scholarly journals Ileoileal knotting: a rare cause of intestinal obstruction: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yusuf Mohammed ◽  
Kirubel Tesfaye

Abstract Background Ileoileal knotting is one of the rarest causes of intestinal obstruction. The pathology involves knotting of the ileum around itself, leading to mechanical intestinal obstruction that can rapidly evolve to gangrene. Case presentation Here we will discuss the case of an 18-year-old Oromo girl who presented with sudden onset of severe abdominal pain and signs of generalized peritonitis.Ultrasound examination showed massive peritoneal and cul-de-sac fluid. Explorative laparotomy was done, with a tentative diagnosis of ruptured ovarian cyst. Intraoperative finding was a gangrenous ileoileal knot. The gangrenous segment was resected and ileotransverse anastomosis done. Postoperative course was uneventful, and the patient was discharged improved on the sixth postoperative day. Conclusion We present this case to highlight the diagnostic difficulty that one can face in females of child-bearing age and to create awareness of this rare cause of intestinal obstruction, as morbidity and mortality are very high because of rapid progression to gangrene.

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.


2020 ◽  
Vol 5 (2) ◽  
pp. 109-112
Author(s):  
Ghazi Laamiri ◽  
◽  
Montassar Ghalleb ◽  
Nouha Ben Ammar ◽  
Slim Zribi ◽  
...  

Introduction. Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency. Generally, it is associated with significant maternal and fetal mortality. The diagnosis is difficult, often delaying the therapeutic management. It is reported an exceptional association of acute intestinal obstruction due to a band adhesion that is put into tension as the uterus enlarges. Case Report. A 35 years old Caucasian pregnant woman with a past medical history of appendectomy was examined and found with abdominal pain, severe vomiting, and bowel obstruction. The patient underwent surgery. Per operatively, the obstruction was caused by an adhesion put into tension by the enlargement of the uterus. The postoperative course was uneventful and the patient was discharged on day 2. Conclusions. The etiological diagnosis of acute intestinal obstruction during pregnancy is difficult. Surgery is the cornerstone of the treatment and the management varies depending on the intraoperative findings and the condition of the patient.


2021 ◽  
Vol 9 (2) ◽  
pp. 090-094
Author(s):  
Fatin R. Polat ◽  
Ilhan Bali ◽  
Yasin Duran ◽  
Suat Benek

Background: Gallstone ileus, which is called Type Vb Mirizzi Syndrome, is a rare case of mechanical intestinal obstruction observed in older patients with history of cholelithiasis or cholecystitis. Diagnostic Imaging plays an important role in the management of patients with suspected gallstone ileus. X-Ray and Abdominal Computed Tomography (CT) are the preferred modality. Case presentation: The patient was diagnosed with gallstone ileus at the age of 45. The case had 10 years history of biliary colic disease. The patient who is suffered from intestinal obstruction. CT demonstrated pneumobilia involving the gallbladder, a 5, 5 cm calcified stone in the ileum and small bowel dilatation. He underwent enterolithotomy and a huge stone was removed. When gallbladder area was checked, the gallbladder was highly adherent (to colon and stomach) and was inflamed. We suspected malignancy so multipl biopsy was taken. Two-stage treatment model was planned. After the surgery, any emerging complications were closely monitored. Conclusions: Abdominal CT are the preferred modality for diagnosis. The main treatment for gallstone intestinal obstruction is surgery. First step enterotomy, later intented for the gallbladder. There are two type of surgical approach for gallbladder: one-stage treatment or two-stage treatment according the inflammation of gallbladder


2021 ◽  
Author(s):  
Wei Ge ◽  
Li-hua Shao ◽  
Hai-yan Gong ◽  
Gang Chen

Abstract Background: Lead poisoning is a rare but serious disease. The clinical manifestations of lead poisoning are various and nonspecific such as abdominal pain, headache, dizziness, nightmare, fatigue and so on. Rapid diagnosis of lead poisoning is challenging because it does not have special symptoms and the morbidity is very low.Case presentation: A 31-year-old woman presented with epigastric discomfort without any obvious cause. The patient was diagnosed with lead poisoning, as the blood levels of heavy metals were detected and the lead was 463.17ug/L, which was very high (normal value was less than 100 ug/L). The patient was treated with intravenous drip of calcium sodium edentate and got better. The patient achieved good recovery and there was no recurrence.Conclusion: Lead poisoning is a rare disease and easy to be misdiagnosed as acute abdomen disease when present with abdominal pain. Lead poisoning should be considered when common causes of abdominal pain are excluded, especially patients with anemia and abnormal liver function. The diagnosis of lead poisoning is mainly replied on the blood or urine lead concentrations. Then we should firstly cut off the contact with lead and use metal complexing agent to facilitate lead excretion.


Author(s):  
Archit Pankajkumar Parikh ◽  
Mohan Prakash Tyagi ◽  
Dheerta Atul Kapadia

Small bowel obstruction due to internal herniation of ileum through congenital defect in falciform ligament is exceedingly rare, about 0.2% such cases of hernia through congenital defect in falciform ligament have been reported. The case presentation of 60 year old male patient present in surgery department with acute abdominal pain since 7 days. Based on clinical assessment and radiological evidence, intestinal obstruction was diagnosed. For which patient underwent exploratory laprotomy. The discussion of Intraoperative a loop ileum was found obstructed in congenital defect in falciform ligament. Obstruction was relieved by division of leaf of defect, without the need of intestinal resection.


2020 ◽  
pp. 16-18
Author(s):  
V. M. Lykhman ◽  
O. M. Shevchenko ◽  
Ye. O. Bilodid ◽  
Igor Vladimirovich Volchenko ◽  
I. A. Kulyk ◽  
...  

Among urgent surgical diseases of abdominal cavity, an acute intestinal obstruction is the most difficult to be diagnosed and treated. Leading factor, determining the development of pathophysiological processes is considered to be the progressive manifestations of enteric insufficiency syndrome, resulting in intestinal barrier impairment, negative changes in ecology of intestinal flora, increased endotoxins. To identify the small intestine microflora in acute intestinal obstruction and determine the role of dysbiotic disorders in clinical manifestations of main pathological process, a study was conducted in 60 patients with mechanical intestinal obstruction. The small intestine has a relatively rare microflora, consisting mainly of gram−positive facultative aerobic microorganisms, streptococci, lactobacilli. The distal ileum in nearly 30−55 % of healthy people contains scanty microflora, and yet the flora of this area differs from the microbial population of the higher gastrointestinal tract due to higher concentration of gram−negative bacteria. Optional−anaerobic coliform bacilli, anaerobic bifidobacteria and fusobacteria, bacteroids, the number of which starts exceeding the one of gram−positive species, are presented in significant quantities. Distal to the ileocecal valve there are significant changes in the microflora quantitative and species composition. Obligatory anaerobic bacteria become the predominant part of microflora, exceeding the number of aerobic and facultative anaerobic bacteria. The bacterial flora in different parts of gastrointestinal tract has its own specifics and is quite constant, as a result of the interaction of many factors, regulating the bacterial population in small intestine. The most important among them are: acidity of gastric juice, normal peristaltic activity of the intestine, bacterial interactions and immune mechanisms. Disorders of the intestine motor and evacuation function with its obstruction lead to slow passage of the chyme and contamination of the upper gastrointestinal tract with new types of microbes. There is a syndrome of small intestine excessive colonization, which means an increased concentration of bacterial populations in it, similar in species composition to the colon microflora. Pathological intra−intestinal contents become a source of endogenous infection and re−infection of the patient, leads to internal digestive disorders, which is manifested by syndrome of malabsorption of proteins, carbohydrates and vitamins. Key words: acute intestinal obstruction, small intestinal microflora, conditionally pathogenic microorganisms, intestinal biocenosis.


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.


CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. e77-e79 ◽  
Author(s):  
Vishal J. Tolia ◽  
Danielle N. O’Hara ◽  
Kazi I. Ullah ◽  
Sahar Ahmad

2021 ◽  
Vol 42 (1) ◽  
pp. 69-75
Author(s):  
Shivani Singh ◽  
Ashok Kumar Ahirwar ◽  
Priyanka Asia ◽  
Niranjan Gopal ◽  
Kirti Kaim ◽  
...  

Abstract COVID-19 caused by SARS CoV2 (The novel corona virus) has already taken lives of many people across the globe even more than anyone could have imagined. This outbreak occurred in China and since then it is expanding its devastating effects by leaps and bounds. Initially it appeared to be an outbreak of pneumonia but soon it was found to be much more than that and the infectivity was found to be very high. This is the reason that it has taken whole globe in its trap and become a pandemic in such a short span of time. Death is occurring because it is a new virus and human body has no specific antibodies for it. Presently there is no approved vaccine so everyone is susceptible but people with co-morbidities appear to be in more risk and the best way for protection is social distancing and increasing one’s natural immunity by taking healthy diet and exercise. When a person is infected the clinical presentation ranges from asymptomatic to severe ARDS, sudden onset of anosmia, headache, cough may be the initial symptoms. This review is focused on immunopathology and effect of COVID-19 on neurological disorders and also the neurological manifestations and the treatment.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammad Saba ◽  
Joshua Rosenberg ◽  
Gregory Wu ◽  
Gudata Hinika

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.


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