Closed loop small bowel obstruction due to mid urethral sling mesh

Closed loop small bowel obstruction is a surgical emergency, which when left untreated leads to vascular compromise resulting in intestinal ischemia, necrosis and perforation. We report the case of a 61 years old female with past surgical history of hysterectomy and a mid-urethral sling, who presented to the emergency department for abdominal pain and obstipation. She was found on imaging to have a closed loop small bowel obstruction. An exploratory laparotomy revealed an adhesive band encompassing the distal terminal ileum, visceral peritoneum and the Mid‐urethral slings mesh. This is a rare complication that, to our knowledge, has not been reported in the surgical literature. This paper will discuss the clinical presentation, diagnostic studies, therapeutic intervention and outcome of this unique case.

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Small Bowel Obstruction by Broad Ligament Hernia: Three Case Reports, Management and Outcomes

Acta Médica Portuguesa ◽

10.20344/amp.10951 ◽

2019 ◽

Vol 32 (3) ◽

pp. 240

Author(s):

Manuela Graça Fernandes ◽

Ana Rita Mateus Loureiro ◽

Maria João Diogo Obrist ◽

César Prudente

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Case Reports ◽

Broad Ligament ◽

Exploratory Laparotomy ◽

Anatomical Location ◽

Internal Hernias ◽

Surgical History ◽

Broad Ligament Defect

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.

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Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

Veterinary Sciences ◽

10.3390/vetsci8050083 ◽

2021 ◽

Vol 8 (5) ◽

pp. 83

Author(s):

Jae-Eun Hyun ◽

Hyun-Jung Han

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Surgical Intervention ◽

Gastrointestinal Symptoms ◽

Exploratory Laparotomy ◽

Abdominal Adhesions ◽

Abdominal Radiography ◽

Foreign Body Removal ◽

Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

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Transmesenteric hernia with closed-loop small bowel obstruction: A case report

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2022.103256 ◽

2022 ◽

pp. 103256

Author(s):

Bibek Man Shrestha ◽

Suraj Shrestha ◽

Shiva Aryal ◽

Susan Pradhan ◽

Romi Dahal ◽

...

Keyword(s):

Case Report ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Closed Loop ◽

Transmesenteric Hernia

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Therapeutic Role of Gastrograffin in Adhesive Small Bowel Obstruction After Unsuccessful Conservative Treatment

Med Phoenix ◽

10.3126/medphoenix.v5i1.31395 ◽

2020 ◽

Vol 5 (1) ◽

pp. 26-31

Author(s):

MD Alam Shahid ◽

Pashupati Bhatta ◽

Akash Raya ◽

Binod Kumar Rai

Keyword(s):

Small Bowel ◽

Conservative Treatment ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Open Appendectomy ◽

Sampling Technique ◽

Exploratory Laparotomy ◽

Water Soluble ◽

Adhesive Small Bowel Obstruction ◽

Therapeutic Role

Background: The management of adhesive small bowel obstruction is quite debatable. Gastrograffin, a water-soluble hyperosmolar contrast is used as a diagnostic tool widely but it also has impressive therapeutic role. Hence this study was to determine its therapeutic role in management of adhesive bowel obstruction after failure of conservative treatment. Methods: This cross-section observational study of 42 patients was conducted in 1-year duration from 01 July 2018 to 30 June 2019 using non-probability purposive sampling technique. All the patients were first managed conservatively for 48 hrs, and then given 100ml of gastrograffin through NG tube and clamped. Appearance of dye in cecum on radiograph at different time frame (4, 8, 12 and 24 hours of administration) signifies the success and who failed to do so within 24 hrs. were planned for laparotomy. Results: A total of 42 patients with their age ranged 14-80 years (mean 44.6) were included. Among them 32 (76.19%) were male and 10 (23.80%) female. Most had open appendectomy followed by gynaecological surgery and exploratory laprotomy. Majority had midline incision followed by gridiron and pfanensteil incision. After 8 hrs of gastrograffin administration, it was positive in 12 patients while 19 had at 24 hrs. Total 31 patients showed complete resolution, while remaining 11 showed no improvement and undergone exploratory laparotomy. Conclusion: Thus, the administration of gastrograffin is an effective approach in the management of adhesive small bowel obstruction after failed conservative management and prevents surgeries.

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Sclerosing Mesenteritis: A Rare Cause of Small Bowel Obstruction

Case Reports in Gastroenterology ◽

10.1159/000444413 ◽

2016 ◽

Vol 10 (1) ◽

pp. 67-71 ◽

Cited By ~ 4

Author(s):

Glenn Harvin ◽

Adam Graham

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Resection ◽

Rare Complication ◽

Small Bowel Resection ◽

Sclerosing Mesenteritis ◽

Exact Etiology ◽

Resected Tissue ◽

Uncommon Condition

Sclerosing mesenteritis falls within a spectrum of primary idiopathic inflammatory and fibrotic processes that affect the mesentery. The exact etiology has not been determined, although the following associations have been noted: abdominal surgery, trauma, autoimmunity, paraneoplastic syndrome, ischemia and infection. Progression of sclerosing mesentritis can lead to bowel obstruction, a rare complication of this uncommon condition. We report a case of a 66-year-old female with abdominal pain who was noted to have a small bowel obstruction requiring laparotomy and a partial small bowel resection. The pathology of the resected tissue was consistent with sclerosing mesenteritis, a rare cause of a small bowel obstruction. Sclerosing mesenteritis has variable rates of progression, and there is no consensus regarding the optimal treatment. Physicians should consider sclerosing mesenteritis in the differential diagnosis of a small bowel obstruction.

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Diagnosis and Management of a Postpyloric Foreign Body Causing Small Bowel Obstruction in an Infant

Clinical Medicine Insights Case Reports ◽

10.1177/1179547617719249 ◽

2017 ◽

Vol 10 ◽

pp. 117954761771924

Author(s):

Victoria Bradford ◽

Marissa Vadi ◽

Harmony Carter

Keyword(s):

Foreign Body ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Pediatric Population ◽

Exploratory Laparotomy ◽

Foreign Body Ingestion ◽

Common Occurrence ◽

Diagnosis And Management ◽

History Of

Foreign body ingestion is a common occurrence in the pediatric population and most ingestions resolve with little morbidity. Although radiopaque objects are easily identified on biplane radiographs, radiolucent objects may elude detection, delaying diagnosis. We report a case of a healthy 10-month-old infant who presented with a 5-day history of postprandial vomiting and imaging consistent with small bowel obstruction. On exploratory laparotomy, she was discovered to have a postpyloric foreign body requiring removal through an enterotomy.

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Closed loop bowel obstruction secondary to left paraduodenal hernia (of Landzert)

BMJ Case Reports ◽

10.1136/bcr-2019-232134 ◽

2019 ◽

Vol 12 (12) ◽

pp. e232134

Author(s):

Yeo Min Cho ◽

Gamze Aksakal ◽

Mohamed Ahmed Tawfik Ashour ◽

Suzanne Moore

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Rare Case ◽

Closed Loop ◽

Flank Pain ◽

Paraduodenal Hernia ◽

Good Recovery ◽

Left Colic Artery ◽

Unusual Phenomenon

A 34-year-old man presented with acute severe left-sided abdominal and flank pain with associated postprandial nausea and vomiting. CT imaging revealed findings suspicious for a closed loop small bowel obstruction. Intraoperative findings were that of a left paraduodenal hernia (of Landzert) secondary to a mesenteric defect immediately posterior to the ascending branch of the left colic artery. The defect was closed via minilaparotomy. Unfortunately, his postoperative course was complicated by small bowel obstruction which required further laparotomy and adhesiolysis. The patient eventually made a good recovery. Here, we present a rare case of intestinal obstruction and discuss the aetiologies and management of this unusual phenomenon.

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Selective Laparoscopic Management of Adhesive Small Bowel Obstruction Using CT Guidance

The American Surgeon ◽

10.1177/000313480907500308 ◽

2009 ◽

Vol 75 (3) ◽

pp. 227-231 ◽

Cited By ~ 3

Author(s):

In Kyu Lee ◽

Do Hyoung Kim ◽

D. Lee Gorden ◽

Yoon Suk Lee ◽

Seung Eun Jung ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Medical Center ◽

Preoperative Imaging ◽

Adhesive Small Bowel Obstruction ◽

Abdominal Ct ◽

Laparoscopic Adhesiolysis ◽

Adhesive Band

Small bowel obstruction after intra-abdominal surgery is a common cause of morbidity necessitating reoperation. The aim of this study was to determine the feasibility of and indications for laparoscopic surgery for acute adhesive small bowel obstruction (AASBO). We conducted a retrospective review of all patients with AASBO who underwent laparoscopic adhesiolysis at a major university medical center. Laparoscopic treatment was performed successfully in 16 patients, and conventional treatment was performed in 13 patients. The rate of conversion from laparoscopic to open was 16.7 per cent. In 15 of 16 total patients who underwent laparoscopic surgery, laparoscopic bandlysis was performed and one patient underwent laparoscopic adhesiolysis. Laparoscopic surgery was performed successfully in nine who had a single adhesive band demonstrated on an abdominal CT, and conventional surgery was performed in all 10 patients without a single adhesive band identified radiographically. Abdominal CT scans facilitate the selection of operative approach for AASBO based on preoperative identification of the obstruction site. Laparoscopic adhesiolysis is a safe and effective treatment modality for patients with AASBO with a single band or single transition zone identified by preoperative imaging.

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