scholarly journals Galinės klubinės žarnos obstrukcinis užspaudimas kirmėlinės ataugos kilpa

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Eglė Zakarauskaitė ◽  
Raimundas Lunevičius
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Terminal Ileum ◽  
Closed Loop ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Vermiform Appendix ◽  
Clinical Report ◽  
Vilnius University ◽  
The Right

Eglė Zakarauskaitė, Raimundas LunevičiusVilniaus universitetas, Gastroenterologijos, chirurgijos ir nefrourologijos klinikosBendrosios chirurgijos centras, Vilniaus universitetinė greitosios pagalbos ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Tikslas Aprašyti ir įvertinti visišką klubinės žarnos galinės dalies obstrukcinį nepraeinamumą dėl jos užspaudimo atipinės padėties kirmėlinės ataugos kilpa suaugusiam pacientui. Klinikinis atvejis Ligonis B. A., 71 metų, dėl sąrėmių pobūdžio skausmų visame pilvo plote, pilvo pūtimo ir pykinimo skubos tvarka hospitalizuotas į pilvo chirurgijos skyrių. Pacientas anksčiau nė karto nebuvo operuotas. Objektyvaus tyrimo rezultatai: pilvas išsipūtęs, skausmingas, maksimalaus skausmingumo ir pilvaplėvės dirginimo vieta – dešinioji klubinė sritis, auskultuojant žarnyną girdėti kliūtinė peristaltika. Apžvalginėje pilvo rentgenogramoje matyti daug Kloiberio dubenėlių išsipūtusioje plonojoje žarnoje. Diagnozavus konservatyviam gydymui atsparų visišką mechaninį žarnyno nepraeinamumą, atlikta vidurinė laparotomija. Operaciniai radiniai: stipriai išsipūtusi, iki galinės dalies perpildyta skysčių ir dujų plonoji žarna. Priežastis – apie galinę klubinės žarnos dalį kilpa apsisukusi, ją visiškai užspaudusi ir prie jos priekinės dalies pasaito prisitvirtinusi kirmėlinė atauga. Atlikta apendektomija, plonoji žarna intubuota peroraliniu enterodekompresiniu zondu. Kirmėlinės ataugos histologiniu tyrimu nustatyti antrinio uždegimo požymiai: paviršinis apendicitas ir hemoraginis periapendicitas. Pooperacinis laikotarpis buvo sklandus. Išvada Šis klinikinis atvejis patvirtina, jog galima labai reta komplikacija dėl atipinės kirmėlinės ataugos padėties: klubinės žarnos galinės dalies obstrukcinis užspaudimas kirmėlinės ataugos kilpa. Pagrindiniai žodžiai: apendiksas, atipinė padėtis, klubinės žarnos obstrukcija Strangulated terminal ileal obstruction due to closed-loop appendix Eglė Zakarauskaitė, Raimundas LunevičiusVilnius University, General Surgery Center of Clinic of Gastroenterology,Nephrourology and Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Objective To describe and estimate a strangulated (by atypical appendix) closed-loop obstruction of the terminal ileum in an adult. Case report 71-year-old male was admitted because of crampy abdominal pain associated with nausea. There was no history of previous intraabdominal operations. On examination, the patient had obvious abdominal distention with peritoneal signs localized in the right iliocecal region. Bowel sounds were decreased. X-ray films showed multiple air fluid levels in the small intestine. Small-bowel obstruction was diagnosed and exploratory laparotomy was performed. The small intestine was heavily dilatated, overflowed by fluids and air because of a vermiform appendix wrapped around the terminal ileum and its mesenterium, and by its tip adhered to the ileocecal recessus. An appendectomy was performed, the small bowel was intubated using an enterodecompressive probe. Histopathology confirmed the diagnosis of secondary superficial appendicitis and hemorrhagic periappendicitis. The convalescence was not delayed. There were no postoperative complications. Conclusions This clinical report shows an unusual but possible very rare complication of atypically located appendix in an adult: a strangulated closed-loop obstruction of the terminal ileum. Key words: appendix, atypical positioning, acute ileal obstruction

scholarly journals Closed loop small bowel obstruction due to mid urethral sling mesh

2020 ◽  
Vol 7 (6) ◽  
pp. 2003
Author(s):  
Marwan Alaoudi ◽  
Bhavana Devanabanda ◽  
Roland Haj ◽  
Martine Louis ◽  
Darshak Shah
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Visceral Peritoneum ◽  
Vascular Compromise ◽  
Surgical History ◽  
Adhesive Band

Closed loop small bowel obstruction is a surgical emergency, which when left untreated leads to vascular compromise resulting in intestinal ischemia, necrosis and perforation. We report the case of a 61 years old female with past surgical history of hysterectomy and a mid-urethral sling, who presented to the emergency department for abdominal pain and obstipation. She was found on imaging to have a closed loop small bowel obstruction. An exploratory laparotomy revealed an adhesive band encompassing the distal terminal ileum, visceral peritoneum and the Mid‐urethral slings mesh. This is a rare complication that, to our knowledge, has not been reported in the surgical literature. This paper will discuss the clinical presentation, diagnostic studies, therapeutic intervention and outcome of this unique case.

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 T-shaped Meckel’s diverticulum: a rare anatomical variant complicating small bowel volvulus

2018 ◽  
Vol 5 (8) ◽  
pp. 2929
Author(s):  
Vergis Paul ◽  
Ramu R. ◽  
Kocheril Sheryl Mathews ◽  
Ashly Thomas ◽  
Reesha P. A. ◽  
...  
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Anatomical Variant ◽  
Small Bowel Volvulus ◽  
Common Presentation ◽  
Congenital Diverticulum

The Meckel's diverticulum is a congenital diverticulum arising from the terminal ileum and is the unobliterated proximal portion of the vitellointestinal duct. Intestinal obstruction due to Meckel’s diverticulum is the most common presentation in adults and is the second most common presentation in children. We present a case of a 58-year-old gentleman presented with acute abdomen who was later found to have Giant T- shaped Meckel’s Diverticulum complicating small bowel volvulus on exploratory laparotomy. A T-shaped Meckel's diverticulum has not yet been described.

scholarly journals Multiple submucosal lipomas of small intestine: a case report

2020 ◽  
Vol 7 (9) ◽  
pp. 3133
Author(s):  
Kritika Tiwari ◽  
Rhishikesh J. Raghuvanshi ◽  
Anuja Athale ◽  
Suresh G. Deshpande
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Small Bowel ◽  
Hypertensive Patient ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Adult Intussusception ◽  
Asymptomatic Adult

Small bowel obstruction can be due to benign or malignant pathologies. Gastro intestinal lipomas are one of the benign subepithelial tumours causing obstruction. These are usually detected incidentally if asymptomatic. Adult intussusception due to intestinal lipoma is a very rare cause. We are presenting a case of male hypertensive patient with features of multiple subacute obstruction due to multiple submucosal lipomas in ileum. Exploratory laparotomy with intra-operative enteroscopy was performed and resection-anastomosis of affected segment was done.

scholarly journals Neuromuscular and Vascular Hamartoma of the Small Bowel: A Rare Cause of Intestinal Obstruction

2010 ◽  
Vol 2 (02) ◽  
pp. 109-110 ◽  
Author(s):  
Vani Krishnamurthy ◽  
Vijiya Basavaraj ◽  
Manjunath Gubbanna Vimalambike ◽  
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Ongoing Debate ◽  
Histological Features ◽  
Rare Lesion ◽  
Vascular Hamartoma

ABSTRACTNeuromuscular and vascular hamartoma (NMVH) is a rare lesion arising chiefly in the small intestine. As it shares many of the histological features with other commonly occurring stricturous conditions of the small bowel, there is an ongoing debate whether it is truly hamartomatous or represents just a reactive condition. We are reporting a case of NMVH in the terminal ileum in a 32-year-old male who presented with symptoms of intestinal obstruction.

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 Closed loop small bowel obstruction due to paracaecal internal herniation: a lesson in rarity

2018 ◽  
Vol 11 (1) ◽  
pp. e227461 ◽  
Author(s):  
Richard Menezes ◽  
Ranjeet Kamble ◽  
Anagha Joshi ◽  
Kalpesh Chaudhari
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Iliac Fossa ◽  
Tertiary Hospital ◽  
Postoperative Recovery ◽  
Abdominal Ct ◽  
Distended Bowel ◽  
The Right

A 40-year-old man presented to the emergency department of our tertiary hospital with acute abdominal pain since 1 day, which responded to conservative measures initially. On further investigation and abdominal CT, he was diagnosed with closed loop small bowel obstruction with an encapsulated lesion with small bowel loops within, in the right iliac fossa, which was initially missed. On exploration, the patient had a sac in the right iliac fossa (paracaecal incarcerated internal hernia) with distended bowel loops within, the sac was excised after reduction of the contents. Postoperative recovery was uneventful.

Complexities of an uncomplicated symptom: two cases of umbilical discharge

2020 ◽  
Vol 13 (9) ◽  
pp. e235604
Author(s):  
Nitin Agarwal ◽  
Nikhil Gupta ◽  
Manu Vats ◽  
Mradul Garg
Keyword(s):  
Small Bowel ◽  
Closed Loop ◽  
Exploratory Laparotomy ◽  
Abdominal Tuberculosis ◽  
Mesenteric Lymph Nodes ◽  
Mesenteric Lymph ◽  
Antituberculosis Therapy ◽  
Complex Fistula ◽  
History Of ◽  
Resection And Anastomosis

A 10-year-old boy presented with a low volume feculent umbilical discharge associated with fever and anorexia. Exploratory laparotomy revealed a complex fistula communicating with multiple small bowel loops and extensive peritoneal nodules with caseous mesenteric lymph nodes; suggestive of abdominal tuberculosis. Fistulectomy, adhesiolysis and a diversion jejunostomy were done and antituberculosis therapy was started. A 20-year-old man presented with serous umbilical discharge, having a history of similar complaints in his infancy. While he was being investigated, he developed peritonitis and had to be operated on emergency basis. An umbilical sinus connected with a fibrous band to Meckel diverticulum and a proximal closed loop small bowel obstruction perforation were found. Resection and anastomosis of the affected segment were done, and the patient recovered well.

scholarly journals Gallstone ileus with an enterovaginal fistula: a rare complication of pelvic radiotherapy

2020 ◽  
Vol 6 (4) ◽  
pp. 20200060
Author(s):  
Luqman Wali ◽  
Fahd Husain ◽  
Sharmarke Ali ◽  
Sasha Humphries ◽  
Linda Turner ◽  
...  
Keyword(s):  
Small Bowel ◽  
Terminal Ileum ◽  
Unusual Case ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Late Complication ◽  
Fistula Formation ◽  
Pelvic Radiotherapy ◽  
Cholecystoduodenal Fistula ◽  
Enterovaginal Fistula

Gallstone ileus is a rare cause of small bowel obstruction. Chronic gallstone irritation can lead to the formation of a cholecystoduodenal fistula, with gallstone impaction typically in the terminal ileum. Rarely gallstones can become impacted in other structures such as the colon or can even erode through the bowel. We present an unusual case of a gallstone ileus which resulted in the formation of an enterovaginal fistula, secondary to previous pelvic radiotherapy. Our case highlights the importance of considering fistula formation as a late complication of radiotherapy and how this can alter expected features of other pathologies, such as a gallstone ileus.

scholarly journals Strangulated Meckel’s Diverticulum in a Littre’s Hernia: A Rare Complication

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Vishnu M ◽  
Oon MJ ◽  
Heah HT ◽  
Huzairi Y ◽  
Nil Amri ◽  
...  
Keyword(s):  
Small Bowel ◽  
Primary Repair ◽  
Rare Complication ◽  
Meckel’S Diverticulum ◽  
Plain Radiograph ◽  
Meckel's Diverticulum ◽  
Abdominal Hernia ◽  
Midline Laparotomy ◽  
Littre’S Hernia ◽  
The Right

Meckel’s diverticulum occurs in 2-3% of general population and can presents as Littre’s hernia. We are reporting an 88-year-old female referred to our surgical unit with a painful right groin hernia 2 weeks, associated with vomiting, fever and diarrhoea. Physical examination showed an irreducible tender lump in the right groin with overlying erythematous skin. Plain radiograph showed dilated small bowel with a loop of bowel seen within the right groin region. A diagnosis of strangulated right femoral hernia was made preoperatively. Right inguinal incision initially employed, however, after a grossly inflamed Meckel's diverticulum with adjacent bowel perforation was found, a midline laparotomy ensues. Meckel's diverticulum was resected together with the perforated segment of small bowel. A primary anastomosis was then performed. In managing Meckel’s diverticulum the proposed treatment for is wedge resection and primary repair of the ileum. If there is oedema or inflammation at the base of the diverticulum, resection and anastomosis of a segment of the ileum may be necessary. Meckel’s diverticulum may be found in any type of abdominal hernia and thus an incarcerated hernia should not be attempted to manually reduce.

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