scholarly journals Small Bowel Internal Herniation through Acquired Defect of Vesicouterine Pouch- A Late Complication following Oophorectomy

2022 ◽  
Author(s):  
Thayalan Rao Appalasamy ◽  
Fahrol Fahmy ◽  
Tan Jih Huei ◽  
Aina Shafiza ◽  
Tuan Nur Azmah
Keyword(s):  
Small Bowel ◽  
Similar Case ◽  
English Literature ◽  
Late Complication ◽  
Lower Abdominal Pain ◽  
Operative Management ◽  
Internal Herniation ◽  
Hollow Viscus ◽  
History Of ◽  
Current Report

Abstract Hollow viscus herniation through a defect between vesicouterine pouch following previous pelvis surgery is exceedingly rare. There was only 1 similar case reported in the English literature. In this current report, we describe a 84-year-old woman presented with lower abdominal pain. She had a history of previous gynecology surgery. Computed tomography of abdomen showed small bowel obstruction with transition zone at the pelvis. Laparotomy revealed small bowel loops trapped in the vesico-uterine space via a narrow defect about 1.5cm. The detailed clinical summary and operative management are described in the report.

Internal herniation during pregnancy after banded Roux-en-Y gastric bypass: a unique location

2020 ◽  
Vol 13 (12) ◽  
pp. e236798
Author(s):  
Daniëlle Susan Bonouvrie ◽  
Evert-Jan Boerma ◽  
Francois M H van Dielen ◽  
Wouter K G Leclercq
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Neonatal Intensive Care ◽  
Postoperative Recovery ◽  
Internal Herniation ◽  
Referral Centre ◽  
Mri Scan ◽  
Tertiary Referral Centre ◽  
Bariatric Complications ◽  
History Of

A 26-year-old multigravida, 30+3 weeks pregnant woman, was referred to our tertiary referral centre with acute abdominal pain and vomiting suspected for internal herniation. She had a history of a primary banded Roux-en-Y gastric bypass (B-RYGB). The MRI scan showed a clustered small bowel package with possible mesenteric swirl diagnosed as internal herniation. A diagnostic laparoscopy was converted to laparotomy showing an internal herniation of the alimentary limb through the silicone ring. The internal herniation was reduced by cutting the silicone ring. Postoperative recovery, remaining pregnancy and labour were uneventful. During pregnancy after B-RYGB, small bowel obstruction can in rare cases occur due to internal herniation through the silicone ring. Education regarding this complication should be provided before bariatric surgery. Treatment of women, 24 to 32 weeks pregnant, in a specialised centre for bariatric complications with a neonatal intensive care unit is advised to improve maternal and neonatal outcome.

scholarly journals Incarcerated Lumbar Hernia Complicated by Retroperitoneal Pseudoaneurysm 50 Years after Resection and Radiation Therapy of a Sarcoma

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Oluwatobi Onafowokan ◽  
Dabanjan Bandyopadhyay ◽  
Dale Johnson ◽  
Hugo J. R. Bonatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ct Scan ◽  
Late Complication ◽  
Abdominal Hernia ◽  
Emergency Laparotomy ◽  
Incisional Hernias ◽  
History Of ◽  
The Right

Background. Lumbar hernias are rare abdominal hernias. Surgery is the only treatment option but remains challenging. Posterior incisional hernias are even rarer especially with incarceration of intra-abdominal contents.Case Presentation. A 68-year old female presented with a 3-day history of worsening acute abdominal pain and distension, with multiple episodes of emesis. A CT scan indicated a large incarcerated posterolateral abdominal hernia. The patient had a history of resection of a sarcoma on her back as a child and also received chemotherapy and radiation. During emergency laparoscopy, a hemorrhagic small bowel segment incarcerated in the hernia was reduced and resected, and the distended small bowel was decompressed. An elective hernia repair was scheduled. After temporary clinical improvement, the patient again developed abdominal pain, distention, and emesis. During emergency laparotomy, a large hematoma in the right flank was found and partially evacuated. The right colon was mobilized out of the hernia and the duodenum was kocherized. A20×20cm BIO-A mesh was placed on top of the Gerota fascia and cranially tucked under liver segment VI. Anteriorly, the mesh was fixated with absorbable tacks. The duodenum and colon were placed into the mesh pocket. A postoperative CT scan identified a 2 cm pseudoaneurysm of a side branch of a lumbar artery, and the bleeding source was embolized. The postoperative course was complicated byClostridium difficile-associated colitis, but ultimately, the patient recovered fully. At 6-month follow-up, there was no evidence for a recurrent hernia.Discussion. There is a paucity of literature concerning lumbar incisional hernias. Repair with bioabsorbable mesh seems feasible, but longer follow-up is necessary as the mesh was placed in an unusual fashion due to the retroperitoneal hematoma. The exact cause of the hemorrhage is unclear and may have been caused during the initial incarceration, during surgery, or may be a late complication of her previous radiation.

Injuries to the Stomach, Small Bowel, Colon, and Rectum

2020 ◽  
Author(s):  
Jordan A Weinberg ◽  
Timothy C. Fabian
Keyword(s):  
Small Bowel ◽  
Abdominal Trauma ◽  
Operative Management ◽  
Bowel Injury ◽  
Organ Injury ◽  
Gastric Injury ◽  
Rectal Injury ◽  
Trauma Patients ◽  
Hollow Viscus ◽  
Hollow Viscus Injury

Hollow viscus injury is most often the consequence of penetrating abdominal trauma. As a result of blunt force trauma, bowel injury occurs with relative infrequency: in one multi-institutional analysis, only 1.2% of blunt trauma admissions had an associated hollow viscus injury. The diagnosis of hollow viscus injury remains a challenge in abdominal trauma patients, and subsequent evaluation is determined by the mechanism of injury. Regardless of the specific injury mechanism, however, the principles and techniques of operative management are largely the same. This review covers determination of need for operation, and operative management. Figures show algorithms outlining the evaluation of blunt hollow organ injury in a hemodynamically stable patient with an unreliable physical examination, the treatment of truncal stab wounds, the treatment of blunt bowel and mesenteric injury, the treatment of gastric injury, the treatment of small bowel injury, the treatment of colon injury, the treatment of rectosigmoid or rectal injury, and a demonstration of presacral drainage through a curved incision midway between the anus and the tip of the coccyx. Tables list the incidence of findings suggestive of blunt mesenteric and bowel injury in true positive and false positive computed tomography  scans, and the American Association for the Surgery of Trauma organ injury scales for gastrointestinal tract and pancreas.   This review contains 8 figures, 3 tables, and 58 references Keywords: Injury, blunt, primary rectal repair, colostomy, laparotomy, trauma

scholarly journals Acute presentation of cocoon abdomen as septic peritonitis mimicking with strangulated internal herniation: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sabah Uddin Saqib ◽  
Rimsha Farooq ◽  
Omair Saleem ◽  
Sarosh Moeen ◽  
Tabish Umer Chawla
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Emergency Room ◽  
Bowel Obstruction ◽  
Emergency Setting ◽  
Internal Herniation ◽  
Sclerosing Peritonitis ◽  
Acute Presentation ◽  
Septic Peritonitis ◽  
History Of

Abstract Background Abdominal cocoon syndrome is a rare cause of intestinal obstruction in which loops of small bowel get entrapped inside a fibro-collagenous membrane. Condition is also known in the literature as sclerosing peritonitis and in the majority of cases, it has no known cause. Although the majority of patients exhibit long-standing signs and symptoms of partial bowel obstruction in an out-patient clinic, its acute presentation in the emergency room with features of sepsis is extremely rare. This case report aims to describe the emergency presentation of cocoon abdomen with septic peritonitis. Case presentation A 35-year-old male with no known co-morbidity and no prior history of prior laparotomy presented in emergency room first time with a 1-day history of generalized abdomen pain, vomiting, and absolute constipation. He was in grade III shock and had metabolic acidosis. The clinical impression was of the perforated appendix, but initial contrast-enhanced computed tomography (CECT) was suggestive of strangulated internal herniation of small bowel. Emergency laparotomy after resuscitation revealed hypoperfused, but viable loops of small bowel entrapped in the sclerosing membrane. Extensive adhesiolysis and removal of the membrane were performed and the entire bowel was straightened. Postoperatively he remained well and discharged as planned. Histopathology report confirms features of sclerosing peritonitis. Discussion Cocoon abdomen is a very rare cause of acute small bowel obstruction presenting in an emergency with features of septic peritonitis. Condition is mostly chronic and generally mimics abdominal TB in endemic areas like India and Pakistan. A high index of suspicion is required in an emergency setting and exploratory laparotomy is diagnostic and therapeutic as well and the condition mimics internal herniation in acute cases. Conclusion Cocoon abdomen as a cause of septic peritonitis is extremely rare and might be an unexpected finding at laparotomy. Removal of membrane and estimation of the viability of entrapped bowel loops is the treatment of choice, which may require resection in the extreme case of gangrene.

scholarly journals An undigested cherry tomato as a rare cause of small bowel obstruction

2015 ◽  
Vol 97 (5) ◽  
pp. e83-e84 ◽  
Author(s):  
A Mortezavi ◽  
PM Schneider ◽  
G Lurje
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Fruits And Vegetables ◽  
Medical Condition ◽  
Sudden Change ◽  
Lower Abdominal Pain ◽  
Cherry Tomato ◽  
Proximal Small Bowel ◽  
History Of

Small bowel obstruction due to undigested fibre from fruits and vegetables is a rare but known medical condition. We report a case of small bowel obstruction caused by a whole cherry tomato in a patient without a past medical history of abdominal surgery. A 66-year-old man presented to the emergency department complaining of lower abdominal pain with nausea and vomiting. His last bowel movement had occurred on the morning of presentation. He underwent abdominal computed tomography (CT), which showed a sudden change of diameter in the distal ileum with complete collapse of the proximal small bowel segment. Laparoscopy confirmed a small bowel obstruction with a transition point close to the ileocaecal valve. An enterotomy was performed and a completely undigested cherry tomato was retrieved. To our knowledge, this is the first reported case of a small bowel obstruction caused by a whole cherry tomato.

Aerodigestive tract obstruction as a late complication of radiotherapy

1995 ◽  
Vol 109 (1) ◽  
pp. 68-69 ◽  
Author(s):  
Benny Nageris ◽  
Joseph Elidan ◽  
Jean-Yves Sichel
Keyword(s):  
Laryngeal Carcinoma ◽  
Similar Case ◽  
English Literature ◽  
Late Complication ◽  
Aerodigestive Tract ◽  
Complete Occlusion ◽  
Irradiation Treatment

AbstractOedema, fibrosis, and stenosis of the hypopharynx and the oesophageal inlet are described in a few publications as a complication of post-laryngectomy irradiation treatment.In this paper a case of laryngeal carcinoma, treated exclusively by irradiation, where severe laryngeal and hypopharyngeal stenosis with complete occlusion of the oesophageal inlet were manifested as a late complication is described. We have found no similar case described in the English literature.

A rare case of duodenal cancer with achalasia cardia

2019 ◽  
Vol 22 (2) ◽  
pp. 32-34
Author(s):  
Kartikesh Mishra
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Similar Case ◽  
Barium Meal ◽  
Duodenal Adenocarcinoma ◽  
Gastrointestinal Malignancies ◽  
Achalasia Cardia ◽  
Proliferative Growth ◽  
History Of ◽  
Duodenal Carcinoma

Duodenal adenocarcinoma constitutes 0.4% of gastrointestinal malignancies. Achalasia incidence rate is 0.5-1.2 per 100000. The combination is rare. This is a report of a 68-year-old male from Nepal with history of five years abdominal pain, dysphasia and weight loss. Duodenoscopy could confirm ulcero-proliferative growth at D1-D2. Barium meal depicted features of achalasia cardia. No similar case report suggests that occurrence of duodenal carcinoma and achalasia cardia is merely co- incidental. Discussion: No similar case report suggests that occurrence of duodenal carcinoma and achalasia cardia is merely co- incidental. Consent: Informed consent was obtained from the patient for publication of this case report .

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