B-Lymphoblastic Lymphoma of the Small Bowel: An Extremely Rare Occurrence

B-lymphoblastic lymphoma is a neoplasm of immature B cells and is characterized by aggressive behavior and disease progression. Common sites of involvement are skin, lymph nodes, bone, soft tissues, breast, and the mediastinum. Gastrointestinal lesions are rarely encountered and therefore not fully described. We herein report the case of a 28-year-old male, who presented with abdominal pain and CT scan showed a tumor involving the small bowel and its mesentery. He underwent emergency laparotomy and enterectomy. Histopathology report revealed B-lymphoblastic lymphoma affecting the small bowel and the adjacent mesentery. This is the first documented case of a small bowel tumor diagnosed as B-lymphoblastic lymphoma in published literature.

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Incarcerated Lumbar Hernia Complicated by Retroperitoneal Pseudoaneurysm 50 Years after Resection and Radiation Therapy of a Sarcoma

Case Reports in Surgery ◽

10.1155/2019/1072821 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Oluwatobi Onafowokan ◽

Dabanjan Bandyopadhyay ◽

Dale Johnson ◽

Hugo J. R. Bonatti

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Ct Scan ◽

Late Complication ◽

Abdominal Hernia ◽

Emergency Laparotomy ◽

Incisional Hernias ◽

History Of ◽

The Right

Background. Lumbar hernias are rare abdominal hernias. Surgery is the only treatment option but remains challenging. Posterior incisional hernias are even rarer especially with incarceration of intra-abdominal contents.Case Presentation. A 68-year old female presented with a 3-day history of worsening acute abdominal pain and distension, with multiple episodes of emesis. A CT scan indicated a large incarcerated posterolateral abdominal hernia. The patient had a history of resection of a sarcoma on her back as a child and also received chemotherapy and radiation. During emergency laparoscopy, a hemorrhagic small bowel segment incarcerated in the hernia was reduced and resected, and the distended small bowel was decompressed. An elective hernia repair was scheduled. After temporary clinical improvement, the patient again developed abdominal pain, distention, and emesis. During emergency laparotomy, a large hematoma in the right flank was found and partially evacuated. The right colon was mobilized out of the hernia and the duodenum was kocherized. A20×20cm BIO-A mesh was placed on top of the Gerota fascia and cranially tucked under liver segment VI. Anteriorly, the mesh was fixated with absorbable tacks. The duodenum and colon were placed into the mesh pocket. A postoperative CT scan identified a 2 cm pseudoaneurysm of a side branch of a lumbar artery, and the bleeding source was embolized. The postoperative course was complicated byClostridium difficile-associated colitis, but ultimately, the patient recovered fully. At 6-month follow-up, there was no evidence for a recurrent hernia.Discussion. There is a paucity of literature concerning lumbar incisional hernias. Repair with bioabsorbable mesh seems feasible, but longer follow-up is necessary as the mesh was placed in an unusual fashion due to the retroperitoneal hematoma. The exact cause of the hemorrhage is unclear and may have been caused during the initial incarceration, during surgery, or may be a late complication of her previous radiation.

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Precursor B Lymphoblastic Lymphoma Involving the Stomach

Case Reports in Gastrointestinal Medicine ◽

10.1155/2013/930918 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Masaya Iwamuro ◽

Yoshinari Kawai ◽

Yasuhide Yamawaki ◽

Katsuyoshi Takata ◽

Kazuhide Yamamoto

Keyword(s):

Bone Marrow ◽

B Cell ◽

Cell Lineage ◽

Lymphoblastic Lymphoma ◽

High Grade ◽

Gastrointestinal Lesions ◽

B Lymphoblastic Lymphoma

Precursor B lymphoblastic lymphoma is a high-grade neoplasm arising from precursor lymphocytes of B-cell lineage. Extranodal sites such as the skin and bone are often involved, but gastrointestinal lesions of this disease are rarely encountered. Due to the infrequency, macroscopic forms of the gastrointestinal lesions have not been fully described. In this report, we present a case of precursor B lymphoblastic lymphoma involving the stomach, pancreas, bone, and bone marrow. Esophagogastroduodenoscopy showed multiple flat elevated lesions with irregular mucosa in the stomach.

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“Meckel’s Diverticulum” – A diagnostic bizarre of abdominal pain in adults

10.25259/aujmsr_2_2020 ◽

2020 ◽

Vol 2 ◽

pp. 58-60

Author(s):

Vipin Kumar Bakshi ◽

Manjot Kaur ◽

Gajendra Bhatti

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Wall Thickening ◽

Emergency Laparotomy ◽

Contrast Enhanced ◽

Antimesenteric Border ◽

Meckel’S Diverticulitis ◽

Bowel Wall Thickening ◽

Subacute Intestinal Obstruction ◽

Enhanced Computed Tomography

A 30-year-old male presented to the emergency room with complaints of periumbilical abdominal pain and vomiting. A contrast-enhanced computed tomography scan of the abdomen revealed subacute intestinal obstruction with dilated small bowel loops and associated bowel wall thickening of mid and distal ileal bowel loops. There was a fairly large small bowel diverticulum arising from the antimesenteric border of distal ileum. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable post-operative course without any complications and was discharged within a week.

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Concurrent intestinal malrotation and Meckel's diverticulum presenting as acute intestinal obstruction in an adult

International Surgery Journal ◽

10.18203/2349-2902.isj20212288 ◽

2021 ◽

Vol 8 (6) ◽

pp. 1904

Author(s):

Aishwarya Emerald Manohar ◽

M. S. Kalyan Kumar ◽

V. Vijayalakshmi ◽

R. Kannan

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Intestinal Obstruction ◽

Meckel’S Diverticulum ◽

Postoperative Recovery ◽

Meckel's Diverticulum ◽

Intestinal Malrotation ◽

Emergency Laparotomy ◽

Meckel’S Diverticulitis ◽

Subacute Intestinal Obstruction

Intestinal malrotation is the partial or complete failure of rotation of midgut around the superior mesenteric artery, while Meckel’s diverticulum is the remnant of vitellointestinal duct and concurrence of these congenital abnormalities in an adult is considered a rarity. Till date only 3 cases of concurrent intestinal malrotation and Meckel's diverticulum have been reported. We report a 18 years male who presented with a 3 day history of abdominal pain, bilious vomiting, obstipation and chronic abdominal pain on and off since 3 years of age. During the last episode which occurred 1 year back, he was diagnosed with intestinal malrotation with subacute intestinal obstruction and was treated conservatively. Examination revealed the presence of signs of peritonitis. After resuscitation, CECT abdomen was taken which showed dilated small bowel loops in the subhepatic region associated with malrotation. Emergency laparotomy revealed a Ladd's band below which the gangrenous small bowel loops 150 cm from the duodenojejunal (flexure until 5 cm proximal to the ileocecal junction) were found herniating into the subhepatic region with a Meckel’s diverticulum and a right sided DJ flexure. We proceeded with the band release and resection of gangrenous bowel followed by proximal jejunostomy with distal ileostomy. HPE was consistent with Meckel’s diverticulitis without any ectopic gastric or pancreatic mucosa. Ostomy reversal was done after 8 weeks. Patient had an uneventful postoperative recovery during both the admissions and he is on regular follow-up now.

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A Rare Cause of Abdominal Pain in Adults: Meckel’s Diverticulitis

Case Reports in Gastroenterology ◽

10.1159/000494752 ◽

2018 ◽

Vol 12 (3) ◽

pp. 709-714 ◽

Cited By ~ 3

Author(s):

Usman Pirzada ◽

Hassan Tariq ◽

Sara Azam ◽

Kishore Kumar ◽

Anil Dev

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Emergency Laparotomy ◽

Contrast Enhanced ◽

Meckel’S Diverticulitis ◽

The Right ◽

Enhanced Computed Tomography

A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel’s diverticulum scan was diagnostic of Meckel’s diverticulum. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable postoperative course without any complications and was discharged within 10 days. At the 3-month follow-up, the patient was well and remained asymptomatic.

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Positive diagnosis in the small bowel tumor

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2016.2.7 ◽

2016 ◽

Vol 11 (2) ◽

pp. 143-146

Author(s):

Ramona CADAR ◽

◽

Dumitru MATEI ◽

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Ct Scan ◽

Intestinal Tract ◽

Upper Endoscopy ◽

Small Bowel Tumor ◽

X Ray ◽

Positive Diagnosis ◽

Gastro Intestinal Tract ◽

Selection Of

The small bowel tumor diagnosis is often late, in the course of this affection, which is explained by the low number of tumors and crude symptomatology (abdominal pain, wight loss, queasiness, vomit, ocult bleeding of gastro-intestinal tract). There is no unique investigation method of the small bowel for patient suspect of SMT. Choices are either X-ray (CT-scan, enteroclysis etc.) or endoscopic (upper endoscopy, wireless video endoscopy etc.). It has not been decided upon the best strategy or the series of investigations. The patient usually requires full imagistic explorations; laparotomy being sometimes useful in the selection of a positive diagnosis.

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Schistosomal Peritonitis Presenting as Acute Abdomen: A Case Report

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v29i6.17 ◽

1970 ◽

Vol 29 (6) ◽

Author(s):

Kirubel Abebe ◽

Abebe Megersa ◽

Engida Abebe

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Small Bowel ◽

Lymph Nodes ◽

Acute Abdomen ◽

Emergency Laparotomy ◽

Atypical Presentation ◽

Granulomatous Disease ◽

Recent Onset ◽

History Of

Background-Schistosomiasis is a trematode infestation causing a chronic granulomatous disease in various organs. Both S. mansoni & S. haematobium are endemic in Ethiopia. Most infected individuals are asymptomatic. Ectopic schistosomiasis can affect the lungs, genitalia, CNS, skin, peritoneum, Lymph nodes & other organs. Schistosomiasis as a cause of acute abdomen is seldom reported.Case Detail-A 51years -old male Ethiopian farmer presented with a two weeks history of abdominal pain with recent onset bilious vomiting and abdominal distention. Emergency laparotomy done & the finding was multiple tiny whitish nodule over the peritoneum & small bowel with multiple mesenteric lymphadenopathy. The diagnosis was confirmed with histopathology study.Conclusions- Schistosomal peritonitis is a very uncommon form of schistosomiasis. Physicians should be aware of such atypical presentation in patients from endemic areas of schistosomiasis. And biopsy should be considered in unsettled forms of peritonitis during laparotomy. The pathogenesis is not well known which warrants further study.

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Primary Segmental Small Bowel Volvulus in an Adolescent Female

European Journal of Pediatric Surgery Reports ◽

10.1055/s-0041-1735808 ◽

2021 ◽

Vol 09 (01) ◽

pp. e76-e79

Author(s):

Friederike Heidtmann ◽

Felicitas Eckoldt ◽

Hans-Joachim Mentzel ◽

Ilmi Alhussami

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Bowel Obstruction ◽

Clinical Presentation ◽

Emergency Laparotomy ◽

Small Bowel Volvulus ◽

Delay In Diagnosis ◽

Bowel Segment ◽

Necrotic Bowel ◽

Underlying Pathology

AbstractSmall bowel volvulus is a rare but important cause of abdominal pain and small bowel obstruction in children and adults. In the neonate, small bowel volvulus is a well-known complication of malrotation. Segmental small bowel volvulus is a lesser-known condition, which occurs in children and adults alike and can rapidly progress to bowel ischemia. Primary segmental small bowel volvulus occurs in the absence of rotational anomalies or other intraabdominal lesions and is rare in Europe and North America. Clinical presentation can be misleading, causing a delay in diagnosis and treatment, in which case the resection of necrotic bowel may become necessary.We report on a 14-year-old girl who presented with severe colicky abdominal pain but showed no other signs of peritoneal irritation or bowel obstruction. An emergency magnetic resonance imaging was highly suspicious for small bowel volvulus. Emergency laparotomy revealed a 115 cm segment of strangulated distal ileum with no underlying pathology. We performed a detorsion of the affected bowel segment. Despite the initial markedly ischemic appearance of the affected bowel segment, the patient achieved full recovery without resection of bowel becoming necessary.

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ACE Inhibitor-Induced Angioedema of the Bowel

Case Reports in Medicine ◽

10.1155/2010/690695 ◽

2010 ◽

Vol 2010 ◽

pp. 1-4 ◽

Cited By ~ 12

Author(s):

Tabitha Campbell ◽

Bradley Peckler ◽

Raleigh David Hackstadt ◽

Austin Payor

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Small Bowel ◽

Ace Inhibitor ◽

Enzyme Inhibitor ◽

Signs And Symptoms ◽

Converting Enzyme ◽

Rare Occurrence ◽

Invasive Procedures ◽

High Index Of Suspicion

Angiotensin converting enzyme inhibitor ACEI-induced angioedema of the intestine is a rare occurrence and often unrecognized complication of ACEI. We present a case of a 45-year-old Hispanic female with angioedema of the small bowel progressing to facial and oral pharyngeal angioedema. Patients are typically middle-aged females on ACEI therapy who present to the emergency department with abdominal pain, nausea, vomiting, and diarrhea. This is a diagnosis of exclusion, and physicians must have a high index of suspicion to make the diagnosis. Symptoms typically resolve within 24–48 hours after ACE inhibitor withdrawal. Recognizing these signs and symptoms, and discontinuing the medication, can save a patient from unnecessary, costly, and invasive procedures.

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Small bowel obstruction and strangulation secondary to an adhesive internal hernia post ESWL for right ureteral calculi: a case report and review of literature

BMC Gastroenterology ◽

10.1186/s12876-021-01760-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elaine N. Gitonga ◽

Haitao Shen

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Internal Hernia ◽

Ureteral Calculi ◽

Emergency Laparotomy ◽

Extracorporeal Shock Wave ◽

Relative Safety

Abstract Background Extracorporeal shock wave lithotripsy (ESWL) is a relatively safe and convenient mode of treatment for ureteral and renal stones, despite its relative safety; ESWL is not without its complications. We present a case of a patient we managed for small bowel obstruction and strangulation due to an adhesive internal hernia after ESWL was done because of right ureteral calculi. Case presentation We report a case of a 59-year-old patient who presented with severe abdominal pain a few hours after ESWL because of a right upper ureteric calculus. The abdominal pain increased in severity in time and became more generalized. The patient had one episode of gross hematochezia as she was being prepped for emergency laparotomy. Intra-op, she had a strangulated internal hernia because of an omental-mesenteric adhesion. Conclusion This case report hopes to highlight the potential of complications like acquired IH due to adhesions in patients with a history of ureteral calculi, and also the complications that may come about post-ESWL. Patients who present with signs of persistent abdominal pain post-ESWL should be vigilantly observed. If symptoms persist, increase in intensity or there is a general deterioration of the patients’ hemodynamic status, even in light of negative MDCT findings, prompt surgical intervention is crucial for definitive diagnosis as well as management.

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