scholarly journals An Alarming Mimicry of Intra-Abdominal Infections: Acute Appendiceal Diverticulitis

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Youseung Kim ◽  
Varun Kesar ◽  
Douglas Grider ◽  
Maithili V. Chitnavis
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Ascites Fluid ◽  
Clinical Correlation ◽  
Fluid Analysis ◽  
Abdominal Abscesses ◽  
Appendiceal Diverticulitis ◽  
Atypical Presentations ◽  
Abdominal Infections

A 65-year-old woman presented with three days of colicky abdominal pain. Abdominal imaging illustrated small bowel enteritis, ascites in both paracolic gutters, and incidental hepatic steatosis. Although ascites fluid demonstrated high neutrophil count consistent with peritonitis and the patient received adequate antibiotics, she clinically deteriorated. Subsequent exploratory laparotomy revealed necrotic appendix and multiple intra-abdominal abscesses. Histopathology showed acute suppurative appendicitis with multiple other intact small diverticula, indicating likely perforation of inflamed appendiceal diverticula with subsequent abscess formation and abdominal peritonitis. This case highlights the importance of ascites fluid analysis and continued clinical correlation, especially in cases of rare entities with atypical presentations.

SMALL INTESTINAL CARCINOID TUMOR-A CASE REPORT

2021 ◽  
pp. 36-37
Author(s):  
B. Santhi ◽  
S. Savitha ◽  
V. G. Vikraman
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Wall Thickening ◽  
Lower Quadrant ◽  
Polypoidal Lesion ◽  
Contrast Enhanced ◽  
Intraluminal Mass ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Carcinoid tumors are neuroendocrine tumours, the most common tumour of the small bowel and its incidence is rising. Most carcinoid tumours grow slowly and mostly asymptomatic or may present with nonspecic abdominal pain or carcinoid syndrome. We had a 38 year old, female patient presented with generalized, intermittent, dull aching abdominal pain accompanied with distension and obstipation for 2 days with associated vomiting. She complained of weight loss and constipation during this period. On examination abdomen showed deep tenderness in periumbilical, right lower quadrant regions. No guarding, rigidity, mass or free uid. On per-rectal examination, there was no tenderness and the rectum was empty. Contrast enhanced computed tomography scan showed enhancing polypoidal lesion noted in distal ileum causing proximal dilatation of small bowel with air uid levels and circumferential wall thickening in dilated ileum proximal to polypoidal lesion, strongly enhancing nodal mass with specs of calcication, multiple mesentric lymph nodes and no liver metastasis. As the conservative management for 48 hours showed no improvement in symptoms, an emergency exploratory laparotomy was performed, and an intraluminal mass was identied from ileocecal junction causing obstruction with dilated loops of ileum and jejunum. Local resection of terminal ileum was performed and a side to side anastomoses was done using GI stapler. Histopathology showed diagnosis of neuroendocrine tumor

scholarly journals An Obstructing Small Bowel Phytobezoar in an Elderly Female Nigerian: A Case Report and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
O. S. Balogun ◽  
A. O. Osinowo ◽  
M. O. Afolayan ◽  
A. A. Adesanya
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Primary Closure ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Elderly Female ◽  
Insidious Onset

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.

scholarly journals SMALL BOWEL DIVERTICULAR DISEASE;

2013 ◽  
Vol 20 (05) ◽  
pp. 776-782
Author(s):  
ANSAR LATIF ◽  
ANILA ANSAR ◽  
MUHAMMAD QASIM BUTT
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Teaching Hospital ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Study Patient ◽  
Military Hospital ◽  
Study Results ◽  
Bleeding Per Rectum

Objectives: 1). To see the prevalence of small bowel diverticulosis in patients presenting with acute abdomen. 2). To knowpresentation and complications of diverticulosis in teaching hospital in Sialkot region of Pakistan. Introduction: Small bowel diverticulardisease may be complicated by small bowel obstruction. Multiple diverticulosis represents an uncommon pathology of the small bowel.Related complications such as diverticulitis, perforation, bleeding or intestinal obstruction, and acute pancreatitis appear in 10-30% ofthe patients, increasing the morbidity and mortality rates. This pathology which is uncommon is much higher in our study in patientsundergoing exploratory laparotomy in district level hospitals in Sialkot region of Pakistan. Study Design: Prospective and observational.Setting and duration: Combined Military Hospital, Sialkot (June 2005 to August 2010). Islam teaching hospital, Sialkot (September 2010to September 2012). Methods: 260 consecutive patients undergoing exploratory laparotomy for obstruction, peritonitis, pain and massabdomen were included in the study. Patient with established cause of obstruction were excluded. The data including demographicinformation, presentation, operative findings, complications and follow up were entered in structured proforma. Patients with less thanthree months of followup were also excluded from study. Results: Small bowel diverticuli were encountered in 24 (9%) out of 260 patientsincluding; 8 (3%) Meckel's, 9 (3.5%) jejunal, 3 (1.2%) duodenal and 4 (1.5%) Ileal diverticuli. These patients with diverticuli presented asintestinal obstruction, peritonitis, mass abdomen, vague abdominal pain and one patient with fresh bleeding per rectum. The indicationsof surgery were peritonitis 6 (25%), intestinal obstruction 13 (54.2%), abdominal mass 3(12.5%), nonspecific abdominal pain 1 (4.2%)and fresh bleeding per rectum of obscure origin 1 (4.2%). Complications encountered as Intestinal obstruction due to adhesion formationin 8; obstruction due to congenital bands attached to diverticuli in 3; diverticular perforation in 2; peritonitis due to diverticulitis in2,bleeding from arteriovenous malformation within the jejuna diverticuli in 1 and mass formation due to volvulus in 1. Three duodenaldiverticuli and 4 jejunal diverticuli were found as silent pathologies synchronous with other active pathologies.

scholarly journals Internal Hernia in Pregnant Woman due to Congenital Transmesenteric Defect

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Yuansheng Xu ◽  
Yi Wang ◽  
Jinyan Fang
Keyword(s):  
Abdominal Pain ◽  
Pregnant Woman ◽  
Small Bowel ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Early Stage ◽  
Left Kidney ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Mesenteric Defect

Congenital transmesenteric hernias are uncommon and are a rare cause of bowel obstruction, which is even rarer in pregnant woman. Because of the lack of specific symptoms or reliable sensitive markers, it is difficult to diagnose internal hernia at early stage, therefore resulting in the delay of surgical intervention and a high mortality rate, especially in pregnant woman. We report a case in which a woman presenting at 16 weeks gestation was admitted with symptoms of nausea, vomiting and left upper abdominal pain similar to her first-trimester morning sickness. Nephrolithiasis of the left kidney detected by ultrasound may lead to early incorrect diagnosis. Due to the patient`s concern about known adverse effects of ionizing radiation on the fetus, computed tomography was postponed until abdominal pain worsened, coffee color gastric contents vomited and anus stopped exhaust and defecation 12 hours later. Low dose CT plain scan showed features of small bowel obstruction by an internal hernia. Emergency exploratory laparotomy revealed a mesenteric defect of the left colon with a 30 cm long jejunal herniating distal to 10 cm of the ligament of Treitz. The involved small bowel was strangulated and gangrened, necrotic segmental resection and end to end anastomosis were performed subsequently, and the mesenteric defect was then successfully repaired with sutures. doi: https://doi.org/10.12669/pjms.37.5.4116 How to cite this:Yuansheng X, Yi W, Jinyan F. Internal Hernia in Pregnant Woman due to Congenital Transmesenteric Defect. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4116 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Supernumerary Remnant Vas Deferens Like Wolffian-Derivatives in a Young Child With Abdominal Cocoon Syndrome—A Clinicopathological Novelty

2021 ◽  
pp. 109352662110016
Author(s):  
Shilpi Agarwal ◽  
Kavita Gaur ◽  
Nikita Agrawal ◽  
Archana Puri
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Young Child ◽  
Intestinal Obstruction ◽  
Vas Deferens ◽  
Exploratory Laparotomy ◽  
Abdominal Cocoon ◽  
Ductus Deferens ◽  
Pediatric Subject ◽  
Documented Case

The abdominal cocoon syndrome is a rare cause of recurring intestinal obstruction in children. It refers to encasement of the small bowel by a fibrocollagenous membrane forming a cocoon. We report a nine year old male presenting with abdominal pain, distension, bilious vomiting and inability to pass stool and flatus for two days. In view of a persistently increasing bilious nasogastric output, an urgent exploratory laparotomy was performed. The small bowel loops were matted together forming a cocoon densely adherent to the parietal peritoneum with supra-colic fibrous bands. The bands histologically displayed multiple ductal remnants with epithelium resembling that of ductus deferens. These structures showed immunopositivity for pan-cytokeratin and basal CD10.Workup for tuberculosis and other etiological causes was unremarkable. This is the first documented case of abdominal cocoon in a pediatric subject associated with supernumerary wolffian remnants.

scholarly journals Biofilm-sealed perforation of the gastric body: a rare sequela of gastric band erosion

2019 ◽  
Vol 2019 (9) ◽  
Author(s):  
Ciaran M Hurley ◽  
Daniel Hechtl ◽  
Kin Cheung Ng ◽  
Jack McHugh ◽  
Rishabh Sehgal ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Gastric Banding ◽  
Gastric Band ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Gastric Body ◽  
Gastric Erosion ◽  
Band Erosion ◽  
History Of

Abstract Laparoscopic Adjustable Gastric Banding is one of the cardinal bariatric interventions and due to its early safety profile, became the mainstay. Major long-term complications of gastric banding include pouch-herniation-dilation and gastric erosion. A 59-year-old female presented to the emergency department with a 2-week history of progressive central abdominal pain and distention on a background history of a laparoscopic adjustable band insertion 11 years previously. Subsequent computed tomography demonstrated an intragastric band erosion. An exploratory laparotomy demonstrated a gastric band eroded through the stomach sealed by a biofilm. Secondary findings included small bowel ischemia and portal vein thrombosis. The gastric band was extracted, and the stomach was repaired. The ischemic small bowel was resected with primary anastomosis. The patient recovered uneventfully. Gastric band erosion should be considered in all patients presenting with abdominal pain and previous weight loss surgery. Prompt recognition may avoid fatal consequences.

scholarly journals Churg-Strauss Syndrome Leading to Small Bowel Infarction: An Unusual Case of Abdominal Pain in a Young Patient

1998 ◽  
Vol 12 (3) ◽  
pp. 219-222 ◽  
Author(s):  
Sunil Sookram ◽  
Camille Hancock-Friesen ◽  
JP Ferguson ◽  
Terry Sosnowski ◽  
Laurie JM Russell
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Bowel Infarction ◽  
Churg Strauss Syndrome ◽  
Entire Small Bowel ◽  
History Of ◽  
Strauss Syndrome ◽  
Small Bowel Infarction ◽  
Churg Strauss

A 33-year-old man with a history of severe asthma presented to the emergency department with a week-long history of severe unrelenting abdominal pain, nausea and decreased appetite. He was admitted to hospital, and routine gastrointestinal investigations were performed, which did not elucidate the cause of his abdominal pain. Exploratory laparotomy demonstrated patchy infarction of the entire small bowel, characteristic of Churg-Strauss syndrome. The patient subsequently underwent 12 separate laparotomies to salvage surviving small bowel. The patient is maintained on total parenteral nutrition.

scholarly journals Bowel perforation presenting with acute abdominal pain and subcutaneous emphysema in a 14-year-old girl with an abandoned distal peritoneal shunt catheter: case report

2016 ◽  
Vol 18 (3) ◽  
pp. 325-328 ◽  
Author(s):  
Gerald J. Riccardello ◽  
Luke K. Barr ◽  
Luigi Bassani
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Subcutaneous Emphysema ◽  
Bowel Resection ◽  
Bowel Perforation ◽  
Complete Removal ◽  
Exploratory Laparotomy ◽  
Small Bowel Resection ◽  
Retained Catheter ◽  
History Of

The authors report the case of 14-year-old girl with a history of myelomeningocele and previously shunt-treated hydrocephalus who presented with right-sided abdominal pain and subcutaneous emphysema that developed over a 1-week period. A CT scan of the patient's abdomen revealed a retained distal ventriculoperitoneal (VP) catheter with air tracking from the catheter to the upper chest wall. Given the high suspicion of the catheter being intraluminal, an exploratory laparotomy was performed and revealed multiple jejunal perforations. The patient required a partial small-bowel resection and reanastomosis for complete removal of the retained catheter. Six other similar cases of bowel perforation occurring in patients with abandoned VP and subdural-peritoneal shunts have been reported. The authors analyzed these cases with regard to age of presentation, symptomatic presentation, management, morbidity, and mortality. While there was 0% mortality associated with bowel perforation secondary to a retained distal VP catheter, the morbidity was significantly high and included peritonitis and small bowel resection.

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.

Lockdown dilemma: ingestion of magnetic beads presenting as right iliac fossa pain and subacute small bowel obstruction

2020 ◽  
Vol 13 (11) ◽  
pp. e236429
Author(s):  
Bankole Oyewole ◽  
Anu Sandhya ◽  
Ian Maheswaran ◽  
Timothy Campbell-Smith
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Magnetic Beads ◽  
Iliac Fossa ◽  
Serous Fluid ◽  
Magnetic Resonance Scan ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Multiple Episodes ◽  
Safety Netting

A 13-year-old girl presented with a 3-day history of migratory right iliac fossa pain. Observations and inflammatory markers were normal, and an ultrasound scan was inconclusive. A provisional diagnosis of non-specific abdominal pain or early appendicitis was made, and she was discharged with safety netting advice. She presented again 6 days later with ongoing abdominal pain now associated with multiple episodes of vomiting; hence, the decision was made to proceed to diagnostic laparoscopy rather than a magnetic resonance scan for further assessment. Intraoperative findings revealed 200 mL of serous fluid in the pelvis, normal-looking appendix, dilated stomach and a tangle of small bowel loops. Blunt and careful dissection revealed fistulous tracts that magnetised the laparoscopic instruments. A minilaparotomy was performed with the extraction of 14 magnetic beads and the repair of nine enterotomies. This case highlights the importance of careful history taking in children presenting with acute abdominal pain of doubtful aetiology.

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