Spontaneous Resolution of Small Bowel Obstruction in a Child following Rupture of a Small Bowel Duplication Cyst

Duplication cysts are rare congenital malformations that can present with a variety of symptoms that may change during the course of an acute admission. We report a case in which a four-year-old boy presented with signs of small bowel obstruction that following imaging were found to be secondary to bowel compression by a large duplication cyst. The symptoms changed when the cyst ruptured. We highlight the importance of ultrasound in establishing the diagnosis of enteric duplication cysts in the symptomatic paediatric population. We also explore the differential diagnosis and complications that can be caused by these congenital anomalies.

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Intraluminal Meckel’s Duplication Cyst Causing Bowel Obstruction in an Infant: A Role for Laparotomy

Case Reports in Pediatrics ◽

10.1155/2016/4717403 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Mitchell R. Ladd ◽

Alejandro V. Garcia ◽

Derek B. Allison ◽

Jeffrey R. Lukish

Keyword(s):

Small Bowel ◽

Bowel Obstruction ◽

Ileocecal Valve ◽

Signs And Symptoms ◽

Duplication Cyst ◽

Ectopic Gastric Mucosa ◽

Lower Quadrant ◽

Intraluminal Mass ◽

Enteric Duplication ◽

Right Lower Quadrant

This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel’s diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.

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A wolf in sheep’s clothing: concomitant appendicitis with occult cecal adenocarcinoma

International Surgery Journal ◽

10.18203/2349-2902.isj20212724 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2154

Author(s):

Jonathan Mejia ◽

Roland Haj ◽

Sutasinee Nithisoontorn ◽

Martine A. Louis ◽

Nageswara Mandava

Keyword(s):

Differential Diagnosis ◽

Small Bowel ◽

Acute Appendicitis ◽

Ct Scan ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Delayed Presentation ◽

Ct Guided ◽

Distal Small Bowel ◽

Risk Of Cancer

We present the case of an 89-years-old female with an atypical presentation of an obstructive acute appendicitis secondary to a cecal carcinoma. The physical exam revealed a distended abdomen with bilateral lower quadrants tenderness without rebound or rigidity. CT scan demonstrated distal small bowel obstruction and ruptured acute appendicitis. Patient was treated conservatively with nasogastric decompression, intravenous fluids, and antibiotics. She later underwent CT guided drainage of a rim-enhancing fluid collection and her symptoms eventually resolved. She returned a week later and a CT imaging showed high grade distal small bowel obstruction, and findings were a 4.5 cm diameter cecal mass. She underwent an exploratory laparotomy and modified right hemicolectomy with ileostomy for. She had an uneventful postoperative course. Pathology revealed poorly differentiated adenocarcinoma of the cecum stage III T4N1Mx. Appendectomy for appendicitis is the most commonly performed emergency operation in the world. Appendicitis are often rare in elderly, with atypical or delayed presentation and expanded differential diagnosis, making preoperative diagnosis challenging. With the increase overall risk of cancer in this age group, occult colonic carcinoma should be high in the differential diagnosis. Three mechanisms potentially leading to obstruction of the appendiceal lumen by the tumor includes: immediate proximity to the lumen, inflammatory changes from the tumor, back pressure on the cecum causing obstruction of the appendix. Despite advances in imaging, local inflammation, collections, and masses may be misleading. The diagnostic accuracy of CT scan reportedly can be as low as 54% for cecal tumors.

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Sudden Unexpected Death Associated with Ileocecal Duplication Cyst and Clinical Review

Clinical Medicine Insights Pediatrics ◽

10.4137/cmped.s4850 ◽

2010 ◽

Vol 4 ◽

pp. CMPed.S4850 ◽

Cited By ~ 2

Author(s):

Y Kashiwagi ◽

S. Suzuki ◽

K. Watanabe ◽

S. Nishimata ◽

H. Kawashima ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Duplication Cyst ◽

Multiple Organ ◽

Watery Diarrhea ◽

Abdominal Radiograph ◽

Unexpected Death ◽

Plain Abdominal Radiograph ◽

Abdominal Symptoms

Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.

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Enterolith ileus and jejunal diverticulitis from jejunal diverticulosis: the complications of a rare gastrointestinal entity

BMJ Case Reports ◽

10.1136/bcr-2021-243252 ◽

2021 ◽

Vol 14 (6) ◽

pp. e243252

Author(s):

Blake Anthony Sykes ◽

Chitrakanti Raj Kapadia

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Large Bowel ◽

Rare Entity ◽

Jejunal Diverticulosis ◽

Bowel Content ◽

Jejunal Diverticulitis

Small bowel diverticulosis is rare. False diverticula form in the jejunum, and less commonly, the ileum. As with their large bowel counterparts, these diverticula provide a pocket for stasis of bowel content, leading to the formation of enteroliths. This case report highlights two complications from jejunal diverticulosis: jejunal diverticulitis and a small bowel obstruction as a result of enterolithiasis; the latter being a rare entity which should be a differential diagnosis for any individual presenting with gastrointestinal obstructive symptoms and radiological evidence of small bowel diverticulosis.

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Gastric Trichobezoar Causing Intermittent Small Bowel Obstruction: Report of a Case and Review of the Literature

Case Reports in Medicine ◽

10.1155/2011/217570 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Nicole G. Coufal ◽

Akash P. Kansagra ◽

Jay Doucet ◽

Jeanne Lee ◽

Raul Coimbra ◽

...

Keyword(s):

Differential Diagnosis ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Unusual Case ◽

Upper Endoscopy ◽

Review Of The Literature ◽

Gastric Trichobezoar ◽

Repeat Endoscopy ◽

Multiple Episodes

We report the unusual case of a 45-year-old woman who presented with multiple episodes of small bowel obstruction. Initial exploratory lap-roscopy did not reveal an etiology of the obstruction. Subsequent upper endoscopy identified a non-obstructing gastric trichobezoar which could not be removed endoscopically but was not thought to be responsible for the small bowel obstruction given its location. One week postoperatively, the patient experienced recurrence of small bowel obstruction. Repeat endoscopy disclosed that the trichobezoar was no longer located in the stomach and upon repeat laparotomy was extracted from the mid-jejunum. In the following 8 months, the patient had no further episodes of small bowel obstruction. Consequently, gastric bezoars should be included in the differential diagnosis of recurrent small bowel obstruction.

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Meckel’s diverticulitis causing small bowel obstruction by a novel mechanism

Clinics and Practice ◽

10.4081/cp.2011.e51 ◽

2011 ◽

Vol 1 (3) ◽

pp. 51

Author(s):

Vishalkumar G. Shelat ◽

Kaiwen Kelvin Li ◽

Anil Rao ◽

Tay Sze Guan

Keyword(s):

Small Bowel ◽

General Population ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Meckel’S Diverticulum ◽

Symptomatic Patient ◽

Paediatric Population ◽

Meckel's Diverticulum ◽

Common Presentation ◽

Meckel’S Diverticulitis

Meckel’s diverticulum occurs in 2% of the general population and majority of patients remain asymptomatic. Gastrointestinal bleeding is the most common presentation in the paediatric population. While asymptomatic and incidentally found Meckel’s diverticulum may be left alone, surgery is essential for treating a symptomatic patient. Despite advances in imaging and technology, pre-operative diagnosis is often difficult. We present a first report of an unusual mechanism of small bowel obstruction due to Meckel’s diverticulitis in a paediatric patient. The diagnosis was only apparent at laparotomy.

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Distal ileal endometriosis as a cause of ileus: A case report

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1204225g ◽

2012 ◽

Vol 140 (3-4) ◽

pp. 225-228 ◽

Cited By ~ 1

Author(s):

Pavle Gregoric ◽

Krstina Doklestic ◽

Milena Pandurovic ◽

Dejan Radenkovic ◽

Borivoje Karadzic ◽

...

Keyword(s):

Differential Diagnosis ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Small Bowel Resection ◽

Reproductive Age ◽

Intestinal Endometriosis ◽

Benign Condition ◽

Acute Small Bowel Obstruction ◽

Symptoms And Signs

Introduction. Endometriosis is a benign condition affecting females of reproductive age. Although intestinal endometriosis is common, it is rarely manifested as an acute bowel obstruction secondary to ileal endometriosis. Enteric endometriosis should be considered as a differential diagnosis when assessing females of reproductive age with acute small bowel obstruction. Case Outline. A 41-year-old woman presented with symptoms and signs of an acute small bowel obstruction requiring emergency surgery. A small bowel resection was performed with end-to-end anastomosis. Histological examination demonstrated endometriosis with fibrosis and stricture of the ileal segment. This case is important to report as it highlights the diagnostic difficulty this particular condition presents to an emergency surgeon. Conclusion. In the differential diagnosis, endometriosis should be taken into consideration when assessing females of reproductive age who present with abdominal pain and small bowel obstruction.

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