scholarly journals An eventful course of a routine laparoscopic appendectomy: case report

2020 ◽  
Vol 7 (9) ◽  
pp. 3089
Author(s):  
Aiden Khalifa ◽  
Bhavana Devanabanda ◽  
Martine Louis
Keyword(s):  
Small Bowel ◽  
Acute Appendicitis ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Surgical Emergencies ◽  
Appendiceal Stump ◽  
Diagnostic Work

Acute appendicitis is one of the most common surgical emergencies in the world. Appendectomy can be done through an open technique, but the laparoscopic approach has become the gold standard for surgical treatment of acute appendicitis. This technique has been found to be associated with decreased postoperative pain, morbidity and length of stay when compared to open appendectomy. However, complications from laparoscopic appendectomy can still occur. We present a case of an internal hernia causing a small bowel obstruction, from adhesions due to loose staples after a laparoscopic appendectomy. Laparoscopic linear cutting staples and automatic clip applier are commonly fired across the appendiceal stump. At the end of the laparoscopy, if the free intraperitoneal staples are not removed with grasper or suction, it can lead to bowel obstruction. We report the clinical presentation, diagnostic work up, treatment and management of mechanical small bowel obstruction caused by loose staples in a pediatric patient. 

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

Med Phoenix ◽  
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.  

scholarly journals The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Enric Sebastian-Valverde ◽  
Ignasi Poves ◽  
Estela Membrilla-Fernández ◽  
María José Pons-Fragero ◽  
Luís Grande
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Laparoscopic Approach ◽  
Adhesive Small Bowel Obstruction

scholarly journals Non-steroidal anti-inflammatory drug-induced diaphragm disease: an uncommon cause of small bowel obstruction

2016 ◽  
Vol 98 (8) ◽  
pp. e189-e191 ◽  
Author(s):  
MME Coolsen ◽  
SJ Leedham ◽  
RJ Guy
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Resection ◽  
Drug Induced ◽  
Inflammatory Drug ◽  
Diaphragm Disease ◽  
Anti Inflammatory ◽  
Diagnostic Work ◽  
Work Up

Surgeons frequently deal with small bowel obstruction. However, small bowel obstruction caused by non-steroidal anti-inflammatory drug (NSAID)-induced diaphragm disease is very rare. The diagnosis is challenging, as symptoms are often non-specific and radiological studies remain inconclusive. We present a case of a 63-year-old man who, after an extensive diagnostic work-up and small bowel resection for obstructive symptoms, was finally diagnosed with NSAID-induced diaphragm disease as confirmed by histology. An unusual aspect of this case is that the patient stopped using NSAIDs after he was diagnosed with a gastric ulcer 2–years previously. This suggests that NSAID-induced diaphragms of the small bowel take some time to develop and underlines the importance of careful history taking.

Laparotomy for small-bowel obstruction: first choice or last resort for adhesiolysis? A laparoscopic approach for small-bowel obstruction reduces 30-day complications

2013 ◽  
Vol 28 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Kristin N. Kelly ◽  
James C. Iannuzzi ◽  
Aaron S. Rickles ◽  
Veerabhadram Garimella ◽  
John R. T. Monson ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Laparoscopic Approach ◽  
First Choice

scholarly journals A wolf in sheep’s clothing: concomitant appendicitis with occult cecal adenocarcinoma

2021 ◽  
Vol 8 (7) ◽  
pp. 2154
Author(s):  
Jonathan Mejia ◽  
Roland Haj ◽  
Sutasinee Nithisoontorn ◽  
Martine A. Louis ◽  
Nageswara Mandava
Keyword(s):  
Differential Diagnosis ◽  
Small Bowel ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Delayed Presentation ◽  
Ct Guided ◽  
Distal Small Bowel ◽  
Risk Of Cancer

We present the case of an 89-years-old female with an atypical presentation of an obstructive acute appendicitis secondary to a cecal carcinoma. The physical exam revealed a distended abdomen with bilateral lower quadrants tenderness without rebound or rigidity.  CT scan demonstrated distal small bowel obstruction and ruptured acute appendicitis. Patient was treated conservatively with nasogastric decompression, intravenous fluids, and antibiotics. She later underwent CT guided drainage of a rim-enhancing fluid collection and her symptoms eventually resolved. She returned a week later and a CT imaging showed high grade distal small bowel obstruction, and findings were a 4.5 cm diameter cecal mass. She underwent an exploratory laparotomy and modified right hemicolectomy with ileostomy for. She had an uneventful postoperative course. Pathology revealed poorly differentiated adenocarcinoma of the cecum stage III T4N1Mx. Appendectomy for appendicitis is the most commonly performed emergency operation in the world. Appendicitis are often rare in elderly, with atypical or delayed presentation and expanded differential diagnosis, making preoperative diagnosis challenging. With the increase overall risk of cancer in this age group, occult colonic carcinoma should be high in the differential diagnosis. Three mechanisms potentially leading to obstruction of the appendiceal lumen by the tumor includes: immediate proximity to the lumen, inflammatory changes from the tumor, back pressure on the cecum causing obstruction of the appendix. Despite advances in imaging, local inflammation, collections, and masses may be misleading. The diagnostic accuracy of CT scan reportedly can be as low as 54% for cecal tumors.

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