scholarly journals Jejuno-jejunal intussusception secondary to diffuse intestinal lipomatosis

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Renee Angela Tabone ◽  
Tom DeGreve ◽  
Peita Webb ◽  
Peter Yuide
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Endoscopy ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Adult Intussusception ◽  
Structural Abnormality ◽  
Successful Approach ◽  
Rare Diagnosis

Abstract A 25-year-old man presented to the emergency department with severe abdominal pain and vomiting. He had previously presented 10 days prior with similar symptoms. Computed tomography imaging showed a large jejuno-jejunal intussusception. Multiple intestinal masses were identified intraoperatively with the rare diagnosis of intestinal lipomatosis later confirmed via histopathology. Diagnosis and management of rare surgical pathologies is always challenging. Intussusception should always be considered as a differential diagnosis for abdominal pain in adults, as adult intussusception is typically due to a structural abnormality with majority of cases requiring surgical intervention. Exploratory laparotomy with segmental resection and primary anastomosis proved to be a successful approach in our case, with the patient having an uneventful recovery. Follow-up has consisted of gastrointestinal endoscopy and colonoscopy, which have not demonstrated any further lipomas.

Sigmoid Volvulus in 16-year-old Boy with an Associated Anomalous Congenital Band

2013 ◽  
Vol 79 (11) ◽  
pp. 1140-1141 ◽  
Author(s):  
Ann A. Albert ◽  
Tracy L. Nolan ◽  
Bryan C. Weidner
Keyword(s):  
Abdominal Pain ◽  
African American Male ◽  
Pediatric Patients ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Sigmoid Volvulus ◽  
Sudden Onset ◽  
Contrast Enema ◽  
Pediatric Age Group ◽  
History Of

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CTwas consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.

scholarly journals Adult neuroblastoma: a rare diagnosis of an adrenal mass

2019 ◽  
Vol 12 (4) ◽  
pp. e228730 ◽  
Author(s):  
Jason Ramsingh ◽  
Helen Casey ◽  
Carol Watson
Keyword(s):  
Adrenal Mass ◽  
Gastrointestinal Symptoms ◽  
Uneventful Recovery ◽  
Functional Tests ◽  
Tertiary Referral Centre ◽  
Small Nodule ◽  
Platinum Based Chemotherapy ◽  
Poorly Differentiated ◽  
Rare Diagnosis

A 22-year-old woman presented to her local district hospital with left-sided abdominal pain. She denied any urinary or gastrointestinal symptoms. She had a CT scan of her abdomen which showed a probable 8×5×8 cm left-sided adrenal mass. Functional tests for hormone excess were negative. She was referred to a tertiary referral centre and given the size of the adrenal mass; she consented for laparoscopic left adrenalectomy. During the operation, the mass was grossly adherent to the celiac axis, left renal pedicle and DJ flexure. A small nodule posterior to the renal vein was also identified. The operation was completed laparoscopically and she made an uneventful recovery. The specimen was reported as a poorly differentiated neuroblastoma. She had a postoperative MIBG scan which was negative for residual or metastatic disease. She was commenced on platinum-based chemotherapy with a plan for further radiological follow-up.

scholarly journals Fifteen-Year Follow-Up of a Patient with Acinar Cystic Transformation of the Pancreas and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Xiaoyun Wen ◽  
Jela Bandovic
Keyword(s):  
Abdominal Pain ◽  
Cystic Lesion ◽  
Pancreatic Head ◽  
Single Layer ◽  
Exploratory Laparotomy ◽  
Final Diagnosis ◽  
Cystic Neoplasm ◽  
Histologic Diagnosis ◽  
Ultrasound Surveillance

Acinar cystic transformation (ACT), also known as “acinar cell cystadenoma,” is a rare and newly recognized benign pancreatic cystic neoplasm. However, its true malignant potential remains unknown. Here, we report a case of ACT with 15-year follow-up. A 10-year-old female initially presented with abdominal pain and was found to have a cystic lesion in the region of pancreatic head on computed tomography scan. She underwent an exploratory laparotomy, and the intraoperative biopsy of the cyst wall showed a true pancreatic cyst without malignancy. Her symptoms subsequently resolved, and she was placed under close ultrasound surveillance. For the next fifteen years, the patient was asymptomatic without any complications and had a successful pregnancy. Surveillance showed the tumor grew in size from 4.2 cm to 6.2 cm in diameter. In the latest five months, she noted occasional abdominal pain. A pylorus-preserving pancreaticoduodenectomy was performed. The resected cystic lesion was multilocular and lined by a single layer of bland epithelium ranging from nondescript flat/cuboidal epithelium to apparent acinar cells which were strongly positive for trypsin, so the final diagnosis was confirmed to be ACT. The prior biopsy was retrospectively reviewed to reveal similar epithelial lining. To the best of our knowledge, this is the longest period of follow-up for ACT to date. Our findings suggest that ACT is a slow-growing neoplasm without malignant transformation after fifteen years. Therefore, we recommend biopsy for histologic diagnosis followed by close ultrasound surveillance without surgical intervention in asymptomatic or young ACT patients.

scholarly journals A Patient with Multiple Gastrointestinal Carcinoid Tumours Presenting with Jejunal Intussusception

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Kavinda Deshapriya Bandara ◽  
Sanjeevan Ravindrakumar ◽  
Kirushanthan Veerasingam ◽  
Umesh Jayarajah ◽  
V. S. D. Rodrigo
Keyword(s):  
Small Bowel ◽  
Carcinoid Tumour ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Adult Intussusception ◽  
Histopathological Diagnosis ◽  
Proximal Jejunum ◽  
Small Bowel Mesentery ◽  
Carcinoid Tumours ◽  
Gastrointestinal Carcinoid

Carcinoid tumours are neuroendocrine tumours which arise from the enterochromaffin cells in the gastrointestinal and bronchopulmonary systems. The presentation of multiple gastrointestinal carcinoids with jejunal intussusception is rare, and the diagnosis may be challenging. A 49-year-old patient with adult onset bronchial asthma presented with pain around the umbilical region for 1-day duration. Physical examination revealed only mild abdominal tenderness. Abdominal computed tomography revealed small bowel intussusception with two separate highly vascular tumours arising in the small bowel mesentery. Exploratory laparotomy was done, with resection of the tumours arising from the small bowel mesentery and the proximal jejunum causing the intussusception which were excised. Histopathological diagnosis confirmed the presence of a Grade 1 carcinoid tumour of classic type. After surgery, he had an uneventful recovery and was asymptomatic. Carcinoid tumours are a very rare cause of adult intussusception. So far, there have been only two reported cases of jejunal intussusception secondary to carcinoid tumours. These will require a combination of surgical intervention and systemic therapy in selective cases for complete management.

scholarly journals Strangulated Morgagni’s Hernia: A Rare Diagnosis and Management

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Malav Modi ◽  
Amit Kumar Dey ◽  
Ajay Mate ◽  
Samir Rege
Keyword(s):  
Primary Repair ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Morgagni Hernia ◽  
Rare Type ◽  
Ischemic Bowel ◽  
Morgagni’S Hernia ◽  
Diaphragmatic Hernias ◽  
Rare Diagnosis

Morgagni hernia is a rare type of congenital diaphragmatic hernia. It accounts for only 3% of all diaphragmatic hernias. The defect is small and hernia being asymptomatic in the majority presents late in adulthood. Obstruction or incarceration in Morgagni hernia is uncommon. We report a rare occurrence of strangulated Morgagni hernia. A 40-year-old gentleman presented to our emergency department with features of intestinal obstruction. Computed tomography of the chest and abdomen showed a strangulated right Morgagni hernia. An exploratory laparotomy was performed with resection of the ischemic bowel segment with anastomosis and a primary repair of the diaphragmatic defect. Postoperative recovery was uneventful and asymptomatic at follow-up.

Rare aetiology of abdominal pain: contained abscess secondary to perforated jejunal diverticulitis

2020 ◽  
Vol 13 (9) ◽  
pp. e235974
Author(s):  
Enoch Yeung ◽  
Vishal Kumar ◽  
Zachary Dewar ◽  
Robert Behm
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Jejunal Diverticulosis ◽  
History Of ◽  
Fluid Levels ◽  
Jejunal Diverticulitis

A patient with a history of multiple jejunal diverticulosis (JD) presented with a non-peritonitic abdominal pain and leucocytosis. CT scan showed a thick-walled interloop collection within the left mid-abdomen with dilated bowels and mild diffuse air-fluid levels. Exploratory laparotomy revealed multiple diverticular outpouchings in the mid-jejunum, one of which was perforated, contained within the mesentery. Resection of the contained abscess and primary anastomosis were performed subsequently.

scholarly journals Nonrotation of gut with nutcracker syndrome: a rare presentation

2021 ◽  
Vol 8 (9) ◽  
pp. 2819
Author(s):  
Saket Jha ◽  
Shahaji Deshmukh ◽  
Apoorva Kulkarni ◽  
Abhaya Gupta ◽  
Paras Kothari
Keyword(s):  
Abdominal Pain ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Simultaneous Presence ◽  
Rare Presentation ◽  
Rare Diagnosis ◽  
Ladd’S Procedure

Nutcracker syndrome is a rare diagnosis which presents with hematuria, abdominal pain and is caused by left renal vein entrapment in between abdominal aorta and superior mesenteric artery. Symptomatic presentation of rotational abnormalities of gut are rare in adults though it can present with abdominal pain. Simultaneous presence of nonrotation with nutcracker syndrome was very rarely reported in literature. The authors reported a 38 year old female who presented with chronic pain in left side of abdomen and was diagnosed as nutcracker syndrome with nonrotation of gut. Patient underwent Ladd’s procedure with left renal vein transposition. Patient was asymptomatic on follow up. Search of literature showed only two previous cases being reported making it a very rare presentation.

scholarly journals Primary mesenchymal chondrosarcoma of the pancreas

2010 ◽  
Vol 92 (3) ◽  
pp. e10-e12 ◽  
Author(s):  
Xianmin Bu ◽  
Xianwei Dai
Keyword(s):  
Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Mesenchymal Chondrosarcoma ◽  
Histopathological Diagnosis ◽  
Hepatoduodenal Ligament ◽  
Hepatic Vessels ◽  
History Of ◽  
Radiological Studies

Extraskeletal chondrosarcomas are rare and there is only one reported case of primary pancreatic chondrosarcoma. We report the case of a 34-year-old woman with a 6-month history of abdominal pain and distention. Radiological studies indicated a mass in the pancreas, and exploratory laparotomy revealed a tumour of the pancreas extending to the hepatic vessels and hepatoduodenal ligament. The mass was completely excised, and the histopathological diagnosis was primary mesenchymal pancreatic chondrosarcoma. Tumour recurred at follow-up 52 months postoperatively.

scholarly journals Biofilm-sealed perforation of the gastric body: a rare sequela of gastric band erosion

2019 ◽  
Vol 2019 (9) ◽  
Author(s):  
Ciaran M Hurley ◽  
Daniel Hechtl ◽  
Kin Cheung Ng ◽  
Jack McHugh ◽  
Rishabh Sehgal ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Gastric Banding ◽  
Gastric Band ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Gastric Body ◽  
Gastric Erosion ◽  
Band Erosion ◽  
History Of

Abstract Laparoscopic Adjustable Gastric Banding is one of the cardinal bariatric interventions and due to its early safety profile, became the mainstay. Major long-term complications of gastric banding include pouch-herniation-dilation and gastric erosion. A 59-year-old female presented to the emergency department with a 2-week history of progressive central abdominal pain and distention on a background history of a laparoscopic adjustable band insertion 11 years previously. Subsequent computed tomography demonstrated an intragastric band erosion. An exploratory laparotomy demonstrated a gastric band eroded through the stomach sealed by a biofilm. Secondary findings included small bowel ischemia and portal vein thrombosis. The gastric band was extracted, and the stomach was repaired. The ischemic small bowel was resected with primary anastomosis. The patient recovered uneventfully. Gastric band erosion should be considered in all patients presenting with abdominal pain and previous weight loss surgery. Prompt recognition may avoid fatal consequences.

scholarly journals Perforated Jejunal Diverticulum - an Unusual Presentation

2015 ◽  
Vol 1 (1) ◽  
pp. 43-45
Author(s):  
Kamal Koirala ◽  
Mahesh Khakurel ◽  
Reeta Barai
Keyword(s):  
Abdominal Pain ◽  
Histopathological Examination ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Health Sciences ◽  
Unusual Presentation ◽  
Jejunal Segment ◽  
Acute Peritonitis ◽  
Jejunal Diverticulum ◽  
Acute Complications

Jejunal diverticula are rare and usually asymptomatic. Acute complications may include haemorrhage, diverticulitis, obstruction, abscess formation and perforation. Here we report a case of 61 years lady who presented with generalized abdominal pain, vomiting and fever. There were features of acute peritonitis on examination. Exploratory laparotomy revealed a perforated jejunal diverticulum. Resection of the jejunal segment containing the perforated diverticulum and primary anastomosis was done. Histopathological examination revealed jejunal diverticulum with pinhole perforation. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13016   Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):43-45

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