scholarly journals Ectopic Perforated Appendicitis in Supraumbilical Region in a Case of Incomplete Intestinal Rotation

2021 ◽  
Vol 10 (31) ◽  
pp. 2521-2524
Author(s):  
Bhimarao Bhimarao ◽  
Rashmi Mysore Nagaraju ◽  
Lingaraj B. Patil
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Perforated Appendicitis ◽  
Intestinal Malrotation ◽  
Emergency Laparotomy ◽  
Markers Of Inflammation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Common Causes ◽  
Uncommon Condition

Acute appendicitis is one of the most common causes of acute abdominal pain and the most common condition requiring emergency surgery. Intestinal malrotation is a relatively uncommon condition. Depending upon the location of the cecum and appendix, patients with acute appendicitis in intestinal malrotation present atypically with abdominal pain localized on the site of appendicitis. Due to atypical presentation of central abdominal pain, other differentials presenting in this region should be excluded and accurate diagnosis should be made. We present a patient who came with central abdominal pain with elevated markers of inflammation. Contrast enhanced CT of abdomen in this patient revealed ectopic appendicitis located in supraumbilical region with signs of incomplete rotation of the bowel. CT played a pivotal role in identifying the underlying rotational abnormality of bowel, in localizing the inflamed appendix, identifying complications (perforation) and excluding other possible intra-abdominal pathologies. It was also helpful in surgical planning. Emergency laparotomy with appendectomy and lavage were performed on this patient who subsequently recovered.

Obstructed ileocaecal tuberculosis with splenic tuberculosis and solid pseudopapillary tumour of tail of pancreas in an immunocompetent woman

2020 ◽  
Vol 13 (9) ◽  
pp. e235195
Author(s):  
Surendran Paramasivam ◽  
Magesh Murali ◽  
Parimuthukumar Rajappa
Keyword(s):  
Abdominal Pain ◽  
Lower Abdominal Pain ◽  
Emergency Laparotomy ◽  
Solid Pseudopapillary Tumour ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Splenic Tuberculosis ◽  
Ileocaecal Junction ◽  
Time Of Admission

A 22-year-old young woman presented with fever, lower abdominal pain and vomiting for 20 days. She had persistent fever and abdominal pain. Fever panel was negative. Clinical features were suggestive of subacute small bowel obstruction. Contrast-enhanced CT abdomen showed thickening of distal ileum, ileocaecal junction and caecum with conglomerate necrotic nodal mass in the ileocolic mesentry along with a lesion in the tail of pancreas. Patient was discussed with multidisciplinary team and decided to undergo a single-stage procedure after adequate nutritional optimisation. During optimisation, she underwent acute obstruction and hence taken up for emergency laparotomy proceeded to right haemicolectomy with distal pancreatectomy and splenectomy 4 weeks after the time of admission. Histopathology showed ileocaecal tuberculosis and solid pseudopapillary tumour with margins free of tumour. Approach of obstructed ileocaecal tuberculosis in the setting of incidental diagnosis of solid pseudopapillary tumour of pancreas in a moribund patient was challenging.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

scholarly journals Case Report: Repetitive Surgical Resections for Intestinal Intussusception due to Multiple Ileal Lipomatosis

2016 ◽  
Vol 101 (9-10) ◽  
pp. 420-425
Author(s):  
Shuichiro Oya ◽  
Yukinori Yamagata ◽  
Kouichi Yagi ◽  
Takashi Kiyokawa ◽  
Susumu Aikou ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ileocecal Valve ◽  
Detailed Examination ◽  
Histologic Diagnosis ◽  
Ileal Resection ◽  
Intestinal Intussusception ◽  
Intermittent Abdominal Pain ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Old Japanese

Adult intestinal intussusception is a rare disease known to be associated with intestinal tumors. We describe a case requiring partial ileal resection in 2 occasions due to intussusception from multiple lipomatosis. A 45-year-old Japanese man was referred to our hospital for detailed examination after positive fecal blood test results and intermittent abdominal pain. He was diagnosed with intussusception of the ileum due to multiple lipomatosis and underwent partial ileal resection. Three years after the first surgery, he again experienced intermittent abdominal pain and nausea, and was referred to our department. Contrast-enhanced computed tomography at this time also showed intussusception near the ileocecal valve, with several fat-density tumors. He underwent partial ileal resection as an emergency surgery, with the histologic diagnosis confirming ileal multiple lipomatosis. Repeated surgical resections are sometimes required for patients with intestinal intussusception due to lipomatosis, since lipomas not causing symptoms are often left untouched after minimal resection. Close follow-up such as contrast-enhanced CT and small-bowel endoscopy after surgery should be performed regularly so that the patients can avoid emergency surgeries because of the insufficient preoperative examinations.

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.

scholarly journals Concurrent intestinal malrotation and Meckel's diverticulum presenting as acute intestinal obstruction in an adult

2021 ◽  
Vol 8 (6) ◽  
pp. 1904
Author(s):  
Aishwarya Emerald Manohar ◽  
M. S. Kalyan Kumar ◽  
V. Vijayalakshmi ◽  
R. Kannan
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Meckel’S Diverticulum ◽  
Postoperative Recovery ◽  
Meckel's Diverticulum ◽  
Intestinal Malrotation ◽  
Emergency Laparotomy ◽  
Meckel’S Diverticulitis ◽  
Subacute Intestinal Obstruction

Intestinal malrotation is the partial or complete failure of rotation of midgut around the superior mesenteric artery, while Meckel’s diverticulum is the remnant of vitellointestinal duct and concurrence of these congenital abnormalities in an adult is considered a rarity. Till date only 3 cases of concurrent intestinal malrotation and Meckel's diverticulum have been reported. We report a 18 years male who presented with a 3 day history of abdominal pain, bilious vomiting, obstipation and chronic abdominal pain on and off since 3 years of age. During the last episode which occurred 1 year back, he was diagnosed with intestinal malrotation with subacute intestinal obstruction and was treated conservatively. Examination revealed the presence of signs of peritonitis. After resuscitation, CECT abdomen was taken which showed dilated small bowel loops in the subhepatic region associated with malrotation. Emergency laparotomy revealed a Ladd's band below which the gangrenous small bowel loops 150 cm from the duodenojejunal (flexure until 5 cm proximal to the ileocecal junction) were found herniating into the subhepatic region with a Meckel’s diverticulum and a right sided DJ flexure. We proceeded with the band release and resection of gangrenous bowel followed by proximal jejunostomy with distal ileostomy. HPE was consistent with Meckel’s diverticulitis without any ectopic gastric or pancreatic mucosa. Ostomy reversal was done after 8 weeks. Patient had an uneventful postoperative recovery during both the admissions and he is on regular follow-up now.

scholarly journals A Rare Cause of Abdominal Pain in Adults: Meckel’s Diverticulitis

2018 ◽  
Vol 12 (3) ◽  
pp. 709-714 ◽  
Author(s):  
Usman Pirzada ◽  
Hassan Tariq ◽  
Sara Azam ◽  
Kishore Kumar ◽  
Anil Dev
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Meckel’S Diverticulum ◽  
Meckel's Diverticulum ◽  
Emergency Laparotomy ◽  
Contrast Enhanced ◽  
Meckel’S Diverticulitis ◽  
The Right ◽  
Enhanced Computed Tomography

A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel’s diverticulum scan was diagnostic of Meckel’s diverticulum. 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 postoperative course without any complications and was discharged within 10 days. At the 3-month follow-up, the patient was well and remained asymptomatic.

scholarly journals Acute Appendicitis Complicated by Pylephlebitis: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ricardo Castro ◽  
Teresa Fernandes ◽  
Maria I. Oliveira ◽  
Miguel Castro
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Portal Vein ◽  
Clinical Presentation ◽  
Intraabdominal Infection ◽  
Septic Thrombophlebitis ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Pylephlebitis is defined as septic thrombophlebitis of the portal vein. It is a rare but serious complication of an intraabdominal infection, more commonly diverticulitis and appendicitis. It has an unspecific clinical presentation and the diagnosis is difficult. The authors report a case of a 21-year-old man with acute appendicitis complicated by pylephlebitis. The diagnosis was made with contrast enhanced CT.

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