scholarly journals Ascariasis in a 75-year-old man with small bowel volvulus: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giovanni Romano ◽  
Paola Pepe ◽  
Serena Cavallero ◽  
Paola Cociancic ◽  
Lorenzo Di Libero ◽  
...  
Keyword(s):  
Small Bowel ◽  
Rural Areas ◽  
Southern Italy ◽  
Exploratory Laparotomy ◽  
Bowel Distension ◽  
Case Presentation ◽  
Small Bowel Volvulus ◽  
Faecal Examination ◽  
Fluid Levels ◽  
Tomography Scan

Abstract Background Ascaris lumbricoides and Ascaris suum are the most common soil-transmitted helminths of humans and pigs, respectively. The zoonotic potential of A. suum has been a matter of debate for decades. This study was aimed to present a case of human ascariasis caused by A. suum in southern Italy. Case presentation A 75-year-old man presented to the department of surgery in Avellino (southern Italy) complaining of abdominal pain and vomiting. Physical examination revealed bloating and abdominal tenderness. A computed tomography scan showed air-fluid levels and small bowel distension. During exploratory laparotomy a small bowel volvulus with mesenteritis was evident and surprisingly an intraluminal worm was detected. The worm was removed with a small enterotomy and identified as an adult female of A. suum based on morphological and molecular analysis. Faecal examination revealed the presence of unfertilized Ascaris eggs with an intensity of 16 eggs per gram (EPG) of faeces. The patient was treated with mebendanzole 100 mg twice a day for 3 days. The post-operative course was regular with re-alimentation after 3 days and discharge after 12 days. Conclusions This report shows as A. suum can function as a relevant agent of human zoonosis. Therefore, in patients with bowel obstruction with no evident aetiology a helminthic infestation should be considered for an accurate diagnosis, especially in patients living in rural areas.

scholarly journals T-shaped Meckel’s diverticulum: a rare anatomical variant complicating small bowel volvulus

2018 ◽  
Vol 5 (8) ◽  
pp. 2929
Author(s):  
Vergis Paul ◽  
Ramu R. ◽  
Kocheril Sheryl Mathews ◽  
Ashly Thomas ◽  
Reesha P. A. ◽  
...  
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Anatomical Variant ◽  
Small Bowel Volvulus ◽  
Common Presentation ◽  
Congenital Diverticulum

The Meckel's diverticulum is a congenital diverticulum arising from the terminal ileum and is the unobliterated proximal portion of the vitellointestinal duct. Intestinal obstruction due to Meckel’s diverticulum is the most common presentation in adults and is the second most common presentation in children. We present a case of a 58-year-old gentleman presented with acute abdomen who was later found to have Giant T- shaped Meckel’s Diverticulum complicating small bowel volvulus on exploratory laparotomy. A T-shaped Meckel's diverticulum has not yet been described.

scholarly journals The Presentation of Multiple Perforations in the Small Bowel as Cytomegalovirus Related Immune Reconstitution Inflammatory Syndrome in an HIV-infected Patient: a Case Report

2021 ◽  
Author(s):  
Wang Yanli ◽  
Xuyong Lin ◽  
Yuji Li ◽  
Ying Wen
Keyword(s):  
Small Bowel ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Exploratory Laparotomy ◽  
Pathological Examination ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract Background: Multiple perforations in the small bowel as cytomegalovirus (CMV) related immune reconstitution inflammatory syndrome (IRIS) in an human immunodeficiency virus (HIV)-infected patient is very rare. Up to now, only five IRIS-associated cases including our case were reported. We performed pathological examination, metagenomic next-generation sequencing (mNGS), CMV and immune cells immunohistochemical staining for rapid diagnosis and differential diagnosis.Case presentation: We describe a case with multiple perforations in the small bowel as CMV related IRIS in an HIV-infected patient. The patient appeared multiple perforations in the small bowel after 26 days of antiretroviral therapy (ART). The patient underwent exploratory laparotomy. Partial resection and surgical repair of small intestine were performed. CMV enteritis was confirmed by immunohistochemistry staining and other opportunistic infections were excluded by mNGS. However, he died from intestinal obstruction and septic shock at 55 days after surgery. Conclusions: Perforations due to CMV related IRIS are very rare, and usually lack the prodromal period symptoms of abdominal pain and diarrhea. It is not easily foreseen and appears shortly after ART. The condition of intestinal perforations is lethal, and early identification and surgical treatment are lifesaving.

scholarly journals An Unusual Case of Small Bowel Volvulus Associated with Pneumatosis Intestinalis: A Case Report

2021 ◽  
Author(s):  
Alia Zouaghi ◽  
Dhafer Hadded ◽  
meryam Mesbahi ◽  
Y Benzarti ◽  
M Cherif ◽  
...  
Keyword(s):  
Small Bowel ◽  
Unusual Case ◽  
Pneumatosis Intestinalis ◽  
Case Presentation ◽  
Small Bowel Volvulus ◽  
Surgical Department ◽  
Complicated Form ◽  
Uncommon Disease ◽  
Bowel Occlusion ◽  
Exploratory Laparoscopy

Abstract INTRODUCTION: Pneumatosis cystoid intestinalis (PCI) is a rare disease reported in the literature affecting 0.03% of the population. It has a variety of causes and its manifestation may change widely. In the acute complicated form of pneumatosis intestinalis, management is challenging for physicians and surgeons. CASE PRESENTATION: We present a case of a 60-year-old patient who was admitted to our surgical department with a symptomatology suggestive of small bowel occlusion. Computed tomography demonstrated ileal volvulus associated with parietal signs suffering and pneumoperitoneum. An emergent exploratory laparoscopy followed by conversion was performed demonstrating segmental ileal pneumatosis intestinalis secondary to a small bowel volvulus due to an inflammatory appendix wrapping around the distal ileum. Detorsion, retrograde draining, and appendectomy were performed. DISCUSSION: PCI is an uncommon disease, affecting 0.03% of the population. It is usually presenting as a marginal finding resulting from various gastrointestinal pathologies. This case is exceedingly rare in the literature, featured by the ileal volvulus due to appendicitis.CONCLUSION: This work emphasizes the importance of surgical procedures in the management of symptomatic pneumatosis intestinalis.

scholarly journals A 61-year-old woman with jejunal lymphatic malformation visualized on computed tomography: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mark Rupasinghe ◽  
Roozbeh Houshyar ◽  
Chantal Chahine ◽  
Thanh-Lan Bui ◽  
Justin Glavis-Bloom ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Exploratory Laparotomy ◽  
Lymphatic Malformation ◽  
Caucasian Woman ◽  
Debulking Surgery ◽  
Lymphatic Malformations ◽  
Case Presentation ◽  
Abdominal Lesions ◽  
Tomography Scan ◽  
Mucinous Ovarian Carcinoma

Abstract Background Jejunal lymphatic malformations are congenital lesions that are seldom diagnosed in adults and rarely seen on imaging. Case presentation A 61-year-old Caucasian woman was initially diagnosed and treated for mucinous ovarian carcinoma. After an exploratory laparotomy with left salpingo-oophorectomy, a computed tomography scan of the abdomen and pelvis demonstrated suspicious fluid-containing lesions involving a segment of jejunum and adjacent mesentery. Resection of the lesion during subsequent debulking surgery revealed that the lesion seen on imaging was a jejunal lymphatic malformation and not a cancerous implant. Conclusions Abdominal lymphatic malformations are difficult to diagnose solely on imaging but should remain on the differential in adult cancer patients with persistent cystic abdominal lesions despite chemotherapy and must be differentiated from metastatic implants.

Small Bowel Volvulus Caused by Migrating Mesh Plug

2007 ◽  
Vol 73 (8) ◽  
pp. 796-797 ◽  
Author(s):  
Christopher L. Stout ◽  
Andrew Foret ◽  
D. Benjamin Christie ◽  
Earl Mullis
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Adverse Events ◽  
Small Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Mesh Plug ◽  
Small Bowel Volvulus ◽  
Neurosurgical Procedure ◽  
Reproductive Structures ◽  
The U.S

The choice of material and technique for repair of inguinal hernias is broad. The mesh plug technique has become one of these techniques. The local complications of this technique are well known and include entrapment and damage of nervous and reproductive structures causing pain and even infertility. Migration of the mesh recently has become evident. We found a few cases of migrating mesh plug in the literature. We report a 76-year-old male patient who presented during admission for a neurosurgical procedure. His hospital course was complicated by migrating mesh eroding into the small intestine presenting as a small bowel obstruction. During exploratory laparotomy, a small bowel volvulus was found and reduced along with resection of the bowel–mesh complex. We discuss and review this technique's complications, including a 9-year review of adverse events reported to the U.S. Food and Drug Administration.

scholarly journals Recurrent Enterolithiasis Small Bowel Obstruction: A Case Seldom Described

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ashish Lal Shrestha ◽  
Pradita Shrestha
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Diffuse Abdominal Pain ◽  
Case Presentation ◽  
Rare Phenomenon ◽  
Significant Clinical Improvement ◽  
History Of ◽  
High Index Of Suspicion

Background. Enterolithiasis of the small bowel is a rare phenomenon in humans although it has been frequently described in equines. Primary enteroliths have been described including those occurring secondary to conditions like Crohn’s disease, small bowel diverticula, tuberculous or postoperative strictures, and blind loops but those occurring in an otherwise normal gut are exceedingly rare. Of even greater rarity is a recurrent small bowel enterolith presenting with obstruction. This may be the first report of such kind.Case Presentation. A 70-year-old man undergoing treatment for stable alcoholic liver disease presented to the emergency with gradually progressive diffuse abdominal pain associated with vomiting and constipation for 7 days. He had gaseous abdominal distention but was not obstipated. He had a history of 2 laparotomies in the past for small bowel obstruction secondary to enterolith impaction. He was initially managed conservatively but since there was no significant clinical improvement, he underwent an exploratory laparotomy. A recurrent enterolith 5 × 5 cm in size was found impacted in the mid ileum with multiple dense serosal adhesions and bands. Adhesiolysis and enterotomy with removal of enterolith were performed.Conclusion. Recurrent enterolithiasis of the small bowel is a rare phenomenon and may present with recurrent obstruction. Definitive preoperative diagnosis is not always possible and a high index of suspicion is required to avoid table misdiagnosis. Surgery is the mainstay of treatment once conservative measures fail. Laparoscopic methods may help in diagnosis and avoid possibility of a subsequent adhesive bowel obstruction but are associated with technical challenges.

scholarly journals Radiological manifestations of benign mesenteric lipoma that presented with acute intestinal obstruction: A case report

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
David Eng Yeow Gan ◽  
Wei Woon Teng ◽  
Theva Darshini Surenthiran ◽  
Chiak Yot Ng ◽  
Firdaus Hayati
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Exploratory Laparotomy ◽  
Recurrent Abdominal Pain ◽  
Transitional Zone ◽  
Postoperative Recovery ◽  
Case Presentation ◽  
Mesenteric Fat ◽  
Mesenteric Lipoma ◽  
Bowel Dilatation

Abstract Background Intestinal obstruction is a common surgical emergency that is presented to the hospital with various aetiologies. Among all, mesenteric lipoma is one of the uncommon extraluminal causes of intestinal obstruction. In such conditions, bowel volvulus, compression or even adhesion are the underlying pathologies. Case presentation We report a 69-year-old gentleman who presented with a triad of intestinal obstruction which required exploratory laparotomy. Preoperative computed tomography revealed multiple coalescing lobulated hypoattenuating lesions encircling part of a small bowel forming transitional zone. These lesions are comparatively more hypoattenuating in comparison with the surrounding mesenteric fat. Intraoperatively, a giant ileal mesenteric lipoma was identified causing compression and folding to the adjacent small bowel, leading to proximal bowel dilatation. Excision of the lipoma with a few mesenteric lymphadenectomy was done, revealing a benign mesenteric lipoma and reactive lymph nodes. Despite ileus, he made a good postoperative recovery and was discharged well. Conclusions Patients with recurrent abdominal pain must have a thorough endoscopic and imaging assessment. Besides common or malignant aetiology, rarities should be considered and actively sought. Mesenteric lipoma is a relatively indolent tumour for which early detection can alter clinical presentation.

scholarly journals Fatal attraction: A case of multiple magnet ingestion in an infant

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Neehar Patil ◽  
◽  
Abhishek Chaturvedi ◽  
Padmalatha S Kadamba ◽  
Jeevak Shetty ◽  
...  
Keyword(s):  
Small Bowel ◽  
Young Children ◽  
Foreign Bodies ◽  
Magnetic Beads ◽  
Loop Ileostomy ◽  
Exploratory Laparotomy ◽  
Case Presentation ◽  
Fatal Attraction ◽  
Magnet Ingestion

Background: Foreign body ingestion is common amongst young children, and they tend to pass spontaneously in most. Multiple magnet ingestion, though not very common, requires early intervention to avoid serious complications. Case presentation: A 1 year old infant was brought to us with symptoms of bilious vomiting and abdominal pain. A plain abdominal x ray revealed presence of multiple radio opaque foreign bodies adherent to each other, lying in the small bowel. This raised the suspicion of accidental ingestion of multiple magnets, which was confirmed on detailed interrogation of the parents. An exploratory laparotomy revealed volvulus with pressure necrosis causing multiple perforations of the small bowel, for which a bowel resection with anastomosis and a loop ileostomy was performed, also all the magnetic beads were removed intact. The stoma was reversed after 4 weeks. At follow up the child has grown well with no residual complaints. Conclusion: The importance of early detection and intervention in a case of multiple magnet ingestion in children should be emphasised amongst the parents of young children. Spread of awareness by the primary paediatricians would help in reducing the morbidity and mortality. Keywords: multiple magnets; intestinal obstruction; perforation.

scholarly journals Patterns and surgical outcome of neonatal small bowel obstruction: a single center experience from Ujjain, India

2019 ◽  
Vol 6 (12) ◽  
pp. 4471 ◽  
Author(s):  
Nitin Agarwal ◽  
Deepika Agarwal ◽  
Deepali Pathak ◽  
Ashish Pathak
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rural Areas ◽  
Retrospective Chart Review ◽  
Exploratory Laparotomy ◽  
Intestinal Atresia ◽  
Paediatric Surgery ◽  
Renal Anomalies ◽  
Surgical Emergency

Background: Neonatal small bowel obstruction is the most commonly encountered paediatric surgical emergency worldwide and in India. The objective of this study was to study the prevalence and spectrum of neonatal small bowel obstruction.Methods: A retrospective chart review of all neonates aged between 1-28 days that underwent surgery for small intestinal obstruction between January 2017 to January 2019 at Department of Paediatric Surgery, R.D. Gardi Medical College, Ujjain, MP. A predesigned questionnaire was used to collect demographic, clinical and outcome related information. Exploratory laparotomy and type of surgical intervention was done as per the cause.Results: A total of 52 neonates (M: F ratio 1.74: 1) were included in the study. The most common clinical features were vomiting (92%), bilious vomiting (85%) and abdominal fullness (75%) and laboratory feature was leucocytosis (42%) and thrombocytopenia (31%). Most (66%) neonates presented between 2-7 days and belonged to rural areas (65%). The two most common final diagnosis were malrotation (56%) and intestinal atresia (23%). Associated anomalies were seen in 29% [vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities association (8%) and congenital heart disease (8%)]. The mean (±SD) duration to reach full feeds and duration of neonatal intensive care unit stay was 6.2±1.3 and 14.1 (±5) days, respectively. Complications were seen in 20% cases, most common being early bowel obstruction. A total of 6 (11.5%) neonates died in the post-operative period, 83% because of sepsis.Conclusions: Small bowel obstruction is common neonatal surgical emergency. Most common cause is malrotation and intestinal atresia. Neonatal sepsis is the most common underlying cause of death post-operatively. 

scholarly journals Hiatal hernia as a late complication after gastrectomy

2019 ◽  
Vol 2 (2) ◽  
pp. 74-76
Author(s):  
Svoronos C ◽  
Dannenberg S ◽  
Eder FR ◽  
Meyer FR
Keyword(s):  
Hiatal Hernia ◽  
Total Gastrectomy ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Late Complication ◽  
Exploratory Laparotomy ◽  
Case Presentation ◽  
History Of ◽  
Bowel Occlusion ◽  
Tomography Scan

Introduction: Hiatal hernia is an extremely rare complication after total gastrectomy. Case presentation: An 80-year-old man presented with acute abdominal pain, vomiting, and orthopnoea. He had a history of total gastrectomy with a Roux-en-Y reconstruction five years before. An abdominal computed tomography scan revealed a right hemithorax herniation with small bowel occlusion. Exploratory laparotomy showed volvulus of the small intestine in the hiatal hernia. Conclusions: Hiatal hernia is a rare complication after gastrectomy but early detection and treatment are important to avoid dismal outcomes.

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