Meconium Ileus: A New Roentgen Sign

PEDIATRICS ◽  
1956 ◽  
Vol 18 (2) ◽  
pp. 253-253
Keyword(s):  
Small Bowel ◽  
Proteolytic Enzymes ◽  
Present Report ◽  
Vascular Occlusion ◽  
Upright Position ◽  
Meconium Ileus ◽  
Uncomplicated Case ◽  
Diagnostic Sign ◽  
Fluid Levels ◽  
Mucosal Secretions

Neuhauser described a "bubble" appearance in roentgenograms of the abdomen, apparently due to air mixed with thick meconium, as a diagnostic sign of meconium ileus. It was present in 40% of cases but has subsequently been found not to be specific, as it occurs in cases of imperforate anus. In the present report the author states that, in six uncomplicated cases of meconium ileus, fluid levels were not observed in the dilated loops of small bowel in films taken in the upright position. The lack of fluid levels in the roentgenogram is attributed to a paucity of mucosal secretions in the uncomplicated case of meconium ileus. This is contrary to the usual findings in intestinal obstruction in the newborn. This diagnostic sign is not seen in the presence of complications such as volvulus, gangrene, and peritonitis. In the complicated cases fluid levels appear probably because of the release of proteolytic enzymes by infection and vascular occlusion, the meconium being rendered more fluid by these released enzymes. This appears to be an additional valuable sign to be observed in the diagnosis of meconium ileus by roentgenograms.

Effect of vascular occlusion on small-bowel intraluminal pressures in dogs

1967 ◽  
Vol 12 (2) ◽  
pp. 154-161 ◽  
Author(s):  
Alvin M. Zfass ◽  
Lawrence Horowitz ◽  
John T. Farrar
Keyword(s):  
Small Bowel ◽  
Vascular Occlusion

scholarly journals A rare case of intestinal obstruction as a result of phytobezoar

2013 ◽  
Vol 94 (1) ◽  
pp. 134-135 ◽  
Author(s):  
D V Bolshakov ◽  
N Z Valiullin ◽  
R R Burganov
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Good Effect ◽  
Midline Laparotomy ◽  
Colon Cleansing ◽  
Peritoneal Drainage ◽  
Set Up ◽  
Fluid Levels

Intestinal obstruction (ileus) due to bezoar is a rare condition. Its combined prevalence among all cases of intestinal obstruction varies from 0.5 to 1%. An observed case is reported. A patient was admitted at the emergency ward with abdominal pain,nausea, bloating, and constipation. At examination - bloating, abdominal distention, moderate abdominal muscular defense at palpation, paraumbilical tenderness. Colon cleansing was started with a good effect. Gastrointestinal fluoroscopy: at 4 and 8 hours after introduction of barium contrast it is located in the dilated loops of small bowel with persisting air fluid levels. The diagnosis of unresolved intestinal obstruction was set up. The midline laparotomy, small bowel decompression by Abbott-Miller, peritoneal drainage with two tubes were performed. Final diagnosis: «Intestinal obstruction (phytobezoar), non-infected peritonitis».

scholarly journals Abdominal Cocoon Syndrome

2019 ◽  
Vol 17 (2) ◽  
pp. 264-266
Author(s):  
Pratit Pokharel ◽  
Yogendra Bista ◽  
Rabindra Desar ◽  
Raj Babu Benjankar ◽  
Pradip Sharma
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Preoperative Diagnosis ◽  
Abdominal Cocoon ◽  
Entire Small Bowel ◽  
Contrast Enhanced ◽  
Mesenteric Vessels ◽  
Enhanced Computed Tomography ◽  
Fluid Levels ◽  
Contrast Enhanced Computed Tomography

Abdominal cocoon syndrome is rare cause of intestinal obstruction characterized by small bowel encapsulation by a fibro-collagenous membrane or “cocoon”.A 30 yearman presented in emergency department with abdominal pain. Preoperatively contrast enhanced computed tomography of abdomen revealed encapsulated cluster of mildly dilated and edematous small bowel loops with multiple air fluid levels with thin membrane and crowding of mesenteric vessels in left upper quadrant.Intra-operatively, the entire small bowel was found to be encapsulated in a dense fibrous sac. The peritoneal sac was excised, followed by lysis of the inter-loop adhesionswith smooth postoperative recovery.High index of suspicion is required in patient presenting with features of recurrent acute or chronic small bowel obstruction for diagnosis of abdominal cocoon syndrome. Contrast enhanced Computed Tomography of abdomen is a useful radiological to aid in preoperative diagnosis of syndrome.Keywords: Abdomen; abdominal cocoon; CECT; encapsulated cluster.

ROENTGENOGRAPHIC MANIFESTATIONS OF CONGENITAL MEGACOLON (HIRSCHSPRUNG'S DISEASE) IN EARLY INFANCY

PEDIATRICS ◽  
1956 ◽  
Vol 18 (2) ◽  
pp. 227-238
Author(s):  
Carroll Z. Berman
Keyword(s):  
Small Bowel ◽  
Barium Enema ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Ileocecal Valve ◽  
Congenital Megacolon ◽  
Inverted Position ◽  
Proximal Half ◽  
Fluid Levels

The roentgenographic findings in the first month of life were reviewed in a series of 23 infants with histologically proven [See FIG. 9. in source pdf] Hirschsprung's disease. The plain roentgenograms of 18 of the babies showed significant large bowel distention and 12 had prominent colonic fluid levels. In 15 of 19 of the patients which had been subjected to barium enema, the roentgenograms are diagnostic of congenital megacolon. In 5 of 7 of the infants contrast enemas in the first week of life demonstrated the characteristic deformity. The conclusions which appear justified from this investigation are: Congenital megacolon (Hirschsprung's disease) may be strongly suspected in the newborn period in a large majority of cases from the appearance of plain roentgenograms of the abdomen made in recumbent and erect projections. In some instances, roentgenograms in the inverted position supply additional or substantiating evidence of the disease. In lesions starting in the proximal half of the colon, the abdominal distention involves mainly small bowel, and the differentiation from low jejunal or ileal obstruction is usually not possible from the plain roentgenograms. Here examination by barium enema may be expected to establish the diagnosis. When the segment of achalasia begins above the ileocecal valve, the plain roentgenograms again indicate small bowel obstruction, but here barium enema does not demonstrate a significant contour or caliber abnormality of the colon. In this type of case, follow-up roentgenograms 24 and 48 hours after the enema will often show considerable retention of the barium thus suggesting the diagnosis which must be confirmed by biopsy. When the proximal end of the involved segment of colon is low in the rectum, the lesion may be very difficult to demonstrate by barium enema. The age factor alone, i.e., the performance of the examination very early in infancy, does not of itself preclude demonstration of the lesion of Hirschsprung's disease by barium enema.

scholarly journals Richter’s hernia in a 5-mm trocar site

2019 ◽  
Vol 7 ◽  
pp. 2050313X1882341 ◽  
Author(s):  
Angeliki Chorti ◽  
Samer AbuFarha ◽  
Antonios Michalopoulos ◽  
Theodosios S Papavramidis
Keyword(s):  
Small Bowel ◽  
Rare Complication ◽  
Recovery Period ◽  
Underlying Disease ◽  
Trocar Site ◽  
Diffuse Abdominal Pain ◽  
Richter’S Hernia ◽  
High Clinical Suspicion ◽  
Richter's Hernia ◽  
Fluid Levels

We present an unusual case of a trocar site incision hernia at a 5-mm trocar port occurring approximately 2 weeks post-operatively after a laparoscopic cholecystectomy. The patient, in her mid-60s, reported diffuse abdominal pain, constipation, nausea and vomiting. An abdominal X-ray demonstrated dilated small bowel loops with gas-fluid levels. Abdominal computed tomography revealed the small bowel herniation through the 5-mm port site. Laparotomy confirmed a Richter’s hernia of the small bowel in the fascia defect. This case highlights the necessity to examine and investigate any complaint post-operatively and deliberate its possible significance. Furthermore, it demonstrates that, even during a normal recovery period for a patient without any underlying disease or risk factors, a rare complication could still develop in a delayed fashion multiple days post-operatively from a laparoscopic procedure. High clinical suspicion is essential in order to avoid further deterioration of the patient condition and optimal treatment.

A COMPARATIVE STUDY OF THE PROTEINS IN NORMAL MECONIUM AND IN MECONIUM FROM MECONIUM ILEUS PATIENTS

1965 ◽  
Vol 43 (3) ◽  
pp. 381-397 ◽  
Author(s):  
Harry Schachter ◽  
Gordon H. Dixon
Keyword(s):  
Proteolytic Enzymes ◽  
Electrophoretic Pattern ◽  
Dry Weight ◽  
Bound State ◽  
Meconium Ileus ◽  
Starch Gel Electrophoresis ◽  
Direct Role ◽  
Low Viscosity ◽  
Phenol Extraction ◽  
Protein Components

Starch gel electrophoresis and immunoelectrophoresis have been used to confirm previous reports that the highly viscous meconium obtained from patients with meconium ileus is rich in albumin and also contains alpha-, beta-, and gamma-globulins. Normal meconium contains only small amounts of these proteins. It is shown that normal meconium contains a TCA-soluble mucoprotein that is resistant to digestion by the combined action of the proteolytic enzymes trypsin and chymotrypsin. Meconium ileus meconium contains this mucoprotein component in a bound state; it can be released by proteolytic digestion with trypsin and chymotrypsin, or by phenol. Enzymic digestion of meconium ileus meconium destroys all the protein components of abnormal meconium except the resistant mucoprotein, thereby converting the electrophoretic pattern of meconium ileus meconium into a normal pattern. It is suggested that meconium ileus meconium is identical with the contents of the upper small bowel of any normal fetus and that meconium ileus can result when the mechanism of intestinal proteolysis is defective. In an attempt to determine whether meconium ileus meconium contains an abnormal mucoprotein that may be responsible for the viscosity of this material, phenol extraction was used to prepare the mucoprotein from both normal meconium and meconium ileus meconium. About 25% of the dry weight of normal meconium consists of this mucoprotein but the yield of mucoprotein from abnormal meconium is only 2–6% of the dry weight. The relatively low viscosity of mucoprotein from meconium ileus meconium and its presence in only small amounts in the abnormal meconium indicate that it does not play a direct role in the etiology of meconium ileus. The chemical composition of this mucoprotein shows it to be a sialomuco-polysaccharide. Although there are consistent differences between preparations from normal and abnormal meconium, these differences are attributed to partial proteolysis of mucoprotein in the normal digestive tract and are probably not related to cystic fibrosis.

scholarly journals Primary Pneumatosis Intestinalis of Small Bowel: A Case of a Rare Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Daniela Berritto ◽  
Raffaello Crincoli ◽  
Francesca Iacobellis ◽  
Francesca Iasiello ◽  
Nunzia Luisa Pizza ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Rare Disease ◽  
Surgical Approach ◽  
Bowel Wall ◽  
Wide Spectrum ◽  
Present Report ◽  
Pneumatosis Intestinalis ◽  
Clinical Suspicion ◽  
One Year

Pneumatosis intestinalis (PI) is a condition in which multiple gas-filled cysts are located in the bowel wall; it can represent a wide spectrum of diseases and a variety of underlying diagnoses. The present report describes the case of an 86-year-old man with symptomatic primary PI of small bowel treated with surgical approach after periodic episodes of cysts rupture and superimposed inflammation revealed on the basis of a clinical suspicion thanks to abdominal computed tomography. Moreover, after one year of followup, there has been no recurrence of digestive symptoms.

scholarly journals Small bowel obstruction due to phytobezoar and adhesions following laparoscopic cholecystectomy

2015 ◽  
Vol 3 (2) ◽  
pp. 63
Author(s):  
Nidal Abu jkeim ◽  
Ahmad Al hazmi ◽  
Awad Alawad ◽  
Rashid Ibrahim ◽  
Ahmad Abu damis ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
History Of ◽  
Metallic Clip ◽  
Fluid Levels ◽  
Gallbladder Fossa

<p>We report a case of 51 –year-old female with history of laparoscopic cholecystectomy presented with abdominal pain and diagnosed as small bowel obstruction caused by adhesions. The initial presentation was periumbilical pain with nausea and vomiting. Plain abdominal radiograph showed dilated small bowel loops and multiple air fluid levels. Due to failure of conservative treatment, laparotomy was performed. An open metallic clip was adhering the bowel to the gallbladder fossa causing sharp angulation. A phytobezoar proximal to this angulation was exteriorized through enterotomy. The patient was recovered smoothly and discharged from our hospital.</p>

Multifocal Myocardial Necrosis and Fibrosis in Pancreatic Diseases of Children

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 361-368
Author(s):  
Christian Nezelof ◽  
Guy LeSec
Keyword(s):  
Cystic Fibrosis ◽  
Small Bowel ◽  
Bowel Resection ◽  
Proteolytic Enzymes ◽  
Coronary Vessels ◽  
Myocardial Necrosis ◽  
Small Bowel Resection ◽  
Pancreatic Diseases ◽  
Heart Lesions ◽  
Extensive Necrosis

From a review of 2,000 autopsies of children, 16 cases of extensive necrosis and scarring fibrosis of the myocardium were found. These lesions involved mainly the left ventricle and spared the endocardium, the pericardium, and the coronary vessels. These necrotic or fibrotic heart lesions were found to be closely associated with various pancreatic diseases: cystic fibrosis (11 cases), pancreatic lipomatosis (2 cases), extensive small bowel resection (3 cases, 2 of which were associated with acute interstitial pancreatitis). To explain these unexpected associations, two hypotheses can be put forth: (1) The lack of absorption of some presently undetermined substances indispensable for the correct trophicity of the myocardium, and (2) the release in the blood of proteolytic enzymes with consecutive activation of phlogistic substances such as kinins.

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