scholarly journals An unusual case of small bowel obstruction secondary to internal herniation of distal ileum through a rent between adhered inflamed vermiform appendix and appendices epiploicae

2021 ◽  
Vol 8 (12) ◽  
pp. 3741
Author(s):  
Rudraiah H. G. M. ◽  
Benita Davis
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Vermiform Appendix ◽  
Distal Ileum ◽  
Successful Outcome ◽  
Internal Herniation ◽  
Abdominal Tumor ◽  
Surgical Exploration ◽  
Appendices Epiploicae ◽  
High Index Of Suspicion

Intestinal obstruction secondary to an internal hernia is rare and that occurring through a rent between the adhered inflamed vermiform appendix and appendices epiploicae of the proximal caecum is so rare that this case was the first of its kind ever to be reported. Such a cause for obstruction should be suspected in a patient with a virgin abdomen with no history/clinical features of an obstructing external hernia or abdominal tumor. A 28 year old man presented to the ER with features of intestinal obstruction, in whom CECT abdomen revealed multiple dilated small bowel loops with breaking-of seen in the region of the terminal ileum. Surgical exploration revealed internal herniation of the distal ileum through a rent between the adhered inflamed vermiform appendix and the appendices epiploicae of the proximal caecum; reduction of which was sufficient to relieve the obstruction and demonstrate healthy reperfusion. Adhesiolysis, epiploicae appendectomy and appendectomy was done with no other points of obstruction along the small bowel. Due to its rarity, non-specific presentation pattern and limited usefulness of imaging for diagnosis, a high index of suspicion with prompt early surgical exploration is a must for a successful outcome in such cases intestinal obstruction; especially in a virgin abdomen.

scholarly journals A Rare Case of Intestinal Obstruction from Internal Hernia through a Foramen Formed by Appendices Epiploicae – A Case Report and Review of Literature

2020 ◽  
Vol 8 (C) ◽  
pp. 4-6
Author(s):  
Thomas Olagboyega Olajide ◽  
Olanrewaju Balogun
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Surgical Intervention ◽  
Internal Herniation ◽  
Review Of Literature ◽  
Improve Outcome ◽  
Internal Hernias ◽  
Appendices Epiploicae ◽  
High Index Of Suspicion

BACKGROUND: Internal hernias are uncommon causes of acute abdomen and intestinal obstruction. Internal herniation due to appendices epiploicae is very rare with only six cases reported in the literature.CASE REPORT: We, herein, present the report of a 64-year-old female who presented with features of intestinal obstruction due to internal herniation of a loop of small intestine through an orifice formed by the fusion of two appendices epiploicae. The band was divided into release the entrapped loop of bowel.CONCLUSION: A high index of suspicion with prompt surgical intervention will improve outcome.

scholarly journals Intestinal obstruction due to small bowel herniation through foramen of Winslow: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
P. K. B. S. C. Bandara ◽  
A. M. Viraj Rohana ◽  
Aloka Pathirana
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Intestinal Obstruction ◽  
Reflux Disease ◽  
Bowel Loop ◽  
Internal Herniation ◽  
Small Bowel Loop ◽  
Foramen Of Winslow

Abstract Background Intestinal obstruction due to internal herniation of the bowel is a rare clinical entity which is often overlooked in the differential diagnosis of patients with abdominal pain who have no previous history of abdominal surgery. Several sites of bowel internal herniation have been described, amongst which internal herniation through the foramen of Winslow accounts for about 8% of cases. These patients present with nonspecific abdominal pain associated with symptoms of gastroesophageal reflux disease, and hence the diagnosis is often overlooked. The usual symptoms of intestinal obstruction can be delayed, which results in a delay in diagnosis and gangrene of the herniated bowel segment. Abdominal radiographs and computed tomography are helpful in the diagnosis. Open reduction is the management of choice; however, laparoscopic reduction has also been attempted, with good results. Case presentation We report a case of a middle-aged Sri Lankan man who presented with features of gastroesophageal reflux disease, developed features of intestinal obstruction and was found to have a gangrenous small bowel loop which had herniated through the foramen of Winslow. Following needle aspiration and reduction of the herniated small bowel loop, the gangrenous part of the small bowel was resected and an ileoileal anastomosis performed. The large foramen of Winslow was partially closed with interrupted stitches. The patient made an uneventful recovery. Conclusion Since delayed diagnosis of bowel obstruction is detrimental, it is of utmost importance to diagnose it early. Because internal herniation of the small bowel through the foramen of Winslow presents with nonspecific symptoms including features of gastroesophageal reflux disease, as documented in several cases worldwide and also presented by our patient, there should be a high degree of suspicion of internal herniation of the bowel causing bowel obstruction and low threshold for extensive investigation of patients presenting with symptoms of gastroesophageal reflux disease which does not resolve with usual medication.

scholarly journals Unusual presentation of eosinophilic enteritis as multiple strictures of small intestine

2012 ◽  
Vol 2 (1) ◽  
pp. 24
Author(s):  
Sunil V. Jagtap ◽  
Dhiraj B. Nikumbh ◽  
Ashok Y. Kshirsagar ◽  
Neha Ahuja
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bowel Wall ◽  
Unusual Presentation ◽  
Unknown Etiology ◽  
Peripheral Eosinophilia ◽  
Variable Depth ◽  
High Index Of Suspicion

Eosinophilic enteritis is a rare disease of unknown etiology. It is characterized by eosinophilic infiltration of the bowel wall to a variable depth and symptoms associated with gastrointestinal tract depending upon the predominant layer involved. Diagnosis of eosinophilic enteritis requires a high index of suspicion and exclusion of various disorders that are associated with peripheral eosinophilia. We report a case of unusual presentation of eosinophilic enteritis clinically presenting as intestinal obstruction due to multiple strictures of the small bowel in an adult male.

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 Neonatal small bowel obstruction due to malrotation: a clinical study

2017 ◽  
Vol 4 (8) ◽  
pp. 2727 ◽  
Author(s):  
Srinivas S. ◽  
Reddy K. R. ◽  
Balraj T. A. ◽  
Gangadhar A.
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Pediatric Surgery ◽  
Clinical Presentation ◽  
Midgut Volvulus ◽  
Fatal Complication ◽  
Small Intestinal ◽  
High Index Of Suspicion

Background:This study was done at Niloufer hospital and institute of child health, Hyderabad with an aim of evaluating the clinical presentation, diagnostic evaluation, management and outcome of malrotation of intestines in the neonates.Methods: Cases of neonatal small intestinal obstruction due to malrotation presenting to the Department of Pediatric Surgery, Niloufer hospital over a period of two years were evaluated.Results: A total of 38 newborns presented to our department with intestinal obstruction due to malrotation. 3/38 patients presented with extensive gangrene of midgut. 4/38 patients died during the course of treatment.Conclusions: Malrotation is a relatively common cause of neonatal small bowel obstruction. A high index of suspicion is needed in neonates presenting with bilious vomiting. Early laparotomy prevents fatal complication of extensive gangrene due to midgut volvulus. 

scholarly journals Diaphragm Disease: The Limitation of Laparoscopy and Assessment of the Small Bowel for Strictures Using a Ball Bearing

2006 ◽  
Vol 6 ◽  
pp. 1139-1143 ◽  
Author(s):  
C.E. Moffat ◽  
M.N. Khyan ◽  
C.G. Davies ◽  
A.S.K. Ghauri ◽  
C.J. Ranaboldo
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Ball Bearing ◽  
Steel Ball ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
High Index Of Suspicion

Diaphragm disease is a rare cause of intestinal obstruction that will be seen with increasing frequency with the widespread use of nonsteroidal anti-inflammatory drugs (NSAIDs). We present a case study of a patient with diaphragm disease where the diagnosis was not apparent at laparoscopy, and passage of a steel ball through the small intestine was required to identify all strictures present. A high index of suspicion, recognition of the limitations of conventional diagnostic aids, and the need to assess the full length of the small bowel are all important in the surgical management of this condition.

scholarly journals INTESTINAL MALROTATION - A COMMON YET DEADLY CAUSE OF NEONATAL SMALL BOWEL OBSTRUCTION

2021 ◽  
Vol 9 (03) ◽  
pp. 472-475
Author(s):  
Saurav Sultania ◽  
◽  
Arvind Kumar Shukla ◽  
Pramila Sharma ◽  
Dinesh Kumar Barolia ◽  
...  
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
High Index ◽  
Diagnostic Tools ◽  
Paediatric Surgery ◽  
Medical College ◽  
Bilious Vomiting ◽  
High Index Of Suspicion

Background: This study was done at SMS Medical College, Jaipur with an aim of emphasizing the need of having a high index of suspicion in newborn presenting with bilious vomiting for the diagnosis of malrotation. Methods: Cases of neonatal small intestinal obstruction due to malrotation presenting to the Department of Paediatric Surgery, SMS Medical College, Jaipur over a period of two years were evaluated. Results: A total of 48 newborns presented to our department with intestinal obstruction due to malrotation. Majority (82%) of the patients presented in the 2nd and 3rd week of life. 6 out of 48 patients presented with extensive gangrene of midgut. 9/48 patients died during the course of treatment and during follow-up. Conclusion: Malrotation is a relatively common cause of neonatal small bowel obstruction. A high index of suspicion is required in neonates presenting with bilious vomiting. Prompt diagnostic tools and early laparotomy prevents fatal complication of extensive midgut gangrene due to volvulus.

scholarly journals Trichobezoars: a hairy cause of intestinal obstruction

2020 ◽  
Vol 7 (5) ◽  
pp. 1658
Author(s):  
Anurag Tiwary ◽  
Pragati Singhal ◽  
Nida Khan ◽  
Pramod Tiwary
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Age Group ◽  
Rapunzel Syndrome ◽  
Surgical Exploration ◽  
Paediatric Age

Trichobezoars are an infrequent form of bezoar found in the stomach or intestine, created from ingested hair. Their most frequent location is in the stomach but they may extend through the pylorus into the small bowel. This condition is known as Rapunzel syndrome. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis in children. Authors report 3 cases of Rapunzel syndrome with a large bezoar in paediatric age group that presented with features of acute intestinal obstruction. They were managed with surgical exploration.

scholarly journals Intestinal obstruction in case of internal hernia through congenital defect in falciform ligament in adult

2019 ◽  
Vol 7 (11) ◽  
pp. 4368
Author(s):  
Archit Pankajkumar Parikh ◽  
Mohan Prakash Tyagi ◽  
Dheerta Atul Kapadia
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Intestinal Resection ◽  
Congenital Defect ◽  
Falciform Ligament ◽  
Internal Herniation ◽  
Case Presentation ◽  
Surgery Department

Small bowel obstruction due to internal herniation of ileum through congenital defect in falciform ligament is exceedingly rare, about 0.2% such cases of hernia through congenital defect in falciform ligament have been reported. The case presentation of 60 year old male patient present in surgery department with acute abdominal pain since 7 days. Based on clinical assessment and radiological evidence, intestinal obstruction was diagnosed. For which patient underwent exploratory laprotomy. The discussion of Intraoperative a loop ileum was found obstructed in congenital defect in falciform ligament. Obstruction was relieved by division of leaf of defect, without the need of intestinal resection.

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