scholarly journals Primary enterolithiasis with intestinal tuberculosis: rare presentation of a common disease

2018 ◽  
Vol 11 (1) ◽  
pp. e225469
Author(s):  
Brijesh Kumar Singh ◽  
Saurabh Negi ◽  
Kusum Meena ◽  
Nain Singh
Keyword(s):  
Intestinal Obstruction ◽  
Intestinal Tuberculosis ◽  
Exploratory Laparotomy ◽  
Common Disease ◽  
Rare Presentation ◽  
Multiple Round ◽  
Diseased Bowel ◽  
Subacute Intestinal Obstruction ◽  
Favourable Environment ◽  
Resection And Anastomosis

Enterolithiasis is the formation of intestinal calculi due to stasis. Tubercular strictures resulting in intestinal stasis provide a favourable environment for enterolith formation. Intestinal tuberculosis occurs commonly in India, but coexistent enterolithiasis has been reported rarely. We are describing three cases of enterolithiasis secondary to tubercular intestinal strictures among female patients in the fourth to fifth decades of life, all of them having pulmonary tuberculosis in the past. All the cases presented with features of subacute intestinal obstruction. X-ray abdomen done for all of them revealed single to multiple round, oval and rectangular, radio-opaque shadows suggestive of stones. Coexistence of enterolithiasis with intestinal tuberculosis may worsen the symptoms of intestinal obstruction and surgery remains the mainstay of treatment. All the patients underwent exploratory laparotomy, resection and anastomosis of the diseased bowel and antitubercular therapy was started. Two patients responded well to the treatment and the third one expired due to cardiac comorbidity.

scholarly journals A Rare Presentation of Small Bowel Diverticulosis Causing Chronic Obstruction and Malnutrition: A Case Study with Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Y. Mathangasinghe ◽  
U. M. J. E. Samaranayake ◽  
J. D. Jayasinghe ◽  
A. S. K. Banagala
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Exploratory Laparotomy ◽  
Review Of Literature ◽  
Rare Presentation ◽  
Short Gut Syndrome ◽  
Chronic Malnutrition ◽  
Small Intestinal ◽  
Subacute Intestinal Obstruction

Small bowel diverticulosis is an uncommon entity. Clinical presentation of small intestinal diverticulosis is variable. A high mortality is associated with complications such as chronic malnutrition, haemorrhage, intestinal obstruction, and perforation. We report a case of a 63-year-old female with multiple small bowel diverticuli spanning from the first part of the duodenum to the proximal ileum presenting with chronic malnutrition and subacute intestinal obstruction. Although exploratory laparotomy was performed, we opted for a totally conservative treatment in order to avoid complications such as short gut syndrome and anastomotic leakage.

scholarly journals Severe PID with sub-acute intestinal obstruction during third trimester of pregnancy: a rare presentation

2019 ◽  
Vol 8 (2) ◽  
pp. 754
Author(s):  
Pesona Grace Lucksom ◽  
Annet Thatal ◽  
Patrika Rai ◽  
Spruha Navinbhai Thakkar ◽  
Kapil Singh Niranjan
Keyword(s):  
Intestinal Obstruction ◽  
Anaerobic Bacteria ◽  
Late Pregnancy ◽  
Exploratory Laparotomy ◽  
Third Trimester ◽  
Rare Presentation ◽  
Left Hypochondrium ◽  
Great Vessels ◽  
Subacute Intestinal Obstruction ◽  
Intestinal Obstructions

Pelvic inflammatory disease (PID) during late pregnancy is rare. Authors report a case of severe PID manifesting as subacute intestinal obstruction at early third trimester of pregnancy. A 26 years woman at 28 weeks of gestation was admitted in OBG department of Central Referral Hospital (CRH), Sikkim for evaluation of pain in left hypochondrium with tachycardia and mild rise in temperature. Her WBC was 26,900/cmm while urine and blood cultures were sterile. USG showed single live gestation of 27weeks 3days with a heterogeneous mass suggestive of degenerative fibroid. She had recurrent episodes of subacute intestinal obstructions. Her condition deteriorated, hence, elective caesarean with exploratory laparotomy was done. Single live baby was delivered after which abdominal exploration revealed purulent ascites with multiple pockets of pus. Omental cake along with the bowel was adhered to the fundus of uterus. There was no area of perforation in the gut. Bilateral adnexa were adherent to the pre-sacral region which was densely adhered to underlying great vessels. Post operatively antibiotic to cover the anaerobic bacteria were given to which she responded. Baby died after 4 days of birth due to sepsis. One week after discharge she was readmitted with left sided pleural effusion which responded to antibiotics. PID should be considered a cause of abdominal pain and rise in temperature in pregnancy, as early diagnosis can be managed conservatively with antibiotics thus decreasing maternal and perinatal morbidity and mortality.

scholarly journals Outcome of intussusception among children in Kano

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Lawal B. Abdullahi ◽  
Mohammad A. Mohammad ◽  
Lofty-John C. Anyanwu ◽  
Mohammad S. Aliyu ◽  
Bilya I. Liman
Keyword(s):  
Intestinal Obstruction ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Exploratory Laparotomy ◽  
Late Presentation ◽  
Adjacent Segment ◽  
Common Cause ◽  
A Prospective Study ◽  
Resection And Anastomosis

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract within the lumen of the adjacent segment usually proximal to distal. It is a common cause of intestinal obstruction in children, rarely it can occur in adult. This condition is reported in both developed and developing countries, however there are few publications in Nigeria about the incidence, presentation and outcome of its management, most especially in children. This is a prospective study of pediatric patients managed in single center Kano over a period of 18months. The demographic data, clinical features, treatment and outcome of the management were evaluated and analyzed using SPSS version 23. Between June 2018 to December 2019, twenty-five children were managed with intussuception at Aminu Kano Teaching Hospital, there were 16 males and 9 females. The age of the patients ranges between 5 months to 6 years with most of patients in the ager range between 6 and 12 months. All of the 25 patients had exploratory laparotomy with manual reduction in 12 patients, while 13 patients had resection and anastomosis. Non-operative reduction using normal saline under ultrasound guidance was attempted for 2 patients, which was not successful. The length of hospital stay ranged between 4 days and 22 days. Few complications were observed which includes surgical site infection, wound dehiscence, postoperative ileus. One patient was re-operated for recurrent intussuception. Two patients died post operatively, while 23 patients were discharged home alive. Intussuception is still a common cause of intestinal obstruction in children in Kano. Late presentation was found to be associated with higher morbidity (complications).

scholarly journals Emergency surgical management of sub-hepatic appendicular perforation with abscess; rare presentation of a common disease: a case report

2021 ◽  
Vol 9 (11) ◽  
pp. 3478
Author(s):  
S. K. Sekendar Ali ◽  
Narendra Nath Mukhopadhyay
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Clinical Suspicion ◽  
Common Disease ◽  
Emergency Setting ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
High Level

Subhepatic appendicitis is a very rare presentation that has been rarely reported, accounting for 0.01% of acute appendicitis case. It is difficult to diagnose and prime to be aware of variants, manage such challenging case in emergency setting. We present a case of 29 years male patient with subhepatic perforated appendicitis and its sequelae-abscess and peritonitis who underwent an exploratory laparotomy and appendectomy. The initial diagnosis and surgical management of such patients is challenging due to very rare and atypical presentation in emergency setting. A high level of clinical suspicion, promote decision to operate and skillful surgical approach is discussed with briefly.

RECURRENT SUB -ACUTE INTESTINAL OBSTRUCTION PRESENTED AS MIDGUT MALROTATION WITH VOLVULUS MANAGED BY LAAD'S PROCEDURE AND SURGERY IN AN ADULT PATIENT: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 6-8
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Tuhinsubhra Mandal
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Adult Population ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Intestinal Malrotation ◽  
Uneventful Recovery ◽  
Midgut Volvulus ◽  
Rare Presentation ◽  
Diagnostic Dilemma

Background: Intestinal malrotation refers to the partial or complete failure of rotation of midgut around the superior mesenteric vessels in embryonic life. Arrested midgut rotation results due to narrow-based mesentery and increases the risk of twisting midgut and subsequent obstruction and necrosis. Midgut volvulus secondary to intestinal malrotation is a rare presentation in adults more so in the elderly. Its rarity portends a diagnostic dilemma for both the surgeon and radiologist, and CT scan showed dilated large and small intestine segments with air-fluid levels and twisted mesentery around superior mesenteric artery and vein indicating "whirlpool sign". In our patient Case presentation: 42 years old male who presented to the emergency department with acute onset of pain in the RUQ, vomiting, and absolute obstipation for the last 2 days. This patient had a history of similar two episodes of sub-acute intestinal obstruction in the last 6 months which has been managed conservatively. The patient underwent an elective exploratory laparotomy after 2 days of failed conservative management. Operative findings included the presence of adhesive bands in the RUQ (Ladd's Band), volvulus of the mid-portion of the small bowel in a clockwise fashion, and multiple intraabdominal adhesions and empty RIF and caecum pulled up in RUQ. We subsequently performed a Ladd's procedure, multiple adhesiolysis, and caecopexy and the patient had an uneventful recovery with eventual discharge on postoperative day 12. This case report reviews the incidence of malrotation in adults. It also high Conclusion: lights the difficulty in diagnosing midgut volvulus in the adult population given the nonspecific, insidious symptoms, therefore, prompting awareness of its existence and a high degree of clinical suspicion. Malrotation should be considered in the differential diagnosis in patients presented with acute abdomen and intestinal ischemia.

scholarly journals Rare case of midgut volvulus with malrotation in an elderly patient

2019 ◽  
Vol 7 (1) ◽  
pp. 303
Author(s):  
Mezhuneituo Raleng ◽  
Anant Prakash Pore ◽  
Vickey Katheria ◽  
Worshim Khamrang ◽  
R. S. Wungramthing
Keyword(s):  
Elderly Patient ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Rare Case ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Midgut Volvulus ◽  
History Of ◽  
Subacute Intestinal Obstruction

A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced. 

scholarly journals Triple Intussusception in an Adult—A Rare Presentation of Adenocarcinoma Ileum

2021 ◽  
Vol 07 (04) ◽  
pp. e271-e274
Author(s):  
Kirankumar P. Jadhav ◽  
Gayathri Krishnan
Keyword(s):  
Rare Case ◽  
Bowel Resection ◽  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Low Grade ◽  
Lead Point ◽  
Rare Presentation ◽  
Small Bowel Intussusception ◽  
Low Grade Dysplasia ◽  
Resection And Anastomosis

AbstractIntestinal intussusception is uncommon in adults. It occurs more often in the small intestine than in the colon. In adults, when small bowel intussusception occurs, it can be due to a malignant lead point. Malignant etiology is most frequently due to diffuse metastatic disease. We present a rare case of an 18-year-old woman who was diagnosed with jejunojejunal, jejunoileal, and colocolic intussusceptions. She presented with vomiting, abdominal pain, and passage of semisolid stools for 5 days. During emergency exploratory laparotomy, multiple polyps were found in the jejunum, ileum, and sigmoid. Jejunotomy and sigmoidotomy were done to remove the respective polyps. The ileal polyp showed hemorrhagic changes; hence, an intraoperative decision was taken to proceed with resection and anastomosis. On histopathological examination, the resected ileal part showed moderately differentiated adenocarcinoma (grade 2) arising from an adenomatous polyp, while the jejunal polyp and sigmoid polyp were adenomatous polyps with low-grade dysplasia. Patient received six cycles of adjuvant chemotherapy consisting of capecitabine and oxaliplatin (CAPEOX regimen). After 2 years, she is symptom free with a normal colonoscopy. The treatment of intussusception in adults typically involves surgery, often with bowel resection as there is always a pathologic leading cause which may be malignant, like in our case.

scholarly journals HAZARDS OF MULTIPLE MAGNET INGESTION IN CHILDREN;

2013 ◽  
Vol 20 (04) ◽  
pp. 634-637
Author(s):  
MUHAMMAD ALI SHEIKH ◽  
TARIQ LATIF ◽  
MASOOM ALI SHAH ◽  
Jamil AKHTAR ◽  
Abdul Qayuum
Keyword(s):  
Foreign Body ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Clinical Features ◽  
Exploratory Laparotomy ◽  
Paediatric Population ◽  
Foreign Body Ingestion ◽  
Magnet Ingestion ◽  
Pass Through ◽  
Subacute Intestinal Obstruction

Foreign body ingestion is relatively common in the paediatric population and most object pass through the gastrointestinaltract spontaneously. With the popularity of small magnetic toys, there have been numerous reports of magnet ingestion with morbidityand even mortality. We report a case of 3-years old boy who presented with clinical features of subacute intestinal obstruction with nohistory of foreign body ingestion. On exploratory laparotomy, he was found to have multiple small bowel perforations due to two smallmagnets. Magnets were removed and perforations repaired. The aim of this report is to awarepaediatricians of the importance of earlysurgical referral in case of magnet ingestion, to prevent severe complications.

scholarly journals Rare case of paracaecal hernia with intussusception presenting as small bowel obstruction: case report

2020 ◽  
Vol 7 (5) ◽  
pp. 1662
Author(s):  
M. S. Kalyan Kumar ◽  
Shyamsundar R. ◽  
Sabari Girieasan M. ◽  
R. Kannan ◽  
S. Nedunchezhiyan
Keyword(s):  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Rare Presentation ◽  
Ileal Loop ◽  
Rare Type ◽  
Internal Hernias

Primary internal hernias are very rare in adults. They are an unusual cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is highly nonspecific. Imaging has limited role in diagnosing the cause of acute intestinal obstruction. Internal hernias are usually detected at laparotomy. We report a case of a 61-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the caecum and ileo ileal intussusception was noted proximal to the herniated loop. The segment of intestine was resected and anastamosed then hernial defect was closed. Paracaecal hernias are the rare type of hernias in internal hernia. In our case, intussusception was noted proximal to the herniated ileal loop which is a very rare presentation. Intussusception was reported previously with paraduodenal type. One should always keep in mind while conducting emergency laparotomy, internal hernias can be a cause for intestinal obstruction.

A Descriptive study on Conservative Management of Subacute Intestinal Obstruction and Its Outcome in Tirupati

2021 ◽  
Vol 8 (33) ◽  
pp. 3150-3155
Author(s):  
Gandikota Venkata Prakash ◽  
Purushotham G ◽  
Ajay Babu K ◽  
Mamgunta Sai Anugna
Keyword(s):  
Intestinal Obstruction ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Postoperative Adhesions ◽  
Female Ratio ◽  
Study Results ◽  
Male Female Ratio ◽  
Subacute Intestinal Obstruction ◽  
Emergency Surgical Intervention ◽  
Resection And Anastomosis

BACKGROUND Intestinal obstruction can be defined as the partial or complete blockage of either the small intestine or large intestine or both, causing failure of intestinal contents to pass beyond the point of obstruction. Subacute intestinal obstruction implies incomplete obstruction. It is characterized by continuous passage of flatus and /or feces beyond 6 -12 hours of the onset of symptoms. We wanted to study the conservative management of subacute intestinal obstruction and its outcome. METHODS Data was collected from patients presenting to outpatient Department of General Surgery, SVRRGGH, Tirupati and emergency with the features of subacute intestinal obstruction during the period of March 2019 to April 2020 were included in the study. RESULTS The incidence is high in patients of age group 41-50 years with Male: Female ratio is 2.1:1. The most common presenting symptom is pain abdomen (92 %), followed by vomiting (84 %). In our study, exaggerated bowel sounds (60 %) are the most common physical finding. The most common cause of obstruction is Postoperative adhesions (36 %), followed by obstructed hernias (22 %). Out of 50 cases, 72 % of cases were managed successfully by conservative management. In the patients who were managed conservatively, most of them are due to postoperative adhesions. In the patients who underwent emergency surgical intervention, 50 % of cases operated on the 2nd day of admission. Most commonly done Surgery include Adhesiolysis (28.6 %), Herniorrhaphy (28.6 %) and Resection and anastomosis (21.5 %). CONCLUSIONS Our study showed that conservative management is successful in about 72 % of patients with subacute intestinal obstruction. Not all the patients attending the emergency ward with features of intestinal obstruction need emergency surgical intervention. Conservative management can be tried in selective cases in patients with SAIO, thereby reducing the rate of negative laparotomies and morbidity and mortality. KEYWORDS Sub-Acute, Intestinal, Obstruction Conservative, Outcome

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