scholarly journals Ileal volvulus due to ascaris lumbricoides: a diagnosis revisited

2019 ◽  
Vol 6 (2) ◽  
pp. 614
Author(s):  
Ipseet Mishra ◽  
Sudip Haldar ◽  
Souvik Paul
Keyword(s):  
Ascaris Lumbricoides ◽  
Wide Spectrum ◽  
Primary Anastomosis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Small Bowel Volvulus ◽  
Clinical Presentations ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Early Surgical Intervention

Ascariasis infestation is a common helminthic disease in developing countries with a wide spectrum of clinical presentations, one of which can be acute abdomen. Small bowel volvulus is a serious life-threatening emergency. The aetiology may be primary as is often seen in Africa and Asia, while in Western countries other predisposing conditions usually initiate the volvulus. Ascariasis is highly prevalent in India and so, a myriad of different presentations is quite obvious. Here the authors have reported a case of a 6year old boy presenting with features of acute intestinal obstruction-central abdominal pain, repeated vomiting and abdominal distension. After evaluation with abdominal radiography and ultrasonography, exploratory laparotomy was planned. A secondary ileal volvulus compact with worms of ascaris lumbricoides was found. Resection of non-viable ileum was done after evacuation of worms by enterotomy followed by primary anastomosis. Prompt clinical diagnosis, a high index of suspicion for complications and early surgical intervention are critical in minimizing morbidity in cases of Intestinal Ascariasis.

Intrauterine Intussusception Presenting as Fetal Ascites and Meconium Peritonitis

2021 ◽  
Vol 5 (0-2) ◽  
pp. 18
Author(s):  
Khalilah Alhuda Binti Kamilen ◽  
Mohd Yusran Othman
Keyword(s):  
Primary Anastomosis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Intestinal Atresia ◽  
Premature Baby ◽  
Abdominal Radiograph ◽  
Meconium Peritonitis ◽  
Ileal Perforation ◽  
Intraabdominal Sepsis ◽  
Intrauterine Intussusception

Intussusception is a well-known cause of intestinal obstruction in children. Its occurrence in fetus as an intrauterine incidence is extremely rare and poses a diagnostic difficulty. Intrauterine intussusception may result in intestinal atresia once the gangrenous segment resorbed. However, a very late occurrence of intussusception just prior to delivery may present as meconium peritonitis. We are reporting a case of premature baby who was born at 35 weeks gestation via emergency caesarean for breech in labour. Routine scan 4 days prior to the delivery showed evidence of fetal ascites. She was born with good Apgar Score and weighed 2.5kg. Subsequently she developed respiratory distress syndrome requiring mechanical ventilation. She passed minimal meconium once after birth then developed progressive abdominal distension and vomiting. Abdominal radiograph on day 4 of life revealed gross pneumoperitoneum and bedside percutaneous drain was inserted to ease the ventilation. Upon exploratory laparotomy, a single ileal perforation was seen 20cm from ileocecal junction with an intussusceptum was seen in the distal bowel. Gross meconium contamination and bowel edema did not favour the option of primary anastomosis, thus stoma was created. Reversal of stoma was performed a month later and she recovered well. Fetus with a complicated intrauterine intussusception may present with fetal ascites and their postnatal clinical and radiological findings need to be carefully assessed for evidence of meconium peritonitis; in which a timely surgical intervention is required to prevent the sequelae of prolonged intraabdominal sepsis in this premature baby.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S18

scholarly journals Capsular dissection technique for reducing recurrent laryngeal neuropraxia and temporary hypoparathyroidism after thyroidectomy: a single center experience

2021 ◽  
Vol 7 (7) ◽  
pp. 1111
Author(s):  
Dimple Sahni ◽  
Rajwant Kaur ◽  
Gagandeep Kaur ◽  
Sangeeta Aggarwal ◽  
Sanjeev Bhagat
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Single Center ◽  
Single Center Experience ◽  
Clinical Presentations ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
A Prospective Study ◽  
Dissection Technique ◽  
Nose And Throat

<p class="abstract"><strong>Background:</strong> Foreign bodies in aerodigestive tract is common, frequent, and sometime life threatening emergency for otorhinolaryngologists mainly in the paediatric group. The aims of the present study was to find the incidence of foreign bodies, in relation to demographic factors, type and sites of foreign bodies its clinical presentations and its management.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted on 100 cases coming to the ear, nose and throat (ENT) emergency and outpatient department (OPD). After thorough history, clinical examination, routine blood and urine investigations and urine done. Radiological examination was done to visualize the radio-opaque foreign body, and if the foreign body was not radio-opaque then computed tomography (CT) scan was done.  </p><p class="abstract"><strong>Results:</strong> Incidence of foreign was 67% in male than 33% in female. Mostly foreign bodies were in nose (49%), followed by oesophageal (31%), abdominal (14%), and bronchus (6%) respectively. 33% were totally asymptomatic, 25% with mucupurulent discharge from nose, dysphagia (16%), nasal obstruction (15%), and odynophagia (11%) respectively. Most of the foreign bodies were inorganic in nature, coin (42%), pearls (8.16%), and battery (6.45%). Among organic foreign bodies peanut was most common (33.33%), grains (10%). All foreign bodies were removed successfully with minimal morbidity and zero mortality.</p><p class="abstract"><strong>Conclusions:</strong> Present study suggested incidence was very common among male children, in rural background, with common asymptomatic presentation. With high index of suspicion, and proper and timely intervention all 100 cases were managed successfully. But still educating the parents about keeping such things away from kids prevent these incident.</p>

scholarly journals Pneumatosis intestinalis: cost paid for rheumatoid arthritis treatment

2019 ◽  
Vol 12 (7) ◽  
pp. e229329 ◽  
Author(s):  
Pratyusha Tirumanisetty ◽  
Jose William Sotelo ◽  
Michael Disalle ◽  
Meenal Sharma
Keyword(s):  
Rheumatoid Arthritis ◽  
Bowel Wall ◽  
Loop Ileostomy ◽  
Pneumatosis Intestinalis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Right Hemicolectomy ◽  
Necrotic Bowel ◽  
History Of ◽  
High Index Of Suspicion

A 75-year-old woman with rheumatoid arthritis on rituximab presented with a 1-week history of constipation and abdominal distension. Subsequent workup showed presence of air in the bowel wall without perforation initially. Due to positive blood cultures, worsening leucocytosis and high suspicion for perforation, an exploratory laparotomy was performed revealing necrotic bowel, walled off perforation and abscess. Patient underwent right hemicolectomy with diversion loop ileostomy. Clinicians must recognise that monoclonal antibodies like rituximab can mask signs of inflammation and therefore should maintain a high index of suspicion for intestinal perforation when evaluating patients with minimal symptoms and pneumatosis intestinalis.

Mesenteric Cystic Lymphangioma “Intra-abdominal Catastrophe”

2020 ◽  
pp. 1-5
Author(s):  
R. S. Kiran ◽  
S. Sarmukh ◽  
H. Azmi
Keyword(s):  
Intestinal Obstruction ◽  
Histopathological Examination ◽  
Primary Anastomosis ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Small Bowel Resection ◽  
Cystic Lymphangioma ◽  
Co Morbidity ◽  
Mesenteric Mass ◽  
Life Threatening

Lymphangioma is a benign tumour of lymphatic origin. Lymphangioma in peritoneal cavity is extremely rare (5%), particularly in adults. Hereby, we are reporting a case of a Malay gentleman with no co morbidity presented with sign and symptoms of intestinal obstruction. We proceeded with exploratory laparotomy with small bowel resection with primary anastomosis. Intraoperatively, revealed soft mesenteric mass measuring around 5X5 cm and it was 80 cm from duodenum-jejunum flexure. Histopathological examination showed mesenteric cystic lymphangioma (MCL). Cystic intra-abdominal mass should be included MCL as a diagnosis although it’s rare. Surgical management is still a mainstay of treatment due to its potential to invade vital structures and develop life threatening complication such as intestinal obstruction and bleeding. The surgical outcome after a complete clear margin resection can avoid recurrence.

scholarly journals Sigmoid Sinus Thrombosis as a Complication of Acute Otitis Media in a 6-Year-Old Male

2021 ◽  
pp. 014556132110157
Author(s):  
Alexandros Poutoglidis ◽  
Nikolaos Tsetsos ◽  
Stergiani Keramari ◽  
Ioannis Skoumpas ◽  
Konstantinos Vlachtsis ◽  
...  
Keyword(s):  
Otitis Media ◽  
Pediatric Patients ◽  
Sinus Thrombosis ◽  
Wide Spectrum ◽  
Acute Otitis Media ◽  
Sigmoid Sinus ◽  
Cortical Mastoidectomy ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
High Index Of Suspicion

Sigmoid sinus thrombosis (SST) is a potentially life-threatening complication of otitis media which is nowadays rare due to the widespread use of antibiotics. A high index of suspicion is necessary to allow for a timely diagnostic and therapeutic intervention. Intravenous wide-spectrum antibiotics and a cortical mastoidectomy are the mainstay of treatment. There is no consensus regarding the necessity of anticoagulants in pediatric patients. We present a 6-year-old boy who presented with an SST as a result of acute otitis media.

scholarly journals Lemierre’s Syndrome: A Thing of the Past?

2020 ◽  
Author(s):  
Nehal Dhaduk ◽  
Sudeepti Vedula ◽  
Aparna Govindan ◽  
Evelyne Kalyoussef
Keyword(s):  
Mortality Rate ◽  
Case Reports ◽  
Case Series ◽  
Lemierre’S Syndrome ◽  
Female Ratio ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Lemierre's Syndrome ◽  
High Index Of Suspicion ◽  
Male To Female

Abstract Introduction: Lemierre’s syndrome (LS), infectious thrombophlebitis of the internal jugular vein, is a rare, life-threatening complication of oropharyngeal infections underrepresented in literature. We reviewed the etiology, clinical characteristics, treatment regiments and prognosis of LS in pediatric patients.Methods: PubMed and MEDLINE were searched from February 10, 2018 to July 28, 2018 for relevant studies. A systematic review was performed using the terms LS and pediatric case. Our criteria included reviews, case reports, and case series with patients under 18 years with a diagnosis of LS. Results: 70 cases of pediatric LS were identified. The male to female ratio was 1:1.7 with an average age of 10.7 years (5 weeks to 17 years). The most common initial clinical presentations were fever (90.0%), sore throat (38.6%), and neck pain or tenderness (35.7%), while the most frequent findings on physical exam were fever (31.4%) and neck involvement (28.6%). F. necrophorum was the predominant organism cultured (62.9%). Septic emboli were seen in 51.4% of cases with the lungs affected in 40 patients. Most commonly used treatments were antibiotics (91.4%) followed by anticoagulation (50.0%) and the overall mortality rate was 8.6%. The average time from initial presentation to diagnosis was 4.9 days. Conclusion: LS is a deadly condition with a staggering mortality rate despite the advent of antibiotic measures. Early identification and a high index of suspicion are necessary to prevent complications associated with LS. Despite its rarity it should remain on the differential for any patient with toxic signs and localized neck findings.

scholarly journals Primary ileal volvulus: a rare twist in an elderly patient—case report

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Srikant Agrawal ◽  
Ashwini Ranjan Yadav ◽  
Bikash Nepal ◽  
Pramod Kumar Upadhyay
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Predisposing Factors ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Abstract Background Small bowel volvulus is a rare entity and it is even rarer for the ileum to undergo torsion without any known predisposing factors. It presents as acute abdomen with features of intestinal obstruction. As it is a life-threatening condition, it should be kept as a differential for small bowel obstruction despite its rarity. Therefore, we report this case. Case report A 60-year-old gentleman presented to our emergency department with a 2-day history of worsening abdominal pain, vomiting, abdominal distension and obstipation. Exploratory laparotomy was done which revealed ileal volvulus with no predisposing factors. Derotation of the segment was done. The postoperative period was uneventful and on follow up after a month, he had a satisfying recovery. Conclusion Though primary ileal volvulus is a rare diagnosis, it should be kept in mind in any patient with small bowel obstruction with pain out of proportion and resistant to opioid management. Early diagnosis and urgent surgical intervention is the key to prevent bowel necrosis and associated morbidity and mortality.

Rare complication of adenomyosis: acute purulent peritonitis and septicaemia in a young nulligravida

2021 ◽  
Vol 14 (11) ◽  
pp. e238374
Author(s):  
Kameshwarachari Pushpalatha ◽  
Ruchi Kalra ◽  
Bharti Singh ◽  
Anusha Devalla
Keyword(s):  
Indian Subcontinent ◽  
Rare Complication ◽  
Ventilatory Support ◽  
Stable Condition ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Purulent Peritonitis ◽  
Multiparous Women ◽  
Life Threatening ◽  
Upper Gastrointestinal Tract Endoscopy

Adenomyosis is a benign gynaecological condition in multiparous women during their middle age commonly presenting as pelvic pain and menorrhagia. We report a case of a 27-year-old nulligravida of Asian origin from the Indian subcontinent who presented with a huge adenomyotic uterus with mild splenomegaly, and portal cavernoma having gross ascites that developed life-threatening peritonitis and septicaemia. Endometrial aspiration done showed no atypia or malignancy and upper gastrointestinal tract endoscopy done showed no dilated varices. With increasing abdominal distension, she developed tachycardia, tachypnoea, septicaemia and oliguria. Exploratory laparotomy done revealed purulent loculi, omentum and bowel adhesion around the uterus. Adnexa was not distinctly identifiable. Hysterectomy with left salpingo-oopherectomy was performed. She required ventilatory support and intensive unit care postoperatively. Histopathology examination showed adenomyosis with suppuration, right ovary endometriotic cyst and left ovary non-specific inflammation. The patient was discharged in stable condition on day 21. Adenomyosis may rarely occur in young nulligravida women as life-threatening manifestations with purulent peritonitis and septicaemia. Early exploration is crucial for diagnosis and recovery.

scholarly journals Meckel’s diverticulum: a rare cause of small bowel obstruction in an adult

2021 ◽  
Vol 8 (4) ◽  
pp. 1289
Author(s):  
Nusrat Jabeen ◽  
Hussain Adnan Abdulla ◽  
Asma Alqaseer ◽  
Mohamed Ayed Abushwemeh ◽  
Amal Alrayes
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Congenital Abnormality ◽  
Rare Case ◽  
Primary Anastomosis ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
High Index Of Suspicion

Meckel’s diverticulum is the most common congenital abnormality of the gastrointestinal tract. Complications involving Meckel’s diverticulum include bleeding, bowel obstruction and inflammation. We present a rare case of small bowel obstruction caused by Meckel’s diverticulum. A 50-year-old male presented to the emergency department with abdominal pain and vomiting. Computed tomography (CT) abdomen showed dilated small bowel loops with transition zone at the mid ileum, consistent with small bowel obstruction. The patient was taken to the operating theatre for exploratory laparotomy and was found to have a Meckel’s diverticulum causing mechanical small bowel obstruction, which was resected with primary anastomosis. The patient recovered with no postoperative complications and was discharged home. Meckel’s diverticulum is difficult to diagnose preoperatively since most patients are asymptomatic and requires a high index of suspicion. In patients presenting with an acute abdomen, it may be overlooked because of nonspecific symptoms. In the case of small bowel obstruction, Meckel’s diverticulum should be kept in mind as part of the differential diagnosis.

scholarly journals Low-grade appendiceal mucinous neoplasms with bowel obstruction

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Constance Houlzé-Laroye ◽  
Clarisse Eveno
Keyword(s):  
Intestinal Obstruction ◽  
Peritoneal Cavity ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Low Grade ◽  
Atypical Symptoms ◽  
Abdominal Symptoms ◽  
Clinical Presentations ◽  
Mucinous Neoplasms ◽  
Abdominal Ct Scan

AbstractBackgroundPerforation of low-grade appendiceal mucinous neoplasms (LAMN) is characterized by its potential to spread mucin into peritoneal cavity, giving rise to pseudomyxoma peritonei, commonly treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Symptoms of intestinal obstruction and appendiceal infection are rare at early stages of the disease, while abdominal distension are observed in the later stages due to mucin spread.MethodsWe report herein a case of LAMN with atypical symptoms in a 35-year-old woman with abdominal symptoms evoking an intestinal obstruction.ResultsAn abdominal CT scan revealed an ileo-caecal intussusception. An exploratory laparotomy and examination of the peritoneal cavity ruled out an exteriorization of mucin and the bowel was resected.ConclusionsThe pathology analysis confirmed the diagnostic of LAMN. This report aims to raise awareness among surgeons, of rare clinical presentations that LAMN may show, to adapt the surgical treatment to these patients and assign them to referral centers.

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