scholarly journals The recurrence of colonic volvulus due to nonrotation after intestinal resection in adulthood: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Yusuke Sakimura ◽  
Hirotaka Kitamura ◽  
Noriyuki Inaki ◽  
Hiroyuki Bando
Keyword(s):  
Abdominal Pain ◽  
Transverse Colon ◽  
Abdominal Cavity ◽  
Intestinal Resection ◽  
Lower Abdominal Pain ◽  
Emergency Laparotomy ◽  
Ascending Colon ◽  
Colonic Volvulus ◽  
Abdominal Symptoms ◽  
Initial Surgery

Abstract Background Intestinal nonrotation is a rare congenital condition that causes fatal colonic volvulus at any age. Once volvulus attack occurs, radical surgical therapy is required for treatment and the prevention of recurrence. This report describes the case of an adult female patient with a recurrence of cecum volvulus due to intestinal nonrotation after transverse colon resection for colonic volvulus. Case presentation A 27-year-old female visited our emergency room (ER) with intermittent abdominal pain and nausea. Enhanced computed tomography (CT) showed enlargement of the level of the ascending and transverse colon and an obstruction with a whirlpool sign at the transverse colon. The small intestine was distributed on the right side of the abdominal cavity, and the large intestine occupied the left side. She was diagnosed with volvulus with intestinal nonrotation, and emergency surgery was performed. Surgical examination indicated that the ascending colon to the transverse colon was not fixed to the retroperitoneum, and the transverse colon was rotated 180° clockwise. The axis of the volvulus was a mesenteric adhesion of the transverse colon. The involved transverse colon was resected, and the intestine was reconstructed by functional end-to-end anastomosis (FEEA). Six years after the initial surgery, the patient presented to the ER with abdominal fullness and lower abdominal pain. Enhanced CT revealed that the cecum, ascending colon, and remaining transverse colon were dilated with an obstruction. The appendix was located in the left upper abdominal cavity. The clinical diagnosis was cecal volvulus with intestinal nonrotation. An emergency laparotomy revealed that the cecum was rotated 180° clockwise. The terminal ileum to the remaining transverse colon was resected, and FEEA was performed. Seven months later, she suffered obstruction of the intestine caused by an operative adhesion, and conservative treatment was successful. The patient has had no abdominal symptoms for one and a half years so far. Conclusions Surgeons should realize that nonrotation of the intestines induces volvulus in adulthood and should familiarize themselves with its clinical findings, appropriate treatment, and prognosis. Even after surgical treatment, awareness of the recurrence of volvulus should be maintained to avoid a late diagnosis.

scholarly journals Giant Ovarian Tumor Presenting as a Huge Abdomino-Pelvic Mass in a Teenage Girl: A Case Report

2021 ◽  
Vol 39 (2) ◽  
pp. 137-141
Author(s):  
Muhammad Jamaluddin ◽  
Hajrah Hilal Ahmed
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ovarian Tumor ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Pelvic Mass ◽  
Interesting Case ◽  
Ovarian Cysts ◽  
Teenage Girl ◽  
Common Causes

Ovarian cysts are common causes of lower abdominal pain and abdominal distention in females. While most of them are benign and rarely grow immensely to achieve a huge size, they may be neoplastic in origin, reaching enormous dimensions with minimum or without raising any symptoms.Here, we present an interesting case of a 19-year-old female,who presented with huge abdominal swelling and pain in whole abdomen from whom a 9.1 kg borderline mucinous ovarian cyst, occupying the whole abdominal cavity was removed. J Bangladesh Coll Phys Surg 2021; 39(2): 137-141

scholarly journals Spontaneous Rupture of Urinary Bladder (SRUB) in a Young Male, Presenting as Anuria – A Case Report and Review of Literature

2014 ◽  
Vol 7 (1) ◽  
pp. 64-66
Author(s):  
Sekar Hariharasudhan ◽  
Sriram Krishnamoorthy ◽  
Sunil Shroff
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Urinary Bladder ◽  
Spontaneous Rupture ◽  
Lower Abdominal Pain ◽  
Young Male ◽  
Bladder Rupture ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Delay In Diagnosis

Spontaneous rupture of urinary bladder is a rare condition. Most of the bladder ruptures occur in association with blunt or penetrating injuries to the lower abdomen. Most often, a vague lower abdominal pain is the mode of presentation. Rarely patients present with oliguria, anuria, uremia or urosepsis. A forty year old male, under the influence of alcohol, presented with lower abdominal pain and anuria for two days with abnormal renal function. He denied history of blunt trauma. He was diagnosed to have an intra-peritoneal rupture of urinary bladder. He underwent emergency laparotomy with repair of bladder rupture. This case report illustrates the need for a high index of clinical suspicion. Prompt diagnosis and appropriate management will help in preventing a poor clinical outcome in patients with spontaneous bladder perforation. If left untreated or if there is a considerable delay in diagnosis and intervention, it usually is associated with a high morbidity.

scholarly journals Volvulus of the liver with intrathoracic herniation

2014 ◽  
Vol 96 (7) ◽  
pp. e27-e29 ◽  
Author(s):  
G Moussa ◽  
PM Thomson ◽  
A Bohra
Keyword(s):  
Abdominal Pain ◽  
Transverse Colon ◽  
Abdominal Cavity ◽  
Liver Perfusion ◽  
Previous History ◽  
Interesting Case ◽  
Oval Window ◽  
Uneventful Recovery ◽  
Pericardial Window ◽  
History Of

Introduction We present a rare case of a liver volvulus, stomach and transverse colon herniating through the diaphragm. This scenario has not been reported previously. We discuss the presentation and management of this interesting case. Case history A 65-year-old woman with a history of sarcoidosis and recurrent pericardial effusions, treated previously with a subxiphoid pericardial oval window fenestration, presented with acute upper abdominal pain radiating to the chest. High contrast computed tomography showed a volvulus of the liver with consequent venous congestion, and herniation of the liver, stomach and transverse colon through an anterior diaphragmatic defect. With liver perfusion threatened, an urgent laparoscopic repair was performed. The stomach and transverse colon were reduced, and the twisted left lobe of the liver was unrotated and reduced into the abdominal cavity. A double-sided synthetic mesh was used to repair the defect. The patient made an uneventful recovery. Conclusions This is a novel complication of a patient presenting with abdominal pain with a previous history of pericardial window fenestration. A laparoscopic reduction and repair can be performed safely with excellent postoperative results.

scholarly journals Unusual Differential Disease Entity of Right Lower Abdominal Pain, Ileal Diverticulitis Perforation: A Report of Three Cases

2017 ◽  
Vol 102 (11-12) ◽  
pp. 530-535
Author(s):  
Pyong Wha Choi ◽  
Mee Joo
Keyword(s):  
Abdominal Pain ◽  
Clinical Manifestations ◽  
Lower Abdominal Pain ◽  
Disease Entity ◽  
Colonic Diverticulitis ◽  
Lower Quadrant ◽  
Ileal Perforation ◽  
Abdominal Symptoms ◽  
Right Lower Quadrant ◽  
Ileal Diverticulitis

Introduction: Small bowel diverticulum is a rare disease entity, and most cases are asymptomatic. However, diverticulitis can cause acute abdomen conditions like colonic diverticulitis. Depending on the location, various abdominal symptoms may ensue. Clinical manifestations of ileal diverticulitis may be similar to those of appendicitis and or colonic diverticulitis. Thus, making a diagnosis based on a physical examination alone may be challenging. Even though imaging techniques such as computed tomography (CT) may provide clues for a definite diagnosis, the majority of cases are confirmed through operation. Here, we present 3 cases of ileal diverticulitis perforation, which were not diagnosed preoperatively. Case presentation: A 71-year-old man, a 77-year-old woman, and a 78-year-old woman presented with abdominal pain. All 3 patients showed local peritoneal irritation signs in the right lower quadrant. Appendicitis or colonic diverticulitis was suspected, but CT scan results revealed free air and mesenteric fat infiltration around the terminal ileum, suggesting ileal perforation. During the operation in each case, terminal ileal perforation was confirmed, and ileocecal resection was performed. Subsequently, histologic examination revealed ileal diverticulitis perforation. Although the postoperative course was uneventful in the first and second patient, the third patient died of sepsis resulting from anastomosis leakage. Conclusion: These cases put forth unusual causes of right lower quadrant pain, which show physical findings similar to those of diverse inflammatory disease. Awareness of this disease is beneficial for making a differential diagnosis based on CT findings and eliciting prompt surgical management.

scholarly journals Uterine Perforation & Abortion- A Case Report

KYAMC Journal ◽  
2017 ◽  
Vol 5 (1) ◽  
pp. 491-493
Author(s):  
Mst Atia Sultana ◽  
Rakib Uddin ◽  
Rubiyat Farzana Hussain ◽  
Masuma Khatun
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Vaginal Bleeding ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Placental Tissue ◽  
Uterine Perforation ◽  
Gentle Traction ◽  
Cord Prolapse

Sreemoti Ratna Sarker 30 years old lady presented to us with the complaints of amenorrhea for 5 months, lower abdominal pain for 5 days, slight per vaginal bleeding for 2-3 days, a cord like structure is coming down p/v on the day of admission. On general examination she was stable and on p/v examination there was cord prolapse. A gentle traction was given and it was expelled out along with a small piece of placental tissue without any fetal parts and bleeding. Then she was advised for USG of abdomen. USG reported a fetus like structure in the abdominal cavity and the empty uterine cavity . She was managed surgically. Now she is doing well.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 491-493

scholarly journals Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kyota Tatsuta ◽  
Mayu Sakata ◽  
Kosuke Sugiyama ◽  
Toshiya Akai ◽  
Katsunori Suzuki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Transverse Colon ◽  
Bowel Wall ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Laparoscopic Approach ◽  
Laparoscopic Procedure ◽  
Adult Intussusception ◽  
Surgical Reduction

Abstract Background Adult intussusception is recognized as an abdominal emergency. More than 90% of adult patients with intussusception have distinct causes that are related to benign or malignant tumors. In contrast, idiopathic intussusceptions, which are observed in children, are rare conditions in adult. Especially, colo-colonic idiopathic intussusceptions are rare among them. Surgery is traditionally considered the primary treatment option. Recently, laparoscopic surgery has been reported to be safe and feasible. However, laparoscopic surgical reduction, which is a common procedure in pediatric surgery, is not common in adult intussusception. Case presentation We report a 34-year-old man who presented with sudden abdominal pain. Computed tomography revealed the target sign in the transverse colon. There was no evidence of bowel obstruction, bowel wall edema, or tumor. We diagnosed idiopathic intussusception and selected laparoscopic procedure because of the strong abdominal pain experienced by the patient. There were no signs of perforation, bowel wall ischemia, or tumor in abdominal cavity. We confirmed idiopathic colo-colonic anterograde intussusception. Laparoscopic surgical reduction was achieved by a combination of delicate direct pressure on the anal side of the transverse colon and gentle pulling on the oral side. The patient’s postoperative course was uneventful. Conclusions We achieved successful surgical reduction laparoscopically because of an accurate preoperative diagnosis based on characteristic computed tomography features and appropriate surgical technique. Laparoscopic procedure and surgical reduction is considered to be an effective treatment strategy for adult idiopathic intussusceptions with severe symptoms.

scholarly journals Vólvulo de ciego con lesión de colon ascendente reporte de un caso y alternativas de tratamiento

2021 ◽  
Vol 51 (3) ◽  
Author(s):  
Germán Brito Sosa ◽  
Ana María Iraizoz Barrios
Keyword(s):  
Abdominal Pain ◽  
Surgical Technique ◽  
Intestinal Resection ◽  
Right Hemicolectomy ◽  
Cecal Volvulus ◽  
Ascending Colon ◽  
Safe Alternative ◽  
Intestinal Necrosis ◽  
History Of ◽  
Mobile Cecum

Cecal volvulus is a rare disease responsible for 1% of the cases of intestinal occlusion, whose main etiology is due to a mobile cecum. A 73-year-old male patient with a history of constipation is presented. He had a clinical picture of abdominal pain and distention, nausea, vomiting, and absence of stool or gas expulsion. A Cecal volvulus with lesion in the ascending colon was found. The surgical technique most frequently performed by surgeons for cecal volvulus is right hemicolectomy with transverse ileus anastomosis, but if the volvulus caused intestinal necrosis and the patient is hemodynamically unstable, it is safer to perform intestinal resection and ileostomy. Ascending ileus anastomosis performed at a higher level of the ascending colon is a safe alternative for the restitution of intestinal transit in patients with cecal volvulus.

Tubal Hydatidiform Mole: A Case Report

2017 ◽  
Vol 31 (2) ◽  
pp. 104-106
Author(s):  
Ferdousi Begum ◽  
Setara Kasem ◽  
Shahnaz Begum ◽  
Amina Zannat ◽  
Farhana Rahman ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Hydatidiform Mole ◽  
Lower Abdominal Pain ◽  
Severe Anaemia ◽  
Emergency Laparotomy ◽  
Molar Pregnancy ◽  
Pelvic Ultrasound ◽  
Excessive Sweating ◽  
Gynecological Examination

The incidence of ectopic pregnancy is 20 per 1,000 pregnancies. Hydatidiform mole occurs in 1 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. We report a case of tubal molar pregnancy diagnosed at the systematic histology examination of an ectopic pregnancy. A 22 years old second gravida presented with five weeks amenorrhea, severe lower abdominal pain and mild vaginal bleeding for one day; and excessive sweating and restlessness for 6 hours. On clinical examination, she had severe anaemia, pulse was 120 per minute and blood pressure was 80/60 mm hg. The gynecological examination was difficult because of lower abdominal pain and tenderness. She was diagnosed as a case of ruptured tubal pregnancy with shock. Pelvic ultrasound revealed an irregular echogenic mass in the left adnexa. She was resuscitated and emergency laparotomy was done: it revealed a left-sided ruptured ampullary ectopic pregnancy. Left salpingectomy was performed. The systematic histologic test identified an ectopic molar pregnancy. The patient was followed with weekly quantitative B-hCG titers until three successive B-hCG levels were negative. It is important that clinicians routinely send for histological examination of tubal specimens in ectopic pregnancy in order to diagnose cases of ectopic molar gestations early and provide appropriate post treatment follow up.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 104-106

scholarly journals Uterus Didelphys: Report of a Puerperal Torsion and a Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Lucio M. A. Cipullo ◽  
Slobodan Milosavljevic ◽  
Elisabeth D. van Oudgaarden
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Caesarean Section ◽  
Lower Abdominal Pain ◽  
Emergency Laparotomy ◽  
Review Of The Literature ◽  
Uterus Didelphys

A 29-year-old Para 2 was admitted to the emergency department with increasing lower abdominal pain. The patient had undergone an uncomplicated elective repeat caesarean section 7 days before being admitted to the emergency department. An emergency laparotomy revealed a uterus didelphys with a torsion of one of the uteri.

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
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Supportive Care ◽  
Intestinal Obstruction ◽  
Lower Abdominal Pain ◽  
Bowel Ischemia ◽  
Ascending Colon ◽  
Symptoms And Signs

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.

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