scholarly journals A Case of Midgut Volvulus Associated with a Jejunal Diverticulum

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Joseph Gutowski ◽  
Rachel NeMoyer ◽  
Glenn S. Parker
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Internal Hernia ◽  
Midgut Volvulus ◽  
Current Case ◽  
Intermittent Abdominal Pain ◽  
Cat Scan ◽  
Jejunal Diverticulum ◽  
Life Threatening ◽  
Swirl Sign

Midgut volvulus in adults is a rare entity that may present with intermittent colicky abdominal pain mixed with completely asymptomatic episodes. This small bowel twist may result in complications of obstruction, ischemia, hemorrhage, or perforation. With a midgut volvulus, complications may be life-threatening, and emergent surgical intervention is the mainstay of treatment. This current case involves an 80-year-old woman with intermittent abdominal pain with increasing severity and decreasing interval of time to presentation. A CAT scan revealed mesenteric swirling with possible internal hernia. A diagnostic laparoscopy followed by laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery, and a large jejunal diverticulum. The adhesions were lysed enabling untwisting of the bowel, allowing placement of the small bowel in the correct anatomic position and resection of the jejunal diverticulum. This is a rare case of midgut volvulus with intermittent abdominal pain, associated with jejunal diverticulum managed successfully. A midgut volvulus should be considered in the differential diagnosis of a patient who present with a small bowel obstruction secondary to an internal hernia, especially when a swirl sign is present on the CAT scan.

scholarly journals Intestinal malrotation with solitary jejunal diverticulum presenting as midgut volvulus in an adult: an unusual presentation

2021 ◽  
Vol 8 (7) ◽  
pp. 2231
Author(s):  
Debarghya Chatterjee ◽  
Subrat Kumar Raul ◽  
Elisheba Patras
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Intestinal Malrotation ◽  
Midgut Volvulus ◽  
Rare Entity ◽  
Intermittent Abdominal Pain ◽  
Post Operative Period ◽  
Jejunal Diverticulum ◽  
Whirlpool Sign

Intestinal malrotation with midgut volvulus presenting in adults is a rare entity, and association with jejunal diverticulum is rarer still. Herein, we report and review such a case of malrotation and volvulus, associated with intestinal band adhesions and a solitary jejunal diverticulum. This 67 years old gentleman had presented with complaints of intermittent abdominal pain for past several years. Imaging of the abdomen revealed twisting of superior mesenteric artery and vein, evidence of midgut volvulus and intestinal malrotation with “whirlpool sign”. Laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery and a jejunal diverticulum. Adhesiolysis was performed, untwisting of the bowel was done and the jejunal diverticulum was resected. Post-operative period was uneventful. This case is being reported on account of its extreme rarity.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

scholarly journals Internal hernia following total gastrectomy with Roux-en-Y reconstruction

2011 ◽  
Vol 93 (6) ◽  
pp. e71-e73 ◽  
Author(s):  
JO Larkin ◽  
F Cooke ◽  
N Ravi ◽  
JV Reynolds
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Total Gastrectomy ◽  
Internal Hernia ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Postoperative Recovery ◽  
Entire Small Bowel ◽  
History Of ◽  
Swirl Sign

Internal herniation is a well-described complication after a gastric bypass, particularly when performed laparoscopically, although it is rarely described following a total gastrectomy. A 55-year-old lady presented with a 24-hour history of vomiting and rigors 10 months after a radical total gastrectomy with Roux-en-Y reconstruction for a gastric adenocarcinoma. Computed tomography (CT) showed a complete small bowel obstruction and a mesenteric swirl sign, indicating a possible internal hernia. The entire small bowel was found at laparotomy to have migrated through the mesenteric defect adjacent to the site of the previous jejunojejunostomy and was dark purple and aperistaltic. The small bowel was reduced through the defect. At a second laparotomy, the small bowel looked healthy and the defect was repaired. Postoperative recovery was unremarkable. Of numerous signs described, the mesenteric swirl sign is considered the best indicator on CT of an internal hernia following Roux-en-Y reconstruction in gastric bypass surgery. A swirl sign on CT in a patient with abdominal pain should always raise the suspicion of an internal hernia.

scholarly journals Unusual Presentation of Meckel’s Diverticulum: Gangrene due to Axial Torsion

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ahmet Rencuzogullari ◽  
Kubilay Dalci ◽  
Orcun Yalav
Keyword(s):  
Congenital Anomaly ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Preoperative Diagnosis ◽  
Iliac Fossa ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Life Threatening ◽  
Operative Findings ◽  
The Right

Meckel’s diverticulum is the most common congenital anomaly of the small bowel. The majority of cases are asymptomatic; however, life-threatening complications can also take place. We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa. The patient was operated on with the preoperative diagnosis of acute appendicitis but the operative findings were consistent with torted Meckel’s diverticulum due to presence of mesodiverticular band and he was treated successfully with surgical resection.

scholarly journals Fetal Midgut Volvulus with Meconium Peritonitis Detected on Prenatal Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Emanuelle J. Best ◽  
Cecelia M. O’Brien ◽  
Wendy Carseldine ◽  
Aniruddh Deshpande ◽  
Rebecca Glover ◽  
...  
Keyword(s):  
Small Bowel ◽  
Abdominal Mass ◽  
Uneventful Recovery ◽  
Team Approach ◽  
Midgut Volvulus ◽  
Meconium Peritonitis ◽  
Third Trimester ◽  
Bowel Necrosis ◽  
Threatening Condition ◽  
Life Threatening

Background. Fetal volvulus is a rare, yet life-threatening condition that requires skilful diagnosis and management. Volvulus occurs when bowel loops become twisted and the twisting of the mesenteric artery leads to congestion, impaired venous return, and bowel necrosis. Case Description. We present a case of fetal ileal volvulus suspected on third trimester ultrasound, complicated by premature labour, small bowel necrosis, and meconium peritonitis. Progressive dilatation and decreased peristalsis of echogenic bowel were noted in the early part of the third trimester. Daily surveillance ultrasound was performed and spontaneous labour occurred at 32 weeks’ gestation. A proactive postnatal approach guided by prenatal sonographic findings allowed prompt treatment and an urgent laparotomy was performed for an ileal volvulus with necrosis and meconium peritonitis. A segment of small bowel volvulus was resected and an end-to-end anastomosis was performed with uneventful recovery. Discussion. Clinically signs of fetal midgut volvulus are not pathognomonic, such as intestinal dilatation, abdominal mass, ascites, peritoneal calcifications, or polyhydramnios; thus, the diagnosis is often challenging. Complications reported in the literature include perforation and haemorrhagic ascites, which may lead to anaemia, hypovolemia, heart failure, and fetal demise. Conclusion. This case highlights the importance of assessing the fetal bowel as a part of routine third trimester ultrasound. The case describes the complexity of diagnosis in the fetus, important considerations along with multidisciplinary team approach to management.

SMALL BOWEL DIVERTICULOSIS UNCOMMON CAUSE OF CHRONIC INTERMITTENT ABDOMINAL PAIN

2003 ◽  
Vol 98 ◽  
pp. S178
Author(s):  
Richard Ma ◽  
Richard Prudencio ◽  
Jose Baez ◽  
Manish Tandon ◽  
Julio Ayala
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intermittent Abdominal Pain

scholarly journals Ruptured Jejunal Diverticulum Due to a Single-Band Small Bowel Obstruction

2008 ◽  
Vol 8 ◽  
pp. 934-940 ◽  
Author(s):  
Rajaraman Durai ◽  
Ashish Sinha ◽  
Mihir Khan ◽  
Happy Hoque ◽  
Rajab Kerwat
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Single Band ◽  
Spontaneous Perforation ◽  
Jejunal Diverticulosis ◽  
Jejunal Diverticulum ◽  
Distal Obstruction

Jejunal diverticulosis is rare and often goes unnoticed until complications occur. The diverticula are true, acquired diverticula and often asymptomatic. Jejunal diverticulosis can be associated with diverticulosis of the duodenum, ileum, and colon. Here we describe a patient with known severe diverticular disease of the large bowel, who presented acutely with abdominal pain and signs of generalised peritonitis. Laparotomy showed ruptured jejunal diverticulosis with a single band over the terminal ileum, causing small bowel obstruction. Spontaneous perforation of a jejunal diverticulum is rare and is usually an intraoperative finding. One should exclude a precipitating cause, such as coexisting distal obstruction, stricture, or a foreign body.

scholarly journals P53 First Reported Case of Successful Non-Surgical Management for Acute Small Intestinal Obstruction Caused by Enterolith as A Rare Complication of Jejunal Diverticulosis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Fang Fang Quek ◽  
Andrew Tanase ◽  
Fang Fang Quek
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
Acute Intestinal Obstruction ◽  
Jejunal Diverticulosis ◽  
Jejunal Diverticulum ◽  
Life Threatening

Abstract Introduction Enterolith ileus is a rare complication of jejunal diverticulosis, which in itself is a rare entity. Here we report a rare case of enterolith ileus as a complication of jejunal diverticulosis which is successfully managed conservatively. Case Report A 75-year-old female presented with a 7- day history of “gripey” abdominal pain with intermittent vomiting. She was able to pass flatus and had open bowel with small amount of loose stool. Patient was previously fit and well with no significant past medical history and had not undergone previous abdominal surgery. On admission, patient was in no acute distress and was afebrile. On examination, she had a very distended tympanic abdomen with left-sided tenderness but no palpable mass. Bowel sounds were present. Laboratory investigations revealed a white cell count of 22.6 x109/L, C-reactive protein of 26 mg/L and haemoglobin of 144 g/L. Abdominal X-rays revealed distended loops of small bowel indicating small bowel obstruction. CT images did not reveal pneumobilia which would be suggestive of gallstone ileus but showed intraluminal small bowel obstruction secondary to an enterolith in the terminal ileum. The scan also showed an inflamed jejunal diverticulum with fat stranding around but no perforation nor abscess was seen. The working diagnosis was acute intestinal obstruction caused by jejunal enterolith expulsed from jejunal diverticulum. Since no perforation nor abscess was noted, this patient was treated conservatively. Patient recovered uneventfully and was discharged with an MRI scheduled in 4-6 weeks for follow-up. The follow-up MRI was completely normal and patient has recovered uneventfully with conservative management. Discussion Acute intestinal obstruction caused by jejunal enterolith expulsed from jejunal diverticulum is rare. However, it is important to diagnose jejunoileal diverticulosis timely as they may lead to acute complications which can be life- threatening and may even cause death. Conclusion Many cases have reported jejunoileal diverticulosis being overlooked or misdiagnosed for other acute abdominal conditions. It is important to have a clinical awareness of this condition as although rare, it can lead to life-threatening complications.

scholarly journals Malrotation of Gut with Internal Mesocolic Hernia Mimicking Mesenteric Cyst

1970 ◽  
Vol 14 (2) ◽  
pp. 90-91
Author(s):  
Md MA Jafor ◽  
SM Safir Uddin Ahmed ◽  
Md Anwarul Islam ◽  
AB Siddiqui ◽  
Md Iqbal Bari
Keyword(s):  
Abdominal Pain ◽  
Clinical Presentation ◽  
Abdominal Mass ◽  
Chronic Abdominal Pain ◽  
Mesenteric Cyst ◽  
Midgut Volvulus ◽  
Internal Herniation ◽  
Intermittent Abdominal Pain ◽  
Clinical Presentations ◽  
Intestinal Rotation

Various clinical presentations from chronic abdominal pain to acute midgut volvulus with ischaemic bowel injury may result from failure of normal intestinal rotation and fixation. A patient having malrotation and internal herniation of gut clinically presented to us with intermittent abdominal pain, bilious vomiting and abdominal mass mimicking mesenteric cyst. This is a very rare and exceptional form of presentation of malrotation of gut. Rarity of the clinical presentation leads us to report this case. DOI: http://dx.doi.org/10.3329/taj.v14i2.8395 TAJ 2001; 14(2): 90-91

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