scholarly journals Superior Mesenteric Venous Thrombosis after Laparoscopic Exploration for Small Bowel Obstruction

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hideki Katagiri ◽  
Shozo Kunizaki ◽  
Mayu Shimaguchi ◽  
Yasuo Yoshinaga ◽  
Yukihiro Kanda ◽  
...  

Mesenteric venous thrombosis is a rare cause of intestinal ischemia which is potentially life-threatening because it can lead to intestinal infarction. Mesenteric venous thrombosis rarely develops after abdominal surgery and is usually associated with coagulation disorders. Associated symptoms are generally subtle or nonspecific, often resulting in delayed diagnosis. A 68-year-old woman underwent laparoscopic exploration for small bowel obstruction, secondary to adhesions. During the procedure, an intestinal perforation was identified and repaired. Postoperatively, the abdominal pain persisted and repeat exploration was undertaken. At repeat exploration, a perforation was identified in the small bowel with a surrounding abscess. After the second operation, the abdominal pain improved but anorexia persisted. Contrast enhanced abdominal computed tomography was performed which revealed superior mesenteric venous thrombosis. Anticoagulation therapy with heparin was started immediately and the thrombus resolved over the next 6 days. Although rare, this complication must be considered in patients after abdominal surgery with unexplained abdominal symptoms.

2019 ◽  
Vol 6 (8) ◽  
pp. 2995
Author(s):  
Swaminathan Ganesan ◽  
Satish Devakumar

High degree suspicion is mandatory in dealing with a post-operative patient presenting with a crampy postprandial abdominal pain, as potential for internal hernias remains fairly under diagnosed. Except in setting of small bowel obstruction or gangrene and radiological proven internal hernia, intervening a patient with herald symptoms is still debatable, though certain authors advocate that in lap. Roux-en Y gastric bypass patients with herald symptoms should promptly be offered elective laparoscopic exploration elective repair safely and expeditiously.


2019 ◽  
Vol 6 (9) ◽  
pp. e00210
Author(s):  
Ahmad Al-Taee ◽  
Zarir Ahmed ◽  
Adam Dhedhi ◽  
Mike Giacaman

2021 ◽  
pp. 1-3
Author(s):  
Abhishek Chaudhary ◽  
Kanchan Sone Lal Baitha ◽  
Yasir Tajdar

Background:The small intestine is the longest and convoluted portion in the digestive tract. It starts from pylorus and ends at ileocaecal valve. The small bowel consists of three parts measuring about 5 to 6 meters. The rst 25cm is the duodenum. Out of the rest part of small gut, jejunum th th. constitute the proximal 2/5 and ileum distal 3/5 The jejunum and ileum extend from the peritoneal fold that supports the duodeno-jejunal junction (Ligament of Treitz) down to ileocaecal valve. Material and Methods:All the patients admitted to PMCH, Patna and KMC, Katihar as intestinal obstruction was included for the study. The time period of study was from October 2014 to November 2016 in PMCH and December 2016 to January 2019 in KMC, Katihar. Out of all Intestinal obstruction 59 cases only of adult small gut obstruction were recorded for comparison and conclusive study.Conclusion: Small bowel obstruction remains a frequently encountered problem in abdominal surgery. Although modern day surgical management continues to focus appropriately on avoiding delayed operation, whatever surgery is indicated, not every patient is always best served by immediate operation


2019 ◽  
Vol 12 (7) ◽  
pp. e230496 ◽  
Author(s):  
Joseph Do Woong Choi ◽  
Michael Yunaev

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.


2016 ◽  
Vol 50 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Karl-Johan Lundström ◽  
Yasin Folkvaljon ◽  
Stacy Loeb ◽  
Anna Bill Axelson ◽  
Pär Stattin ◽  
...  

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Santhosh Loganathan ◽  
Adam O'Connor ◽  
Amal Singh ◽  
Mazyar Fani

Abstract Introduction The small bowel obstruction in a non-operated abdomen is rare, and the most common causes are hernia and neoplasm. The complete mechanical small bowel obstruction due to an omental band in a patient with no previous abdominal surgery is rare, and less than five cases have been reported in the literature. Case presentation We report a 65 year old male patient presented to the emergency department with complaints of abdominal pain, distension, vomiting and obstipation for four days. On clinical examination, his abdomen was distended, diffusely tender, guarding. The blood investigations showed elevated White blood cells and neutrophils with normal CRP and the Serum lactate. The Abdominal X-ray was suggestive of SBO. The Computed tomography of the abdomen and pelvis showed marked dilatation of the jejunum, the ileum is entirely collapsed, the impression of a double beak sign in the mid-abdomen which would suggest closed-loop obstruction due to a possible internal hernia. We proceeded with emergency diagnostic laparoscopy converted to laparotomy, which showed omental band causing closed-loop proximal small bowel obstruction. The bowel loops appeared congested with the constriction band due to omental band. The omental band was divided, and the obstruction was relieved. Postoperatively patient recovered well and was discharged on day three post-op. Discussion The timely diagnosis and intervention could prevent complications like strangulation, ischemia and gangrene. Though the omental band is rare, it should still be suspected as an aetiology in patients without prior abdominal surgery.


2010 ◽  
Vol 4 ◽  
pp. CMPed.S4850 ◽  
Author(s):  
Y Kashiwagi ◽  
S. Suzuki ◽  
K. Watanabe ◽  
S. Nishimata ◽  
H. Kawashima ◽  
...  

Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.


2014 ◽  
Vol 80 (6) ◽  
pp. 572-579 ◽  
Author(s):  
Elizabeth A. O'Leary ◽  
Sameer Y. Desale ◽  
William S. Yi ◽  
Kari A. Fujita ◽  
Conor F. Hynes ◽  
...  

Controversy remains as to which patients with small bowel obstruction (SBO) need immediate surgery and which may be managed conservatively. This study evaluated the ability of clinical risk factors to predict the failure of nonoperative management of SBO. The electronic medical record was used to identify all patients with SBO over one year. Clinical, laboratory, and imaging data were recorded. Univariate and multivariable analyses were performed to identify risk factors predicting need for surgery. Cox proportional hazards regression was used to identify risk factors that influence need and timing for surgery. Two hundred nineteen consecutive patients were included. Most patients did not have a prior history of SBO (75%), radiation therapy (92%), or cancer (70%). The majority had undergone previous abdominal or pelvic surgery (82%). Thirty-five per cent of patients ultimately underwent laparotomy. Univariate analysis showed that persistent abdominal pain, abdominal distention, nausea and vomiting, guarding, obstipation, elevated white blood cell count, fever present 48 hours after hospitalization, and high-grade obstruction on computed tomography (CT) scan were significant predictors of the need for surgery. Multivariable analysis revealed that persistent abdominal pain or distention (hazard ratio [HR], 3.04; P = 0.013), both persistent abdominal pain and distention (HR, 4.96; P < 0.001), fever at 48 hours (HR, 3.66; P = 0.038), and CT-determined high-grade obstruction (HR, 3.45; P = 0.017) independently predicted the need for surgery. Eighty-five per cent of patients with none of these four significant risk factors were successfully managed nonoperatively. Conversely, 92 per cent of patients with three or more risk factors required laparotomy. This analysis revealed four readily evaluable clinical parameters that may be used to predict the need for surgery in patients presenting with SBO: persistent abdominal pain, abdominal distention, fever at 48 hours, and CT findings of high-grade obstruction. These factors were combined into a predictive model that may of use in predicting failure of nonoperative SBO management. Early operation in these patients should decrease length of stay and diagnostic costs.


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
O. S. Balogun ◽  
A. O. Osinowo ◽  
M. O. Afolayan ◽  
A. A. Adesanya

Small bowel obstruction secondary to phytobezoars is an unusual presentation in surgery. We present a case of an elderly female patient with an insidious onset of abdominal pain, abdominal distension, and bilious vomiting diagnosed radiologically to be small bowel obstruction. Exploratory laparotomy revealed a trapped mass of vegetable matter in the distal ileum. She had enterotomy with primary closure for removal of obstructing ileal phytobezoars. Her postoperative recovery was uneventful.


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