Duplication Cyst with Intestinal Volvulus Causing Intestinal Atresia/Stenosis in Neonates

Duplication cysts of small bowel seldom present in newborns and usually represent the development of complications. In utero complications may lead to mesenteric vascular accidents and thus resulting in intestinal atresias. We report three neonates with duplication cyst of small bowel causing localized intestinal volvulus, leading to small bowel intestinal atresia/stenosis. The neonates underwent excision of the duplication cyst and resection anastomosis of the small bowel. Post-operative recovery was uneventful in all three of them.

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In-utero segmental volvulus around vitellointestinal duct remnants leading to ileal atresia and stenosis: A case series

Journal of Neonatal Surgery ◽

10.47338/jns.v9.522 ◽

2020 ◽

Vol 9 ◽

pp. 16

Author(s):

Vidyanand Deshpande ◽

Rajgopal Totla ◽

Arjun Pawar ◽

Pravin Suryawanshi

Keyword(s):

Case Series ◽

Intestinal Atresia ◽

In Utero ◽

Ileal Atresia ◽

X Ray ◽

Intestinal Stenosis ◽

First Case ◽

Neonatal Intestinal Obstruction ◽

Vascular Accidents ◽

Fluid Levels

Background: The etiology of intestinal atresia is multifactorial with vascular accidents being the most common event in its development. In-utero volvulus is a well-known type of vascular accident leading to intestinal atresia. Segmental volvulus around vitellointestinal duct remnants is rarely described vascular accident leading to ileal atresia. Case Series: We report two cases of segmental ileal volvulus around vitellointestinal duct remnants in neonates leading to ileal atresia in one case and intestinal stenosis in the other one. Both neonates presented with signs of neonatal intestinal obstruction. X-ray abdomen performed in both neonates showed air-fluid levels. Both neonates were operated with suspicion of intestinal atresia. At surgery, a segment of the small bowel was found twisted around vitellointestinal duct remnants in both cases. The first case also had intestinal atresia whereas the second one had intestinal stenosis secondary to the segmental volvulus. Conclusion: Segmental volvulus around vitellointestinal duct remnants can also cause ileal atresia or stenosis.

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An interesting case of left paraduodenal hernia.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.05.4648 ◽

2021 ◽

Vol 28 (05) ◽

pp. 755-758

Author(s):

Sahar Saeed ◽

Abeera Butt ◽

Syed Asghar Naqi ◽

Muhammad Mohsin Ali

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Interesting Case ◽

Paraduodenal Hernia ◽

Absorbable Suture ◽

Internal Hernias ◽

Plain Abdominal Radiography ◽

History Of ◽

Operative Recovery

Paraduodenal fossa hernias (PDFHs) represent 53% of all congenital internal hernias and 0.2-0.9% of all small bowel obstructions. Most of these hernias are diagnosed incidentally on laparotomy, and carry up to 50% lifetime risk of development of small bowel obstruction. We present our experience in diagnosing and treating a case of a massive left paraduodenal fossa hernia in a 17 year male, containing over 30% of the small bowel (jejunum and ileum), presenting with a history of recurrent incomplete small bowel obstruction. Plain abdominal radiography showed distended loops of jejunum and few air fluid levels. After laparotomy and identification of hernia, small gut was reduced and examined, which was found to be structurally and functionally intact with normal vascularity. The defect was closed with continuous absorbable suture (Vicryl 2-0) sparing the inferior mesenteric vessels. Patient’s post-operative recovery remained uneventful and he was discharged on 4th post-operative day.

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Spontaneous Biliary Perforation: Biloma Resembling a Small Bowel Duplication Cyst

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/00005176-200008000-00024 ◽

2000 ◽

Vol 31 (2) ◽

pp. 201-203 ◽

Cited By ~ 15

Author(s):

David Goldberg ◽

David Rosenfeld ◽

Sharon Underberg-Davis

Keyword(s):

Small Bowel ◽

Duplication Cyst ◽

Spontaneous Biliary Perforation

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Intraluminal Meckel’s Duplication Cyst Causing Bowel Obstruction in an Infant: A Role for Laparotomy

Case Reports in Pediatrics ◽

10.1155/2016/4717403 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Mitchell R. Ladd ◽

Alejandro V. Garcia ◽

Derek B. Allison ◽

Jeffrey R. Lukish

Keyword(s):

Small Bowel ◽

Bowel Obstruction ◽

Ileocecal Valve ◽

Signs And Symptoms ◽

Duplication Cyst ◽

Ectopic Gastric Mucosa ◽

Lower Quadrant ◽

Intraluminal Mass ◽

Enteric Duplication ◽

Right Lower Quadrant

This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel’s diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.

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Mesenteric defects as a cause of intestinal volvulus without malrotation and as the possible primary etiology of intestinal atresia

Journal of Pediatric Surgery ◽

10.1016/0022-3468(94)90111-2 ◽

1994 ◽

Vol 29 (10) ◽

pp. 1339-1343 ◽

Cited By ~ 40

Author(s):

Preston R. Black ◽

Dale Mueller ◽

John Crow ◽

Robert C. Morris ◽

Aliya N. Husain

Keyword(s):

Intestinal Atresia ◽

Intestinal Volvulus ◽

Mesenteric Defects

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EP.TU.533A rare clinical presentation of Goblet Cell Adenocarcinoma of the appendix: Recommendations for safe & effective management

British Journal of Surgery ◽

10.1093/bjs/znab311.072 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Ganeshan Ramsamy ◽

Zoe Slack ◽

Giovanni Tebala

Keyword(s):

Small Bowel ◽

Goblet Cell ◽

Clinical Presentation ◽

Histopathological Examination ◽

Clinical Signs ◽

Operative Management ◽

Small Bowel Resection ◽

Right Hemicolectomy ◽

Bowel Ischaemia ◽

Operative Recovery

Abstract Background Goblet cell carcinoma (GCC) is a rare mixed neoplasm arising from the appendix, consisting of glandular and neuroendocrine tissue. It typically presents in adults with a mean age of 55-65 years old. Diagnosis is usually incidental via histopathological examination after 0.3% to 0.9% of all appendicectomies. Literature remains sparse on classification and prognosis of GCC, and cases documented in younger patients. Aims To highlight an interesting clinical presentation and intra- and post-operative management of GCC. To increase awareness for future practice when managing patients with GCC. Methods A 37 year-old male presented with left sided abdominal pain, constipation and fresh rectal bleeding. Computed Tomography demonstrated extensive SMV thrombus causing small bowel ischaemia. On the Intensive Care Unit, he underwent thrombolysis through a Transjugular Intrahepatic Porto-Systemic Shunt. A few days later, he developed bowel obstruction, necessitating a small bowel resection secondary to an ischaemic stricture. 9 months later, he presented with clinical signs of appendicitis. After an uneventful appendicectomy, he was diagnosed with GCC upon histopathological examination of the specimen. Results The patient made an uneventful post-operative recovery. A multidisciplinary team (MDT) decision was made to perform a completion right hemicolectomy, with histology confirming pT3N1M0 GCC. Adjuvant chemotherapy with 5-Fluorouracil was started. Conclusion This case highlights GCC with a preceding clinical course not yet published in the literature. It stresses the importance of the MDT in managing GCC. Although primarily diagnosed histologically, a clinical suspicion of GCC of the appendix is worth considering in pro-thrombotic patients.

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A Minor Innovation in Constructing a Small Bowel Stoma in Neonates with Small Bowel Atresia to Reduce the Morbidity

Journal of Neonatal Surgery ◽

10.21699/jns.v5i4.474 ◽

2016 ◽

Vol 5 (4) ◽

pp. 45 ◽

Cited By ~ 1

Author(s):

Naeem Khan ◽

Saba Bakht ◽

Nadia Zaheer

Keyword(s):

Small Bowel ◽

Primary Anastomosis ◽

Intestinal Atresia ◽

Stoma Formation ◽

New Type ◽

Small Bowel Atresia ◽

Bowel Atresia ◽

A Minor ◽

Lost To Follow Up

Background: Intestinal atresia has still significant morbidity in developing countries. Stomas are now not recommended in every case of intestinal atresia; primary anastomosis is the goal of surgery after resection of dilated adynamic gut. A new type of stoma formation along with primary anastomosis is being presented here.Materials and Methods: This report is based on our experience of many cases with this technique in last 12 years but all the details and long follow-up of each case is not available. However the method of surgical procedure, progress, complications, and advantages encountered have been highlighted.Results: Presently we have data of 7 patients; others are lost to follow up. Three had died with other associated problems, namely one with multiple atresias, two with septic shock and prematurity. Two stomas did not require formal closure because stoma shriveled and disappeared. Two other stomas had grown very long like a diverticulum when these were closed after 5 and 8 months.Conclusion: This technique is another attempt to decrease morbidity of patients of intestinal atresia especially in those cases where short bowel syndrome is feared after resection of proximal dilated gut.

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Supplementation of Mother’s Own Milk with Donor Milk in Infants with Gastroschisis or Intestinal Atresia: A Retrospective Study

Nutrients ◽

10.3390/nu12020589 ◽

2020 ◽

Vol 12 (2) ◽

pp. 589 ◽

Cited By ~ 3

Author(s):

Rebecca Hoban ◽

Supriya Khatri ◽

Aloka Patel ◽

Sharon L. Unger

Keyword(s):

Retrospective Study ◽

Small Bowel ◽

Length Of Stay ◽

Intestinal Atresia ◽

Central Line ◽

Hospital Outcomes ◽

Donor Milk ◽

Small Bowel Atresia ◽

Bowel Atresia ◽

Mother’S Own Milk

Background: Mother’s own milk (MOM) improves in-hospital outcomes for preterm infants. If unavailable, donor milk (DM) is often substituted. It is unclear if DM vs. formula to supplement MOM is associated with improved in-hospital outcomes in term/late preterm surgical infants with gastroschisis or intestinal atresia. Methods: This retrospective study included infants born ≥33 weeks gestational age (GA) with a birth weight of >1500 g who were admitted to a quaternary neonatal intensive care unit (NICU). Using Chi square and Mann-Whitney u testing, we compared hospital outcomes (length of stay, parenteral nutrition and central line days) before and after a clinical practice change to offer DM instead of formula in this surgical population. Results: Baseline characteristics were similar between eras for the 140 infants (median GA 37 weeks). Fewer infants in DM era were receiving formula at discharge (50.0% vs. 31.4%, p = 0.03). In sub-analyses including only small bowel atresia and gastroschisis infants, the median length of stay (35 vs. 25, p < 0.01) and the central line days (28 vs. 20, p < 0.01) were lower in the DM era. Conclusion: In this retrospective study, offering DM instead of formula was associated with less formula feeding at discharge, and in infants with gastroschisis or small bowel atresia, shorter length of stay and central line days.

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