scholarly journals Intestinal obstruction in case of internal hernia through congenital defect in falciform ligament in adult

Author(s):  
Archit Pankajkumar Parikh ◽  
Mohan Prakash Tyagi ◽  
Dheerta Atul Kapadia

Small bowel obstruction due to internal herniation of ileum through congenital defect in falciform ligament is exceedingly rare, about 0.2% such cases of hernia through congenital defect in falciform ligament have been reported. The case presentation of 60 year old male patient present in surgery department with acute abdominal pain since 7 days. Based on clinical assessment and radiological evidence, intestinal obstruction was diagnosed. For which patient underwent exploratory laprotomy. The discussion of Intraoperative a loop ileum was found obstructed in congenital defect in falciform ligament. Obstruction was relieved by division of leaf of defect, without the need of intestinal resection.

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
P. K. B. S. C. Bandara ◽  
A. M. Viraj Rohana ◽  
Aloka Pathirana

Abstract Background Intestinal obstruction due to internal herniation of the bowel is a rare clinical entity which is often overlooked in the differential diagnosis of patients with abdominal pain who have no previous history of abdominal surgery. Several sites of bowel internal herniation have been described, amongst which internal herniation through the foramen of Winslow accounts for about 8% of cases. These patients present with nonspecific abdominal pain associated with symptoms of gastroesophageal reflux disease, and hence the diagnosis is often overlooked. The usual symptoms of intestinal obstruction can be delayed, which results in a delay in diagnosis and gangrene of the herniated bowel segment. Abdominal radiographs and computed tomography are helpful in the diagnosis. Open reduction is the management of choice; however, laparoscopic reduction has also been attempted, with good results. Case presentation We report a case of a middle-aged Sri Lankan man who presented with features of gastroesophageal reflux disease, developed features of intestinal obstruction and was found to have a gangrenous small bowel loop which had herniated through the foramen of Winslow. Following needle aspiration and reduction of the herniated small bowel loop, the gangrenous part of the small bowel was resected and an ileoileal anastomosis performed. The large foramen of Winslow was partially closed with interrupted stitches. The patient made an uneventful recovery. Conclusion Since delayed diagnosis of bowel obstruction is detrimental, it is of utmost importance to diagnose it early. Because internal herniation of the small bowel through the foramen of Winslow presents with nonspecific symptoms including features of gastroesophageal reflux disease, as documented in several cases worldwide and also presented by our patient, there should be a high degree of suspicion of internal herniation of the bowel causing bowel obstruction and low threshold for extensive investigation of patients presenting with symptoms of gastroesophageal reflux disease which does not resolve with usual medication.


2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.


Author(s):  
Ahmet Gürkan Erdemir ◽  
Yasin Yaraşır ◽  
Mehmet Ruhi Onur

Introduction: Torsion of the falciform ligament, one of the rarest causes of acute abdominal pain, often presents with pain in the right upper quadrant and epigastrium. Case Presentation: In this case, we present the computed tomography (CT) and magnetic resonance imaging (MRI) findings of torsion of the falciform ligament that occured in the presence of omental fat herniation through the foramen of Morgagni in an 88-year-old female patient who presented to the emergency department with acute epigastric pain. Conclusion: Torsion of the falciform ligament may develop secondary to omental hernia in the setting of Morgagni hernia and should be taken in consideration as one of the rarest causes of acute abdominal pain, even in elderly patients.


2021 ◽  
Author(s):  
Van Trung Hoang ◽  
The Huan Hoang ◽  
Ngoc Trinh Thi Pham ◽  
Vichit Chansomphou ◽  
Duc Thanh Hoang

Abstract Background: Bezoar bowel obstruction is a rare entity and remains difficult to detect on imaging studies. Recognition of its characteristic imaging pattern will be useful for diagnosis and management in the setting of intestinal obstruction.Case presentation: We report a 68-year-old female patient who was admitted to the hospital with signs of intestinal obstruction including abdominal pain, nausea, vomiting, and abdominal distention. She was diagnosed with phytobezoar small bowel obstruction on computed tomography (CT) imaging. The patient underwent surgery to confirm the diagnosis and subsequently recovered well.Conclusions: Bezoar is indicated by the sign of floating fat-density debris sign on CT images. It needs to be differentiated from small-bowel feces sign in intestinal obstruction.


2021 ◽  
pp. 1-3
Author(s):  
Paolo Aonzo ◽  
Paolo Aonzo ◽  
Michela Ceriotti ◽  
Antonio Fernando Anania ◽  
Matteo Morena ◽  
...  

Acute abdominal pain secondary to intussusception is rare in adults and mainly caused by malignancy (70-90%), whereas in childhood intussusception’s etiology is mostly idiopathic (90% of cases). Gastrointestinal lipomas, especially in small bowel, represent an unusual cause of intussusception with complete intestinal obstruction or bleeding (acute or chronic) from mucosal ulceration. In acute settings, computed tomography (CT) should be confidently considered the gold standard for diagnosis. In adulthood, surgical management of acute symptomatic intussusception caused by lipoma is mandatory. We report a case of complete jejunal obstruction with intussusception due to 5 cm submucosal lipoma.


2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yusuf Mohammed ◽  
Kirubel Tesfaye

Abstract Background Ileoileal knotting is one of the rarest causes of intestinal obstruction. The pathology involves knotting of the ileum around itself, leading to mechanical intestinal obstruction that can rapidly evolve to gangrene. Case presentation Here we will discuss the case of an 18-year-old Oromo girl who presented with sudden onset of severe abdominal pain and signs of generalized peritonitis.Ultrasound examination showed massive peritoneal and cul-de-sac fluid. Explorative laparotomy was done, with a tentative diagnosis of ruptured ovarian cyst. Intraoperative finding was a gangrenous ileoileal knot. The gangrenous segment was resected and ileotransverse anastomosis done. Postoperative course was uneventful, and the patient was discharged improved on the sixth postoperative day. Conclusion We present this case to highlight the diagnostic difficulty that one can face in females of child-bearing age and to create awareness of this rare cause of intestinal obstruction, as morbidity and mortality are very high because of rapid progression to gangrene.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Roham Borazjani ◽  
Seyed Reza Seraj ◽  
Mohammad Javad Fallahi ◽  
Zhila Rahmanian

Abstract Background COVID-19 pneumonia exhibits several extra-pulmonary complications. Case presentation A 23-year old, asthmatic male with coronavirus pneumonia developed with generalized, acute abdominal pain. Further evaluations revealed a mild ascites and portal vein thrombosis although the patient received proper anticoagulation therapy. Routine lab data regarding the secondary causes of portal vein thrombosis were normal. Conclusion We speculated that the underlying cause of portal vein thrombosis in our case was coronaviruses. Therefore, clinicians should always consider thrombosis and other hypercoagulable diseases in patients with COVID-19.


1992 ◽  
Vol 37 (2) ◽  
pp. 54-55 ◽  
Author(s):  
H.E. Ellamushi ◽  
I.S. Smith

Crohn's disease of the small intestine is usually managed by medical therapy with surgery being reserved for obstruction or fistula formation. A patient is described who developed small bowel obstruction due to an adenocarcinoma of the ileum after over twenty years of medical therapy for Crohn's disease, originally diagnosed at a laparotomy for acute abdominal pain. The possibility of malignancy in such long-standing disease should be considered.


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