Less Common Nontraumatic Bowel Perforations: Diagnosis and Management through a Retrospective Study

2013 ◽  
Vol 79 (4) ◽  
pp. 381-387 ◽  
Author(s):  
Stavros Gourgiotis ◽  
Nikolaos Liakos ◽  
George Gemenetzis ◽  
Charalampos Seretis ◽  
Stavros Aloizos ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bowel Perforation ◽  
Abdominal Radiograph ◽  
Emergency Laparotomy ◽  
Spontaneous Perforation ◽  
Computed Tomography Scan ◽  
Common Cause ◽  
Mortality And Morbidity ◽  
Diagnosis And Management ◽  
Tomography Scan

Nontraumatic bowel perforation has always been a consideration because of associated morbidity and mortality. The aim of this study is to define etiologies, treatment, and outcomes as well as to highlight difficulties in the diagnosis and management of nontraumatic bowel perforation. We conducted a retrospective study of 35 patients with less common nontraumatic bowel perforations hospitalized during a six-year period. The most common cause was ulcerative colitis (34.3%). Abdominal pain was the constant symptom. Physical examination showed signs of peritoneal irritation in 29 cases. The abdominal radiograph failed to reveal abnormal findings in two patients; the abdominal computed tomography scan confirmed the diagnosis in all cases. Twenty patients (57.1%) were operated on within 24 hours of developing perforation, whereas seven patients (20%) were initially misdiagnosed. Most of the perforations were located only in the large intestine (60%). There was only one perforation in 25 patients (71.5%) and two or more perforations in 10 patients (28.5%). Many less common diseases are responsible for the spontaneous perforation of the bowel. Early diagnosis before the patient's general condition deteriorates decreases mortality and morbidity rates. Adequate resuscitation and emergency laparotomy followed by resection with or without anastomosis remains the treatment of choice.

An Infant with COVID-19-Associated Intussusception

2021 ◽  
pp. 000313482110474
Author(s):  
Gwyneth A. Sullivan ◽  
Nicholas J. Skertich ◽  
Kody B. Jones ◽  
Michael Williams ◽  
Brian C. Gulack ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Lymphoid Hyperplasia ◽  
Computed Tomography Scan ◽  
Ileocolic Intussusception ◽  
Common Cause ◽  
Caregiver Education ◽  
Intermittent Abdominal Pain ◽  
The Right ◽  
Tomography Scan

Intussusception is the most common cause of bowel obstruction in infants four to ten months old and is commonly idiopathic or attributed to lymphoid hyperplasia. Our patient was a 7-month-old male who presented with two weeks of intermittent abdominal pain associated with crying, fist clenching and grimacing. Ultrasound demonstrated an ileocolic intussusception in the right abdomen. Symptoms resolved after contrast enemas, and he was discharged home. He re-presented similarly the next day and was found to be COVID-19 positive. Computed tomography scan demonstrated a left upper quadrant ileal-ileal intussusception. His symptoms spontaneously resolved, and he was discharged home. This suggests that COVID-19 may be a cause of intussusception in infants, and infants presenting with intussusception should be screened for this virus. Additionally, recurrence may happen days later at different intestinal locations. Caregiver education upon discharge is key to monitor for recurrence and need to return.

scholarly journals Pneumoretroperitoneum and Pneumomediastinum Revealing a Left Colon Perforation

2015 ◽  
Vol 100 (6) ◽  
pp. 984-988 ◽  
Author(s):  
Giulia Montori ◽  
Giacomo Di Giovanni ◽  
Zeineb Mzoughi ◽  
Cedric Angot ◽  
Sophie Al Samman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Laboratory ◽  
Left Thigh ◽  
Left Colon ◽  
Colon Perforation ◽  
Emergency Laparotomy ◽  
Computed Tomography Scan ◽  
End Colostomy ◽  
Retroperitoneal Perforation ◽  
Tomography Scan

Left colon perforation usually occurs in complicated diverticulitis or cancer. The most frequent signs are intraperitoneal abscess or peritonitis. In cases of retroperitoneal colonic perforation, diagnosis may be difficult. A 59-year-old woman presented with left thigh pain and with abdominal discomfort associated with mild dyspnea. Computed tomography scan showed air bubbles and purulent collection in the retroperitoneum, with subcutaneous emphysema extending from the left thigh to the neck. Computed tomography scan also revealed portal vein gas and thrombosis with multiple liver abscesses. An emergency laparotomy revealed a perforation of the proximal left colon. No masses were found. A left colectomy was performed. The retroperitoneum was drained and washed extensively. A negative pressure wound therapy was applied. A second-look laparotomy was performed 48 hours later. The retroperitoneum was drained and an end colostomy was performed. Intensive Care Unit postoperative stay was 9 days, and the patient was discharged on the 32nd postoperative day. Pneumoretroperitoneum and pneumomediastinum are rare signs of colonic retroperitoneal perforation. The diagnosis may be delayed, especially in the absence of peritoneal irritation. Clinical, laboratory, and especially radiologic parameters might be useful. Surgical treatment must be prompt to improve prognosis.

scholarly journals Complete sigmoid colon erosion by an intrauterine contraception device in an ectopic pregnancy: a case report

2021 ◽  
Vol 13 (3) ◽  
pp. 283
Author(s):  
Chuah Jun Sen ◽  
Nur Hayati Abd Samad ◽  
Tan Jih Huei ◽  
Lee Ee Peng
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Planning ◽  
Ectopic Pregnancy ◽  
Sigmoid Colon ◽  
Bowel Perforation ◽  
Abdominal Radiograph ◽  
Emergency Laparotomy ◽  
Contraceptive Device ◽  
Primary Health

ABSTRACT INTRODUCTIONAn intrauterine contraceptive device (IUCD) is a common contraception method used for family planning. IUCD erosion into adjacent organs is a rare but serious complication of IUCD use. CASE PRESENTATIONA 41-year-old female presented to us with a leaking left ectopic pregnancy. Emergency laparotomy and left salpingectomy were performed. A copper ICUD was found intraperitoneally and part of it had completely eroded into the sigmoid colon. Sigmoid colotomy was performed and the IUCD was removed successfully. Further history revealed that the patient had her IUCD inserted 12 years previously but was forgotten. The patient was discharged well after 4 days of admission. DISCUSSIONErosion of an IUCD into the colon is uncommon and may be asymptomatic or present with bowel perforation and obstruction. There should be a high index of suspicion for pregnancy occurring among women post-IUCD insertion. A misplaced IUCD can cause chronic inflammation of the fallopian tube, which may alter tubal functionality and increase the risk of ectopic pregnancy. Family planning is commonly done in primary health care. Primary care education and counselling are essential to improve awareness of fertile women to prevent similar complications. Periodic examination of IUCD string either by users or primary health-care practitioners is crucial. Ultrasound can be advocated if there are difficulties with the insertion. An abdominal radiograph is useful and should be performed in the case of missing IUCDs.

scholarly journals Acute Small Bowel Perforation Caused by Obstruction of a Novel Tag-Less AgileTM Patency Capsule

2018 ◽  
Vol 12 (2) ◽  
pp. 337-343 ◽  
Author(s):  
Katsuji Sawai ◽  
Takanori Goi ◽  
Yumi  Takegawa ◽  
Yoshihiko Ozaki ◽  
Seiichi  Taguchi ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Pathological Examination ◽  
Small Bowel Perforation ◽  
Computed Tomography Scan ◽  
Patency Capsule ◽  
Severe Peritonitis ◽  
Transmural Inflammation ◽  
Multiple Ulcers ◽  
Tomography Scan

A 74-year-old man visited our hospital complaining of abdominal pain. An abdominal computed tomography scan showed multiple wall thickness of the small bowel. Capsule endoscopy was recommended for further evaluation, and patency capsule examination was performed. Eighteen hours after patency capsule ingestion, he experienced small bowel perforation with severe peritonitis caused by intestinal pressure rising because of the patency capsule trapped in his terminal ileum. An ileocolic resection was performed, including the removal of the sclerotic ileum as an emergency surgery. A pathological examination showed transmural inflammation and multiple ulcers with perforation of the small intestine, consistent with Crohn’s disease. Here, we report a rare and valuable case of novel tag-less AgileTM patency capsule (Given Imaging Ltd., Yoqneam, Israel) retention leading to small bowel perforation.

scholarly journals Characterization of Cystic Lesions of Pancreas by Computed Tomography Scan- A Retrospective Study

2020 ◽  
Vol 9 (10) ◽  
pp. 726-730
Author(s):  
Rajoo Ramachandran ◽  
Kumaresh Athiyappan ◽  
Prabhu Radhan Radhakrishnan ◽  
Ananda Kumar Balasubramanian
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Cystic Lesions ◽  
Computed Tomography Scan ◽  
Tomography Scan

scholarly journals Traumatic shock and altered mentality following motor vehicle accident

2020 ◽  
pp. 102490792091365
Author(s):  
Youngeun Park ◽  
Byungchul Yu ◽  
Giljae Lee ◽  
Jungnam Lee
Keyword(s):  
Computed Tomography ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Traumatic Shock ◽  
Diagnostic Methods ◽  
Computed Tomography Scan ◽  
Mortality And Morbidity ◽  
Vehicle Accident ◽  
Tomography Scan ◽  
Significant Mortality

Traumatic atlanto-occipital dislocation is associated with significant mortality and morbidity. We present an 18-year-old female who visited the emergency department after a motor vehicle accident. A cervical spine computed tomography scan showed the postero-inferior atlanto-occipital dissociation and several diagnostic methods coincided with the diagnosis of atlanto-occipital dislocation.

scholarly journals Small bowel perforation after low-velocity trauma: a case report

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
S Sinz ◽  
L Benigno ◽  
M A Zadnikar ◽  
M E Biraima-Steinemann
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Diagnostic Laparoscopy ◽  
Bowel Perforation ◽  
Small Bowel Perforation ◽  
Computed Tomography Scan ◽  
Low Velocity ◽  
Tomography Scan

Abstract We report the case of a 63-year-old patient with a low-velocity abdominal trauma and bowel perforation. The patient slipped on a wet floor and fell down the stairs. On admission, the patient complained about abdominal pain. A computed tomography scan showed traumatic hematoma of the jejunum in the left upper quadrant and a small amount of intra-abdominal air. Also rib fractures on the left side were diagnosed. We performed a diagnostic laparoscopy and found a bowel perforation, which was manually repaired.

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