scholarly journals Predisposing factors of intestinal intussusception in older children

2019 ◽  
pp. 136-140
Author(s):  
I. Kh. Shidakov

The article provides a brief description of the causes and mechanisms of intestinal intussusception and a description of two cases of invagination in children over 7 years. The occurrence of intestinal intussusception in children older than 1 year often has a pathological leading point – a disease or pathological condition, as a result, of the course or complication of which it is possible to introduce one section of the intestine into another. Two children, 8 and 7 years old, were hospitalized at our clinic with signs of acute surgical pathology in the abdominal cavity, were operated on in an emergency order. In both cases, necrosis of the intestinal area, as a result, of invagination was detected, resection and anastomosis were performed. The leading points in these cases were Schönlein-Genoch purpura and Peutz-Jeghers polyps. Invagination of the intestines in these diseases occurs with atypical clinical symptoms, making it difficult to diagnose in time and leads to more frequent development of ischemia and necrosis of the intestinal wall.

Ruminants ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 46-57
Author(s):  
Rodrigo Muiño ◽  
Joaquín Hernández ◽  
Cristina Castillo

Acute abdomen (AA) is the term used to define a pathological condition that affects the abdominal cavity and frequently manifests itself with acute clinical symptoms capable of compromising a cow’s life. Therefore, it should be considered as an emergency that should be evaluated as quickly as possible to adopt the appropriate therapeutic measure (medical or surgical). In an AA situation, the clinician must consider the appropriate diagnostic approach as well as the therapeutic choice. Given the emergency, the veterinarian’s experience will be decisive for the appropriate resolution. In this article, we briefly review the causes that may lead to this condition, as well as the different diagnostic tests available in field conditions to establish the correct diagnosis and treatment.


2021 ◽  
Vol 23 (1) ◽  
pp. 41-50
Author(s):  
Victoria A. Pechenikova ◽  
Anastasia S. Danilova ◽  
Victoria E. Kvarku ◽  
Nadezhda N. Ramzaeva

A clinical observation of the combined endometriotic lesion of the small intestine and the appendix is given below. Extragenital endometriosis is a rare pathology in which endometrioid heterotopies develop outside the reproductive system organs. At about 1825% of women suffering from the pelvic organs endometriosis, the intestines are involved in the pathological process. In this regard, it is believed that in most cases its lesion is secondary while the primary lesion of the intestine with endometriosis is rarely observed and occurs as a result of hematogenous introduction of endometrial elements into the intestinal wall. Of all parts of the intestine, endometriosis most often affects the rectum and sigmoid colon (7080%), then the jejunum, less often the cecum. The most rare gastrointestinal tract endometriosis localization is the appendix, the frequency of its lesion is 0.8%. It was carried out in a clinicopathologic analysis of 14 endometriosis cases in various parts of the intestine (4 cases of the small intestine lesions, 2 rectosigmoid part of the large intestine, 2 rectum, 2 sigmoid colon, 3 appendix, 1 combined lesion of the small intestine and the appendix). In most cases, the clinical diagnosis of extragenital endometriosis is difficult, and as a rule women come with complaints typical of acute surgical pathology: intestinal obstruction, appendicitis. An important role in differential diagnosis is given to the ultrasound examination of the pelvic organs and abdominal cavity, magnetic resonance imaging, endoscopic research methods, as well as the connection of clinical symptoms with the menstrual cycle.


2018 ◽  
Vol 230 (06) ◽  
pp. 319-325
Author(s):  
Lucia Gerstl ◽  
Raphael Weinberger ◽  
Rüdiger von Kries ◽  
Florian Heinen ◽  
Andreas Sebastian Schroeder ◽  
...  

Hintergrund Die zeitliche Verzögerung zwischen Symptombeginn und Diagnose ist eine Herausforderung in der Behandlung von Kindern mit arteriell ischämischem Schlaganfall. Frühere Studien zur klinischen Präsentation beschäftigten sich v. a. mit kumulativen Symptomen. Zielsetzung Ziel dieser Studie ist es, mögliche Symptommuster aufzuzeigen. Methoden In einer aktiven Beobachtungsstudie zwischen 01/2015 und 12/2016 (ESPED-Studie) wurden Kinder mit Erstdiagnose eines arteriell ischämischen Schlaganfalls eingeschlossen. Isoliert auftretende Erstsymptome wurden verschiedenen Symptomkombinationen gegenübergestellt. Zudem wurde untersucht, inwieweit ein als „akut“ oder „progredient“ klassifiziertes Auftreten der Symptome Rückschlüsse auf die zugrundeliegende Ätiologie erlaubt. Ergebnisse Es wurden 99 Kinder in die Studie eingeschlossen. Unabhängig vom Alter traten überwiegend fokale Symptome auf (86%). Krampfanfälle als Initialsymptom wurden insbesondere bei Säuglingen beschrieben (67%), wohin-gegen diffuse, unspezifische Symptome vor allem bei Vorschulkindern (38%) und älteren Kindern (59%) auftraten. Isoliert traten fokale Symptome bei 37 Kindern auf, 48 Kinder zeigten zusätzlich unspezifische Symptome, darunter auch 9 Kinder mit Krampfanfällen. Isolierte unspezifische Symptome zeigten sich lediglich bei 7 Kindern, 2 Kinder wurden nur mit Krampfanfällen symptomatisch. Die Akuität des Symptombeginns wurde bei 53/78 als „akut“ und bei “25/78 Fällen als „progredient“ klassifiziert, lieferte jedoch keinen Hinweis auf die zugrundeliegende Ätiologie. Schlussfolgerung Jedes neue fokal neurologische Defizit sollte unabhängig vom Auftreten (isoliert oder kombiniert, akut oder progredient) an einen kindlichen Schlaganfall denken lassen. Background Time delay between onset of clinical symptoms and diagnosis is a challenge in childhood arterial ischemic stroke. Most previous studies reported cumulative symptoms. Objective We attempted to identify typical symptom patterns and assessed their emergence in childhood stroke. Methods Prospective active surveillance in ESPED, a hospital based Pediatric Surveillance Unit for rare diseases in Germany, between January 2015 and December 2016. Case definition: first diagnosis of a radiologically confirmed arterial ischemic stroke. Symptom patterns were identified as occurring in isolation or in combination. We distinguished acute vs. progressive onset. We ascertained risk factors to identify the possible etiology. Results 99 children with childhood arterial ischemic stroke were reported. Focal symptoms were the predominant presenting feature (86%), independent of age. Seizures were more often seen in infants < 1 year (67%), whereas diffuse symptoms were more present in pre-school children (38%) and older children (59%). 37 children had focal features alone and 48 additional non-specific features, including 9 with seizures. Isolated non-specific features accounted for 7 cases, and 2 children had (focal) seizures as the only symptom. In 77% of all cases at least one risk factor was identified. The emergence of symptoms was acute in 53/78 cases and progressive in 25/78 cases. The pattern of emergence was unrelated to the underlying etiology. Conclusions Any new focal neurological deficit in isolation, or associated with seizures or further non-specific symptoms should alert to childhood stroke.


2020 ◽  
Vol 13 (4) ◽  
pp. 344-347
Author(s):  
Islam Khuseynovich Shidakov

Intestinal intussusception is rare in children over the age of 6 years and, in most cases, is due to the presence of anatomical reasons. Tumors of the gastrointestinal tract are one of the etiological factors in the development of ileus in older children. The paper presents the case of a 7-year-old child who was admitted to the clinic with the abdominal pain syndrome that resolved on its own. With a repeated pain attack, intestinal intussusception was diagnosed, the patient was urgently operated. Laparoscopic complete reduction of intussusception failed, which required conversion of the access. After straightening the intussusception of the small intestine, there was detected a tumor of the ileum, which practically blocked the intestinal lumen. The segment of the intestine with the tumor was resected with an end-to-end anastomosis. In the postoperative period, the patient was diagnosed with intestinal lymphoma based on the test studies of the operating material. After stabilizing the condition, the child was transferred to an oncological center.


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.


1983 ◽  
Vol 245 (2) ◽  
pp. E143-E147
Author(s):  
H. Eiler ◽  
W. A. Lyke

In this work, consideration was given to the possibility that increased retention of Ca in the intestinal wall may have resulted in the glucocorticoid-treated animal. Rabbits were treated with pharmacological doses of either dexamethasone, estrogen, or progesterone during 1 wk. Two milliliters of solution containing Ca (plus Mg, K, and Na) were infused into a double-ligated (4 cm apart) gut loop (jejunum). In addition, an adjacent loop was double ligated but received no infusion. Uterine horns were treated in the same way as the gut and were used as controls to test for organ specificity. After the organs were infused with the calcium solution, they were returned into the abdominal cavity for a 4-h period. Dexamethasone treatment was given to a different group of rabbits in which neither surgery was performed nor mineral solution was infused into the lumen of the intestine; in this experiment calcium concentrations were measured in the mucosa, submucosa, and serosa layer obtained from the duodenum, midjejunum, and distal jejunum. In rabbits subjected to surgery, the concentration of Ca in the whole wall of the intestine of the dexamethasone-treated rabbits (45.4 +/- 2.6 mM/kg dry tissue) was twice as large as in controls (22.6 +/- 3.2 mM/kg dry tissue) (P less than 0.05). Mg concentrations were moderately (17%) increased (P less than 0.05). In the group of rabbits receiving dexamethasone but not subjected to surgery, the concentration of Ca in the duodenum (mucosa, submucosa, and whole wall), midjejunum (whole wall), and distal jejunum (submucosa) was significantly (P less than 0.05) elevated as compared with controls. In these rabbits, the duodenum was the most affected segment of the intestine. The effect of dexamethasone was both organ and steroid specific but not mineral specific. This result suggests that one of the effects of the glucocorticoid (dexamethasone) treatment on the intestinal wall was to increase the retention of Ca.


Author(s):  
Khushbu P. Shah ◽  
Mandakini M. Patel

Background: Parasitic infestation has a worldwide prevalence and it affects almost all age groups and both the sexes. The incidence of these infections is slowly rising in today’s era. Parasites are mainly found in stool samples but due to increase in a immunocompromised state now a days, tissue parasitaemia has increased globally necessitating more such type of studies. Parasite found in surgical pathology either incidentally or in clinically suspicious cases not only improves morbidity but also saves clinician’s time and patient’s money.Methods: A retrospective-cross sectional study is done based on histomorphological and cytomorphological evaluation of 25 cases diagnosed at The Department of pathology, New Civil Hospital Surat from January 2015 to January 2017.Results: Most common parasite seen was Echinococcus presenting as hydatid cyst in liver followed by filariasis. Most common age group affected was 0-20 years of age. Most common intestinal parasite found in our study was Entamoeba histolytica. Patients presented with variety of symptoms.Conclusions: Distribution of parasite in tissue section in relation to frequency, age, sex, various system involvements and its correlation with clinical symptoms are analyzed in our study.


2016 ◽  
Vol 97 (1) ◽  
pp. 84-89
Author(s):  
E K Salakhov ◽  
K K Salakhov

The article presents the basic concepts and definitions of compartment syndrome, some mechanisms of its development, methods of treatment and prevention. Abdominal compartment syndrome is diagnosed in 20% of patients with therapeutic and 30% of patients with surgical pathology. Mortality in its development amid the treatment reaches 42-68%, and without treatment - 100%. The high risk of abdominal compartment syndrome development is characteristic for patients with generalized peritonitis. The trigger mechanism of syndrome development becomes increased intra-abdominal pressure, which leads to the multiple organ failure development. Currently, there are different approaches to the abdominal compartment syndrome prevention. There is no doubt that it is better to prevent this syndrome than cure, as well as any other pathological condition. It is necessary to bear in mind the probability of its formation and routinely measure intra-abdominal pressure in high-risk patients. Treatment tactics choice and timely detection of intra-abdominal hypertension are crucial in prevention of the abdominal compartment syndrome development in patients with abdominal surgical pathology. In general, it is recommended to perform preventive measures in respect of abdominal compartment syndrome in two directions. As the first one, the decision on the type of wound suturing is considered. Tissue perfusion optimization is considered as another preventive direction. Currently, there is no single approach in the abdominal compartment syndrome prevention in patients with generalized peritonitis, and further studies in this area are highly relevant. Since this pathology leads to impairment of almost all vital body functions and is associated with extremely high mortality, its early diagnosis by the intra-abdominal pressure monitoring, which allows to perform timely actions that prevent an adverse outcome, is of particular importance.


2021 ◽  
pp. 5-8
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesna ◽  
V. A. Filonenko

Summary. Aim. To analyze the features of differential diagnosis of urgent surgical pathology during a coronavirus infection pandemic. Materials and methods. The work is based on the analysis of the results of additional examination of 28 patients at the admission department, who sought medical help in an urgent manner. Results. The advantages and disadvantages of using instrumental methods for detecting atypical forms of coronavirus infection and acute abdominal pathology are analyzed. Based on this, a diagnostic algorithm was developed using express tests for the determination of COVID-19 and urgent ultrasound protocols, which made it possible to identify lung lesions without clinical symptoms in 8 (28.6 %) patients, and to confirm acute surgical pathology in 5 (17.9 %) patients. Conclusion. Еxamining patients with suspected acute abdominal pathology for the purpose of differential diagnosis with the gastrointestinal form of COVID-19, it is necessary to use rapid tests for detecting antibodies to coronavirus infection and sonographic examination of the abdominal organs (FAST protocol), chest organs (BLUE protocol).


2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-E491-ONS-E491 ◽  
Author(s):  
Astrid Weyerbrock ◽  
Todd Mainprize ◽  
James T. Rutka

Abstract OBJECTIVE: Cysts of the septum pellucidum (CSPs) may become symptomatic because of obstruction of cerebrospinal fluid flow, resulting in increased intracranial pressure and hydrocephalus requiring surgical intervention. Endoscopic fenestration may be the most effective and least invasive technique to treat this pathological condition. CLINICAL PRESENTATION: An 11-year-old boy sought treatment for frequent episodes of severe headache. On examination, he had papilledema. There was evidence on magnetic resonance imaging scans of a space-occupying CSP with obstructive hydrocephalus. INTERVENTION: The endoscopic technique of fenestration of both lateral walls of an enlarged CSP via a left frontal approach under ultrasound guidance using a rigid endoscope was successful. After surgery, the patient became asymptomatic, his papilledema resolved, and magnetic resonance imaging scans demonstrated collapse of the walls of the CSP toward the midline. CONCLUSION: Neuroendoscopic fenestration should be strongly considered as the treatment of choice for symptomatic CSPs. This procedure alone can lead to complete resolution of clinical symptoms and hydrocephalus, can reduce the size of the CSP, and can obviate the need for an implantable cerebrospinal fluid shunt.


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