scholarly journals Small bowel obstruction due to herniation into an extra-anatomical arterial bypass tunnel: a first case report

2010 ◽  
Vol 92 (2) ◽  
pp. e20-e22
Author(s):  
Jacqueline Simms ◽  
Karim El-Sakka ◽  
Domenico Valenti ◽  
Mark Tyrrell ◽  
Klaus-Martin Schulte
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bypass Graft ◽  
Small Bowel Resection ◽  
Critical Limb Ischaemia ◽  
Emergency Laparotomy ◽  
Limb Ischaemia ◽  
Arterial Bypass ◽  
First Case

Introduction We highlight the importance of considering rarer causes of small bowel obstruction in patients presenting after extra-anatomical arterial bypass. Case presentation Our patient underwent a left common iliac-to-bifemoral bypass extra-anatomical graft for critical limb ischaemia. The patient developed mechanical small bowel obstruction on the 20th postoperative day. Emergency laparotomy revealed incarcerated, obstructed small bowel trapped in the graft tunnel. Recovery was satisfactory following small bowel resection. Conclusions To the best of our knowledge, small bowel herniation into an arterial bypass graft tunnel, with successful treatment outcome, has not been reported to date.

scholarly journals 976 Traumatic Damage to The Liver Capsule: An Unusual Cause of Small Bowel Obstruction

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Aloni ◽  
H Harris ◽  
G Colucci ◽  
M McFall
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Blunt Trauma ◽  
Bowel Obstruction ◽  
Primary Anastomosis ◽  
Operative Management ◽  
Small Bowel Resection ◽  
Medical Attention ◽  
Emergency Laparotomy ◽  
Liver Capsule

Abstract A 57-year-old man presented to the emergency department with severe abdominal pain. Three months prior to presentation, he had sustained blunt trauma to his right side whilst cycling but had not sought medical attention. On admission, a CT scan showed small bowel obstruction and he underwent an emergency laparotomy. Intraoperatively, a subcapsular liver haematoma was identified, with incarcerated, necrotic small bowel within the liver capsule. The patient underwent deroofing of the haematoma with an omental patch and a small bowel resection with primary anastomosis. Small bowel obstruction is a common presentation in A&E and is responsible for half of emergency laparotomies in the UK each year. Although hepatic haematomas are also a relatively common complication of blunt trauma to the abdomen, associated bowel herniation into the liver capsule is very unusual. We believe this is the first time such a case of small bowel obstruction has been reported in the literature and we discuss details of operative management and highlight key learning points.

scholarly journals Two cases of small bowel obstruction due to a shiitake mushroom

2017 ◽  
Vol 7 (4) ◽  
pp. 298-300
Author(s):  
Jinfu Tan ◽  
Kaitao Yuan ◽  
Jidong Zuo ◽  
Weigang Dai ◽  
Yujie Yuan ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Lentinula Edodes ◽  
Surgical Intervention ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Shiitake Mushroom ◽  
Shiitake Mushrooms

Abstract The shiitake mushroom (Lentinula edodes), known as Xiang-gu in China, has been an important component of Asian cuisine for hundreds of years. Although not easily digestible, there are few reports of them causing bowel obstruction. We present two cases of small bowel obstruction due to a shiitake mushroom requiring surgical intervention. Two patients who did not have any teeth and did not use dentures presented with intestinal bowel obstruction and were referred to the Emergency Department of our hospital after eating a meal including shiitake mushrooms without cutting. The first patient underwent an emergency laparotomy and a semental small bowel resection and the other underwent laparoscopic small bowel incision for removal of a foreign body. The causes of the small bowel obstruction for the two patients were uncut shiitake mushrooms in the small bowel. The two patients recovered uneventfully post-operatively.

scholarly journals Fibroid expulsion: a unique presentation of mechanical small bowel obstruction 11 years after uterine artery embolization: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jeffrey L. Roberson ◽  
Lauren N. Krumeich ◽  
Nabil F. Darwich ◽  
Victor Babatunde ◽  
Dorottya Laczko ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
African American Woman ◽  
Uterine Fibroids ◽  
American Woman ◽  
Small Bowel Resection ◽  
Artery Embolization

Abstract Background Uterine artery embolization in the treatment of uterine leiomyoma has been rarely associated with dislodgement and expulsion of infarcted uterine fibroids through the vagina, peritoneum, or bowel wall, predominantly occurring within 6 months of uterine artery embolization. Case presentation We present the case of a 54-year-old African American woman who underwent uterine artery embolization 11 years prior and developed mechanical small bowel obstruction from the migration of fibroid through a uteroenteric fistula with ultimate impaction within the distal small bowel lumen. Small bowel resection and hysterectomy were curative. Conclusions Uteroenteric fistula with small bowel obstruction due to fibroid expulsion may present as a delayed finding after uterine artery embolization and requires heightened awareness.

Jewish Holiday “Tu Bishvat” or Two Cases of Small Bowel Obstruction with Dried Apricot

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Kukeev I ◽  
◽  
Replyansky I ◽  
Czeiger D ◽  
Atias S ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gastric Bypass Surgery ◽  
Surgical Removal ◽  
Cellulose Content ◽  
Lead Point ◽  
First Case ◽  
Dried Fruit ◽  
High Level

Introduction: Small bowel obstruction caused by bezoars is rare. One of the causes of phytobezoars is dried fruits. We present two cases of small bowel obstruction caused by dried apricots during Jewish holiday “Tu BiShvat”. Case Presentation: Two men, 54 and 86 years old hospitalized with acute abdomen attributed to small bowel obstruction. In the first case - intoxicated patient, due to suspicion of mesenteric ischemia underwent laparotomy. A lead point caused obstruction was found and after enterotomy whole dried apricot was removed. The patient swallowed it whole three days before hospitalization. In the second case, edentulous patient with small bowel obstruction and peritonitis underwent laparotomy. The cause of obstruction was a dried apricot swallowed whole by the patient. Discussion: Presentation of bezoar with features of acute surgical abdomen is extremely rare, accounting for only 1% of the patients. The expansion of phytobezoar that is high in cellulose content can absorb a large amount of fluid causing an obstruction of the small bowel. The treatment of small bowel obstruction caused by bezoars varies from dissolving with cellulase, papain and even Coca-Cola, followed by endoscopic and surgical removal. Conclusion: A high level of suspicion needs to exist in the presence of a history of eating dried fruit, which can cause gastrointestinal obstruction. Especially on background gastric bypass surgery and inadequate mastication.

scholarly journals Sclerosing Mesenteritis: A Rare Cause of Small Bowel Obstruction

2016 ◽  
Vol 10 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Glenn Harvin ◽  
Adam Graham
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Resection ◽  
Rare Complication ◽  
Small Bowel Resection ◽  
Sclerosing Mesenteritis ◽  
Exact Etiology ◽  
Resected Tissue ◽  
Uncommon Condition

Sclerosing mesenteritis falls within a spectrum of primary idiopathic inflammatory and fibrotic processes that affect the mesentery. The exact etiology has not been determined, although the following associations have been noted: abdominal surgery, trauma, autoimmunity, paraneoplastic syndrome, ischemia and infection. Progression of sclerosing mesentritis can lead to bowel obstruction, a rare complication of this uncommon condition. We report a case of a 66-year-old female with abdominal pain who was noted to have a small bowel obstruction requiring laparotomy and a partial small bowel resection. The pathology of the resected tissue was consistent with sclerosing mesenteritis, a rare cause of a small bowel obstruction. Sclerosing mesenteritis has variable rates of progression, and there is no consensus regarding the optimal treatment. Physicians should consider sclerosing mesenteritis in the differential diagnosis of a small bowel obstruction.

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 Non-steroidal anti-inflammatory drug-induced diaphragm disease: an uncommon cause of small bowel obstruction

2016 ◽  
Vol 98 (8) ◽  
pp. e189-e191 ◽  
Author(s):  
MME Coolsen ◽  
SJ Leedham ◽  
RJ Guy
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Resection ◽  
Drug Induced ◽  
Inflammatory Drug ◽  
Diaphragm Disease ◽  
Anti Inflammatory ◽  
Diagnostic Work ◽  
Work Up

Surgeons frequently deal with small bowel obstruction. However, small bowel obstruction caused by non-steroidal anti-inflammatory drug (NSAID)-induced diaphragm disease is very rare. The diagnosis is challenging, as symptoms are often non-specific and radiological studies remain inconclusive. We present a case of a 63-year-old man who, after an extensive diagnostic work-up and small bowel resection for obstructive symptoms, was finally diagnosed with NSAID-induced diaphragm disease as confirmed by histology. An unusual aspect of this case is that the patient stopped using NSAIDs after he was diagnosed with a gastric ulcer 2–years previously. This suggests that NSAID-induced diaphragms of the small bowel take some time to develop and underlines the importance of careful history taking.

Bowel Ischemia Score Predicts Early Operation in Patients With Adhesive Small Bowel Obstruction

2021 ◽  
pp. 000313482098882
Author(s):  
Rachel S. Morris ◽  
Patrick Murphy ◽  
Kelly Boyle ◽  
Louis Somberg ◽  
Travis Webb ◽  
...  
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Characteristic Curve ◽  
Small Bowel Resection ◽  
Bowel Ischemia ◽  
Operative Intervention ◽  
Early Operation ◽  
Adhesive Small Bowel Obstruction

Background Nonoperative management of adhesive small bowel obstruction (SBO) is successful in up to 80% of patients. Current recommendations advocate for computed tomography (CT) scan in all patients with SBO to supplement surgical decision-making. The hypothesis of this study was that cumulative findings on CT would predict the need for operative intervention in the setting of SBO. Methods This is an analysis of a retrospectively and prospectively collected adhesive SBO database over a 6-year period. A Bowel Ischemia Score (BIS) was developed based on the Eastern Association for the Surgery of Trauma guidelines of CT findings suggestive of bowel ischemia. One point was assigned for each of the six variables. Early operation was defined as surgery within 6 hours of CT scan. Results Of the 275 patients in the database, 249 (90.5%) underwent CT scan. The operative rate was 28.3% with a median time from CT to operation of 21 hours (Interquartile range 5.2-59.2 hours). Most patients (166/217, 76.4%) with a BIS of 0 or 1 were successfully managed nonoperatively, whereas the majority of those with a BIS of 3 required operative intervention (5/6, 83.3%). The discrimination (area under the receiver operating characteristic curve) of BIS for early surgery, any operative intervention, and small bowel resection were 0.83, 0.72, and 0.61, respectively. Conclusion The cumulative signs of bowel ischemia on CT scan represented by BIS, rather than the presence or absence of any one finding, correlate with the need for early operative intervention.

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