scholarly journals Improvement of a cecal bascule by supportive care

2017 ◽  
Vol 25 (3) ◽  
pp. 169-172
Author(s):  
Yong In Kim ◽  
Sang Kyoon Han ◽  
Mun Ki Min ◽  
Sung Wook Park ◽  
Seok Ran Yeom

A cecal bascule is a rare cause of intestinal obstruction, and the diagnosis is often challenging because the symptoms and signs are similar to those of small bowel obstruction. We, herein, present the case of an 82-year-old female who presented to our emergency department with lower abdominal pain. Computed tomography showed anterior medial folding of the cecum over the ascending colon with cecal dilatation, without bowel ischemia or perforation. A good outcome was obtained immediately after supportive care. To the best of our knowledge, this is the first report of a cecal bascule that was improved by supportive care.

2021 ◽  
Author(s):  
Van Trung Hoang ◽  
The Huan Hoang ◽  
Ngoc Trinh Thi Pham ◽  
Vichit Chansomphou ◽  
Duc Thanh Hoang

Abstract Background: Bezoar bowel obstruction is a rare entity and remains difficult to detect on imaging studies. Recognition of its characteristic imaging pattern will be useful for diagnosis and management in the setting of intestinal obstruction.Case presentation: We report a 68-year-old female patient who was admitted to the hospital with signs of intestinal obstruction including abdominal pain, nausea, vomiting, and abdominal distention. She was diagnosed with phytobezoar small bowel obstruction on computed tomography (CT) imaging. The patient underwent surgery to confirm the diagnosis and subsequently recovered well.Conclusions: Bezoar is indicated by the sign of floating fat-density debris sign on CT images. It needs to be differentiated from small-bowel feces sign in intestinal obstruction.


2018 ◽  
pp. 124-128
Author(s):  
Ali Kamran

Small bowel obstruction is an important diagnosis to consider in an adult presenting with abdominal pain with previous risk factors. Abdominal pain of unclear etiology in the Emergency Department has an exhaustive differential, but key historical and physical exam findings can help narrow the differential considerably. Key management steps for a bowel obstruction include obtaining an appropriate history and physical examination, ordering necessary laboratory studies to exclude other diagnoses, making the patient nil per os, addressing any serious electrolyte derangements, obtaining necessary imaging and a surgical consult. Multidetector computed tomography of the abdomen provides the highest sensitivity for the diagnosis of a small bowel obstruction, but an abdominal X-ray or an abdominal ultrasound can be utilized to help make the diagnosis.


Author(s):  
Levan Tchabashvili ◽  
Dimitris Kehagias ◽  
Charalampos Kaplanis ◽  
Elias Liolis ◽  
Ioannis Perdikaris ◽  
...  

A 77-year-old woman was admitted to our emergency department complaining of abdominal pain. Computed tomography was performed and showed aerobilila and a large 5.1 cm gallstone lodged in the small intestine. She underwent emergency surgery. Intraoperative findings noted small bowel obstruction caused by a large gallstone.


2021 ◽  
pp. 1-3
Author(s):  
Paolo Aonzo ◽  
Paolo Aonzo ◽  
Michela Ceriotti ◽  
Antonio Fernando Anania ◽  
Matteo Morena ◽  
...  

Acute abdominal pain secondary to intussusception is rare in adults and mainly caused by malignancy (70-90%), whereas in childhood intussusception’s etiology is mostly idiopathic (90% of cases). Gastrointestinal lipomas, especially in small bowel, represent an unusual cause of intussusception with complete intestinal obstruction or bleeding (acute or chronic) from mucosal ulceration. In acute settings, computed tomography (CT) should be confidently considered the gold standard for diagnosis. In adulthood, surgical management of acute symptomatic intussusception caused by lipoma is mandatory. We report a case of complete jejunal obstruction with intussusception due to 5 cm submucosal lipoma.


2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Ioannis Vassiliou ◽  
Aliki Tympa ◽  
Michalis Derpapas ◽  
Georgios Kottis ◽  
Nikolaos Vlahos

The diagnosis of intestinal obstruction in pregnancy is difficult, as the symptoms may mimic pregnancy-associated complaints. The surgical management is challenging, as the mortality rate of midgut volvulus in pregnancy is high. We report the case of a 35-year-old woman at 21 weeks and 5 days of gestation with small bowel obstruction who presented to our institution with a 24 h history of colicky abdominal pain and nausea and who finally had a successful open repair.


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 ◽  
...  

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.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
P. K. B. S. C. Bandara ◽  
A. M. Viraj Rohana ◽  
Aloka Pathirana

Abstract Background Intestinal obstruction due to internal herniation of the bowel is a rare clinical entity which is often overlooked in the differential diagnosis of patients with abdominal pain who have no previous history of abdominal surgery. Several sites of bowel internal herniation have been described, amongst which internal herniation through the foramen of Winslow accounts for about 8% of cases. These patients present with nonspecific abdominal pain associated with symptoms of gastroesophageal reflux disease, and hence the diagnosis is often overlooked. The usual symptoms of intestinal obstruction can be delayed, which results in a delay in diagnosis and gangrene of the herniated bowel segment. Abdominal radiographs and computed tomography are helpful in the diagnosis. Open reduction is the management of choice; however, laparoscopic reduction has also been attempted, with good results. Case presentation We report a case of a middle-aged Sri Lankan man who presented with features of gastroesophageal reflux disease, developed features of intestinal obstruction and was found to have a gangrenous small bowel loop which had herniated through the foramen of Winslow. Following needle aspiration and reduction of the herniated small bowel loop, the gangrenous part of the small bowel was resected and an ileoileal anastomosis performed. The large foramen of Winslow was partially closed with interrupted stitches. The patient made an uneventful recovery. Conclusion Since delayed diagnosis of bowel obstruction is detrimental, it is of utmost importance to diagnose it early. Because internal herniation of the small bowel through the foramen of Winslow presents with nonspecific symptoms including features of gastroesophageal reflux disease, as documented in several cases worldwide and also presented by our patient, there should be a high degree of suspicion of internal herniation of the bowel causing bowel obstruction and low threshold for extensive investigation of patients presenting with symptoms of gastroesophageal reflux disease which does not resolve with usual medication.


2017 ◽  
Vol 11 (2) ◽  
pp. 452-461
Author(s):  
Azusa Kawasaki ◽  
Kunihiro Tsuji ◽  
Hisashi Doyama

A 73-year-old female was admitted to our hospital with abdominal pain and diarrhea. Computed tomography detected distension of the small intestine. A palmar erythema, multiple oral ulcers, and desquamation of the fingers appeared after hospitalization. Small-bowel endoscopic images showed multiple ulcers. We attributed this case to infection with Yersinia pseudotuberculosis based on the changes in Y. pseudotuberculosis antibody titers throughout the course of the illness. This report is valuable, as it illustrates the endoscopic characteristics of a Y. pseudotuberculosis infection with skin lesion and ileus, which may enable us to deepen the pathologic understanding of this disease.


2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.


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