scholarly journals Smooth muscle degeneration of the mesenteric and branching veins causing ischemic enteritis: a case report

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Taiki Sunakawa ◽  
Nobuo Ito ◽  
Ryo Moriyasu ◽  
Nobuya Seki ◽  
Daisuke Takeuchi ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Small Intestine ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Resected Specimen ◽  
Muscle Degeneration ◽  
Collateral Arteries ◽  
Short Period ◽  
Ischemic Enteritis

Abstract Background Ischemic bowel injuries are generally caused by arteriosclerosis, thromboembolism, or vasculitis. Ischemic enteritis is less common than ischemic colitis because of the rich collateral arteries of the small intestine. In the present case, smooth muscle degeneration of the mesenteric to the submucosal veins caused ischemic enteritis and small bowel obstruction. Case presentation An 85-year-old woman with recurrent enteritis eventually developed small bowel obstruction. We performed laparoscopic partial resection of the small intestine. The pathological findings revealed smooth muscle degeneration of the mesenteric veins that caused ischemic enteritis. Venous changes were detected not only in the injured region, but also in a part of the normal region of the resected specimen. She continued to experience some minor symptoms postoperatively; however, these symptoms subsided in a short period with medicine discontinuation. Conclusion This report shows the possibility that a disease causes ischemic enteritis with unique venous pathological changes and may recur postoperatively.

scholarly journals Bowel obstruction and perforation secondary to barbed suture after minimally invasive inguinal hernia repair: report of two cases and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Liming Wang ◽  
Taku Maejima ◽  
Susumu Fukahori ◽  
Shoji Nishihara ◽  
Daitaro Yoshikawa ◽  
...  
Keyword(s):  
Small Intestine ◽  
Inguinal Hernia ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Perforation ◽  
Barbed Suture ◽  
Small Bowel Perforation ◽  
Peritoneal Closure ◽  
Pubmed Database

Abstract Background Laparoscopic transabdominal preperitoneal patch (TAPP) is now commonly used in the repair of inguinal hernia. Barbed suture can be a fast and effective method of peritoneal closure. We report two rare cases of small bowel obstruction and perforation caused by barbed suture after TAPP. Cases Patient 1 is a 45-year-old man who underwent laparoscopic repair of a right inguinal hernia. Barbed suture was used to close the peritoneal defect. At 47 days after the operation, he was diagnosed with a small bowel obstruction caused by an elongated tail of the barbed suture. Emergency laparoscopic exploration was performed for removal of the embedded suture and detorsion of the volvulus. The second patient is a 50-year-old man who was admitted with a small bowel perforation one week after TAPP herniorrhaphy. Emergency exploration revealed that the tail of the barbed suture had pierced the small intestine, causing a tiny perforation. After cutting and releasing the redundant tail of the barbed suture, the serosal and muscular defect was closed with 2 absorbable single-knot sutures. Both patients have recovered well. Finally, we searched the PubMed database and reviewed the literature on the effectiveness and safety of barbed suture for TAPP. Conclusions Surgeons should understand the characteristics of barbed suture and master the technique of peritoneum closure during TAPP in order to reduce the risk of bowel obstruction and perforation.

META-ANALYSIS ON ETIOPATHOGENESIS OF SMALL BOWEL OBSTRUCTION IN THE DEPARTMENT OF GEN. SURGERY P.M.C.H. & K.M.C.H., BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Abhishek Chaudhary ◽  
Kanchan Sone Lal Baitha ◽  
Yasir Tajdar
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Meta Analysis ◽  
Ileocaecal Valve ◽  
Time Period ◽  
Ligament Of Treitz

Background:The small intestine is the longest and convoluted portion in the digestive tract. It starts from pylorus and ends at ileocaecal valve. The small bowel consists of three parts measuring about 5 to 6 meters. The rst 25cm is the duodenum. Out of the rest part of small gut, jejunum th th. constitute the proximal 2/5 and ileum distal 3/5 The jejunum and ileum extend from the peritoneal fold that supports the duodeno-jejunal junction (Ligament of Treitz) down to ileocaecal valve. Material and Methods:All the patients admitted to PMCH, Patna and KMC, Katihar as intestinal obstruction was included for the study. The time period of study was from October 2014 to November 2016 in PMCH and December 2016 to January 2019 in KMC, Katihar. Out of all Intestinal obstruction 59 cases only of adult small gut obstruction were recorded for comparison and conclusive study.Conclusion: Small bowel obstruction remains a frequently encountered problem in abdominal surgery. Although modern day surgical management continues to focus appropriately on avoiding delayed operation, whatever surgery is indicated, not every patient is always best served by immediate operation

scholarly journals Modern aspects of surgical treatment of patients with adhesive small bowel obstruction

2021 ◽  
Vol 12 (4) ◽  
pp. 47-54
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Sergey V. Petrov ◽  
Diyora H. Qalandarova
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Small Bowel ◽  
Mortality Rate ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Diagnostic Algorithm ◽  
Diagnostic Methods ◽  
Adhesive Small Bowel Obstruction ◽  
Surgical Interventions

Despite the ongoing preventive measures aimed at reducing the formation of adhesions in the abdominal cavity with an increase in the number of surgical interventions on the abdominal organs, the number of patients admitted to surgical hospitals with adhesions of the small intestine is also increasing. It should be noted that annually about 12% of previously operated patients undergo treatment in surgical departments while the exceptional fact is that 5070% are patients with acute adhesive ileus of the small intestine and the mortality rate in this group ranges from 13 to 55%. In recent years the literature has been actively discussing the advantages of minimally invasive technologies in the treatment of adhesive small bowel obstruction since the use of traditional methods often leads to the development of complications with repeated (in 60% of cases) surgical interventions. The purpose of this study was the development and implementation of an improved therapeutic and diagnostic algorithm in patients with adhesive small bowel obstruction which made it possible to improve the results of treatment. A comparative analysis of 338 patients with adhesive small bowel obstruction who were treated in the surgical departments of the St. Elizabeth Hospital in St. Petersburg in the period from 2016-2019 was carried out. All the patients were divided into 2 groups: the main (I) group (2018-2019), which consisted of 198 patients who received the improved diagnostic and treatment algorithm as well as the comparison group (II) (2016-2017) which included 140 cases these are patients examined according to the standard protocol and operated on in the traditional way. Moreover, in 98 cases, it was possible to resolve acute adhesive small intestinal obstruction in a conservative way, and 240 patients underwent surgical treatment. The developed diagnostic algorithm is based on the consistent application of the most informative diagnostic methods. At the same time the indications and the sequence of their application were established which ultimately made it possible to shorten the preoperative time interval as well as to determine the optimal treatment strategy with the choice of the type of surgical treatment (laparotomy or laparoscopy). The proposed treatment and diagnostic algorithm allowed to reduce the complication rate from 46.5% (53) to 22.2% (28) (р 0,001), and the mortality rate from 14.9% (17) to 3.9% (5) (p 0,01).

Diaphragm disease in emergency surgery

2020 ◽  
Vol 81 (3) ◽  
pp. 1-6
Author(s):  
Diwakar R Sarma ◽  
Pratik Bhattacharya
Keyword(s):  
Risk Factors ◽  
Small Intestine ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Emergency Laparotomy ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Acute Small Bowel Obstruction ◽  
Anti Inflammatory

Background/Aims Diaphragm disease of the small bowel has been described in the literature over the last three decades. The pathognomonic characteristic of multiple circumferential stenosis is noted on gross examination of the bowel. It is a severe form of non-steroidal anti-inflammatory drug-induced enteropathy, often presenting as acute small bowel obstruction. A systematic review was performed to identify risk factors and patient outcomes in histologically-proven diaphragm disease of the small intestine in patients undergoing emergency operation for small bowel obstruction. Methods A comprehensive search was performed between January 1975 and March 2019 using relevant MeSH terms. Studies were chosen based on predefined inclusion criteria. Diaphragm disease of the small intestine was defined as macroscopically detected thin diaphragm-like mucosal folding inside the lumen of the bowel. The parameters assessed included patient characteristics, duration of use of non-steroidal anti-inflammatory drugs, type of emergency surgery performed, complications, recurrence, presentation and diagnosis of diaphragm disease. Results A total of 21 studies were analysed which included 17 case reports, one case series, and three retrospective comparative studies. Overall 29 patients with diaphragm disease of the small bowel were reported following emergency laparotomy for small bowel obstruction. Use of non-steroidal anti-inflammatory drugs was noted in all cases with an average duration of 3–5 years. All patients presented acutely with features of small bowel obstruction and had emergency laparotomy, except one who underwent laparoscopic resection. In the comparative studies patients were more likely to be female and to have been taking non-steroidal anti-inflammatory drugs for more than 7 years. Conclusions This is a rare disease, difficult to diagnose and often confirmed by the intra-operative macroscopic appearance of circumferential stenosis of the bowel. Risk factors for developing small bowel diaphragm disease include long-term use of non-steroidal anti-inflammatory drugs, and female gender. Patients with this disease are at increased risk of developing acute small bowel obstruction, so early identification is important.

scholarly journals Multiple submucosal lipomas of small intestine: a case report

2020 ◽  
Vol 7 (9) ◽  
pp. 3133
Author(s):  
Kritika Tiwari ◽  
Rhishikesh J. Raghuvanshi ◽  
Anuja Athale ◽  
Suresh G. Deshpande
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Small Bowel ◽  
Hypertensive Patient ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Adult Intussusception ◽  
Asymptomatic Adult

Small bowel obstruction can be due to benign or malignant pathologies. Gastro intestinal lipomas are one of the benign subepithelial tumours causing obstruction. These are usually detected incidentally if asymptomatic. Adult intussusception due to intestinal lipoma is a very rare cause. We are presenting a case of male hypertensive patient with features of multiple subacute obstruction due to multiple submucosal lipomas in ileum. Exploratory laparotomy with intra-operative enteroscopy was performed and resection-anastomosis of affected segment was done.

scholarly journals Acute small bowel obstruction due to intussusception of malignant amelonatic melanoma of the small intestine

2012 ◽  
Vol 2012 (jul31 1) ◽  
pp. bcr2012006352-bcr2012006352 ◽  
Author(s):  
R. B. Patel ◽  
N. C. Vasava ◽  
M. B. Gandhi
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Small Bowel Obstruction

scholarly journals A case of idiopathic myointimal hyperplasia of the mesenteric veins presenting with small bowel obstruction

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kohei Yamada ◽  
Masatsugu Hiraki ◽  
Toshiya Tanaka ◽  
Daisuke Mori ◽  
Futoshi Tanaka ◽  
...  
Keyword(s):  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Disease ◽  
Smooth Muscles ◽  
Final Diagnosis ◽  
Mesenteric Veins ◽  
Ischemic Bowel

Abstract Background Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare ischemic bowel disease with venous occlusion resulting from the proliferation of smooth muscles in the venous intima. In most patients, the disease affects rectosigmoid colon and causes persistent abdominal pain and hematochezia, which is similar to inflammatory bowel disease (IBD). In addition, it is difficult to make a precise diagnosis of IMHMV without surgery. Case presentation An 81-year-old woman was admitted to our hospital with mild abdominal pain, nausea and vomiting. Repeated adhesive ileus was suspected due to the previous open and laparoscopic surgeries. Surgery was planned to treat small bowel obstruction. Intraoperatively no adhesive lesions were observed. However, a mass lesion was seen at the terminal ileum, which was suspected to have caused her bowel obstruction. Partial resection of the small intestine was performed. Macroscopic and histopathological examinations of the excised specimen showed circumferential ulceration with scarring, a thickened venous wall with active inflammation, and fibrotic changes that consequently produced stenosis and obstruction of the venous lumen in the subserosa. Additionally, Elastica van Gieson staining demonstrated thickening of the venous intima. The final diagnosis was IMHMV. At two years and 8 months after the operation, the patient was well without any additional medication. Conclusion IMHMV of the small intestine is rare. We described a case of IMHMV that was associated with ileus.

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