scholarly journals Chylous Ascites Accompanying Internal Hernia after Total Gastrectomy with Roux-en-Y Reconstruction

2019 ◽  
Vol 13 (3) ◽  
pp. 481-486
Author(s):  
Ryota Koyama ◽  
Yoshiaki Maeda ◽  
Nozomi Minagawa ◽  
Toshiki Shinohara ◽  
Tomonori Hamada
Keyword(s):  
Internal Hernia ◽  
Esophagogastric Junction ◽  
Intestinal Resection ◽  
Chylous Ascites ◽  
Defect Closure ◽  
Mesenteric Defect ◽  
Esophagogastric Junction Cancer ◽  
History Of ◽  
Reliable Sign

We report the case of a 69-year-old man with a history of esophagogastric junction cancer (Barrett’s esophageal cancer; pT1b [SM], N0, M0, pStage IA) that was surgically resected 2 years prior to the present episode. Recurrence was not observed during follow-up. Following complaints of dysphagia and abdominal pain, computed tomography revealed signs of internal hernia. Thus, laparoscopic exploration was performed. Intraoperatively, accumulation of chylous ascites accompanying the internal hernia through the jejunojejunostomy mesenteric defect was observed, which was successfully treated with laparoscopic hernia reduction and defect closure by sutures without intestinal resection. Here, we discuss the case and report that along with previous studies, our study suggests that chylous ascites might be a reliable sign of intestinal viability for herniated intestines.

Obesity is a risk factor for internal hernia after laparoscopic or robot-assisted gastrectomy with mesenteric defect closure for gastric cancer

2019 ◽  
Vol 34 (1) ◽  
pp. 436-442 ◽  
Author(s):  
Tetsuro Toriumi ◽  
Rie Makuuchi ◽  
Satoshi Kamiya ◽  
Yutaka Tanizawa ◽  
Etsuro Bando ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Internal Hernia ◽  
Defect Closure ◽  
Mesenteric Defect ◽  
Robot Assisted

scholarly journals Intestinal intussusception and occlusion caused by small bowel polyps in the Peutz-Jeghers syndrome. Management by combined intraoperative enteroscopy and resection through minimal enterostomy: case report

2000 ◽  
Vol 55 (6) ◽  
pp. 219-224 ◽  
Author(s):  
Joaquim J. Gama-Rodrigues ◽  
José Hyppolito da Silva ◽  
Adilson A. Aisaka ◽  
Ricardo Jureidini ◽  
Renato Falci Júnior ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Surgical Intervention ◽  
Intestinal Resection ◽  
Hereditary Disease ◽  
Secondary Complications ◽  
Surgical Interventions ◽  
History Of ◽  
Peutz Jeghers Syndrome

The Peutz-Jeghers syndrome is a hereditary disease that requires frequent endoscopic and surgical intervention, leading to secondary complications such as short bowel syndrome. CASE REPORT: This paper reports on a 15-year-old male patient with a family history of the disease, who underwent surgery for treatment of an intestinal occlusion due to a small intestine intussusception. DISCUSSION: An intra-operative fiberscopic procedure was included for the detection and treatment of numerous polyps distributed along the small intestine. Enterotomy was performed to treat only the larger polyps, therefore limiting the intestinal resection to smaller segments. The postoperative follow-up was uneventful. CONCLUSION: We point out the importance of conservative treatment for patients with this syndrome, especially those who will undergo repeated surgical interventions because of clinical manifestation while they are still young.

scholarly journals PENILE PARAFFINOMA RECONSTRUCTION WITH SCROTAL FLAP AND SURGICAL OUTCOME: A CASE REPORT

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Ida Bagus Oka Widya Putra ◽  
Irfan Wahyudi ◽  
Arry Rodjani
Keyword(s):  
Liquid Paraffin ◽  
Good Choice ◽  
Defect Closure ◽  
Penile Shaft ◽  
Complete Excision ◽  
Case Presentation ◽  
One Stage ◽  
History Of ◽  
Surrounding Skin

Objective: To present a case of penile paraffinoma reconstructed with scrotal flap. Case presentation: We report a case of 33-year-old male patient with penile paraffinoma. The patient had a history of injecting liquid paraffin into his penis two times – at 6 months and 2 months prior to his admission to the hospital. His IIEF-5 was 10 (moderate erectile dysfunction). The penile shaft was circumferentially enlarged. There was ulceration on the ventral aspect with signs of inflammation on the surrounding skin. Discussion: We perform a complete excision of paraffinoma. The raw surface was repaired with a one-stage scrotal flap. At six-month follow up, the wound was good, and the patient was able to micturate normally. He was able to achieve painless erection, and IIEF-5 score was improved. Conclusion: A one-stage scrotal flap may offer a good choice in defect closure in penile paraffinoma reconstruction.

scholarly journals Laparoscopic Reduction and Closure of an Internal Hernia Secondary to Gynecologic Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor
Keyword(s):  
Bowel Obstruction ◽  
Internal Hernia ◽  
Intestinal Resection ◽  
Gynecologic Surgery ◽  
Pelvic Cavity ◽  
Continuous Suture ◽  
Definitive Therapy ◽  
History Of ◽  
Emergent Surgery ◽  
Tomography Scan

Internal hernia is a rare cause of bowel obstruction which often requires emergent surgery. In general, the preoperative diagnosis of internal hernia is difficult. The pelvic cavity has various spaces with the potential to result in a hernia, especially in females. In this report, we describe a patient with an internal hernia secondary to previous gynecologic surgery. A 49-year-old woman presented with acute abdominal pain and a history of previous right oophorectomy for a benign ovarian cyst. Computed tomography scan of the abdomen showed obstruction with strangulation and emergent laparoscopic exploration was performed. Intraoperatively, there was an incarcerated internal hernia in the pelvis, located in the vesicouterine pouch, which was reduced. The orifice of the hernia was a 2 cm defect caused by adhesions between the uterus and bladder. The defect was closed with a continuous suture. The herniated bowel was viable, and the operation was completed without intestinal resection. She was discharged four days after surgery without complications. Laparoscopy is useful to diagnose bowel obstruction in selected patients and may also be used for definitive therapy. It is important to understand pelvic anatomy and consider an internal hernia of the pelvic cavity in females, in the differential diagnosis of bowel obstruction, especially those with a history of gynecological surgery.

scholarly journals Efficacy of early intervention on the bowel damage and intestinal surgery of Crohn’s disease, based on the Lémann index

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mingming Zhu ◽  
Qi Feng ◽  
Xitao Xu ◽  
Yuqi Qiao ◽  
Zhe Cui ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Early Intervention ◽  
Crohn's Disease ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Intestinal Surgery ◽  
History Of ◽  
Disease Behavior ◽  
The Impact

Abstract Background Clinicians aim to prevent progression of Crohn’s disease (CD); however, many patients require surgical resection because of cumulative bowel damage. The aim of this study was to evaluate the impact of early intervention on bowel damage in patients with CD using the Lémann Index and to identify bowel resection predictors. Methods We analyzed consecutive patients with CD retrospectively. The Lémann Index was determined at the point of inclusion and at follow-up termination. The Paris definition was used to subdivide patients into early and late CD groups. Results We included 154 patients, comprising 70 with early CD and 84 with late CD. After follow-up for 17.0 months, more patients experienced a decrease in the Lémann Index (61.4% vs. 42.9%), and fewer patients showed an increase in the Lémann Index (20% vs. 35.7%) in the early compared with the late CD group. Infliximab and other therapies reversed bowel damage to a greater extent in early CD patients than in late CD patients. Twenty-two patients underwent intestinal surgery, involving 5 patients in the early CD group and 17 patients in the late CD group. Three independent predictors of bowel resection were identified: baseline Lémann index ≥ 8.99, disease behavior B1, and history of intestinal surgery. Conclusions Early intervention within 18 months after CD diagnosis could reverse bowel damage and decrease short-term intestinal resection. Patients with CD with a history of intestinal surgery, and/or a Lémann index > 8.99 should be treated aggressively and monitored carefully to prevent progressive bowel damage.

Twelve-year natural history of early esophagogastric junction cancer in an extremely old patient

2018 ◽  
Vol 18 (12) ◽  
pp. 1648-1649 ◽  
Author(s):  
Mitsuhiro Nikaido ◽  
Shin'ichi Miyamoto ◽  
Takeshi Setoyama ◽  
Yuki Yamauchi ◽  
Hiroshi Seno
Keyword(s):  
Natural History ◽  
Esophagogastric Junction ◽  
Esophagogastric Junction Cancer ◽  
History Of

scholarly journals Internal Hernia After One Anastomosis Gastric Bypass (OAGB): Lessons Learned from a Retrospective Series of 3368 Consecutive Patients Undergoing OAGB with a Biliopancreatic Limb of 150 cm

2021 ◽  
Author(s):  
Niccolo Petrucciani ◽  
Francesco Martini ◽  
Radwan Kassir ◽  
Gildas Juglard ◽  
Celine Hamid ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Internal Hernia ◽  
Intestinal Resection ◽  
High Volume ◽  
Lessons Learned ◽  
One Anastomosis Gastric Bypass ◽  
Morbidity Rate ◽  
Specificity And Sensitivity ◽  
Biliopancreatic Limb ◽  
History Of

Abstract Background Internal hernia (IH) represents a relatively common and well-known complication after Roux-en-Y gastric bypass. IH after one anastomosis gastric bypass (OAGB) is less frequent and rarely reported in the literature. This study presents a series of IH after OAGB observed in a high-volume bariatric center. Methods Data of patients who underwent OAGB with an afferent limb of 150 cm between May 2010 and September 2019 were prospectively collected and retrospectively analyzed. Data of patients undergoing surgery for IH during follow-up were collected and analyzed. Results Ninety-six patients out of 3368 with a history of OAGB had intestinal incarceration in the Petersen’s orifice (2.8%). Specificity and sensitivity of computed tomography scans in the diagnosis of IH were 59% and 76%, respectively. The mean timeframe between OAGB and surgery for IH was 21.9±18.3 months. Mean body mass index at the time of IH surgery was 24.7 ± 3.6. Surgery was completed laparoscopically in 96.8% of cases. Nine patients (9.3%) had signs of bowel hypovascularization. In all patients, the herniated bowel was repositioned, and the Petersen’s orifice was closed, without the need for bowel resection. Mean hospital stay was 1.9 ± 4.8 days. The postoperative morbidity rate was 8.3%. Long-term IH relapse was observed in 14 patients; signs of bowel hypovascularization due to incarceration in a small orifice was observed in eight of these patients (57%). Conclusions Incidence of IH after OAGB is 2.8%. IH is associated with a low rate of bowel ischemia and the need for intestinal resection.

Evidence in Follow-up and Prognosis of Esophagogastric Junction Cancer

2019 ◽  
Vol 97 (8) ◽  
pp. 465-469
Author(s):  
Lourdes Sanz Álvarez ◽  
Estrella Turienzo Santos ◽  
José Luis Rodicio Miravalles ◽  
María Moreno Gijón ◽  
Sonia Amoza Pais ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Esophagogastric Junction Cancer
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