scholarly journals Ileus tube placement combined with laparoscopy in the treatment of refractory small bowel obstruction: Case series and literature review

2019 ◽  
Vol 8 (1) ◽  
pp. 55-58
Author(s):  
Wei-Hai Shi ◽  
Hao-Qiang Chao ◽  
Nian-Yuan Ye ◽  
Hong-Jian Shi
Keyword(s):  
Small Bowel ◽  
Literature Review ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Case Series ◽  
Tube Placement

scholarly journals 373. Immune Reconstitution Inflammatory Syndrome in Patients with HIV/AIDS and Histoplasmosis: A Case Series

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S195-S195 ◽  
Author(s):  
Afroditi Boulougoura ◽  
Elizabeth Laidlaw ◽  
Gregg Roby ◽  
Yolanda Mejia ◽  
Alice Pau ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Histoplasma Capsulatum ◽  
Case Reports ◽  
Case Series ◽  
The United States ◽  
Inflammatory Syndrome

Abstract Background Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV infection is the unexpected clinical deterioration due to worsening (paradoxical) or uncovering (unmasking) of an infection or malignancy upon initiation of antiretroviral therapy (ART). Histoplasma capsulatum (H. capsulatum) is the most common endemic mycosis in patients with AIDS, usually manifesting as disseminated disease at CD4 counts < 150 cells/μl. In the ART era, histoplasmosis IRIS has been described in case reports, but there has been a limited description regarding clinical presentations and pathogenesis in the United States. Methods ART-naive HIV+ patients with a CD4+ T-cell count < 100 cells/µL enrolled in prospective studies at the National Institutes of Health (NIH) (NCT00286767, NCT02147405) were evaluated to identify those with histoplasmosis and followed after ART initiation to identify those who would eventually develop IRIS. Results From a total of 271 patients, we identified 9 patients with histoplasmosis. The median age, CD4+ count and HIV VL of these 9 patients was 36 years, 40 cells/mm3 and 193,184 copies/mL, respectively. Two patients developed IRIS only to histoplasmosis (1 unmasking and 1 paradoxical), 2 patients developed IRIS to both histoplasmosis and nontuberculous mycobacteria (NTM) and 3 patients developed IRIS to other infections (1 VZV, and 2 NTM). The manifestations of histoplasmosis IRIS in our cohort ranged from worsening lymphadenopathy to small bowel obstruction and worsening pulmonary symptoms. Conclusion Histoplasma-related IRIS can present with worsening lymphadenopathy, small bowel obstruction, and worsening pulmonary symptoms. The emergence of IRIS appears to be very common in people with HIV and disseminated histoplasmosis but the underlying trigger may be histoplasma, other co-infections or both. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Analysis of the Curative Effect of a Transnasal Ileus Tube in the Treatment of Small Bowel Obstruction Caused by a Phytobezoar

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yong-Xu Lin ◽  
Sun-Jian Wang ◽  
Hui-Shun Liang ◽  
Su Lin ◽  
Li-Yong Bian ◽  
...  
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Albumin Level ◽  
Tube Placement ◽  
Curative Effect ◽  
Duration Of Symptoms ◽  
Conservative Group ◽  
Significant Difference

Objective. To investigate the curative effect of a transnasal ileus tube in the treatment of small bowel obstruction caused by a phytobezoar. Methods. Seventy-one patients with small bowel obstruction caused by a phytobezoar who underwent treatment in three provincial tertiary grade A hospitals in Fujian Province from March 2011 to February 2020 were included in this study. Patients were divided into the following two groups according to the treatment received: (1) conservative group, comprising patients who received medical conservative treatment, and (2) combined group, including patients who received combined medical conservative treatment and transnasal ileus tube placement. The clinical symptoms, changes in abdominal imaging, tube depth of the first day, reduction of pressure volume on the first day after catheterization, length of hospital stay, and nonsurgical rate were compared between the combined and conservative groups. Results. There was no significant difference in age, sex, history of previous abdominal surgery and abdominal radiotherapy, symptoms at admission, duration of symptoms before admission, signs at admission, laboratory data, and obstruction position between the combined and conservative groups. There was a statistically significant difference in the nonsurgical rate (19/24 vs. 23/47, P = 0.014 ) between the combined and conservative groups. Logistic analysis showed that the duration of symptoms before admission, albumin level, and use of a transnasal ileus tube might be independent factors affecting the transition to surgery for patients with small bowel obstruction caused by a phytobezoar ( P < 0.05 ). Conclusion. Timely conservative medical treatment with transnasal ileus tube placement can effectively improve the nonsurgical rate of small bowel obstruction caused by a phytobezoar. The duration of symptoms before admission, albumin level, and use of a transnasal ileus tube were closely related to whether patients with small bowel obstruction caused by phytobezoar were transferred to surgery.

scholarly journals Gallstone Ileus Decades after Cholecystectomy and Pylorus-Preserving Whipples

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Miho Mugino ◽  
Takako Eva Yabe ◽  
Bruce Ashford
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Literature Review ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Transition Point ◽  
Gallstone Ileus ◽  
Whipple Procedure ◽  
Stone Analysis ◽  
Intraluminal Mass

We report a case of small bowel obstruction due to gallstone ileus found in a patient with previous pancreaticoduodenectomy (Whipple procedure). Investigation by computed tomography of the abdomen showed a transition point in the midjejunum due to a radioopaque intraluminal mass. Following resuscitation, the patient underwent laparotomy to remove the offending mass from the midjejunum. Subsequent stone analysis confirmed a cholesterol-rich gallstone. This is thus the first description of gallstone ileus following Whipple procedure. The rarity of this presentation and a literature review is presented.

scholarly journals Small bowel obstruction secondary to diaphragmatic herniation following transabdominal cardiac ablation

2020 ◽  
Vol 102 (3) ◽  
pp. e57-e59
Author(s):  
E Sharma ◽  
C Bussa-Rao ◽  
A Sergot ◽  
K Ratnasigham ◽  
GP Thomas
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Diaphragmatic Hernia ◽  
Literature Search ◽  
Unusual Case ◽  
Case Series ◽  
Cardiac Ablation ◽  
Diaphragmatic Herniation

We report an unusual case of strangulated diaphragmatic hernia secondary to a pericardial ablation, which resulted in necrosis of the incarcerated small bowel. Through a literature search, we have found a limited number of similar cases introducing a case series for this rare but potentially fatal condition.

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