scholarly journals Laparoscopic Management of Strangulated Broad Ligament Hernia

2018 ◽  
Vol 3 (3) ◽  
pp. 104-106
Author(s):  
Tanvi Khetan ◽  
Abdulzahra Hussain ◽  
Ihsan Al-Shoek ◽  
Shamsi EL-Hasani
Keyword(s):  
Small Bowel ◽  
Broad Ligament ◽  
Lower Abdominal Pain ◽  
Small Bowel Resection ◽  
Uneventful Recovery ◽  
Significant Past Medical History ◽  
Lower Quadrant ◽  
Bowel Infarction ◽  
Laparoscopic Management ◽  
The Right

Introduction: Broad ligament hernia was first reported post-autopsy by Quain in 1861. In a 1995 review article, only 61 cases had ever been reported. This paper presents a case report of broad ligament hernia and explores the literature surrounding this topic. Case Presentation: The patient presented with no significant past medical history, acute lower abdominal pain (several hours), nausea, and vomiting. Clinical examination showed a heart rate of 85 beats per minute; normal temperature, blood pressure, and respiratory rate; and a mildly distended abdomen with tenderness across the right lower quadrant. A plain abdominal X-ray showed dilated small bowel loops, and a blood test showed leukocytosis. Urgent diagnostic laparoscopy showed a broad ligament strangulated hernia with small bowel infarction. Reduction of the small bowel, resection, and side-side anastomosis were performed. The patient had an uneventful recovery, and follow up reported no postoperative complications. Conclusion: Laparoscopic management of small bowel obstruction due to broad ligament internal hernia is a safe and effective option.

scholarly journals A rare case of a closed loop obstruction due to epiploic appendage of the sigmoid colon

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Rathin Gosavi ◽  
Ee Ban
Keyword(s):  
Small Bowel ◽  
Sigmoid Colon ◽  
Rare Case ◽  
Closed Loop ◽  
Primary Anastomosis ◽  
Uterine Cancer ◽  
Small Bowel Resection ◽  
Uneventful Recovery ◽  
Ischemic Bowel ◽  
The Right

Abstract An internal hernia is a protrusion of viscera through a congenital or acquired defect in the mesentery of peritoneum. They account for <0.9% of all small bowel obstructions [1] and ~4% of obstructions due to hernias [2]. We present a rare case of closed loop obstruction secondary to a band adhesion traversing the lower abdomen from a sigmoid colon appendage epiploicae to the right pelvic wall. A 82-year-old woman presented to the emergency department with nausea, vomiting and worsening right sided abdominal pain for 24 h, on the background of previous pelvic radiation and hysterectomy for uterine cancer. She was subsequently found to have a closed loop obstruction with 30 cm of ischemic bowel strangulated by a band adhesion from a sigmoid colon appendage epiploicae to the right abdominal wall. The patient underwent a successful small bowel resection with primary anastomosis and made an uneventful recovery.

scholarly journals Intestinal Obstruction due to Bilateral Strangulated Femoral Hernias

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Ioannis Nikolopoulos ◽  
Eshan Oderuth ◽  
Eleni Ntakomyti ◽  
Bengt Kald
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Uneventful Recovery ◽  
Mortality And Morbidity ◽  
Delay In Diagnosis ◽  
Risk Of Mortality ◽  
Published Report ◽  
Femoral Ring ◽  
The Right

Introduction. Femoral hernias are at high risk of strangulation due to the narrow femoral canal and femoral ring. This can lead to symptoms of obstruction or strangulation requiring emergency surgery and possible bowel resection. To our knowledge, there is only one previous published report of bilateral strangulated femoral hernia. We present our case of this phenomenon.Case Report. An 86-year-old woman presented with symptoms of small bowel obstruction. Examination revealed two tender lumps in the area of the femoral triangle. CT scan revealed bilateral femoral hernias. Both hernias were repaired and a small bowel resection on the right side was performed with side to side anastomosis. She made an uneventful recovery.Conclusion. Bilateral femoral hernias are a rare occurrence with only one reported case of bilateral strangulation. Our case highlights the importance of meticulous history taking and clinical examination as any delay in diagnosis will increase the risk of mortality and morbidity for the patient. Hernias should always be considered as a cause if one presents with symptoms of abdominal pain or obstruction.

scholarly journals Recurrence hernia in the broad ligament of the uterus: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshifumi Hashimoto ◽  
Tatsuo Kanda ◽  
Tadasu Chida ◽  
Kazuyoshi Suda
Keyword(s):  
Small Bowel ◽  
Rare Disease ◽  
Broad Ligament ◽  
Significant Risk ◽  
Disease Recurrence ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Bowel Segments ◽  
Hernia Orifice ◽  
Bowel Herniation

Abstract Background Bowel herniation through a defect in the broad ligament of the uterus is a rare disease and few cases of recurrence have been reported. We report herein a recurrence case of a patient with broad ligament hernia (BLH), along with a review of the literature. Case presentation A 53-year-old woman complaining of abdominal pain was transported to our hospital. She had a history of laparotomy for small-bowel obstruction associated with hernia in the broad ligament of the uterus 10 years ago at a local hospital. Abdominal pelvic contrast-enhanced computed tomography revealed that the mesentery of the dilated bowels converged at a thick band in the pelvis, suggesting closed loop obstruction of the small bowel. The patient underwent urgent laparotomy and was diagnosed with bowel herniation through an opening in the broad ligament of the uterus on the right side, which was ipsilateral with the previous surgery. The hernia orifice was widened by incision and incarcerated bowel segments were released and preserved because ischemia was reversible. The membranous defect of BLH was closed by suture with braded silk strings. Conclusions Although BLH is a rare disease, patients face a significant risk of disease recurrence. Nonabsorbable suture may be advisable for closure of the hernia orifice in BLH.

scholarly journals A very persistent chicken bone: two separate perforations from the same foreign object 2 months apart

2019 ◽  
Vol 12 (5) ◽  
pp. e228050
Author(s):  
Andrew James Brown ◽  
Thomas Whitehead-Clarke ◽  
Vera Tudyka
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Linear Structure ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Small Bowel Perforation ◽  
Chicken Bone ◽  
Abdomen Ct ◽  
Distal Migration ◽  
The Right

A 56-year-old man presented acutely with abdominal pain and raised inflammatory markers. Initial CT images demonstrated acute inflammation in the right upper quadrant surrounding a high-density linear structure. The appearance was of a chicken bone causing a contained small bowel perforation. This was managed conservatively with intravenous antibiotics and the patient was discharged 10 days later. The same patient returned to the hospital 2 months later, once again with an acute abdomen. CT imaging on this occasion showed distal migration of the chicken bone as well as free gas and fluid indicative of a new small bowel perforation. The patient underwent an emergency laparotomy, washout and small bowel resection. No foreign body was found at laparotomy or in the histopathology specimen. The postoperative course was complicated by an anastomotic leak. A further CT on that admission demonstrated that the chicken bone had migrated to the rectum!

Laparoscopic Management of Small Bowel Incarceration Caused by a Broad Ligament Defect: Report of a Case

Surgery Today ◽  
2007 ◽  
Vol 37 (5) ◽  
pp. 437-439 ◽  
Author(s):  
Satoru Takayama ◽  
Takahisa Hirokawa ◽  
Masaki Sakamoto ◽  
Hiroki Takahashi ◽  
Minoru Yamamoto ◽  
...  
Keyword(s):  
Small Bowel ◽  
Broad Ligament ◽  
Laparoscopic Management ◽  
Small Bowel Incarceration ◽  
Broad Ligament Defect

scholarly journals Resected bowel syndrome: clinical course and treatment options

2020 ◽  
Vol 92 (12) ◽  
pp. 36-42
Author(s):  
I. E. Hatkov ◽  
T. N. Kuzmina ◽  
E. A. Sabelnikova ◽  
A. I. Parfenov
Keyword(s):  
Small Bowel ◽  
Mixed Type ◽  
Bowel Resection ◽  
Clinical Course ◽  
Abdominal Cavity ◽  
Small Bowel Resection ◽  
Nutritional Risk ◽  
Protein Energy ◽  
The Right ◽  
Resected Bowel

The current concepts of the short bowel syndrome and malabsorption after intestinal surgery are generally accepted, but do not fully reflect the patients condition, making it difficult to diagnose and treat it. Aim.The purpose of the study is to analyze the clinical course of the patients after bowel resection, to create a classification based on the variants identified to allow for a differentiated treatment and to introduce the concept of the resected bowel syndrome. Materials and methods.We observed 239 patients (96 men and 143 women) aged 18 to 80 who underwent intestinal resection for 1 month to 16 years (from 2002 to 2018). The 1st group included 96 patients with small bowel resection (40 men and 56 women). The 2nd group included 39 men and 58 women with small bowel resection, including the resection of the ileocecal valve and the right-hand side of the colon (n=97). The 3rd group included 17 men and 29 women with the resection of the right-hand side of the colon or colectomy (n=46). The survey included the NRS-2002 (Nutritional Risk Screening 2002) screening test to identify nutritional risk, a clinical assessment of the symptoms that occurred after the surgery, instrumental methods (esophagogastroduodenoscopy, colonoscopy with biopsy, ultrasound of the abdominal cavity organs and the kidneys, a plain radiography of the abdominal cavity organs, an X-ray examination of the small intestine and the intestinal passage), serum citrulline and short-chain fatty acids in faeces. Results.Based on the analysis of the clinical symptoms and the nutritional status of the patients, a new concept is proposed the resected bowel syndrome with two variants of its progression: either with or without the development of nutritional insufficiency of three types: the dehydration type, the protein-energy insufficiency type and a mixed type. Type 1 requires the use of antimicrobials with the control of SCFA concentrations in faeces. Type 2 requires the introduction of an optimal amount of easily digestible protein to correct protein-energy deficit. The 3rd (most severe) mixed type requires prescription of a parenteral nutrition component with the control of citrulline concentration in the blood serum. Conclusion.The proposed concept the resected bowel syndrome makes it possible to improve its diagnosis, take into account the variants of its progression and allow for a differentiated treatment.

scholarly journals Internal hernia caused by a free intraperitoneal staple after laparoscopic appendectomy

2018 ◽  
Vol 4 (1) ◽  
pp. 14 ◽  
Author(s):  
Lisa M. Angotti ◽  
Christopher Decker ◽  
Brittany Pahwa ◽  
Carl Rosati ◽  
Todd Beyer
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Laparoscopic Appendectomy ◽  
Internal Hernia ◽  
Closed Loop ◽  
Ease Of Use ◽  
Lower Quadrant ◽  
Transition Points ◽  
The Veil ◽  
The Right

Background: Laparoscopic appendectomy is the gold standard for treatment of appendicitis. Stapled closure of the appendiceal stump is commonly performed and has several advantages. Few prior cases have demonstrated complications from free staples left within the abdomen after the stapler has been fired.Case report: A 29-year-old female underwent laparoscopic appendectomy for acute uncomplicated appendicitis during which the appendix and mesoappendix were divided using laparoscopic gastrointestinal anastomosis (GIA) staplers. Her initial recovery was uncomplicated. She returned on postoperative day 17 with sharp mid-abdominal pain, obstipation, and emesis. Her abdomen was distended, and she had a mild leukocytosis. Computed tomography (CT) demonstrated twisted loops of dilated small bowel in the right lower quadrant with two transition points, suggestive of internal hernia with closed loop bowel obstruction. Diagnostic laparoscopy was performed through the three prior appendectomy incisions. An adhesion between the Veil of Treves and the mesentery of the ileum caused by a solitary free closed staple, remote from the staple lines, had caused an internal hernia. The hernia was reduced, and the small bowel was noted to have early ischemic discoloration. The adhesion was lysed by removing the staple from both structures. The compromised loops of bowel began to show peristaltic movement and color returned to normal, and the procedure was concluded without resection. She was discharged home the following day.Conclusions: Gastrointestinal staplers are commonly used due to ease of use and low complication rate. It is not uncommon to leave free staples in the abdomen as retrieval can be difficult and time consuming. Our case is only the second in the literature reporting an internal hernia with closed loop bowel obstruction as a complication of retained staples. Choosing the most appropriate size staple load to reduce the number of extra staples, removing free staples, or the use of an endoloop can prevent potentially devastating complications.

scholarly journals Idiopathic Left Ovarian Vein Thrombosis

2020 ◽  
Vol 8 ◽  
pp. 232470962094725
Author(s):  
Ngon Trang ◽  
Manasa Kalluri ◽  
Tushar Bajaj ◽  
Greti Petersen
Keyword(s):  
New Left ◽  
Ovarian Vein ◽  
Significant Past Medical History ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Gynecological Malignancy ◽  
Vein Thrombosis ◽  
The Right ◽  
Caucasian Female ◽  
Ovarian Vein Thrombosis

Ovarian vein thrombosis (OVT) was first described in 1956 and is well known for its association with gynecological malignancy, pregnancy, postpartum, pelvic diseases, surgeries, and other thrombophilic etiologies. Most commonly OVT presents on the right ovarian vein. We report a rare case of a 47-year-old Caucasian female G7P7 with no significant past medical history who presented to the emergency room for acute nonspecific back pain and left lower quadrant pain of 1 day. Imaging with a computed tomography with contrast demonstrated a new left OVT. After a thorough literature review, this is presumed to be the third reported case of idiopathic left OVT.

scholarly journals Ureteropelvic Junction Disruption and Distal Ureter Injury Associated with a Chance Fracture following a Traffic Accident: A Case Report

2007 ◽  
Vol 15 (2) ◽  
pp. 248-250 ◽  
Author(s):  
GP Slobogean ◽  
SJ Tredwell ◽  
JST Masterson
Keyword(s):  
Small Bowel ◽  
Traffic Accident ◽  
Small Bowel Resection ◽  
Rear Seat ◽  
Ureteropelvic Junction ◽  
Ureter Injury ◽  
Distal Ureter ◽  
Ureteral Reconstruction ◽  
Chance Fracture ◽  
The Right

A 10-year-old girl sustained a ureteropelvic junction disruption and distal ureter injury associated with the Chance fracture following a traffic accident. She was sitting on the rear seat of a car wearing a lap belt. Extensive small bowel mesenteric trauma was noted. Radiography revealed a left haemothorax with mediastinal shift and an unstable flexion-distraction vertebral fracture at L2 (Chance fracture). Subsequent intravenous pyelography demonstrated proximal extravasation from the right kidney without continuity to the upper and mid ureter, indicating a ureteropelvic junction avulsion or necrosis. Definitive surgery was delayed until day 33 because of urosepsis. Due to extensive small bowel resection, ischaemia of the ureter, and the history of urosepsis, a right subcapsular nephrectomy (rather than ureteral reconstruction) was considered the safest option for minimising further complications. It is important that trauma specialists recognise additional injuries after major trauma. Early use of a multidisciplinary approach is recommended to reduce morbidity and mortality.

scholarly journals Barium Appendicitis 1 Month After a Barium Meal

2013 ◽  
Vol 97 (4) ◽  
pp. 296-298 ◽  
Author(s):  
Masaaki Urade ◽  
Toshihumi Shinbo
Keyword(s):  
Rare Complication ◽  
Barium Meal ◽  
Lower Abdominal Pain ◽  
Lower Quadrant ◽  
Barium Examination ◽  
Gastrointestinal Imaging ◽  
Uncommon Disease ◽  
Plain Roentgenogram ◽  
Barium Appendicitis ◽  
The Right

Abstract Because barium sulfate (BaSO4) is not harmful to the mucosa, it is widely used for gastrointestinal imaging. Barium appendicitis is a very rare complication of barium meals and barium enema. We report a case of acute appendicitis associated with retained appendiceal barium. A 47-year-old man presented with right lower abdominal pain after upper gastrointestinal imaging was performed using barium 1 month earlier. The abdominal plain roentgenogram showed an area of retained barium in the right lower quadrant. Multiplanar reconstruction of computed tomography scans showed barium retention in the appendix. Emergency appendectomy was performed. A cross section of the specimen revealed the barium mass. Barium-associated appendicitis is a very rare clinical entity but we should be cautious of this uncommon disease when we encounter barium deposits in the appendix after barium examination. This report is significant because barium was identified both macroscopically and microscopically.

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