scholarly journals Retained enteroscopy capsule in a patient with diaphragm disease

2016 ◽  
Vol 98 (5) ◽  
pp. e79-e81 ◽  
Author(s):  
A-WN Meshikhes
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Resection ◽  
Diagnostic Modality ◽  
Colicky Abdominal Pain ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Subacute Intestinal Obstruction ◽  
High Index Of Suspicion

Introduction Diaphragm disease is a rare consequence of small-bowel enteropathy, and usually occurs as a result of longstanding ingestion of non-steroidal anti-inflammatory drugs. DD is characterized by multiple strictures and saccular dilatations leading to symptoms of subacute intestinal obstruction. Often, the diagnosis is made on histological examination after laparotomy and resection of diseased small bowel. Case History Here, we report a case of an elderly female who suffered for many years from chronic, colicky abdominal pain and anaemia due to undiagnosed diaphragm disease. Eventually, she was referred to our surgical team because of a retained enteroscopy capsule. The diagnosis was made after laparotomy and bowel resection. This surgical intervention alleviated chronic symptoms, and the patient remained well at 1-year follow-up. Conclusions This case highlights the difficulty of diagnosing diaphragm disease without laparotomy and bowel resection. A high index of suspicion must be exercised in any patient with chronic, colicky abdominal pain and anaemia together with multiple strictures and saccular dilatations on computed tomography even in the absence of longstanding NSAID ingestion. Moreover, capsule enteroscopy should be avoided as a diagnostic modality of small-bowel disease if computed tomography raises the suspicion of strictures.

scholarly journals Diaphragm Disease: The Limitation of Laparoscopy and Assessment of the Small Bowel for Strictures Using a Ball Bearing

2006 ◽  
Vol 6 ◽  
pp. 1139-1143 ◽  
Author(s):  
C.E. Moffat ◽  
M.N. Khyan ◽  
C.G. Davies ◽  
A.S.K. Ghauri ◽  
C.J. Ranaboldo
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Ball Bearing ◽  
Steel Ball ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
High Index Of Suspicion

Diaphragm disease is a rare cause of intestinal obstruction that will be seen with increasing frequency with the widespread use of nonsteroidal anti-inflammatory drugs (NSAIDs). We present a case study of a patient with diaphragm disease where the diagnosis was not apparent at laparoscopy, and passage of a steel ball through the small intestine was required to identify all strictures present. A high index of suspicion, recognition of the limitations of conventional diagnostic aids, and the need to assess the full length of the small bowel are all important in the surgical management of this condition.

scholarly journals Diaphragm Disease: NSAID-Induced Small Bowel Stricture

2018 ◽  
Vol 12 (2) ◽  
pp. 327-330 ◽  
Author(s):  
Bruce J. Grattan Jr. ◽  
Tracy Bennett ◽  
Michael R. Starks
Keyword(s):  
Risk Factor ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Stricture ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Bowel Stricture

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is ubiquitous. However, it remains an oftentimes under-recognized risk factor for the development of strictures and small bowel obstruction. Herein we describe the case of a 63-year-old female with a prolonged course of abdominal pain and occult anemia found to have a diaphragmatic stricture in the small bowel related to chronic NSAID use.

scholarly journals Multiple Small Intestine Ulcers with Desquamation of the Fingers

2017 ◽  
Vol 11 (2) ◽  
pp. 452-461
Author(s):  
Azusa Kawasaki ◽  
Kunihiro Tsuji ◽  
Hisashi Doyama
Keyword(s):  
Computed Tomography ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Yersinia Pseudotuberculosis ◽  
Oral Ulcers ◽  
Palmar Erythema ◽  
Antibody Titers ◽  
Endoscopic Characteristics ◽  
Multiple Ulcers

A 73-year-old female was admitted to our hospital with abdominal pain and diarrhea. Computed tomography detected distension of the small intestine. A palmar erythema, multiple oral ulcers, and desquamation of the fingers appeared after hospitalization. Small-bowel endoscopic images showed multiple ulcers. We attributed this case to infection with Yersinia pseudotuberculosis based on the changes in Y. pseudotuberculosis antibody titers throughout the course of the illness. This report is valuable, as it illustrates the endoscopic characteristics of a Y. pseudotuberculosis infection with skin lesion and ileus, which may enable us to deepen the pathologic understanding of this disease.

MUCINOUS MESENTERIC CYST OF SIGMOID MESOCOLON : A RARE ENTITY

2021 ◽  
pp. 22-23
Author(s):  
K.Prasanth Kumar ◽  
A.D.V. Lavanya ◽  
P.Surendra Reddy
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Physical Examination ◽  
Mesenteric Cyst ◽  
Rare Entity ◽  
Small Bowel Mesentery ◽  
Mesenteric Cysts ◽  
Sigmoid Mesocolon

Mesenteric cysts are rare and occur in patients of any age. They are asymptomatic and found incidentally or during the management of their complications. They commonly originate from the small bowel mesentery, although a proportion of them have been found to originate from the mesocolon (24%) and the retroperitoneum [1] [2,3,4,5] (14.5%). A mesenteric cyst originating in the sigmoid mesocolon is a very rare nding. They are a rare cause of abdominal pain and are discovered incidentally. If symptomatic, patients with these cysts present with abdominal pain, vomiting and low backache. Performing a thorough physical examination and conducting radiological investigations like ultrasonography (USG), computed tomography (CT) are keys in diagnosing the mesenteric cysts.

scholarly journals A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Aghyad K Danial ◽  
Ahmad Al-Mouakeh ◽  
Yaman K Danial ◽  
Ahmad A Nawlo ◽  
Ahmad Khalil ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Medical History ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Past Medical History ◽  
Abdominal Symptoms ◽  
Diaphragm Disease ◽  
History Of ◽  
Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of NSAID use.

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 Small Bowel Diverticulosis Causing Pneumoperitoneum without Peritonitis: A Case Report

2018 ◽  
Vol 01 (01) ◽  
pp. 069-071
Author(s):  
Geena Benjamin ◽  
Agnes Thomas ◽  
Mathew Koshy
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Perforation ◽  
Chronic Abdominal Pain ◽  
Rare Finding ◽  
X Ray ◽  
Computed Tomography Images ◽  
Clinical Presentations ◽  
Fatal Complications

AbstractSmall bowel diverticulosis is a rare finding, with varied clinical presentations, which make the diagnosis difficult and delayed. Many cases are asymptomatic. However, it is an entity that can present with fatal complications. Here, we present a case of a 79-year-old male patient with diffuse small bowel diverticulosis, who presented with loose stools and acute exacerbation of chronic abdominal pain. Plain abdominal X-ray showed dilated bowel loops and pneumoperitoneum, which raised the possibility of bowel perforation. Computed tomography images revealed diffuse small bowel diverticulosis and pneumoperitoneum. Subsequent explorative laparotomy revealed no bowel perforation. Small bowel diverticulosis is a well-known cause of chronic/recurrent pneumoperitoneum without peritonitis or surgery.

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals Abdominal Pain and Vomiting in a Patient with Over-anticoagulation -- a Rare Case of Spontaneous Intramural Hematoma of the Jejunum

2020 ◽  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Vitamin K Antagonists ◽  
Intramural Hematoma ◽  
Rare Condition ◽  
The Body ◽  
Diagnostic Process ◽  
Tomography Scan

Anticoagulants, including vitamin K antagonists, are widely used for therapeutic and prophylactic purposes. Bleeding is the most important complication of anticoagulant therapy due to over-anticoagulation. Over-anticoagulation may present in unusual ways, such as spontaneous intramural hematoma of the small bowel. The classical clinical picture consists of abdominal pain, small bowel obstruction (that can present as vomiting) and hemorrhagic symptoms that can be related to the bowel or other parts of the body. Radiological examinations are essential for the diagnosis. Ultrasound can be helpful in the diagnostic process, but computed tomography is the procedure of choice. Conservative treatment is usually successful, including procedures that stop the over-anticoagulant consequences. A surgical approach is reserved for complications such as necrosis or perforation of the bowel. The diagnosis is definitively confirmed by the spontaneous resolution of the pathological findings on a follow-up computed tomography scan. We present a case of a 72-year-old woman who was diagnosed with this rare condition affecting the jejunum in the emergency department in our hospital.

scholarly journals “Meckel’s Diverticulum” – A diagnostic bizarre of abdominal pain in adults

2020 ◽  
Vol 2 ◽  
pp. 58-60
Author(s):  
Vipin Kumar Bakshi ◽  
Manjot Kaur ◽  
Gajendra Bhatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Wall Thickening ◽  
Emergency Laparotomy ◽  
Contrast Enhanced ◽  
Antimesenteric Border ◽  
Meckel’S Diverticulitis ◽  
Bowel Wall Thickening ◽  
Subacute Intestinal Obstruction ◽  
Enhanced Computed Tomography

A 30-year-old male presented to the emergency room with complaints of periumbilical abdominal pain and vomiting. A contrast-enhanced computed tomography scan of the abdomen revealed subacute intestinal obstruction with dilated small bowel loops and associated bowel wall thickening of mid and distal ileal bowel loops. There was a fairly large small bowel diverticulum arising from the antimesenteric border of distal ileum. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable post-operative course without any complications and was discharged within a week.

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