scholarly journals SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Obturator Hernia ◽  
Uneventful Recovery ◽  
Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

scholarly journals Intestinal Obstruction due to Acute Appendicitis

2020 ◽  
Vol 14 (2) ◽  
pp. 346-353 ◽  
Author(s):  
Pham Hong Duc ◽  
Ngo Minh Xuan ◽  
Nguyen Huu Thuyet ◽  
Huynh Quang Huy
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Acute Appendicitis ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Male Patient ◽  
Bowel Obstruction ◽  
Clinical Manifestations ◽  
Specific Research ◽  
The Right

Acute appendicitis has been proven to be a usual cause of mechanical small bowel obstruction since 1901, but there has been very little specific research on this subject. It usually occurs as an effect of adhesion because of periappendicular inflammation. Although previous studies exist, this presentation of acute appendicitis is not widely identified, which might lead to delays in making the right diagnosis and initiating treatment. We herein report a 17-year-old male patient who presented with the clinical manifestations of intestinal obstruction and fever for 3 days. Preoperative ultrasound and subsequent computed tomography were performed. On laparotomy, an obstructed bowel was seen, and the appendix was recognized to be the cause. We herein report a case of intestinal obstruction due to acute appendicitis and present an overview of the literature.

Accuracy of Computed Tomography in Small Bowel Obstruction

2013 ◽  
Vol 79 (6) ◽  
pp. 641-643 ◽  
Author(s):  
Rebecca E. Barnett ◽  
Jason Younga ◽  
Brady Harris ◽  
Robert C. Keskey ◽  
Daryl Nisbett ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
Ischemic Bowel

Small bowel obstruction is a common clinical occurrence, primarily caused by adhesions. The diagnosis is usually made on the clinical findings and the presence of dilated bowel loops on plain abdominal radiograph. Computed tomography (CT) is increasingly used to diagnose the cause and location of the obstruction to aid in the timing of surgical intervention. We used a retrospective chart review to identify patients with a diagnosis of small bowel obstruction between 2009 and 2012. We compared the findings on CT with the findings at operative intervention. Sixty patients had abdominal CT and subsequent surgical intervention. Eighty-three per cent of CTs were correct for small intestine involvement and 80 per cent for colon involvement. The presence of adhesions or perforation was correctly identified in 21 and 50 per cent, respectively. Sixty-four per cent correctly identified a transition point. The presence of a mass was correctly identified in 69 per cent. Twenty per cent of the patients who had ischemic small bowel at surgery were identified on CT. CT has a role in the clinical assessment of patients with small bowel obstruction, identifying with reasonable accuracy the extent of bowel involvement and the presence of masses and transition points. It is less reliable at identifying adhesions, perforations, or ischemic bowel.

scholarly journals Small bowel obstruction due to internal herniation through a defect in the falciform ligament: a rare case report and review of the literature

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Habib Ahmad Esmat ◽  
Mohammad Wali Naseri
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Falciform Ligament ◽  
Uneventful Recovery ◽  
Internal Herniation ◽  
Delayed Treatment ◽  
Rare Case Report

Abstract Background The falciform ligament hernia is a type of internal herniation, caused by a defect in the falciform ligament of the liver. The etiology for this defect may be congenital or iatrogenic, created after the laparoscopic intervention. Case presentation A 45-year-old male was presented to our hospital, complaining of abdominal pain for 2 days. The physical examination revealed diffuse abdominal tenderness and guarding. The abdominal X-ray was suggestive of intestinal obstruction. On abdominal CT images, dilated proximal ileal loops between the left hepatic lobe and anterior abdominal wall, forming a closed-loop with mesenteric edema and fat stranding, were observed. There were findings of ileus in the jejunal loops proximal to this segment, but the ileal loops and the colon were completely collapsed, consistent with small bowel obstruction due to internal herniation through a defect in the falciform ligament. The patient underwent surgical intervention, reduction of the herniated bowel loops, and repairing the hernia defect. He had an uneventful recovery with a favorable outcome. Conclusion Herniation through a defect in the falciform ligament is extremely rare but should be considered in the differential diagnosis of acute abdomen. The clinical manifestations of falciform ligament hernia are nonspecific and may underestimate the diagnosis, leading to a delayed treatment that affects the management outcome. Computed tomography plays an important role in the timely diagnosis and planning of surgical intervention, precluding intestinal strangulation.

Role of computed tomography in elderly patients with small bowel obstruction

2012 ◽  
Vol 73 (4) ◽  
pp. 233-233
Author(s):  
Rajaraman Durai ◽  
Ahmad El Gaddal ◽  
Chu Yiu ◽  
Midhat Siddiqui ◽  
Tayo Oke
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction

High-Density Free Fluid on Computed Tomography: a Predictor of Surgical Intervention in Patients with Adhesive Small Bowel Obstruction

2016 ◽  
Vol 20 (11) ◽  
pp. 1861-1866 ◽  
Author(s):  
Kazuhide Matsushima ◽  
Kenji Inaba ◽  
Ryan Dollbaum ◽  
Vincent Cheng ◽  
Moazzam Khan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
High Density ◽  
Free Fluid ◽  
Adhesive Small Bowel Obstruction

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

META-ANALYSIS ON ETIOPATHOGENESIS OF SMALL BOWEL OBSTRUCTION IN THE DEPARTMENT OF GEN. SURGERY P.M.C.H. & K.M.C.H., BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Abhishek Chaudhary ◽  
Kanchan Sone Lal Baitha ◽  
Yasir Tajdar
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Abdominal Surgery ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Meta Analysis ◽  
Ileocaecal Valve ◽  
Time Period ◽  
Ligament Of Treitz

Background:The small intestine is the longest and convoluted portion in the digestive tract. It starts from pylorus and ends at ileocaecal valve. The small bowel consists of three parts measuring about 5 to 6 meters. The rst 25cm is the duodenum. Out of the rest part of small gut, jejunum th th. constitute the proximal 2/5 and ileum distal 3/5 The jejunum and ileum extend from the peritoneal fold that supports the duodeno-jejunal junction (Ligament of Treitz) down to ileocaecal valve. Material and Methods:All the patients admitted to PMCH, Patna and KMC, Katihar as intestinal obstruction was included for the study. The time period of study was from October 2014 to November 2016 in PMCH and December 2016 to January 2019 in KMC, Katihar. Out of all Intestinal obstruction 59 cases only of adult small gut obstruction were recorded for comparison and conclusive study.Conclusion: Small bowel obstruction remains a frequently encountered problem in abdominal surgery. Although modern day surgical management continues to focus appropriately on avoiding delayed operation, whatever surgery is indicated, not every patient is always best served by immediate operation

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