scholarly journals Small Bowel Adenocarcinoma Simulating Superior Mesenteric Artery Syndrome (SMAS): A Case Report

2021 ◽  
Vol 3 (4) ◽  
pp. 3-5
Author(s):  
Othmane El Yamine ◽  
Nassima Fakhiri ◽  
Dounia Benkiran ◽  
Rachid Boufettal ◽  
Farid Chehab ◽  
...  
Keyword(s):  
Low Molecular Weight ◽  
Small Bowel Adenocarcinoma ◽  
Gastrointestinal Cancers ◽  
Compression Stockings ◽  
Digestive Cancer ◽  
Invasive Adenocarcinoma ◽  
Abdominal Ct ◽  
Multidisciplinary Consultation ◽  
Abdominal Ct Scan

The adenocarcinoma of the small intestine is a rare tumor of all gastrointestinal cancers often occurs on a predisposing ground we report the case of a 40-year-old patient chronic smoker has 1 pack year weaned 2 years ago, alcoholic weaned 5 years ago whose symptomatology dates back to 3 months by the appearance of epigastralgia and vomiting post prandial, Complicated by a high occlusive syndrome made of post prandial vomiting with abdominal pain all evolving in a context of alteration of general state made the patient was addressed to the service of digestive cancer surgery and liver transplantation of CHU Ibn Rochd Casablanca. The patient had an abdominal CT scan which showed duodenojejunal distension with incarceration of an undistended loop at the level of the aorto-mesenteric clamp. The patient was sent to the operating room in emergency, he underwent a segmental Greco-Resection of 15 cm taking away a jejunal mass under laparoscopy with extra corporal anastomosis latero-lateral jejuno-jejunal with at the exploration one notes the presence of a tumoral mass of 3cm mobile at the level of the 2nd loop jejunal stenosing responsible for a jejunal distension upstream measuring 4cm in diameter. The anatomopathological study of the specimen showed a moderately differentiated and invasive adenocarcinoma, classified as pT3N1Mx. The postoperative follow-up was marked by a deep venous thrombosis involving the ileo-femoral-popliteal axis of the ilio-femoral-popliteal trunk on day 2 postoperatively, for which the patient was put on low molecular weight Heparin at a curative dose with compression stockings and monitoring. The patient had resumed transit in the form of gas on postoperative day 3, with a correct assessment, and was declared discharged on postoperative day 6. The patient's file was discussed in a multidisciplinary consultation meeting and the decision was to undergo adjuvant chemotherapy and oesogastroduodal fibroscopy (FOGD) and colonoscopy to look for predisposing diseases.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

Selective non-operative management of anterior abdominal stab wounds with emphasis on the value of follow-up abdominal CT scanning

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 194-202
Author(s):  
El Yamani Fouda ◽  
Alaa Magdy ◽  
Sameh Hany Emile
Keyword(s):  
Ct Scan ◽  
Ct Scanning ◽  
Operative Management ◽  
Abdominal Ct ◽  
Management Group ◽  
Abdominal Ct Scan ◽  
Laparotomy Group ◽  
Abdominal Stab Wounds ◽  
Non Operative Management

Background and aim Selective non-operative management of patients with penetrating abdominal stabs is the preferred treatment strategy. The present study aimed to assess the efficacy and safety of non-operative management with emphasis on the value of follow-up abdominal CT scanning in management of patients with penetrating anterior abdominal stab. Patients and methods This is a retrospective chart review of stable patients with anterior abdominal stab wounds. Patients were divided in terms of initial decisions into two groups: laparotomy group and non-operative management group. Abdominal CT scan was performed for patients in the non-operative management group on admission and follow-up CT scanning was performed in cases of clinical and/or biochemical deterioration. Results The laparotomy group included 82 patients and 68.2% of them had unnecessary laparotomies. The non-operative management group comprised 97 patients and 90.7% of them did not require subsequent laparotomy. Abdominal CT scan had a sensitivity of 88.9% and specificity of 100% in detection of intra-abdominal injuries. Follow-up CT scanning detected bowel injuries missed by initial CT scan in three patients. The non-operative management group had significantly lower post-operative complication rate than the laparotomy group (4.1% vs. 18.3%), with a significantly shorter length of stay. Conclusions Non-operative management is the optimal management strategy for stable patients with penetrating anterior abdominal stab to decrease unnecessary laparotomy rates, hospital stay and costs. Follow-up abdominal CT scanning facilitated the decision making for patients selected for non-operative management and is highly sensitive in the diagnosis of patients who require subsequent exploration.

scholarly journals No histology for diminutive duodenal neuroendocrine tumors: Is it safe?

2019 ◽  
Vol 07 (02) ◽  
pp. E308-E309
Author(s):  
Thomas Walter
Keyword(s):  
Natural History ◽  
Ct Scan ◽  
Neuroendocrine Tumors ◽  
Surgical Procedures ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Interesting Approach ◽  
History Of ◽  
Duodenal Neuroendocrine Tumors

AbstractFor the management of diminutive duodenal neuroendocrine tumors (d-NETs), Harshit et al. have proposed – in the work accompanying this editorial – an interesting approach, the endoscopic banding without resection (BWR) technique. Given the risks associated with classic endoscopic resections and surgical procedures, and the likely favorable natural history of diminutive d-NETs, BWR may be an option for these selected patients with a very low risk of LN + and recurrence. However, a close follow-up (endoscopic, EUS and thoraco-abdominal CT scan) is then required to guarantee the safety of this policy.

Timing and Pattern of Recurrence after Gastrectomy for Adenocarcinoma

2015 ◽  
Vol 81 (10) ◽  
pp. 1057-1060 ◽  
Author(s):  
Mohammad Alnoor ◽  
Joshua A. Boys ◽  
Stephanie G. Worrell ◽  
Daniel S. Oh ◽  
Jeffrey A. Hagen ◽  
...  
Keyword(s):  
Ct Scan ◽  
Gastric Adenocarcinoma ◽  
Complete Resection ◽  
High Recurrence Rate ◽  
Abdominal Ct ◽  
Time To Recurrence ◽  
Abdominal Disease ◽  
Abdominal Ct Scan ◽  
Pattern Of Recurrence

Gastric adenocarcinoma has a high recurrence rate. The goal of this study was to determine the timing and pattern of recurrence after gastrectomy. A retrospective review was performed of patients with gastric adenocarcinoma having curative partial or total gastrectomy with R0/D2 lymph node resection from 1999 to 2013. Follow-up included CT scans of the chest, abdomen, and pelvis at 3-month intervals for the first three years, at 6-month intervals for the next two years, and annually thereafter. There were 62 patients, 38 males and 24 females, with a median age of 65 years. Median follow-up was 29 months and recurrence was identified in 21 per cent of patients. Median time to recurrence was 12 months and 92 per cent of recurrences occurred within two years. The last recurrence was identified at 34 months. Abdominal CT scan identified all patients with recurrence, although some patients had disease elsewhere in addition to the abdominal disease. There were no extra-abdominal isolated recurrences. In conclusion, recurrence after complete resection for gastric adenocarcinoma typically occurs within the first two years, and can be found by abdominal CT scan. Close cancer follow-up appears unnecessary after three years because all recurrences were identified within 34 months of resection.

scholarly journals Arterial Mesenteric Thrombosis as a Complication of SARS-CoV-2 Infection

2020 ◽  
Author(s):  
Lia a Beccara ◽  
Carlotta Pacioni ◽  
Sara Ponton ◽  
Simone Francavilla ◽  
Antonio Cuzzoli
Keyword(s):  
Molecular Weight ◽  
Arterial Thrombosis ◽  
Mesenteric Artery ◽  
Low Molecular Weight Heparin ◽  
Symptomatic Patient ◽  
Low Molecular Weight ◽  
Abdominal Ct ◽  
Bowel Distension ◽  
Abdominal Ct Scan ◽  
Mesenteric Thrombosis

A 52-year-old patient with SARS-CoV-2 was diagnosed with interstitial pneumonia and treated with darunavir/ritonavir, hydroxychloroquine, azithromycin and low molecular weight heparin (LMWH). After LMWH cessation, he developed superior mesenteric arterial thrombosis. An abdominal CT scan showed arterial thrombosis of vessels efferent of the superior mesenteric artery with bowel distension. COVID-19 may predispose to venous and arterial thromboembolism. Anticoagulation prophylaxis should be considered in hospitalized patients with COVID-19, and potential thromboembolism investigated in each symptomatic patient affected by SARS-CoV-2.

scholarly journals NEFROLITIASIS PADA ANAK USIA TIGA TAHUN DI RSUD DR. HI. ABDUL MOELOEK, LAMPUNG: SEBUAH LAPORAN KASUS

2020 ◽  
Vol 7 (2) ◽  
pp. 47-53
Author(s):  
Angga Hendro Priyono ◽  
Exsa Hadibrata
Keyword(s):  
Laboratory Finding ◽  
Flank Region ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Physical Examinations ◽  
The Right ◽  
Ammonium Urate ◽  
Sodium Urate ◽  
Phosphate Carbonate

ABSTRACT  Background: The incidence of nephrolithiasis in children increases over time. It has been reported an increase of 6 to 10% per year for the last twenty-five years. Research in developing country showed that urinary tract infection and metabolic disorders were the caused of nephrolithiasis. Illustration Case: Three years 10 months old boy had a complaint of pain in plank region followed by tea-like urine since two months ago. Physical examination showed that he appeared to be moderately ill and compos mentis. His physical examinations were normal except positive ballotement and positive costoverebral angle (CVA) pain in the right flank region. Laboratory finding showed positive eritrocyte in urinalysis. Ultrasonography and abdominal CT-scan consistent with nephrolithiasis. Management: Pyelolitotomy was performed under general anesthesia. Postoperatively, patient treated in a pediatric surgery room and observation was carried out. He was given  D5NS 500 ml administered 20 drops per minute microdrip IV, paracetamol 3 x 225 mg IV, and cefotaxime injection 2 x 500 mg IV after a skin test first.  Result and Follow Up: An irregular stone 1,5 cm x 1 cm in size consist of 45% ammonium urate, 31% sodium urate monohydrate, and 24% amorphous calcium phosphate carbonate was found. Discussion: Nephrolithiasis in children occurs due to several related conditions such as genetics, ethnicity, climate, and nutrition. Complications can be prevented by managing and controlling appropriate risk factors.

scholarly journals Left Diaphragmatic Herniation following Orthotopic Liver Transplantation in an Adult

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Adriá Rosat ◽  
Ayaya Alonso ◽  
Javier Padilla ◽  
Pablo Sanz ◽  
M. Aránzazu Varona ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Correct Diagnosis ◽  
Gastric Fundus ◽  
Abdominal Ct ◽  
Associated Symptoms ◽  
Abdominal Ct Scan ◽  
Diaphragmatic Herniation ◽  
Upper Abdomen ◽  
Uncommon Complication

Diaphragmatic herniation is an uncommon complication in the postquirurgic follow of the liver transplant. The associated symptoms are unspecific and may not suggest the correct diagnosis. It may explain why in many patients the diagnosis remains unmade or it is made only after a long interval of time. We present the case of a fifty-seven-year-old male who required an orthotopic liver transplant in 2010 due to a trifocal hepatocarcinoma. In postoperatory follow-up the patient showed alimentary regurgitation, vomiting, and dyspepsia. The diagnosis was made by an oesophagogastroduodenal transit with barium and an abdominal CT scan that showed a left diaphragmatic herniation with the gastric fundus into the thorax. With these findings we decided to perform a programmed surgery. After takedown of adhesions and replacement of the stomach into the upper abdomen, the palm-sized diaphragmatic opening was closed with a synthetic material. The patient’s condition remained stable throughout the entire operation. The postoperative course was uneventful and he was discharged at the fifth day after surgery with a normal digestive intake. In a 12-month follow-up the patient shows no symptoms.

Intramural gastric hematoma imitating a gastrointestinal stromal tumor – case report and literature review

2017 ◽  
Vol 89 (2) ◽  
pp. 62-65 ◽  
Author(s):  
Arkadiusz Spychała ◽  
Piotr Nowaczyk ◽  
Aleksandra Budnicka ◽  
Ewa Antoniewicz ◽  
Dawid Murawa
Keyword(s):  
Case Report ◽  
Gastrointestinal Stromal Tumor ◽  
Ct Scan ◽  
Histopathological Examination ◽  
Posterior Wall ◽  
Stromal Tumor ◽  
Abdominal Ct ◽  
Ki 67 ◽  
Abdominal Ct Scan

The article presents a case report of a patient with an intramural gastric hematoma. Diagnostic examinations were suggestive of a suspected gastrointestinal stromal tumor Normal image was observed in gastroscopic examination while abdominal CT scan revealed a nodular lesion along the greater curvature of the stomach extending from the posterior wall and adjoining the pancreas and the spleen. The patient was qualified for surgical treatment. Laparotomy was performed followed by total gastric resection and Roux-en-Y reconstruction of the gastrointestinal tract. Post-operative histopathological examination revealed the presence of an extensive hematoma penetrating the perigastric fat tissue along with numerous hemosiderinophages and segmental indicators of formation of inflammatory granulation tissue suggestive of a chronic nature of the lesion. Immunohistochemical GIST assays (CD117, DOG-1, CD34, CD31, SMA, S-100, CKAE1/AE3, Ki-67) were negative. No complications were observed in the post-operative course. Patient is subject to continued follow-up and observation. Follow-up gastroscopy and abdominal CT scan performed 6 months after the surgery revealed an unremarkable image.

scholarly journals Tubercular splenic abscess and recurrent acute on chronic tubercular pancreatitis: a rare coincidence in an immune competent child

2020 ◽  
Vol 7 (11) ◽  
pp. 2243
Author(s):  
Saugata Acharyya ◽  
Kakoli Acharyya
Keyword(s):  
Splenic Abscess ◽  
Needle Aspiration ◽  
Pancreatic Enzymes ◽  
Nucleic Acid Amplification ◽  
Left Shoulder ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Upper Abdominal ◽  
Lesion Treatment

Tubercular splenic abscess in association with chronic tubercular pancreatitis is scarcely reported in an immune competent child. 12 years old boy had presented with recurrent attacks of upper abdominal pain radiating towards left shoulder. He had multiple hospitalizations with similar complaints. The child had associated anorexia and significant weight loss during the period of his illness. Clinical examination revealed tenderness and muscle guard over the epigastric region. The pancreatic enzymes were markedly raised. Abdominal CT scan had suggested chronic pancreatitis with multiple splenic abscesses. The cartridge- based nucleic acid amplification test (CBNAAT) of the pus aspirated from the abscess confirmed the presence of pan sensitive mycobacterium tuberculosis. Image guided fine needle aspiration biopsy revealed the presence of caseating granulomatous lesion. Treatment with anti-tubercular drugs led to complete clinical recovery and normalization of pancreatic enzymes at follow up. An immunocompetent child had chronic tubercular pancreatitis associated with tubercular splenic abscess.

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