Chronic intentional chicken bone ingestion mimicking inflammatory bowel disease

2021 ◽  
Vol 14 (6) ◽  
pp. e239022
Author(s):  
Jacob T Dines ◽  
Amie Harvey
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Terminal Ileum ◽  
Recent Onset ◽  
Foreign Objects ◽  
Chicken Bone ◽  
Life Threatening ◽  
Bone Fragments ◽  
Endoscopic Retrieval ◽  
Inflammatory Bowel

Ingestion of food by-products, such as peach pits, chicken bones and fish bones, may lead to intestinal complications. The ingestion of the foreign body is often acute and non-intentional. Acute and life-threatening complications include intestinal perforation or obstruction. Sharp-pointed objects are associated with an estimated 35% rate of complications within the gastrointestinal tract prior to passage and require prompt removal. Endoscopic retrieval is often recommended if foreign objects have not transited beyond the proximal duodenum. We present a unique case of a previously healthy 23-year-old male suffering months of abdominal pain. While the initial presentation and imaging were suspicious for Crohn’s disease, the endoscopic findings were unexpected. Numerous chicken bone fragments were clustered in the caecum and in the terminal ileum. The distal terminal ileum was edematous and ulcerated. Subsequent patient history revealed years of chronic and intentional foreign body consumption with recent onset of abdominal pain.

Crohn’s disease

2018 ◽  
Vol 11 (8) ◽  
pp. 435-442
Author(s):  
James Franklin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Weight Loss ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Bowel Disease ◽  
Rare Condition ◽  
Inflammatory Bowel

Crohn’s disease is a chronic relapsing gastrointestinal condition. It is an inflammatory bowel disease that can affect any part of the gastrointestinal tract from mouth to anus, but most commonly affects the terminal ileum and colon. Individuals can present with a wide variety of symptoms, but diarrhoea, abdominal pain and weight loss are the most common. It is a rare condition, but GPs play an important role in recognising Crohn’s disease and supporting patients through their lifelong treatment.

scholarly journals Large Bowel Occlusion: Clinical and Imaging Characteristics - Caecum Volvulus

2019 ◽  
Vol 7 (13) ◽  
pp. 2150-2153
Author(s):  
Danilo Coco ◽  
Silvana Leanza
Keyword(s):  
Abdominal Pain ◽  
Terminal Ileum ◽  
Large Bowel ◽  
Death Rate ◽  
Ascending Colon ◽  
Case Presentation ◽  
Imaging Characteristics ◽  
Life Threatening ◽  
Bowel Occlusion ◽  
Anatomical Finding

BACKGROUND: Caecum volvulus (CV) is defined as an axial twisting that causes an inversion position of the caecum, ascending colon and terminal ileum. This anatomical finding is responsible for some clinical features. Obstruction and strangulation are the most important and life-threatening. CASE PRESENTATION: We are presenting a 50 years old woman presented to the hospital with sudden acute severe abdominal pain and distension of about 24 hours associated with vomiting and no flatus. CONCLUSION: Mortality in patients with CV can be kept near 10%-12% if operative intervention is accomplished before caecum strangulation. Once the cecum has become gangrenous, a death rate of 30 to 40% can be expected. Tailored made surgery on patients status is the strategy.

scholarly journals Flare-Up Diverticulitis in the Terminal Ileum in Short Interval after Conservative Therapy: Report of a Case

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Kensuke Nakatani ◽  
Takaharu Kato ◽  
Shinichiro Okada ◽  
Risa Matsumoto ◽  
Kazuhiro Nishida ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Antibiotic Therapy ◽  
Terminal Ileum ◽  
Therapeutic Strategy ◽  
Conservative Therapy ◽  
Short Interval ◽  
Right Hemicolectomy ◽  
Sudden Onset ◽  
Inflammatory Bowel ◽  
Ileal Diverticulitis

Diverticulitis in the terminal ileum is uncommon. Past reports suggested that conservative therapy may be feasible to treat terminal ileum diverticulitis without perforation; however, there is no consensus on the therapeutic strategy for small bowel diverticulitis. We present a 37-year-old man who was referred to our hospital for sudden onset of abdominal pain and nausea. He was diagnosed with diverticulitis in the terminal ileum by computed tomography (CT). Tazobactam/piperacillin hydrate (18 g/day) was administered. The antibiotic treatment was maintained for 7 days, and the symptoms disappeared after the treatment. Thirty-eight days after antibiotic therapy, he noticed severe abdominal pain again. He was diagnosed with diverticulitis in terminal ileum which was flare-up of inflammation. He was given antibiotic therapy again. Nine days after antibiotic therapy, laparoscopy assisted right hemicolectomy and resection of 20 cm of terminal ileum were performed. Histopathology report confirmed multiple ileal diverticulitis. He was discharged from our hospital 12 days after the surgery. Colonoscopy was performed two months after the surgery and it revealed no finding suggesting inflammatory bowel disease. Surgical treatment should be taken into account as a potential treatment option to manage the diverticulitis in the terminal ileum even though it is not perforated.

scholarly journals An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body

HPB Surgery ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Justin S. Gundara ◽  
Richard Harrison
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Liver Abscess ◽  
Foreign Bodies ◽  
High Rate ◽  
Gut Epithelium ◽  
Chicken Bone ◽  
Upper Abdominal ◽  
Distal Sigmoid ◽  
Portal Drainage

A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

scholarly journals Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 643
Author(s):  
Angela Saviano ◽  
Mattia Brigida ◽  
Alessio Migneco ◽  
Gayani Gunawardena ◽  
Christian Zanza ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Human Health ◽  
Bowel Disease ◽  
Chronic Constipation ◽  
Lactobacillus Reuteri ◽  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Inflammatory Bowel

Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed® from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.

scholarly journals Intruding implements: a pictorial review of retained surgical foreign objects in neuroradiology

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Alessandra D’Amico ◽  
Teresa Perillo ◽  
Lorenzo Ugga ◽  
Renato Cuocolo ◽  
Arturo Brunetti
Keyword(s):  
Differential Diagnosis ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Correct Identification ◽  
Pathophysiological Mechanism ◽  
Local Inflammatory Response ◽  
Inflammatory Reactions ◽  
Foreign Objects ◽  
Pictorial Review ◽  
Review Reports

AbstractIntra-cranial and spinal foreign body reactions represent potential complications of medical procedures. Their diagnosis may be challenging as they frequently show an insidious clinical presentation and can mimic other life-threatening conditions. Their pathophysiological mechanism is represented by a local inflammatory response due to retained or migrated surgical elements. Cranial interventions may be responsible for the presence of retained foreign objects represented by surgical materials (such as sponges, bone wax, and Teflon). Spinal diagnostic and therapeutic procedures, including myelography, chordotomy, vertebroplasty, and device implantation, are another potential source of foreign bodies. These reactions can also follow material migration or embolization, for example in the case of Lipiodol, Teflon, and cement vertebroplasty. Imaging exams, especially CT and MRI, have a central role in the differential diagnosis of these conditions together with patient history. Neuroradiological findings are dependent on the type of material that has been left in or migrated from the surgical area. Knowledge of these entities is relevant for clinical practice as the correct identification of foreign bodies and related inflammatory reactions, material embolisms, or migrations can be difficult. This pictorial review reports neuroradiological semeiotics and differential diagnosis of foreign body-related imaging abnormalities in the brain and spine.

Terminal ileum resection as a trigger for Strongyloides stercoralis hyperinfection and ensuing serial sepsis in a 37-year-old patient with complicated Crohnʼs disease: a case report

2018 ◽  
Vol 56 (04) ◽  
pp. 380-383 ◽  
Author(s):  
Mirjana Topić ◽  
Silvija Čuković-Čavka ◽  
Marko Brinar ◽  
Mirjana Kalauz ◽  
Ivica Škrlec ◽  
...  
Keyword(s):  
Terminal Ileum ◽  
Skin Penetration ◽  
Strongyloides Stercoralis ◽  
Developed Countries ◽  
Clinical Settings ◽  
Solid Organ ◽  
Transplant Patients ◽  
Skin Contact ◽  
Life Threatening ◽  
The Tropics

AbstractThe nematode Strongyloides stercoralis, outside the tropics and subtropics present in small endemic foci, can cause an infection after direct skin contact with contaminated soil containing infective filariform larvae and, rarely, after intimate interhuman contact or after transplantation of an infected solid organ. Following skin penetration, migration, and maturation through several stages, a small number of invasive filariform larvae can develop anew in the gut lumen, perpetuating new cycles of penetration, tissue migration, and reproduction, without leaving the host.In a state of immunosuppression, autoinfection can progress to life-threatening hyperinfection and/or infection disseminated through virtually any organ. In developed countries, the most frequently recognized risk for severe hyperinfection is corticosteroid therapy, but this has been also described in malnourished, alcoholic, cancer, and transplant patients. Due to the frequent need for immunosuppressive therapy, patients suffering from inflammatory bowel disease (IBD) are susceptible to develop overwhelming strongyloidiasis. Strongyloidiasis can be easily overlooked in clinical settings, and in many European regions there is poor insight into the epidemiological burden of this disease.We present a case of S. stercoralis hyperinfection that triggered 3 successive episodes of sepsis caused by pathogens of the gut flora in a young patient suffering from stenotic form of Crohn’s disease. S. stercoralis hyperinfection occurred in the corticosteroid-free period, shortly after resection of the terminal ileum, which was probably the trigger for the overwhelming course. The patient was successfully treated with 10-day albendazole therapy.

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