scholarly journals Metastatic melanoma causing recurrent intussusception and perforation of small bowel: case reports and literature review

2021 ◽  
Vol 8 (1) ◽  
pp. MMT54
Author(s):  
Yusuf Yagmur ◽  
Mehmet Ali Açıkgöz
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Malignant Melanoma ◽  
Small Bowel ◽  
Metastatic Melanoma ◽  
Case Reports ◽  
Pain Abdomen ◽  
Free Air ◽  
Recurrent Intussusception ◽  
Short Time

Aim: To present cases of recurred jejuno-jejunal intussusception and jejunal perforation due to melanoma. Materials & methods: Case 1: A 43-year-old male under treatment for malignant melanoma was presented with abdominal pain and distention. Ten centimeter intussuscepted jejunum was resected. Second exploration was done due to failure to pass gas and stool. The reintussusception was detected and resection of reintussuscepted jejunum was performed. Case 2: A 63-year-old male was presented with abdominal pain. Abdomen computed tomography showed free air in the abdomen suggesting intestinal perforations. Perforated area at 80 cm in the jejunum sutured. Conclusion: We present the seemingly first report of reintussusception of resected segment in a very short time. Surgeons should be aware of both intussusception and perforation in metastatic melanoma.

scholarly journals Clinical characteristics of nasointestinal ileus tube-induced intussusception: three case reports and a literature review

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051987835
Author(s):  
Lin Zhu ◽  
Yi xiong Zheng ◽  
Kai bo Chen
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Literature Review ◽  
Adverse Effects ◽  
Clinical Characteristics ◽  
Case Reports ◽  
Treatment Guideline ◽  
Tube Placement ◽  
Mickey Mouse

Placement of a nasointestinal ileus tube or long tube for gastrointestinal decompression is a new and effective treatment for small bowel obstruction. Such tubes are associated with very few adverse effects. However, several cases of intussusception caused by a nasointestinal ileus tube have been reported. No general diagnosis or treatment guideline has been established for such a complication. We herein present three cases of intussusception caused by nasointestinal ileus tube placement along with a literature review that summarizes some important clinical characteristics of nasointestinal ileus tube-induced intussusception. A diagnosis of intussusception should be considered if severe abdominal pain and distension recur after insertion of a nasointestinal ileus tube. Computed tomography may assist making the diagnosis, especially in patients with typical features such as the “Target sign,” “Glasses sign,” or “Mickey Mouse sign.” Although nasointestinal ileus tube-induced intussusception is rare, clinicians should give more attention to the risk of this complication.

scholarly journals Granuloma Caused by Carbon Deposition in the Dermis

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Rintaro Shibuya ◽  
Yuichiro Endo ◽  
Akihiro Fujisawa ◽  
Miki Tanioka ◽  
Yoshiki Miyachi
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Malignant Melanoma ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Foreign Body Reaction ◽  
Carbon Deposition ◽  
Case Reports ◽  
Initial Injury ◽  
Pencil Lead

Pencil core granuloma is characterized by a delayed foreign-body reaction against retained fragments of pencil lead. Previous case reports presented pencil core granuloma resembling malignant melanoma, haemangioma, or soft tissue sarcoma. We present a case of pencil core granuloma arising from the palm 25 years after the initial injury. The patient presented a bluish nodule that had been present over 25 years before. The nodule initially measured 5 mm in diameter. However, five years before presentation, it suddenly enlarged to the size of 30 mm during six months. Computed tomography (CT) of the lesion revealed a linear radiopaque structure of 8 mm long with a mass on its distal end. Surgical resection revealed a bluish muddy mass and pencil lead. Histological examination revealed degenerative tissue with calcification surrounded by massive amounts of black granular material in the middle and lower dermis.

scholarly journals Multiple Small Intestine Ulcers with Desquamation of the Fingers

2017 ◽  
Vol 11 (2) ◽  
pp. 452-461
Author(s):  
Azusa Kawasaki ◽  
Kunihiro Tsuji ◽  
Hisashi Doyama
Keyword(s):  
Computed Tomography ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Yersinia Pseudotuberculosis ◽  
Oral Ulcers ◽  
Palmar Erythema ◽  
Antibody Titers ◽  
Endoscopic Characteristics ◽  
Multiple Ulcers

A 73-year-old female was admitted to our hospital with abdominal pain and diarrhea. Computed tomography detected distension of the small intestine. A palmar erythema, multiple oral ulcers, and desquamation of the fingers appeared after hospitalization. Small-bowel endoscopic images showed multiple ulcers. We attributed this case to infection with Yersinia pseudotuberculosis based on the changes in Y. pseudotuberculosis antibody titers throughout the course of the illness. This report is valuable, as it illustrates the endoscopic characteristics of a Y. pseudotuberculosis infection with skin lesion and ileus, which may enable us to deepen the pathologic understanding of this disease.

MUCINOUS MESENTERIC CYST OF SIGMOID MESOCOLON : A RARE ENTITY

2021 ◽  
pp. 22-23
Author(s):  
K.Prasanth Kumar ◽  
A.D.V. Lavanya ◽  
P.Surendra Reddy
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Physical Examination ◽  
Mesenteric Cyst ◽  
Rare Entity ◽  
Small Bowel Mesentery ◽  
Mesenteric Cysts ◽  
Sigmoid Mesocolon

Mesenteric cysts are rare and occur in patients of any age. They are asymptomatic and found incidentally or during the management of their complications. They commonly originate from the small bowel mesentery, although a proportion of them have been found to originate from the mesocolon (24%) and the retroperitoneum [1] [2,3,4,5] (14.5%). A mesenteric cyst originating in the sigmoid mesocolon is a very rare nding. They are a rare cause of abdominal pain and are discovered incidentally. If symptomatic, patients with these cysts present with abdominal pain, vomiting and low backache. Performing a thorough physical examination and conducting radiological investigations like ultrasonography (USG), computed tomography (CT) are keys in diagnosing the mesenteric cysts.

scholarly journals Metastatic melanoma to the small bowel complicated by fistula formation

2011 ◽  
Vol 15 (4) ◽  
pp. 127 ◽  
Author(s):  
Nausheen Khan ◽  
Irma Van de Werke ◽  
Zaeem Ismail Ebrahim ◽  
Farzanah Ismail
Keyword(s):  
Malignant Melanoma ◽  
Small Bowel ◽  
Metastatic Melanoma ◽  
Poor Prognosis ◽  
Fistula Formation ◽  
Gi Bleeding ◽  
Gi Tract ◽  
Presenting Symptoms ◽  
Late Manifestation ◽  
Widespread Dissemination

Malignant melanoma (MM) is an unpredictable tumour that can metastasise to any organ, and is well known for its widespread dissemination. The incidence of metastases to the gastro-intestinal (GI) tract is well documented; this, however, is a late manifestation of the disease with an overall poor prognosis. Most GI metastases are asymptomatic and are only discovered on postmortem, with the majority in the small bowel. The presenting symptoms are usually of obstruction or intussusception; GI bleeding is also common. Fistula formation with the small bowel is rare; ours is believed to be the second case documented.

scholarly journals Small Bowel Diverticulosis Causing Pneumoperitoneum without Peritonitis: A Case Report

2018 ◽  
Vol 01 (01) ◽  
pp. 069-071
Author(s):  
Geena Benjamin ◽  
Agnes Thomas ◽  
Mathew Koshy
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Perforation ◽  
Chronic Abdominal Pain ◽  
Rare Finding ◽  
X Ray ◽  
Computed Tomography Images ◽  
Clinical Presentations ◽  
Fatal Complications

AbstractSmall bowel diverticulosis is a rare finding, with varied clinical presentations, which make the diagnosis difficult and delayed. Many cases are asymptomatic. However, it is an entity that can present with fatal complications. Here, we present a case of a 79-year-old male patient with diffuse small bowel diverticulosis, who presented with loose stools and acute exacerbation of chronic abdominal pain. Plain abdominal X-ray showed dilated bowel loops and pneumoperitoneum, which raised the possibility of bowel perforation. Computed tomography images revealed diffuse small bowel diverticulosis and pneumoperitoneum. Subsequent explorative laparotomy revealed no bowel perforation. Small bowel diverticulosis is a well-known cause of chronic/recurrent pneumoperitoneum without peritonitis or surgery.

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals Abdominal Pain and Vomiting in a Patient with Over-anticoagulation -- a Rare Case of Spontaneous Intramural Hematoma of the Jejunum

2020 ◽  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Vitamin K Antagonists ◽  
Intramural Hematoma ◽  
Rare Condition ◽  
The Body ◽  
Diagnostic Process ◽  
Tomography Scan

Anticoagulants, including vitamin K antagonists, are widely used for therapeutic and prophylactic purposes. Bleeding is the most important complication of anticoagulant therapy due to over-anticoagulation. Over-anticoagulation may present in unusual ways, such as spontaneous intramural hematoma of the small bowel. The classical clinical picture consists of abdominal pain, small bowel obstruction (that can present as vomiting) and hemorrhagic symptoms that can be related to the bowel or other parts of the body. Radiological examinations are essential for the diagnosis. Ultrasound can be helpful in the diagnostic process, but computed tomography is the procedure of choice. Conservative treatment is usually successful, including procedures that stop the over-anticoagulant consequences. A surgical approach is reserved for complications such as necrosis or perforation of the bowel. The diagnosis is definitively confirmed by the spontaneous resolution of the pathological findings on a follow-up computed tomography scan. We present a case of a 72-year-old woman who was diagnosed with this rare condition affecting the jejunum in the emergency department in our hospital.

scholarly journals Small bowel knots

2020 ◽  
Vol 102 (8) ◽  
pp. 571-576
Author(s):  
MY Beg ◽  
L Bains ◽  
P Lal ◽  
H Maranna ◽  
P Kumar N
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Full Text ◽  
Rare Case ◽  
Case Reports ◽  
Systematic Search ◽  
Abdominal Distention ◽  
The West ◽  
Resection And Anastomosis

Introduction Intertwining of bowel loops to form a knot is very rare cause of intestinal obstruction. Among intestinal knots, ileoileal knotting is the most rare, with only a handful of cases reported in literature. We present a rare case of ileoileal knotting and review of small bowel knots. The aim of this review was to summarise the existing evidence on small bowel knots and to postulate the possible mechanisms for knotting. Methods A systematic search was conducted for literature published up to December 2019 using MEDLINE, PubMed and Google Scholar databases, together with the references of the full-text articles retrieved. Papers with case reports of small bowel knots were considered to be eligible for inclusion in the review. Findings A total of 14 case reports were evaluated. There was no clear predilection for age or sex. Mostly cases were from Asia and Africa with no cases from the West. The presenting complaints were abdominal pain (93%), vomiting (64%), abdominal distention (57 %) and obstipation (43%). The bowel was gangrenous in 78% of cases. All underwent exploration, with the majority requiring resection and anastomosis of the involved segment. Conclusion Ileoileal knotting is a very rare cause of intestinal obstruction. Possible mechanisms include loaded bowel with longer mesentery, vigorous peristalsis, single bulky meal, pregnancy and intussusception. The condition is extremely difficult to diagnose preoperatively and it is usually diagnosed intraoperatively. The standard of treatment is resection of gangrenous part and anastomosis.

scholarly journals Retained enteroscopy capsule in a patient with diaphragm disease

2016 ◽  
Vol 98 (5) ◽  
pp. e79-e81 ◽  
Author(s):  
A-WN Meshikhes
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Resection ◽  
Diagnostic Modality ◽  
Colicky Abdominal Pain ◽  
Diaphragm Disease ◽  
Inflammatory Drugs ◽  
Subacute Intestinal Obstruction ◽  
High Index Of Suspicion

Introduction Diaphragm disease is a rare consequence of small-bowel enteropathy, and usually occurs as a result of longstanding ingestion of non-steroidal anti-inflammatory drugs. DD is characterized by multiple strictures and saccular dilatations leading to symptoms of subacute intestinal obstruction. Often, the diagnosis is made on histological examination after laparotomy and resection of diseased small bowel. Case History Here, we report a case of an elderly female who suffered for many years from chronic, colicky abdominal pain and anaemia due to undiagnosed diaphragm disease. Eventually, she was referred to our surgical team because of a retained enteroscopy capsule. The diagnosis was made after laparotomy and bowel resection. This surgical intervention alleviated chronic symptoms, and the patient remained well at 1-year follow-up. Conclusions This case highlights the difficulty of diagnosing diaphragm disease without laparotomy and bowel resection. A high index of suspicion must be exercised in any patient with chronic, colicky abdominal pain and anaemia together with multiple strictures and saccular dilatations on computed tomography even in the absence of longstanding NSAID ingestion. Moreover, capsule enteroscopy should be avoided as a diagnostic modality of small-bowel disease if computed tomography raises the suspicion of strictures.

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