scholarly journals Colon stenosis due to acute neonatal appendicitis in a preterm baby: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Takuto Naito ◽  
Hiromu Teramen ◽  
Hiroaki Hayashi ◽  
Mai Takegawa ◽  
Haruko Sakamoto ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Exploratory Laparotomy ◽  
Intestinal Lumen ◽  
Ascending Colon ◽  
Preterm Baby ◽  
Inflammatory Reactions ◽  
Neonatal Appendicitis ◽  
Japanese Male ◽  
Perforated Appendix ◽  
Colon Stenosis

Abstract Background Colon stenosis and acute appendicitis are rare diseases among premature babies. To the best of our knowledge, no study has identified both the conditions in preterm babies. Case presentation Here we report a case of a preterm Japanese male baby who developed ascending colon stenosis and appendicitis. During his neonatal intensive care unit stay, he developed increasing apnea and vomiting with rapidly worsening abdominal distention. Contrast radiographs indicated colon stenosis. Emergent exploratory laparotomy revealed ascending colon stenosis with appendix adhesion; both the lesions were surgically resected. The pathological findings suggested that he had appendicitis several weeks prior to the surgery; the onset of colon lesion seemed later than that of appendix. The perforated appendix was covered by the ascending colon, and inflammatory reactions led to the narrowing of the intestinal lumen. Conclusions Neonatal appendicitis and colon stenosis are both challenging for the diagnosis, and early laparotomy is necessary when these conditions are suspected.

Appendicitis Perforata in CAPD Patients -Report of Two Cases

1985 ◽  
Vol 5 (4) ◽  
pp. 237-240 ◽  
Author(s):  
Konstantin Vogt ◽  
Bernhard Hess ◽  
Dieter Baumgartner ◽  
Dirk Maass ◽  
Gerald Keusch ◽  
...  
Keyword(s):  
Rare Complication ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Fecal Peritonitis ◽  
Therapeutic Implications ◽  
Replacement Treatment ◽  
Perforated Appendix ◽  
Appendicitis Perforata ◽  
High Level

Two patients on CAPD had peritonitis due to perforated appendicitis. Both presented with diffuse painful peritonitis with nausea, fever and prostration. There was blood leukocytosis with a shift to the left. The peritonitis did not respond to antibiotic therapy. The diagnosis was made after 8 and 18 days respectively by exploratory laparotomy. Both patients had a gangrenous perforated appendix surrounded by abscess. Both patients had uncomplicated recovery after appendectomy, drainage, removal of the Tenckhoff catheter with discontinuation of CAPD and change to hemodialysis. Our experience suggests that a perforated appendix might be recognized early in a patient with apparent fecal peritonitis in whom other more common causes (e.g. diverticulosis/ diverticulitis) have been ruled out, or when he presents with severe symptoms and a low peritoneal white cell count. Perforated appendicitis leading to fecal peritonitis is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). Among 85 patients treated with CAPD since 1978 for a total of 1062 patient months, we observed two such cases. Although CAPD now is established as a kidney replacement treatment and appendicitis is a common condition, we know of no other report of perforated appendicitis during CAPD. Therefore we describe our experience with two such patients, treated with CAPD for 14 and 5 months, respectively. The diagnostic and therapeutic implications are discussed in the context of other forms of fecal peritonitis, mainly due to colonic perforation, secondary to diverticular disease. This report emphasizes the need for a high level of suspicion that the peritonitis may be related to bowel disease, especially when it does not respond quickly to standard treatment.

CT diagnosis and management of mesenteric torsion in a dog

2020 ◽  
Vol 8 (3) ◽  
pp. e001102
Author(s):  
Gabriel Carbonell Rossello ◽  
Ricardo Guillem Gallach ◽  
Manuel Jimenez Pelaez
Keyword(s):  
Abdominal Pain ◽  
Medical Treatment ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Abdominal Distention ◽  
Intestinal Lumen ◽  
Ct Diagnosis ◽  
En Bloc ◽  
Diagnosis And Management ◽  
Small Intestines

An eight-year-old, 35 kg, female spayed Doberman Pincher dog was presented with peracute abdominal distention and severe abdominal pain associated with vomiting. Radiographs showed segmental gas and fluid-distended small intestines and loss of serosal detail. Abdominal ultrasound revealed segmental hypomotile, fluid distended small intestines and high amount of gas in the intestinal lumen. CT showed signs consistent with a segmental mesenteric torsion. Exploratory laparotomy and en bloc enterectomy of the torsioned necrotic segment of the jejunum (50 per cent approximately) was performed. The patient was discharged 1 week after surgery with some sporadic vomiting and diarrhoea, which resolved with medical treatment within a week.

scholarly journals Gallstone Ileus: A Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 121-124
Author(s):  
Darmadi Darmadi ◽  
Riska Habriel Ruslie ◽  
Carolus Trianda Samosir
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Bowel Obstruction ◽  
High Mortality ◽  
Medical Condition ◽  
Gallstone Ileus ◽  
Exploratory Laparotomy ◽  
Water Soluble ◽  
Intestinal Lumen ◽  
Female Population

BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population. CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic. CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.

scholarly journals Outcome of primary peritoneal drainage in perforated necrotizing enterocolitis: an experience with 96 infants

2021 ◽  
Author(s):  
Kumar Abdul Rashid ◽  
Reyaz Ahmad Wani ◽  
Shafat Ahmad Tak ◽  
Omar Masood ◽  
Amat U. Samie ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Exploratory Laparotomy ◽  
Extremely Low Birth Weight ◽  
Major Surgery ◽  
Low Birth Weight Infants ◽  
Peritoneal Drainage

Background: Necrotizing enterocolitis is a life-threatening inflammation of neonatal intestine of multifactorial etiology. In early stages, medical management is considered; while as a transmural disease with pneumatosis or perforation needs surgical attention. Primary peritoneal drainage has evolved as an alternative to classic exploratory laparotomy especially in sick preterm and very low birth weight infants.Methods: In our study, we tried to employ primary peritoneal drainage as an initial intervention in all surgical necrotizing enterocolitis patients and analyzed the results and final outcome in terms of total days in neonatal intensive care unit, total parenteral nutrition days, days to start oral feeds, need for laparotomy, mortality and other complications.Results: Around one-third patients were either very low or extremely low birth weight and 80% patients were preterm. Primary peritoneal drainage was successful without need for laparotomy in around 65% of patients. In the rest 34 patients, 24 were subjected to rescue laparotomy, while 10 could not be stabilized for major surgery. Overall mortality was 29.16%.Conclusions: Early bedside primary peritoneal drainage can be employed in all cases of NEC with perforation with rescue laparotomy to be determined by subsequent monitoring. This strategy seems to be safe and cost-effective in a resource challenged set up and lifesaving in sick and extremely low birth weight infants.

scholarly journals Ascites with hepatic extravasation of total parenteral nutrition (TPN) secondary to umbilical venous catheter (UVC) malposition in an extremely preterm baby

2018 ◽  
pp. bcr-2018-226377 ◽  
Author(s):  
Satyaranjan Pegu ◽  
Poornima Murthy
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Standard Of Care ◽  
Central Line ◽  
Preterm Baby ◽  
Extremely Preterm ◽  
Ease Of Access ◽  
Abdominal Paracentesis

The ease of access and advantages of a secure central line makes use of umbilical venous catheter (UVC) and umbilical artery catheters a part of the standard of care in the extremely premature babies in the neonatal intensive care unit. However, there are complications associated with their use. One of the uncommon complications reported is total parenteral nutrition (TPN) ascites secondary to vessel perforation or hepatic erosion by the tip of the catheter due to malposition of a UVC. We present here a case of such catheter perforation causing ascites and right hepatic collection of TPN in a 28-week-old infant. Abdominal paracentesis was therapeutic by relieving the distension as well as confirming the presence of parenteral nutrition in the peritoneal cavity.

Exploratory Laparotomy for Necrotizing Enterocolitis

2018 ◽  
Author(s):  
Karla E. K. Wyatt ◽  
Olutoyin A. Olutoye
Keyword(s):  
Risk Factors ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Exploratory Laparotomy ◽  
Anesthesia Care ◽  
Comorbid Conditions ◽  
Surgical Interventions ◽  
Pediatric Anesthesiologist ◽  
Inflammatory Bowel

Necrotizing enterocolitis (NEC) is a severe inflammatory bowel disease that commonly affects premature infants. The pathogenesis is multifactorial and poorly understood, although certain risk factors have been identified. This disease, more commonly detected in premature infants with accompanying cardiac and pulmonary comorbid conditions, is associated with increased morbidity and mortality. Multiorgan system homeostasis becomes critical for the pediatric anesthesiologist when approaching medical and surgical interventions for affected patients. This chapter focuses on the population at risk for developing necrotizing enterocolitis, medical and surgical management, providing anesthesia care in the neonatal intensive care unit, as well as perioperative considerations and complications.

scholarly journals Maternal and Foetal outcome in Cholestasis of Pregnancy

2017 ◽  
Vol 14 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
C. R. Das
Keyword(s):  
Neonatal Intensive Care ◽  
Age At Onset ◽  
College Teaching ◽  
High Risk Group ◽  
Foetal Distress ◽  
Preterm Baby ◽  
Medical College ◽  
Membrane Rupture ◽  
Increased Risk ◽  
Foetal Outcome

Background: Obstetric cholestasis has been associated with an increased risk of preterm delivery, intrapartum meconium, foetal distress and intrauterine foetal death.Objectives: To know the perinatal outcome of cholestasis in pregnancy.Materials & Methods: This is a hospital based Observational study conducted in the department of Obstetrics & Gynaecology at Nepalgunj Medical College Teaching Hospital Kohalpur between August 2015 to January 2016.A total of 40 patients were included in the study with diagnosis of obstetric cholestasis. Data were recorded & analysed.Results: The study group of 40 mothers delivered 40 new born. Mean age group of women in the study was 24.9±5.5 years & 70% were primigravida. The mean gestational age at onset of pruritus was 30.33±4.24 weeks. The rate of caesarean section was 40%. Premature membrane rupture noted in 20% cases while 17.5% were postpartum haemorrhage. Regarding foetal outcome; meconium baby 32.5%, Intrapartum foetal distress 17.5%, preterm baby 10% while 37.5% were complication free. There was 2.5% of intrauterine foetal death, where pregnancy continued beyond 38 weeks. Thirteen new borns (32.5%) were admitted to neonatal intensive care unit.Conclusion: Cholestasis in pregnancy is high risk group with adverse perinatal outcomes.JNGMC Vol. 14 No. 1 July 2016, page: 32-35

scholarly journals Adult ileocolic intususception: a case report

2017 ◽  
Vol 4 (10) ◽  
pp. 3529
Author(s):  
Akhilesh Kumar Yadav ◽  
Tushar Goel ◽  
Anand Thawait ◽  
Sankalp Dwivedi
Keyword(s):  
Case Report ◽  
Accurate Diagnosis ◽  
Intestinal Lumen ◽  
Lead Point ◽  
Benign Neoplasms ◽  
Ascending Colon ◽  
Ileocolic Intussusception ◽  
Detailed History ◽  
X Ray ◽  
Experienced Surgeon

Intussusception is defined as the pathology in which a segment of intestine telescopes into the adjoining intestinal lumen. Ileocolic accounts for 75% of all cases of intussusception. The average age of affected adults is between 50 and 60 years old and it occurs more often in women. The higher percentage of intussusception in adults (65%) occurs due to malignant or benign neoplasms. Appendix is part of intussusception of commonest ileocolic type but appendix as lead point for intussusception is rare. Patient details were collected by patient’s IPD file. Complete detailed history, patient vitals, hemogram, ABO, with X-ray Abd erect, USG abdomen and CECT abdomen was done. Post-OP patient was followed by USG review. 60-year-old female diagnosed and operated as for ileocolic intussusception with appendix as lead point. Ileo transverse anastomosis was performed with hemicolectomy involving the terminal ileum along with caecum and ascending colon. Post op patient did well passed stools on 5th day. Intussusception is a pathology in which a segment of intestine telescopes into the adjoining intestinal lumen causing intestinal obstruction. Intussusception are two types antegrade and retrograde. CT scan and colonoscopy, which provide an accurate diagnosis, allowed the best surgical choice in the hands of an experienced surgeon.

scholarly journals Pedunculated Cecal Lipoma Causing Colo-Colonic Intussusception: A Rare Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Stefanos Atmatzidis ◽  
Grigoris Chatzimavroudis ◽  
Aristidis Patsas ◽  
Basilis Papaziogas ◽  
Spiros Kapoulas ◽  
...  
Keyword(s):  
Case Report ◽  
Preoperative Diagnosis ◽  
Rare Case ◽  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Right Hemicolectomy ◽  
Resected Specimen ◽  
Ascending Colon ◽  
Imaging Studies ◽  
Rare Case Report

Colonic lipomas are uncommon nonepithelial neoplasms that are typically sessile, asymptomatic and incidentally found during endoscopy, surgery, or autopsy. We present a very rare case of a 34-year-old female patient with symptomatic pedunculated cecal lipoma causing intermittent colo-colonic intussusception. Despite adequate imaging studies, definite preoperative diagnosis was not established and the patient underwent exploratory laparotomy. Intraoperatively, intussusception of the cecum into the ascending colon was found and right hemicolectomy was performed. Macroscopic assessment of the resected specimen showed the presence of a giant cecal pedunculated polypoid tumor with features of lipoma, causing intussusception. Histopathological examination confirmed the diagnosis of pedunculated cecal lipoma.

scholarly journals Spontaneous Pneumoperitoneum due to Constipation

2015 ◽  
Vol 9 (3) ◽  
pp. 361-365 ◽  
Author(s):  
Ippei Yamana ◽  
Tomoaki Noritomi ◽  
Shinsuke Takeno ◽  
Tatsuya Hashimoto ◽  
Keisuke Sato ◽  
...  
Keyword(s):  
Bowel Wall ◽  
Exploratory Laparotomy ◽  
Mucosal Injury ◽  
Pertinent Literature ◽  
Free Air ◽  
Japanese Male ◽  
Spontaneous Pneumoperitoneum ◽  
Old Japanese ◽  
Colon And Rectum ◽  
Bowel Mucosa

We report a rare case of spontaneous pneumoperitoneum. An 82-year-old Japanese male patient was referred to our hospital because of constipation and abdominal pain. Abdominal computed tomography revealed a large amount of feces in the colon and rectum, and free air in the abdomen. Based on these findings, the patient was diagnosed with gastrointestinal perforation. Emergency exploratory laparotomy was performed. Neither perforation nor ischemic changes were recognized in the digestive tract. The patient's defecation was managed postoperatively until discharge on the 13th postoperative day. The authors assumed that free air, which was released after a mucosal injury due to the internal pressure caused by the presence of a large amount of feces in the colon and rectum, had penetrated the bowel wall through the bowel mucosa. We herein report the present case while also reviewing the pertinent literature.

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