A unique method for management of benign colonic masses: case report

Even though lipomas are most common non-epithelial tumors of the large intestine, they mostly present with non-specific symptoms. Intussusception is the most common morbidity related to such lesions and may present as intestinal obstruction. We present here a case of a young female who presented to gastroenterology department as a case of pain abdomen and nausea and a provisional diagnosis of subacute intestinal obstruction was kept. Contrast enhanced CT confirmed a diagnosis of intussusception due to an ascending colon mass? likely lipoma. The colonoscopy was done and biopsy was taken which was non-specific for malignancy. Patient, after taking due consent, was taken for surgery and laparoscopic assisted submucosal excision of lipoma was done and we will discuss the same. Endoscopic excision of lipomas has been reported but when failed, mostly segmental resection of the colon has been reported. To the best of our knowledge, this is the second reported case of laparoscopic assisted colotomy with submucosal excision of an intussuscepting colonic lipoma and first one in ascending colon.

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Complete Intraluminal Migration of Surgical Sponge (Gossypiboma) With Complete Intestinal Obstruction

KYAMC Journal ◽

10.3329/kyamcj.v4i1.32264 ◽

2017 ◽

Vol 4 (1) ◽

pp. 362-365

Author(s):

Mohd Farid Hossain ◽

Anisur Rahman ◽

Abdur Rouf

Keyword(s):

Intestinal Obstruction ◽

Open Cholecystectomy ◽

Exploratory Laparotomy ◽

Internal Communication ◽

Surgical Sponge ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Intraluminal Mass ◽

Intraluminal Migration

A 33 years aged gentle lady presented with the features suggestive of acute intestinal obstruction due to complete intraluminal migration of a laparotomy sponge, five years after open cholecystectomy in a private clinic. Contrast enhanced CT scan of whole abdomen revealed an elongated intraluminal mass in the distal ileum causing intestinal obstruction. Exploratory laparotomy revealed circumvented loop of ileum with intraluminal mass sized around 6x12 cm in the terminal ileum. Enterotomy delivered a surgical sponge with no external or internal communication. Though intraluminal migration of retained surgical sponge has often been reported. But complete migration with features of intestinal obstruction is rare.KYAMC Journal Vol. 4, No.-1, July 2013, Page 362-365

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Ileal cavernous haemangioma in an adult presenting as a rare cause of small bowel obstruction

BMJ Case Reports ◽

10.1136/bcr-2020-239115 ◽

2021 ◽

Vol 14 (3) ◽

pp. e239115

Author(s):

Hitali Vasant Majethia ◽

Vijay Waman Dhakre ◽

Husain Gheewala ◽

Prajesh Bhuta

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Neuroendocrine Tumour ◽

Histopathological Analysis ◽

Cavernous Haemangioma ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Laparoscopic Assisted

Haemangiomas of the small bowel are a very rare entity and rarely considered as an aetiology for an intestinal obstruction. Contrast-enhanced CT is the investigation of choice but the lesion can be confused with malignancy or rarely a neuroendocrine tumour. Commonly it presents as abdominal pain with anaemia and/or melaena. With patients presenting without obstruction or acute gastrointestinal bleed, capsule endoscopy has shown to be a useful diagnostic tool.We present here our experience of managing a case of a patient with ileal haemangioma who presented with a subacute small bowel obstruction and underwent a laparoscopic-assisted ileal segmental resection with side-to-side anastomosis. The lesion was a cavernous haemangioma on histopathological analysis.

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Computed tomography in intestinal obstruction: a tertiary care perspective from Northern India

International Surgery Journal ◽

10.18203/2349-2902.isj20215129 ◽

2021 ◽

Vol 9 (1) ◽

pp. 48

Author(s):

Varun Dogra ◽

Shyam Gupta ◽

Ishfaq Ahmad Gilkar ◽

Silvi Sandhu

Keyword(s):

Computed Tomography ◽

Intestinal Obstruction ◽

Tertiary Care ◽

Oral Contrast ◽

Emergency Rooms ◽

Additional Information ◽

Northern India ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Background: Intestinal obstruction is a very common surgical emergency faced today in surgical ERs (emergency rooms) all around the globe. With the advent of newer technology, management of intestinal obstruction has changed significantly. Today computed tomography (CT) employs both intravenous as well as oral contrast for determining the cause and the level of obstruction. It also gives additional information regarding any malignancy causing the obstruction, its staging and status of vessels. Thus, a surgeon can go in the procedure with a plan already in mind which can be discussed in detail with experienced surgeons beforehand.Methods: This was a prospective observational study that was done in department of surgery at GMC Jammu over a period of two years. Patients of intestinal obstruction who presented to our department were enrolled in this study. They were subjected to a contrast enhanced CT after due preparation and managed accordingly. Data was recorded in a tabulated fashion and evaluated.Results: After implementing the exclusion criteria’s, a total of 163 patients were included in this study, majority being males in the age group of 20-40 years. Major cause of intestinal obstruction was attributed to post-operative adhesions followed by band obstruction due to various cause. CT findings were seen to be quite significant in evaluation and management of intestinal obstruction. About 30 % of the patients enrolled in our study were treated conservatively while 70 % required operative intervention in form of exploratory laparotomy.Conclusions: Computed tomography is widely available now a days at a cheaper cost. It greatly increases the armamentarium of the surgeon in dealing with this condition. A lot many cases today are dealt conservatively due to high utilisation of CT scan. It also helps the surgeon to preoperatively plan a proper surgical approach

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