, monitored closely, and discharged on day 4.Conclusion. Since the patient did not have airway compromise holding anticoagulant, reversing anticoagulation, close monitoring and observation were enough for management of both sublingual and spontaneous intramural small bowel hematoma.

Hypercoagulability in Septic Shock Patients With Thrombocytopenia

2021 ◽  
pp. 088506662110241
Author(s):  
Sang-Min Kim ◽  
Sang-Il Kim ◽  
Gina Yu ◽  
June-Sung Kim ◽  
Seok In Hong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Multivariate Analysis ◽  
Platelet Count ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Sofa Score ◽  
Odds Ratio ◽  
Fibrinogen Level ◽  
Limited Information

Background: Despite thrombocytopenia, patients with sepsis often experience hypercoagulability. However, limited information is available on the prevalence and effect of hypercoagulability in patients with sepsis-induced thrombocytopenia. Hence, we evaluated the prevalence of hypercoagulability and the association between hypercoagulability and clinical outcomes in septic shock patients with thrombocytopenia. Methods: Thromboelastography (TEG) was performed prospectively in 1294 patients with septic shock at the emergency department (ED) between January 2016 and December 2019. After excluding 405 patients who did not require resuscitation, refused enrollment, or developed septic shock after ED presentation, 889 patients were included. We defined thrombocytopenia as an admission platelet count lower than 150,000/µl according to SOFA score. We defined hypocoagulability and hypercoagulability as coagulation index (CI)< −3 and >3 on TEG, respectively. Results: Of the 889 septic shock patients (mean age 65.6 ± 12.7 years, 58.6% male), 473 (53.2%) had thrombocytopenia. Eighty-five (18.0%) patients showed hypercoagulable TEG and73 (15.4%) patients showed hypocoagulable TEG. The hypercoagulable TEG group had a significantly higher fibrinogen level and a lower 28-day mortality rate than the normal and hypocoagulable TEG groups (518 vs. 347 and 315 mg/dL; 7.1% vs. 21.1% and 36.8%, P < 0.01, respectively). In multivariate analysis, hypercoagulable TEG was associated with a decreased mortality rate (odds ratio: 0.395; 95% confidence interval, 0.162-0.965). Conclusions: In septic shock patients with thrombocytopenia, hypercoagulability was not uncommon. TEG can quickly distinguish the hypercoagulability and hypocoagulability states and serve as a valuable tool for evaluating the degree and risk in septic shock patients with thrombocytopenia.

Unusual presentation of Crohn’s disease

2021 ◽  
Vol 14 (6) ◽  
pp. e242703
Author(s):  
Kate Edwards ◽  
Karen Yearsley
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Wedge Resection ◽  
Rare Condition ◽  
Unusual Presentation ◽  
Protein Losing Enteropathy ◽  
Inflammatory Bowel ◽  
Alpha 1 Antitrypsin ◽  
Underlying Pathophysiology

A previously well 37-year-old woman attended the emergency assessment unit with symptoms of lethargy, breathlessness and peripheral oedema, whereby initial basic investigations revealed an iron deficiency anaemia and serum hypoalbuminaemia. The patient subsequently had multiple admissions to secondary care over a 2-year period due to worsening peripheral and central oedema. Investigations ruled out non-gastrointestinal causes of serum hypoalbuminaemia, such as renal, cardiac and hepatic failures. Gastrointestinal investigations later revealed raised faecal alpha-1 antitrypsin and small bowel ulceration on capsule endoscopy, with a histological diagnosis of Crohn’s disease made after a small bowel wedge resection. This case describes the unusual presentation of Crohn’s disease displaying symptoms primarily of protein-losing enteropathy, an uncommon and under-recognised consequence of inflammatory bowel disease. A review of current literature and the underlying pathophysiology for this rare condition are discussed, particularly in relation to Crohn’s disease.

scholarly journals Acute postoperative perforated ulcers of the small bowel as a topical problem of modern surgery

2019 ◽  
Vol 178 (2) ◽  
pp. 33-37
Author(s):  
V. P. Zemlyanoy ◽  
A. B. Singaevskiy ◽  
D. V. Gladyshev ◽  
N. M. Vryblevskiy ◽  
E. M. Nesvit ◽  
...  
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Mortality Rate ◽  
Postoperative Period ◽  
Topical Problem ◽  
Emergency Operations ◽  
Pelvic Organs ◽  
The Past ◽  
Oncological Diseases ◽  
High Level

The objective is to study acute perforated ulcers of the small bowel, which arise as a complication after operations on the abdominal and pelvic organs.Material and methods. A retrospective analysis of patient’s cases whose postoperative period was complicated by the development of acute perforated ulcers of small bowel.Results. Over the past 20 years, the frequency of this complication increased by 8 times. In the structure of primary nosology, various types of oncological diseases prevail (69.4 %), moreover most patients underwent emergency operations. Most often, this complication occurred on the 4–10th day of the postoperative period, and the ulcers were multiple. Among these patients, there was an extremely high mortality rate of 74.2 %.Conclusion. Considering the significant increase in the number of this complication in recent years and the high level of mortality among patients, a detailed study of acute perforated ulcers of the small intestine of the postoperative period is necessary.

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