scholarly journals Ileo-ileo-colic intussusception in adults: a rare event causing acute intestinal obstruction

2019 ◽  
Vol 6 (5) ◽  
pp. 1796
Author(s):  
Vishnu Pratap ◽  
Pallavi Shambhu ◽  
Bhushan Kale ◽  
S. Prabhakar
Keyword(s):  
Intestinal Obstruction ◽  
Ct Scan ◽  
Rare Event ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Common Finding ◽  
Radiographic Findings ◽  
Bowel Segment ◽  
Abdominal Emergencies ◽  
Variable Presentation

Intussusception is a common finding in children accounting for approximately 25% of all abdominal emergencies in patients below five years of age. This, however, is a rare observation in adults accounting for only 5% of all intussusceptions. Among them, those leading to acute intestinal obstruction are about 1-5%. Diagnosis is based on radiographic findings seen on ultrasonography or CT scan as the presentation in adults is often difficult to diagnose clinically due to the variable presentation. We present here a case of intussusception in a 24 year old male presenting as acute intestinal obstruction. Exploratory laparotomy with resection of the bowel segment was done followed by end to end anastomosis. Post-operative course was uneventful. 

scholarly journals Ileosigmoid knotting: an unusual cause of acute intestinal obstruction with bowel gangrene

2019 ◽  
Vol 12 (5) ◽  
pp. e226663
Author(s):  
Raj Kumar ◽  
Pavan Kumar Shamanur Kenchappa ◽  
Kusum Meena ◽  
Brijesh Kumar Singh
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Large Bowel Obstruction ◽  
Acute Intestinal Obstruction ◽  
Haemodynamic Instability ◽  
Ileocolic Anastomosis ◽  
Bowel Gangrene

Ileosigmoid knotting (ISK) is a rare cause of intestinal obstruction rapidly progressing to bowel gangrene. It is characterised by the wrapping of loops of ileum and sigmoid colon around each other. The condition often remains undiagnosed preoperatively; however, it can be suspected by the triad of small bowel obstruction, radiographic features suggestive of predominately large bowel obstruction and inability to deflate the intestine by a sigmoidoscope. We are reporting a case of 56-year-old man who presented with features of acute intestinal obstruction and compensated shock within 24 hours of onset of symptoms. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. In view of haemodynamic instability, end ileostomy was done after excising gangrenous segments. The patient improved and stoma closure and ileocolic anastomosis were done after 3 months in follow-up.

scholarly journals Acute Intestinal Obstruction Complicating Abdominal Pregnancy: Conservative Management and Successful Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Gerald Okanandu Udigwe ◽  
George Uchenna Eleje ◽  
Eric Chukwudi Ihekwoaba ◽  
Onyebuchi Izuchukwu Udegbunam ◽  
Richard Obinwanne Egeonu ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
University Teaching ◽  
Successful Outcome ◽  
Management Approach ◽  
Abdominal Pregnancy ◽  
Case Presentation ◽  
X Ray ◽  
Female Baby

Background. Acute intestinal obstruction during pregnancy is a very challenging and unusual nonobstetric surgical entity often linked with considerable fetomaternal morbidity and mortality. When it is synchronous with abdominal pregnancy, it is even rarer.Case Presentation. A 28-year-old lady in her second pregnancy was referred to Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, at 27 weeks of gestation due to vomiting, constipation, and abdominal pain. Examination and ultrasound scan revealed a single live intra-abdominal extrauterine fetus. Plain abdominal X-ray was diagnostic of intestinal obstruction. Conservative treatment was successful till the 34-week gestational age when she had exploratory laparotomy. At surgery, the amniotic sac was intact and the placenta was found to be adherent to the gut. There was also a live female baby with birth weight of 2.3 kg and Apgar scores of 9 and 10 in the 1st and 5th minutes, respectively, with the baby having right clubbed foot. Adhesiolysis and right adnexectomy were done. The mother and her baby were well and were discharged home nine days postoperatively.Conclusion. To the best of our knowledge, this is the first report of abdominal pregnancy as the cause of acute intestinal obstruction in the published literature. Management approach is multidisciplinary.

scholarly journals Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia

2020 ◽  
Author(s):  
Liqa A Rousan ◽  
Eyhab Elobeid ◽  
Musaab Karrar ◽  
Yousef Khader
Keyword(s):  
Ct Scan ◽  
Chest Ct ◽  
Common Finding ◽  
X Rays ◽  
Radiographic Findings ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

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.

scholarly journals Surgical and medical management of 05 cases of acute intestinal obstruction on pregnancy in university hospital center of Treichville, Côte d’Ivoire

2018 ◽  
Vol 5 (8) ◽  
pp. 2921
Author(s):  
Lassina Traore ◽  
Privat D. Ango ◽  
N’djeche Anoh ◽  
Laurent Kouadio ◽  
Lamine J. M. H. Dia ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Intestinal Obstruction ◽  
Rare Event ◽  
Acute Intestinal Obstruction ◽  
The Other ◽  
University Hospital ◽  
Obstetrics And Gynecology ◽  
Review Of The Literature ◽  
Made In ◽  
Hospital Center

From January 2003 to December 2017, the authors report five cases of acute intestinal obstruction during pregnancy. Two of them were received in digestive and proctological surgery emergencies. The other three patients were received urgently from the obstetrics and gynecology department. This association is a rare event. Clinical polymorphism delays the therapeutic management. In 1/5 cases only the diagnosis of occlusion on pregnancy was made. In 2/5 of the cases the diagnosis of occlusion was made and that of the pregnancy which at the 1st trimester was unknown. In last 2/5 of cases the pregnancies were at the 3rd trimester, the diagnosis of occlusion during pregnancy was made intraoperatively; Caesarean section being indicated for the fetal in distress on probable urinary tract infection. Authors did not have any maternal-fetal deaths.  Through five cases of this association and a review of the literature, authors highlight the diagnostic and therapeutic difficulties and the therapeutic attitudes likely to improve the feto-maternal prognosis. This fetal prognosis depends essentially on the age of the pregnancy and the speed of the management. 

Non-traumatic abdominal emergencies: imaging of acute intestinal obstruction

2002 ◽  
Vol 12 (9) ◽  
pp. 2151-2160 ◽  
Author(s):  
P. Taourel ◽  
N. Kessler ◽  
A. Lesnik ◽  
P. Blayac ◽  
L. Morcos ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Abdominal Emergencies

scholarly journals Rare case of paracaecal hernia with intussusception presenting as small bowel obstruction: case report

2020 ◽  
Vol 7 (5) ◽  
pp. 1662
Author(s):  
M. S. Kalyan Kumar ◽  
Shyamsundar R. ◽  
Sabari Girieasan M. ◽  
R. Kannan ◽  
S. Nedunchezhiyan
Keyword(s):  
Intestinal Obstruction ◽  
Internal Hernia ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Rare Presentation ◽  
Ileal Loop ◽  
Rare Type ◽  
Internal Hernias

Primary internal hernias are very rare in adults. They are an unusual cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is highly nonspecific. Imaging has limited role in diagnosing the cause of acute intestinal obstruction. Internal hernias are usually detected at laparotomy. We report a case of a 61-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the caecum and ileo ileal intussusception was noted proximal to the herniated loop. The segment of intestine was resected and anastamosed then hernial defect was closed. Paracaecal hernias are the rare type of hernias in internal hernia. In our case, intussusception was noted proximal to the herniated ileal loop which is a very rare presentation. Intussusception was reported previously with paraduodenal type. One should always keep in mind while conducting emergency laparotomy, internal hernias can be a cause for intestinal obstruction.

scholarly journals Obturator Hernia with Meckel’s Diverticulum Mimicking Incarcerated Small Bowel Hernia: A Case Report

2020 ◽  
Vol 17 (4) ◽  
Author(s):  
Won Jae Choi ◽  
Yoon Young Jung ◽  
Yongsang Kim ◽  
Dong Hee Kim
Keyword(s):  
Intestinal Obstruction ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Meckel's Diverticulum ◽  
Obturator Hernia ◽  
Abdominal Hernia ◽  
Imaging Features ◽  
Rare Type

: An obturator hernia is a rare type of abdominal hernia that can cause acute intestinal obstruction. Meckel’s diverticulum, the most common gastrointestinal tract malformation, is an uncommon cause of intestinal obstruction. The combination of obturator hernia and Meckel’s diverticulum is extremely rare. We report a rare case of obturator hernia with Meckel’s diverticulum in a 76-year-old woman who presented at the emergency room with complaints of abdominal pain. The diagnosis was confirmed by a computed tomography (CT) scan and exploratory laparotomy. Since obturator hernia is uncommon and rarely associated with Meckel’s diverticulum, we described the imaging features in this case study.

scholarly journals PHYTOBEZOAR

2006 ◽  
Vol 13 (03) ◽  
pp. 478-480
Author(s):  
ALI ASIA BANU ◽  
REHAN MASOOD ◽  
ISHTIAQ AHMED CHAUDHARY
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Exploratory Laparotomy ◽  
Acute Intestinal Obstruction ◽  
Small Intestinal Obstruction ◽  
Small Intestinal

Objectives: We are presenting a case report of an11 year old boy brought in emergency with acute intestinal obstruction. An exploratory Laparotomy revealed two stonyhard large phytobezoars to be the cause of the acute small intestinal obstruction at terminal ileum. Enterotomy wasdone to remove the bezoars and patient had smooth recovery.

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