scholarly journals Low-grade appendiceal mucinous neoplasms with bowel obstruction

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Constance Houlzé-Laroye ◽  
Clarisse Eveno
Keyword(s):  
Intestinal Obstruction ◽  
Peritoneal Cavity ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Low Grade ◽  
Atypical Symptoms ◽  
Abdominal Symptoms ◽  
Clinical Presentations ◽  
Mucinous Neoplasms ◽  
Abdominal Ct Scan

AbstractBackgroundPerforation of low-grade appendiceal mucinous neoplasms (LAMN) is characterized by its potential to spread mucin into peritoneal cavity, giving rise to pseudomyxoma peritonei, commonly treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Symptoms of intestinal obstruction and appendiceal infection are rare at early stages of the disease, while abdominal distension are observed in the later stages due to mucin spread.MethodsWe report herein a case of LAMN with atypical symptoms in a 35-year-old woman with abdominal symptoms evoking an intestinal obstruction.ResultsAn abdominal CT scan revealed an ileo-caecal intussusception. An exploratory laparotomy and examination of the peritoneal cavity ruled out an exteriorization of mucin and the bowel was resected.ConclusionsThe pathology analysis confirmed the diagnostic of LAMN. This report aims to raise awareness among surgeons, of rare clinical presentations that LAMN may show, to adapt the surgical treatment to these patients and assign them to referral centers.

scholarly journals Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 73-75
Author(s):  
R Hamid ◽  
AH Shera ◽  
NA Bhat ◽  
A Baba ◽  
A Rashid
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Transverse Colon ◽  
Late Onset ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Colonic Stenosis ◽  
Colonic Atresia ◽  
Mucous Fistula

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446   J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75  

scholarly journals Ileal volvulus due to ascaris lumbricoides: a diagnosis revisited

2019 ◽  
Vol 6 (2) ◽  
pp. 614
Author(s):  
Ipseet Mishra ◽  
Sudip Haldar ◽  
Souvik Paul
Keyword(s):  
Ascaris Lumbricoides ◽  
Wide Spectrum ◽  
Primary Anastomosis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Small Bowel Volvulus ◽  
Clinical Presentations ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Early Surgical Intervention

Ascariasis infestation is a common helminthic disease in developing countries with a wide spectrum of clinical presentations, one of which can be acute abdomen. Small bowel volvulus is a serious life-threatening emergency. The aetiology may be primary as is often seen in Africa and Asia, while in Western countries other predisposing conditions usually initiate the volvulus. Ascariasis is highly prevalent in India and so, a myriad of different presentations is quite obvious. Here the authors have reported a case of a 6year old boy presenting with features of acute intestinal obstruction-central abdominal pain, repeated vomiting and abdominal distension. After evaluation with abdominal radiography and ultrasonography, exploratory laparotomy was planned. A secondary ileal volvulus compact with worms of ascaris lumbricoides was found. Resection of non-viable ileum was done after evacuation of worms by enterotomy followed by primary anastomosis. Prompt clinical diagnosis, a high index of suspicion for complications and early surgical intervention are critical in minimizing morbidity in cases of Intestinal Ascariasis.

scholarly journals Bilateral Serous Psammocarcinoma of Ovary: Rare Variant Low Grade Serous Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Saubhagya Kumar Jena ◽  
Pritinanda Mishra ◽  
Vandana Mohapatra ◽  
Sweta Singh
Keyword(s):  
Rare Variant ◽  
Elevated Serum ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Serous Carcinoma ◽  
Ca 125 ◽  
Low Grade ◽  
Primary Debulking Surgery ◽  
Stage Disease ◽  
Enhanced Computed Tomography

Serous psammocarcinoma is a rare variant of serous carcinoma arising from either ovary or peritoneum, characterized by massive psammoma body formation, low grade cytologic features, and invasiveness. Its clinical behavior is similar to serous borderline tumors with relatively favorable prognosis. We report herein a case of a 60-year-old postmenopausal woman who presented with abdominal distension. Contrast enhanced computed tomography (CECT) revealed calcified pelvic masses with ascites. Elevated serum CA-125 (970 U/mL) suggested malignant ovarian neoplasm. Patient underwent exploratory laparotomy with primary debulking surgery. Histopathology showed bilateral serous psammocarcinoma of ovary with invasive implants on omentum. Adjuvant chemotherapy was advised in view of advanced stage disease, although its benefits are poorly defined due to rarity of the tumor. However, patient opted out of it and is now on follow-up.

scholarly journals A Case of Intestinal Obstruction in Pregnancy Diagnosed by MRI and Treated by Intravenous Hyperalimentation

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Atsushi Daimon ◽  
Yoshito Terai ◽  
Yoko Nagayasu ◽  
Atsuko Okamoto ◽  
Takumi Sano ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Rare Complication ◽  
Oral Intake ◽  
Abdominal Distension ◽  
Pelvic Surgery ◽  
Intravenous Hyperalimentation ◽  
Abdominal Symptoms ◽  
Starting Point ◽  
History Of ◽  
In Pregnancy

Intestinal obstruction in pregnancy is rare and is mainly caused by prior pelvic surgery. We herein report a case of intestinal obstruction in a pregnant female with a history of laparoscopic myomectomy, who presented with hypogastric pain, abdominal distension, and vomiting at 26 weeks of gestation. A simple intestinal obstruction was diagnosed by MRI. Conservative treatments, including intravenous hyperalimentation and the placement of an ileus tube, were provided and her abdominal symptoms improved for 14 days. After restarting oral intake, she had no abdominal symptoms. She gave birth to a 2,146 g female infant by caesarean section at 37 weeks and 1 day of gestation. Although an area of cicatrization, which was thought to have been the starting point of the occlusion that caused the intestinal obstruction, was found, the excision of the small intestine was not necessary. Her postoperative course was uneventful. Intestinal obstruction requires a prompt diagnosis and aggressive intervention may be necessary to minimize the morbidity and mortality associated with this rare complication of pregnancy. MRI can be safely used during pregnancy to diagnose intestinal obstruction and intravenous hyperalimentation may improve the maternal and fetal prognoses.

scholarly journals Acute Abdomen and Perforated Bowel with a Rare Pathology: Nonfamilial Visceral Myopathy

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Jakob Burcharth ◽  
Caroline Olsen ◽  
Jacob Rosenberg
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Colonic Obstruction ◽  
Abdominal Distension ◽  
Gastrointestinal Diseases ◽  
Sigmoid Volvulus ◽  
Prior History ◽  
Visceral Myopathy ◽  
Abdominal Ct Scan ◽  
History Of

Visceral myopathy is a rare chronic disease affecting the peristalsis of the bowel causing intermittent pseudoobstruction. We report an atypical case of an eighty-nine-year-old woman with no prior history of abdominal illness who was admitted to our hospital with 2 days of increasing nausea, abdominal distension, and abdominal pain. On arrival at the hospital, she was critically ill. Abdominal X-ray showed distended loops of the colon and liquid levels resembling colonic obstruction. A subsequent abdominal CT scan confirmed the colonic obstruction. A suspicion of sigmoid volvulus was raised, that is why a barium enema was performed but no lower colonic obstruction could be confirmed. Acute laparotomy showed perforated cecum without intestinal obstruction. Postoperatively, the patient became septic which was fatal for the patient. Pathology gave the diagnosis visceral myopathy. It is very difficult to make the diagnosis clinically and radiologically since visceral myopathy mimics other more common gastrointestinal diseases. It is important to consider visceral myopathy as a possible diagnosis in cases with recurrent episodes of abdominal pain, vomiting, and abdominal distension, but without actual intestinal obstruction.

scholarly journals Rare case of midgut volvulus with malrotation in an elderly patient

2019 ◽  
Vol 7 (1) ◽  
pp. 303
Author(s):  
Mezhuneituo Raleng ◽  
Anant Prakash Pore ◽  
Vickey Katheria ◽  
Worshim Khamrang ◽  
R. S. Wungramthing
Keyword(s):  
Elderly Patient ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Rare Case ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Midgut Volvulus ◽  
History Of ◽  
Subacute Intestinal Obstruction

A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced. 

scholarly journals Uncommon Solitary Mesenteric Mass: Mesenteric Panniculitis

2013 ◽  
Vol 52 (189) ◽  
pp. 288-291
Author(s):  
Abhishek Shah ◽  
Dianbo Cao ◽  
Deepa Shah ◽  
Wenbin Sun
Keyword(s):  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Unknown Etiology ◽  
Resected Specimen ◽  
Rapid Progression ◽  
Mesenteric Panniculitis ◽  
Abdominal Ct ◽  
Mesenteric Fat ◽  
Abdominal Ct Scan ◽  
Mesenteric Mass

Mesenteric panniculitis is a rare, benign disease characterized by a chronic non-specific inflammatory process of mesenteric fat tissue with unknown etiology. Its clinical outcome ranges from complete resolution without any treatment to rapid progression culminating in death. So far, there is no established treatment available for its management. A 53-year-old female was admitted to our hospital because of intermittent abdominal pain, abdominal distension and early satiety for three months. Her abdominal CT scan revealed a solitary, well-defined, heterogeneous mass with a diameter of approximately 3.5cm x 2.8cm in the mesentery of small bowel. Exploratory laparotomy revealed yellowish-grey mass with a gritty consistency and histopathology of the resected specimen confirmed it to be mesenteric panniculitis. An increased awareness may lead to the use of a less invasive diagnostic approach and optimal management of this rare disease entity. Keywords: Computerized Tomography (CT); Mesenteric Panniculitis (MP); treatment.

Pathologic Diagnosis, Origin, and Natural History of Pseudomyxoma Peritonei

2013 ◽  
pp. 221-225 ◽  
Author(s):  
Rebecca Buell-Gutbrod ◽  
Katja Gwin
Keyword(s):  
Peritoneal Cavity ◽  
Pseudomyxoma Peritonei ◽  
Abdominal Distension ◽  
Primary Tumors ◽  
Lower Quadrant ◽  
Radiologic Findings ◽  
Mucinous Neoplasms ◽  
Mucinous Epithelium ◽  
Characteristic Features ◽  
The Right

Mucinous ascites and pools of mucin within the peritoneal cavity associated with neoplastic, mucinous epithelium are the characteristic features of pseudomyxoma peritonei (PMP). Clinically, PMP presents with abdominal distension and gelatinous ascites. In female patients, pelvic masses can be seen. Radiologic findings on computed tomography include scalloping of the hepatic and splenic margins and dense ascites. Surgically, PMP is encountered as grossly visible mucin in the peritoneal cavity. The presence of mucin outside of the appendix, in the right lower quadrant, and beyond is an important diagnostic finding. The appendix may be distended or ruptured. In women, there is often bilateral surface involvement of the ovaries, raising the differential diagnosis of primary ovarian neoplasms; however, these are extremely rare causes of PMP. Because of the association between appendiceal lesions and metastatic mucinous neoplasms of the ovary, appendectomy in the setting of any mucinous peritoneal or ovarian process may be prudent, even if the appendix is grossly normal. The gastrointestinal tract, especially the hepatopancreato biliary system, also needs to be assessed by the surgeon. Pathologically, PMP arises almost exclusively from low- or high-grade mucinous neoplasms of the appendix. These neoplasms must be distinguished both from rare benign causes of mucinous ascites and from nonappendiceal primary tumors. PMP has a protracted clinical course with progressive fibrous adhesions and obstructive disease; aggressive surgical and cytoreductive therapy with hyperthermic intraperitoneal chemotherapy has been reported to improve clinical outcomes.

scholarly journals RETAINED FOREIGN BODIES

2010 ◽  
Vol 17 (02) ◽  
pp. 218-222
Author(s):  
SHEHZAD AHMAD QAMAR ◽  
TAHIR IDREES ◽  
MUNAWAR JAMIL ◽  
Humaira Sobia
Keyword(s):  
Foreign Body ◽  
Intestinal Obstruction ◽  
Foreign Bodies ◽  
Surgical Complication ◽  
Tertiary Care ◽  
Case Series ◽  
Exploratory Laparotomy ◽  
Tertiary Care Centre ◽  
Adequate Treatment ◽  
Clinical Presentations

Objectives: (1) To look into clinical presentations of intra-abdominal foreign bodies; (2) To document surgical procedure performed. (3) To see measures for prevention. Design: Observational case series. Setting: Bahawal Victoria Hospital Bahawalpur. Period: From 1.06.07 to 31.5.08. Patient & Methods: Eleven patients with retained having intra-abdominal foreign body were treated. Relevant history, clinical examination and necessary investigations were done. Exploratory laparotomy was done in 10 cases to remove the foreign body and in one case foreign body passed from the rectum without laparotomy. Results: Out of 11 cases, 54.54% are males and 45.45% were females. Operated in emergency 81.81% and elective 18.18%. 90.91% were operated in periphery and 9.09% in the tertiary care centre. Clinical presentations were intestinal obstruction (27.27%), intraabdominal abscess (13.18%), Discharging sinus (18.18%), mass abdomen (18.18%),entero cutaneous fistula (9.09%), peritonitis (9.09%). Exploratory laparotomy was done in 90.91%, to remove the foreign body and in 1 case passed per rectum. Conclusions: Retained foreign bodies presented as intestinal obstruction, abscess, sinus fistula mass, or peritonitis. It is avoidable iatrogenic surgical complication, mostly found in operations done in emergency and at peripheral hospitals. Exploratory laparotomy remains the mainstay of treatment to remove the intra-abdominal foreign body. Surgeon should be vigilant to avoid mishap by check on counting, tucking sponge, blackboard counting, examining abdomen, screening in suspicious case and claim for radio-opaque sponges.Referral system needs improvements for in time adequate treatment. 

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