scholarly journals Isolated segmental mega-diverticulosis of ileum: a rare presentation of acute intestinal obstruction

2017 ◽  
Vol 4 (6) ◽  
pp. 2098
Author(s):  
Veena A. ◽  
Hanumanthaiah K. S. ◽  
Manjunath K. ◽  
Sandeep S. ◽  
Sai Suraj Kotera
Keyword(s):  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Interesting Case ◽  
Acute Intestinal Obstruction ◽  
Rare Entity ◽  
Rare Presentation ◽  
Pathological Evaluation ◽  
Initial Imaging ◽  
Operative Findings ◽  
Low Prevalence

We present an interesting case of acute intestinal obstruction where a woman, aged 26, presented to emergency room with constipation for 2 days and vomiting for 1 day. The examination and initial imaging suggested sub-acute intestinal obstruction, since the condition progressed she was taken to operating room for laparotomy. The intra-operative findings revealed isolated segmental mega-diverticulosis of ileum. She underwent resection of terminal ileum and caecum with ileo-colic anastomosis. Pathological evaluation of specimen showed diverticular features. Ileal diverticulosis excluding Meckel’s is an extremely rare entity and complicating into acute intestinal obstruction is strange. With a low prevalence and absence of suspicion for it, diagnosis will be made intra operatively most of the time.

scholarly journals Diagnostic accuracy of ultrasound in common acute abdominal conditions

2019 ◽  
Vol 6 (12) ◽  
pp. 4460
Author(s):  
Shashank Deshmukh ◽  
A. Manmadha Kishan
Keyword(s):  
Acute Pancreatitis ◽  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Diagnostic Accuracy ◽  
Acute Intestinal Obstruction ◽  
Ct Findings ◽  
Perforation Peritonitis ◽  
Good For ◽  
Operative Findings ◽  
Acute Perforation

Background: Ultrasound evaluation is cheap, easily available, even at rural level, and can predict need for surgical intervention in majority of conditions. It involves no exposure to radiation, can diagnose easily, can be repeated any number of times for follow up. Disadvantages are that it is user dependent and distended bowel containing air prevents satisfactory evaluation of abdomen. The objective was to study diagnostic accuracy of ultrasound in common acute abdominal conditions.Methods: All patients presenting to the emergency Department of General Surgery, Narayana general hospital, Nellore with abdominal pain of acute onset and who were diagnosed to be suffering from acute appendicitis, acute perforation peritonitis, acute intestinal obstruction, acute pancreatitis, acute calculous cholecystitis were included in the present study.Results: Diagnostic accuracy of USG for acute appendicitis was little bit low with sensitivity of 71.8% and specificity of 59.1% for operative findings and similar for CT findings. For acute perforation peritonitis it was still very low with sensitivity of 42.9% and specificity of 66.7% for operative findings and similar for CT findings. It was very good for acute intestinal obstruction with sensitivity of 90.9% and specificity of 83.3%, but here it was low compared to CT findings. It was also pretty good for diagnosing acute calculus cholecystitis in comparison with operative as well as CT findings.Conclusions: USG can be used as a diagnostic tool for diagnosis of acute intestinal obstruction and acute calculus cholecystitis but doubtful role in the diagnosis of acute appendicitis and acute perforation peritonitis and acute pancreatitis. 

scholarly journals Case Report: Pediatric pharmacobezoar with subacute intestinal obstruction

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1037
Author(s):  
Mahnaz Hakeem ◽  
Heeramani Lohana ◽  
Sarwat Urooj ◽  
Sheraz Ahmed
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Abdominal Distension ◽  
Acute Intestinal Obstruction ◽  
Rare Entity ◽  
Persistent Vomiting ◽  
Delay In Diagnosis ◽  
History Of ◽  
Subacute Intestinal Obstruction ◽  
High Index Of Suspicion

Bezoars are an undigested mass causing an intraluminal obstruction in children.  Pharmacobezoars are formed from medicines or their vehicle, considered as a less frequent type observed in children. Our objective is to report a relatively rare entity as a potential cause of intestinal obstruction in children.  Here we report a case of 13-year-old girl with a history of herbal medicine intake who presented with persistent vomiting and abdominal distension. She was diagnosed with acute intestinal obstruction and managed conservatively without any complications. The patient became stable within two days so was discharged home. We found that ineffective history could lead to a delay in diagnosis and management. Clinicians should have a high index of suspicion for pica and psychiatric disorders, especially in adolescent children.

scholarly journals Acute Intestinal Obstruction: A Rare Aetiology

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Shamita Chatterjee ◽  
Souvik Chatterjee ◽  
Sanjeev Kumar ◽  
Shahana Gupta
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Paraduodenal Hernia ◽  
Rare Clinical Entity ◽  
Rare Entity ◽  
Internal Herniation ◽  
Diagnostic Challenge ◽  
High Index Of Suspicion ◽  
Bowel Strangulation

Internal herniation of small intestine is a very rare entity, and it poses a real diagnostic challenge clinically. Recurrent entrapment of the bowel may lead to partial to complete intestinal obstruction and eventually strangulation of the small bowel. Of this rare clinical entity, left paraduodenal hernia is more common. High index of suspicion with prompt management may prevent bowel strangulation and gangrene. We present a case of acute intestinal obstruction due to left paraduodenal hernia with malrotation of midgut in a 55-year-old male patient.

scholarly journals ACUTE INTESTINAL OBSTRUCTION - A RARE PRESENTATION OF MUCINOUS CYSTADENOMA OF APPENDIX

2015 ◽  
Vol 4 (64) ◽  
pp. 11240-11243
Author(s):  
Sourabh Mukharjee ◽  
Harshit Agarwal ◽  
Chikila Kanak Durga ◽  
Anil Kaler ◽  
Rachan Kathpaul
Keyword(s):  
Intestinal Obstruction ◽  
Mucinous Cystadenoma ◽  
Acute Intestinal Obstruction ◽  
Rare Presentation

scholarly journals Clinical study and surgical management of acute intestinal obstruction in the adults

2020 ◽  
Vol 7 (11) ◽  
pp. 3703
Author(s):  
Jaydeep M. Gadhavi ◽  
Rahul Charpot
Keyword(s):  
Hernia Repair ◽  
Intestinal Obstruction ◽  
Treatment Protocol ◽  
Signs And Symptoms ◽  
Right Hemicolectomy ◽  
Acute Intestinal Obstruction ◽  
Provisional Diagnosis ◽  
The Common ◽  
Operative Findings ◽  
Resection And Anastomosis

Background: The aim of this study was to evaluate the treatment protocol of intestinal obstruction in adults.Methods: A total of 60 patients diagnosed with intestinal obstruction were included in the study. All the patients with the provisional diagnosis of the intestinal obstruction were assessed clinically after the admission. Appropriate surgical procedures were implemented on the patients with clear signs and symptoms of acute abdominal obstruction. Surgery adopted and criteria for deciding the procedure were noted.Results: For the management of small bowl obstruction. Adhesiolysis was done in 14 patients, resection and anastomsis was done in 8 patients, in 4 patients the band release procedure was performed, hernia repair was done in 8 patients, followed by resection, hernia repair, volvulus derotation and Mekels diverticulectomy was done in 2 patients respectively. For the management of large bowl obstruction the Colostomy was done in 8 cases, resection and anastomosis in 4 cases, intussusception milking in two cases, volvulus derotation was done in 2 cases and right hemicolectomy was done in 4 cases of CA ascending colon.Conclusions: Success in the treatment of acute intestinal obstruction depends largely upon early diagnosis skilful management and treating the pathological effects of the obstruction just as much as the cause itself. Postoperative adhesions are the common cause to produce intestinal obstruction. Clinical radiological and operative findings put together can diagnose the intestinal obstruction. Mortality is still significantly high in acute intestinal obstruction.

RECURRENT SUB -ACUTE INTESTINAL OBSTRUCTION PRESENTED AS MIDGUT MALROTATION WITH VOLVULUS MANAGED BY LAAD'S PROCEDURE AND SURGERY IN AN ADULT PATIENT: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 6-8
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Tuhinsubhra Mandal
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Adult Population ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Intestinal Malrotation ◽  
Uneventful Recovery ◽  
Midgut Volvulus ◽  
Rare Presentation ◽  
Diagnostic Dilemma

Background: Intestinal malrotation refers to the partial or complete failure of rotation of midgut around the superior mesenteric vessels in embryonic life. Arrested midgut rotation results due to narrow-based mesentery and increases the risk of twisting midgut and subsequent obstruction and necrosis. Midgut volvulus secondary to intestinal malrotation is a rare presentation in adults more so in the elderly. Its rarity portends a diagnostic dilemma for both the surgeon and radiologist, and CT scan showed dilated large and small intestine segments with air-fluid levels and twisted mesentery around superior mesenteric artery and vein indicating "whirlpool sign". In our patient Case presentation: 42 years old male who presented to the emergency department with acute onset of pain in the RUQ, vomiting, and absolute obstipation for the last 2 days. This patient had a history of similar two episodes of sub-acute intestinal obstruction in the last 6 months which has been managed conservatively. The patient underwent an elective exploratory laparotomy after 2 days of failed conservative management. Operative findings included the presence of adhesive bands in the RUQ (Ladd's Band), volvulus of the mid-portion of the small bowel in a clockwise fashion, and multiple intraabdominal adhesions and empty RIF and caecum pulled up in RUQ. We subsequently performed a Ladd's procedure, multiple adhesiolysis, and caecopexy and the patient had an uneventful recovery with eventual discharge on postoperative day 12. This case report reviews the incidence of malrotation in adults. It also high Conclusion: lights the difficulty in diagnosing midgut volvulus in the adult population given the nonspecific, insidious symptoms, therefore, prompting awareness of its existence and a high degree of clinical suspicion. Malrotation should be considered in the differential diagnosis in patients presented with acute abdomen and intestinal ischemia.

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