scholarly journals Spontaneous pneumoperitoneum secondary to intestinal pneumatosis: an uncommon cause of acute abdomen

2021 ◽  
Author(s):  
Jonathan Salgado Vives ◽  
Enrique Chávez Serna ◽  
Fernando Uraik Hernandez Bustos ◽  
Guadalupe Grisel Yañez Herrera
Keyword(s):  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Intestinal Tract ◽  
Rare Entity ◽  
Intestinal Pneumatosis ◽  
Entire Small Intestine ◽  
Spontaneous Pneumoperitoneum ◽  
Primary Presentation

Intestinal pneumatosis is a rare entity characterized by gas accumulation in the submucosa and or subserosa of the intestinal tract wall and is generally associated with other diseases, the primary presentation is rare. Most of the cases are asymptomatic, being infrequent the presentation as an acute abdomen secondary to a spontaneous pneumoperitoneum. We report the case of a patient with systemic sclerosis, who presented to the emergency department with abdominal pain and intestinal obstruction, without improvement to conservative treatment and with progression to acute abdomen, for which surgical treatment was performed showing intestinal pneumatosis that compromised the entire small intestine.

Proctitis and Pyrexia Caused by Body Packing of Cannabis Resin

2000 ◽  
Vol 7 (2) ◽  
pp. 114-115
Author(s):  
Ra Cocks ◽  
Pf Green
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Physical Examination ◽  
Intestinal Tract ◽  
Unknown Origin ◽  
Body Packing ◽  
Pyrexia Of Unknown Origin ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
Gastro Intestinal Tract

We report the case of a 48 year old man who attended the Accident and Emergency Department after smuggling a large number of pellets of cannabis resin in his gastro-intestinal tract. Five days after ingesting the pellets, which were wrapped in portions of rubber condom, he developed abdominal pain and proctitis. He continued to exhibit a pyrexia even after the removal of the majority of the pellets, and was investigated for pyrexia of unknown origin (PUO). The importance of obtaining a good history from sick travellers, and the need for thorough physical examination, are emphasized.

scholarly journals Inflammation and obstruction of the small intestine due to phytobezoar

2021 ◽  
Author(s):  
Van Trung Hoang ◽  
The Huan Hoang ◽  
Ngoc Trinh Thi Pham ◽  
Vichit Chansomphou ◽  
Duc Thanh Hoang
Keyword(s):  
Computed Tomography ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Rare Entity ◽  
Imaging Studies ◽  
Case Presentation ◽  
Characteristic Imaging

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.

scholarly journals Ascaris lumbricoides causing jejunal perforation after trivial trauma

2017 ◽  
Vol 4 (9) ◽  
pp. 3169
Author(s):  
Kandula Venkata Tejareddy ◽  
A. Venkanna Babu ◽  
K. Deepak Varma ◽  
D. Bal Singh
Keyword(s):  
Emergency Department ◽  
Developing Countries ◽  
Acute Abdomen ◽  
Ascaris Lumbricoides ◽  
Intestinal Perforation ◽  
Emergency Laparotomy ◽  
Rare Entity ◽  
Human Beings ◽  
Unique Case ◽  
Wide Range

Ascariasis is one of the most common parasitic illnesses in human beings living in underdeveloped and developing countries. Infestation with this can result in wide range of manifestations. Most are asymptomatic, very few patients may develop complications like obstruction, perforation, cholangiohepatitis, pancreatitis, etc. We came across a patient, 20-year-old male who presented to the emergency department with acute abdomen followed by trivial trauma, investigations lead to peritonitis as diagnosis. On emergency laparotomy, unexpectedly Ascaris worms wriggling through jejunal perforation and live adult worms freely floating in peritoneal cavity were seen. It is suggested that trivial trauma might have exacerbated impending Ascaris perforation. A jejunal perforation of Ascaris after trivial trauma is a rare entity. This unique case has highlighted the fact that Ascaris can lead to intestinal perforation in heavily infested individuals particularly in tropical countries following trivial trauma.

scholarly journals FATE OF BILIRUBIN IN THE SMALL INTESTINE

1934 ◽  
Vol 60 (2) ◽  
pp. 189-198 ◽  
Author(s):  
M. S. Sackey ◽  
C. G. Johnston ◽  
I. S. Ravdin
Keyword(s):  
Small Intestine ◽  
Intestinal Tract ◽  
Jejunal Loop ◽  
Intestinal Cells ◽  
Bile Pigment ◽  
No Conversion ◽  
Entire Small Intestine ◽  
Intestinal Contents ◽  
Per Se ◽  
No Absorption

Since there was no loss of bilirubin from the jejunal loop, and no loss of bilirubin when pigment was incubated with juice from the loop segment, or juice from the entire small intestine, it may be concluded that the intestinal juice per se has no effect in converting bilirubin to urobilin in a 2 hour period, and that in the jejunal loop there was no absorption of pigment or no conversion to urobilin. The experiments showing loss of pigment in the entire intestinal tract suggest that in some place other than the jejunal portion of the intestine the combined activity of intestinal contents and intestinal cells does affect the bilirubin in the intestine. Whether the loss of bile pigment under such circumstances is due entirely to conversion, or to conversion and absorption, or to absorption of bilirubin as such, remains to be answered by subsequent investigations.

scholarly journals Specific Management of Patients with Acute Abdomen during the COVID-19 Pandemic: A Surgical Perspective from Germany

2020 ◽  
Vol 36 (5) ◽  
pp. 417-420
Author(s):  
Florian Kühn ◽  
Matthias Klein ◽  
Henning Laven ◽  
Nikolaus Börner ◽  
Tobias Weinberger ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Epithelial Cells ◽  
Acute Abdomen ◽  
Clinical Features ◽  
Clinical Case ◽  
Acute Abdominal Pain ◽  
Gastrointestinal Symptoms ◽  
Critical Conditions ◽  
Specific Management

During the current COVID-19 pandemic, the triage, assessment, and management of patients presenting to the emergency department with critical conditions has become ­challenging. The clinical features of COVID-19 are heterogeneous and subtle in many cases. They may easily be overlooked in the case of other acute diseases. Gastrointestinal symptoms are common in patients with COVID-19 as SARS-CoV-2 is able to enter gastrointestinal epithelial cells. However, these complaints can also be caused by a COVID-19-independent concomitant abdominal pathology. Therefore, patients with acute abdominal pain and fever need to be assessed very thoroughly. Based on a clinical case, we present our approach of managing emergency patients with acute abdomen and concomitant suspicion of ­COVID-19.

scholarly journals Malrotation Induced Small Intestine Ischemia in an Adolescent

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Karadeniz Erdem ◽  
Atamanalp Selçuk Sabri
Keyword(s):  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Emergency Surgery ◽  
Mesenteric Artery ◽  
Duodenal Obstruction ◽  
Mesenteric Ischemia ◽  
Clockwise Rotation ◽  
Small Intestinal

Intestinal malrotation occurs if midgut does not complete or partially completes its 270° counter-clockwise rotation around the superior mesenteric artery during embryologic life. In general, it frequently manifests with vomiting due to duodenal obstruction and volvulus in the initial months of life, and it is very rare to manifest in the adulthood. A 20-year-old male patient who had severe abdominal pain, nausea, vomiting, and distention for one day was evaluated at the emergency department. On abdominal tomography “swirling appearance of structures around the superior mesenteric artery” was reported. CT appearance was considered compatible with a rotational anomaly. Emergency surgery was planned for the patient. In laparotomy, it was observed that an approximately 100 cm long small intestine segment was rotated around a band (Ladd) and ischemia was developed in this segment due to rotation of its mesentery. The rotation of the small intestinal mesentery was corrected by opening the bands. After the warm application to the intestinal mesenteric ischemia for a while, the color and the peristalsis of the intestines became normal. The patient was discharged on postoperative day 2 with suggestions.

scholarly journals Can Fetuin-A Level, CRP, and WBC be a Predictive Value in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?

2019 ◽  
Author(s):  
Abuzer Coskun ◽  
Cengiz Güney
Keyword(s):  
Emergency Department ◽  
Regression Analysis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Perforated Appendicitis ◽  
Multivariate Regression Analysis ◽  
Predictive Values ◽  
Fetuin A ◽  
Reactive Protein

Background: Acute appendicitis (AA) is the most common cause of emergency surgery. Perforation is more common than adults. Early diagnosis and new markers are needed. The aim of this study was to investigate the effects of plasma Fetuin-A (FA) levels in patients with the acute abdomen (AB). Material and Method: This prospective study included 107 patients younger than 16 years of age who were admitted to the emergency department for abdominal pain between January 2018 and December 2018. The patients who presented to abdominal pain were divided into two groups as AA and other causes (OC) of AB. T Patients with acute appendicitis; intraperitoneal, retrocolic / retrocecal and appendicitis were divided into three groups. Also, the AA group was divided into two groups as perforated appendicitis and non-perforated appendicitis. Serum FA levels of the patients were evaluated in the emergency department. Results: In the AA group, C-reactive protein (CRP) and white blood cell (WBC) levels were higher, and FA levels were significantly lower than in the AB group. Intraperitoneal localization was 95.2% and perforation was frequent. When significant values in the univariate regression analysis for acute abdomen and perforation were compared in the multivariate regression analysis, CRP, WBC, and FA levels were found to be prognostic. Also, decreased FA levels were associated with AA while too much decreased FA levels were associated with the risk of perforation. Conclusion: While trying to diagnose AA in children, the FA level, CRP and WBC may be predictive values to identify risk factors.

scholarly journals Routine Measurement of Serum Amylase in Acute Abdomen

2014 ◽  
Vol 52 (196) ◽  
pp. 982-985 ◽  
Author(s):  
Roshan Ghimire ◽  
Anurag Singh Thapa ◽  
Dimindra Karki ◽  
Dipendra Kumar Shrestha
Keyword(s):  
Emergency Department ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Serum Amylase ◽  
Acute Abdominal Pain ◽  
College Teaching ◽  
Amylase Level ◽  
Serum Amylase Level ◽  
Routine Measurement

Introduction: Acute abdominal pain is a common condition presenting to both the emergency department and surgical admission unit. Increase in serum amylase levels are found in much gastrointestinal pathology. Serum amylase level is consistently high in acute pancreatitis though high values are not pathognomonic of pancreatitis .The aim of this study to assess the level of serum amylase in various diseases presenting with acute abdominal pain and to evaluate the role of routine measurement of serum amylase in the screening of patient with acute abdominal pain for the diagnosis of acute pancreatitis in a prospective series. Methods: A prospective observational study was performed from 15th May 2014 – 15th Nov 2014 (6 months) at Department of Surgery of Kathmandu medical College Teaching Hospital; Kathmandu. All consecutive patients presented at emergency department and required admissions in surgical ward were included. A multivariate analysis was performed to assess the level of serum amylase in various diseases presenting with acute abdominal pain including acute pancreatitis. Results: Overall, 318 patients were included during a period of 6 months among them 48 patients were excluded. 34 cases (12.6 %) were diagnosed of acute pancreatitis. three cases (1.1%) of non pancreatic pathology with raised serum amylase level (> 1000 U\L). Conclusions: Routine assessment of serum amylase is helpful in excluding differential diagnosis of patient presenting with acute abdomen and this study identified serum amylase as a good screening tool if done in cases with clinical suspicion.  Keywords: acute abdominal pain; acute pancreatitis; serum amylase.

scholarly journals Acute Abdomen in a 91-Year-Old Male due to Perforated Jejunal Diverticulitis

2020 ◽  
Vol 14 (3) ◽  
pp. 598-603
Author(s):  
Francesco Sammartino ◽  
Ivana Selvaggio ◽  
Gioacchino Maria Montalto ◽  
Carolina Pasecinic ◽  
Sirvjo Dhimolea ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Mortality Rate ◽  
Diverticular Disease ◽  
Acute Abdomen ◽  
The Elderly ◽  
Review Of The Literature ◽  
Key Points ◽  
Jejunal Diverticulitis

Non-Meckel small intestine diverticular disease is a rare and mostly asymptomatic condition. However, rare cases of acute and emergent complications bear a high mortality rate. We report a case of a 91-year-old male that presented with an acute abdomen due to perforated jejunal diverticulitis. A review of the literature and key points of the condition are depicted. Although jejunal diverticulosis is rare, it must be considered in the differential diagnosis, especially in the elderly with signs of ambiguous abdominal pain and peritonitis.

A case report of abdominal sponge in ileum in a patient with intestinal obstruction

2020 ◽  
pp. 1-7
Author(s):  
Ahmed Siddique Ammar
Keyword(s):  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Case Report ◽  
Comorbid Conditions ◽  
X Ray ◽  
The Past ◽  
Surgical Ward ◽  
History Of ◽  
Fluid Levels

Abstract A 36-year-old woman presented in the emergency department of East Surgical Ward of MAYO Hospital Lahore, Pakistan, in August 2019 with compliant of abdominal pain and vomiting for the past five days. The patient had a history of three Caesarean sections, the last one three years back. Off and on, she experienced abdominal pain and distension which was relieved after taking local medicines. She had no comorbid conditions and her baseline investigations were normal. On examination she had tachycardia with pulse 110/min and her whole abdomen was tender with exaggerated bowel sounds. X ray of the abdomen showed multiple air fluid levels in the small intestine. Exploration plan was made; a distended segment of ileum was later found to have abdominal sponge inside its lumen. Continuous...  

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