scholarly journals Acute Intestinal Obstruction Complicating Abdominal Pregnancy: Conservative Management and Successful Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Gerald Okanandu Udigwe ◽  
George Uchenna Eleje ◽  
Eric Chukwudi Ihekwoaba ◽  
Onyebuchi Izuchukwu Udegbunam ◽  
Richard Obinwanne Egeonu ◽  
...  

Background. Acute intestinal obstruction during pregnancy is a very challenging and unusual nonobstetric surgical entity often linked with considerable fetomaternal morbidity and mortality. When it is synchronous with abdominal pregnancy, it is even rarer.Case Presentation. A 28-year-old lady in her second pregnancy was referred to Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, at 27 weeks of gestation due to vomiting, constipation, and abdominal pain. Examination and ultrasound scan revealed a single live intra-abdominal extrauterine fetus. Plain abdominal X-ray was diagnostic of intestinal obstruction. Conservative treatment was successful till the 34-week gestational age when she had exploratory laparotomy. At surgery, the amniotic sac was intact and the placenta was found to be adherent to the gut. There was also a live female baby with birth weight of 2.3 kg and Apgar scores of 9 and 10 in the 1st and 5th minutes, respectively, with the baby having right clubbed foot. Adhesiolysis and right adnexectomy were done. The mother and her baby were well and were discharged home nine days postoperatively.Conclusion. To the best of our knowledge, this is the first report of abdominal pregnancy as the cause of acute intestinal obstruction in the published literature. Management approach is multidisciplinary.

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Nazish Naseer ◽  
Sonia Yaqub

associated with vomiting and constipation. On examination he was an obese, ill looking male with a distended abdomen and bilateral palpable flank masses. Gut sounds were sluggish. Small and large bowel loops were found to be dilated on abdominal x-ray. Computed tomography scan of the abdomen showed grossly enlarged kidneys occupying almost whole of the abdomen pushing small bowel loops anteriorly. Based on clinical and radiological findings a diagnosis of sub-acute intestinal obstruction was made. Patient was managed conservatively (i.e. with NG tube and rectal decompression). This case highlights intestinal obstruction as a rare complication of ADPKD.


2019 ◽  
Vol 12 (5) ◽  
pp. e226663
Author(s):  
Raj Kumar ◽  
Pavan Kumar Shamanur Kenchappa ◽  
Kusum Meena ◽  
Brijesh Kumar Singh

Ileosigmoid knotting (ISK) is a rare cause of intestinal obstruction rapidly progressing to bowel gangrene. It is characterised by the wrapping of loops of ileum and sigmoid colon around each other. The condition often remains undiagnosed preoperatively; however, it can be suspected by the triad of small bowel obstruction, radiographic features suggestive of predominately large bowel obstruction and inability to deflate the intestine by a sigmoidoscope. We are reporting a case of 56-year-old man who presented with features of acute intestinal obstruction and compensated shock within 24 hours of onset of symptoms. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. In view of haemodynamic instability, end ileostomy was done after excising gangrenous segments. The patient improved and stoma closure and ileocolic anastomosis were done after 3 months in follow-up.


2020 ◽  
Vol 7 (9) ◽  
pp. 3140
Author(s):  
Kewithinwangbo Newme ◽  
Donkupar Khongwar ◽  
Ranendra Hajong ◽  
Vandana Raphel

Gastrointestinal stromal tumours (GIST) as such is a rare disease, but according to some study it may end up to malignant type in approximately 10-30%. Herein we present a 2 cases of GIST who presented with acute intestinal obstruction in emergency department. In imaging studies (X-ray erect abdomen, ultrasonography abdomen), it showed a features of intestinal obstruction but could not rule out the exact mechanism or pathology behind the obstruction. As commonly adhesions is a main culprit behind the cause of acute intestinal obstruction in case of any post-operative patient. So, we try to highlight that in case of any old aged individual and in virgin abdomen GIST should be keep in mind as a cause of intestinal obstruction.


2000 ◽  
Vol 118 (6) ◽  
pp. 192-194 ◽  
Author(s):  
Renato Passini Júnior ◽  
Roxana Knobel ◽  
Mary Ângela Parpinelli ◽  
Belmiro Gonçalves Pereira ◽  
Eliana Amaral ◽  
...  

CONTEXT: The lithopedion (calcified abdominal pregnancy) is a rare phenomenon and there are less than 300 cases reported in the medical literature. CASE REPORT: In this case, a 40 year-old patient had had her only pregnancy 18 years earlier, without medical assistance since then. She came to our hospital with pain and tumoral mass of approximately 20 centimeters in diameter. Complementary examinations (abdominal X-ray, ultrasonography and computerized tomography) demonstrated an extra-uterine abdominal 31-week pregnancy with calcification areas. Exploratory laparotomy was performed, with extirpation of a well-conserved fetus with partially calcified ovular membranes.


2020 ◽  
Vol 10 ◽  
pp. 3
Author(s):  
Ravi Patcharu ◽  
Karunesh Chand ◽  
Badal Parikh

Background: Phytobezoars are concretions of non-digestible vegetative matter in the gastroin­testinal tract and are a rare cause of intestinal obstruction in children. Case presentation: We report a case of intestinal obstruction in a 2-day-old neonate with no specific radiological features pointing to any common etiology. On exploratory laparotomy, a swollen raisin was found impacted in the ileum causing intestinal obstruction. The history taken in retrospect revealed that the elder sibling had witnessed her father perform a traditional ritual of putting a drop of honey into the mouth of the newborn and she imitated the same with a raisin, which led to the obstruction. Conclusion: A careful detailed history of local traditional rituals is at times, the most important pointer towards the etiology of a clinical condition. The basic clinical skill of history taking is still very important, despite the availability of advanced radiological investigations.


2021 ◽  
Vol 4 (8) ◽  
pp. 01-04
Author(s):  
Kiran R.S ◽  
Sarmukh S ◽  
Azmi H

Gallstone ileus is common in elderly female population. To obtain a diagnosis of gallstone ileus is a challenge requiring clinical and radiological assistance. It’s a rare cause of intestinal obstruction, accounts approximately 1-4%. Here we report a case of 56 years old lady presented with intestinal obstruction sign and symptoms. Per abdomen examination revealed generalised tenderness with sluggish bowel sound. Abdominal X-ray revealed prominent small bowel with presence of gas till rectum. CT abdomen noted intraluminal mass over distal small bowel loops mimickering intusseption. Exploratory laparotomy with small bowel enterotomy was performed. Intra-operative finding noted impacted gallstone measuring 2x3cm, 360cm from duodenal-jejunal flexure and 50cm from terminal ileum. Post-operative patient had speedy recovery and discharged home. Here we emphasize in elderly female patient presented with sign and symptoms of intestinal obstruction, diagnosis of gallstone ileus should be one of differential diagnosis.


2021 ◽  
pp. 6-8
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Tuhinsubhra Mandal

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.


Radiology ◽  
1938 ◽  
Vol 31 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Leon Solis-Cohen ◽  
Samuel Levine

1941 ◽  
Vol 14 (157) ◽  
pp. 11-22
Author(s):  
P. B. Ascroft ◽  
Eric Samuel

2019 ◽  
Vol 6 (5) ◽  
pp. 1796
Author(s):  
Vishnu Pratap ◽  
Pallavi Shambhu ◽  
Bhushan Kale ◽  
S. Prabhakar

Intussusception is a common finding in children accounting for approximately 25% of all abdominal emergencies in patients below five years of age. This, however, is a rare observation in adults accounting for only 5% of all intussusceptions. Among them, those leading to acute intestinal obstruction are about 1-5%. Diagnosis is based on radiographic findings seen on ultrasonography or CT scan as the presentation in adults is often difficult to diagnose clinically due to the variable presentation. We present here a case of intussusception in a 24 year old male presenting as acute intestinal obstruction. Exploratory laparotomy with resection of the bowel segment was done followed by end to end anastomosis. Post-operative course was uneventful. 


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