A rare case of intestinal obstruction due to ascariasis in Niš, south Serbia

AbstractAscariasis is a helminthic infection of global distribution, and intestinal obstruction is its most common gastrointestinal complication. This is a case of a 7-year-old boy admitted to Pediatric Surgery because of intestinal obstruction caused by ascariasis. On admission, the patient presented with colicky abdominal pain, bile-stained vomiting and meteorism. On physical examination, the patient was thin, pale, and dehydrated. An abdominal examination showed distention and diffuse tenderness. After admission, the patient had fecal vomiting and expulsion of worms through the mouth. Laboratory-test results showed leucocytosis, eosinophilia, hypoalbuminaemia, and hypochloremia. Abdominal radiographs and ultrasound studies were indicative of small-bowel obstruction due to roundworms, which led to the performance of an exploratory laparotomy. On bowel exploration, an intraluminal mass, 10 by 6 cm in diameter, consisting of roundworms in the middle third of the ileum was found. A longitudinal enterotomy was performed, and the worms were meticulously extracted manually. Postoperatively, broad-spectrum antibiotics and antihelminthic drugs were administered. Our case of intestinal obstruction caused by ascariasis is the first to be reported in Serbia, according to the Serbian literature.

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Atypical anti-glomerular basement membrane disease with anti-GBM antibody negativity and ANCA positivity: a case report

BMC Nephrology ◽

10.1186/s12882-021-02232-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Na Guo ◽

Qinghua Yin ◽

Song Lei ◽

Yanjun He ◽

Ping Fu

Keyword(s):

Basement Membrane ◽

Glomerular Basement Membrane ◽

Rare Case ◽

Test Results ◽

Serum Samples ◽

Tissue Samples ◽

Case Presentation ◽

Severe Renal Insufficiency ◽

Laboratory Test Results ◽

Organ Specific

Abstract Background Anti-glomerular basement membrane (anti-GBM) disease is an organ-specific autoimmune disease that involves the lung and kidneys and leads to rapid glomerulonephritis progression, with or without diffuse alveolar hemorrhage, and even respiratory failure. Classic cases of anti-GBM disease are diagnosed based on the presence of the anti-GBM antibody in serum samples and kidney or lung biopsy tissue samples. However, atypical cases of anti-GBM disease are also seen in clinical practice. Case presentation We herein report the rare case of a patient with atypical anti-GBM disease whose serum was negative for the anti-GBM antibody but positive for the myeloperoxidase (MPO) anti-neutrophil cytoplasmic antibody (p-ANCA) and another atypical ANCA. Laboratory test results showed severe renal insufficiency with a creatinine level of 385 μmol/L. Renal biopsy specimen analysis revealed 100% glomeruli with crescents; immunofluorescence showed immunoglobulin G (IgG) linearly deposited alongside the GBM. Finally, the patient was discharged successfully after treatment with plasmapheresis, methylprednisolone and prednisone. Conclusion This patient, whose serum was negative for the anti-GBM antibody but positive for p-ANCA and another atypical ANCA, had a rare case of anti-GBM disease. Insights from this unusual case might help physicians diagnose rare forms of glomerulonephritis and treat affected patients in a timely manner.

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A Rare Cause of Acute Abdomen: An Isolated Falciform Ligament Necrosis

Case Reports in Emergency Medicine ◽

10.1155/2014/570751 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Ziya Taner Ozkececı ◽

Mustafa Ozsoy ◽

Bahadır Celep ◽

Ahmet Bal ◽

Coskun Polat

Keyword(s):

Acute Abdomen ◽

Leukocyte Count ◽

Exploratory Laparotomy ◽

Falciform Ligament ◽

Test Results ◽

Imaging Studies ◽

Anatomical Structures ◽

Case Presentation ◽

Air Density ◽

Laboratory Test Results

The falciform ligament is one of the anatomical structures which attach the liver to the diaphragm and anterior abdominal wall. Primary falciform ligament is very rare. In this article, we present a case of an isolated falciform ligament necrosis, a rare primary pathology of the falciform ligament, who was admitted with acute abdomen. Case presentation: A 64-year-old female patient was admitted with the complaints of pain. Laboratory test results showed a leukocyte count of 17,000/mm3. Imaging studies demonstrated intra-abdominal reactionary fluid along with a heterogeneous mass localized in the falciform ligament. Exploratory laparotomy revealed a necrotic mass of the falciform ligament. No other pathology responsible for falciform ligament necrosis was found. We believe that falciform ligament necrosis should be considered a preliminary diagnosis, if any ligament abnormality, tumor, intraligament air density, or the presence of reactionary fluid surrounding the ligament is detected through abdominal imaging studies.

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Primary ileal volvulus: a rare cause of small intestinal obstruction

International Surgery Journal ◽

10.18203/2349-2902.isj20201416 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1304

Author(s):

Syed Faizan ◽

Amit Kumar C. Jain ◽

Durganna Thimmappa

Keyword(s):

Intestinal Obstruction ◽

Iliac Fossa ◽

Significant Risk ◽

Exploratory Laparotomy ◽

Small Bowel Volvulus ◽

The Past ◽

Risk Of Mortality ◽

History Of ◽

Abdominal Examination ◽

Small Intestinal

A 50-year-old lady presented to us in the emergency department with history of acute abdominal pain and vomiting since the past 24 hours. Abdominal examination showed tenderness and guarding in the hypogastrium, lumbar and right iliac fossa region. Initial diagnosis of ruptured appendicitis was considered but exploratory laparotomy gave us an intra-operative surprise. Small bowel volvulus is extremely rare in clinical practice and their symptoms are usually nonspecific. The diagnosis is typically confirmed at surgery most of the time just like in this case. No etiology of this volvulus was found in this patient. Ileal volvulus carries a significant risk of mortality. Awareness of this condition among surgeons will help to reduce the morbidity and mortality associated with this unusual form of intestinal obstruction.

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Intestinal Obstruction in a Child with Massive Ascariasis

Case Reports in Pediatrics ◽

10.1155/2021/8857291 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Munanura Turyasiima ◽

Paul Matovu ◽

Gloria Kiconco ◽

Walufu Ivan Egesa ◽

Phillip Sunday ◽

...

Keyword(s):

Abdominal Pain ◽

Intestinal Obstruction ◽

Clinical Presentation ◽

Acute Abdominal Pain ◽

Exploratory Laparotomy ◽

Postoperative Management ◽

Soft Mass ◽

History Of ◽

Abdominal Examination ◽

The Tropics

Soil-transmitted helminths are so prevalent in the tropics and low developing countries. Pediatric clinical presentation of ascariasis, the most common helminth, as the intestinal obstruction is not only rare but also less described. We present a case of a 4-year-old girl with massive ascariasis. She presented with a 3-day history of acute abdominal pain associated with vomiting and an episode of passing long white roundworms, about 5 cm in length, through the nose. The child had mild constipation and passed pellets of hard stool once in the last 72 hours. She was in fair general condition at the examination but had significant findings on abdominal examination. On palpation, there was a soft mass localized in the left paraumbilical area and no tenderness, with normal bowel sounds on auscultation. Exploratory laparotomy was sanctioned where roundworms (Ascaris lumbricoides), saucepan full, were delivered through a 2.5 cm enterotomy incision. Postoperative management was carried out, and the child discharged on the 7th day of treatment including a 3-day course of albendazole 400 mg daily.

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Gallstone ileus: Rare Entity for Mechanical Small Bowel Obstruction

Journal of Surgical Case Reports and Images ◽

10.31579/2690-1897/088 ◽

2021 ◽

Vol 4 (8) ◽

pp. 01-04

Author(s):

Kiran R.S ◽

Sarmukh S ◽

Azmi H

Keyword(s):

Small Bowel ◽

Intestinal Obstruction ◽

Gallstone Ileus ◽

Exploratory Laparotomy ◽

Bowel Sound ◽

Rare Entity ◽

Female Population ◽

X Ray ◽

Elderly Female ◽

Intraluminal Mass

Gallstone ileus is common in elderly female population. To obtain a diagnosis of gallstone ileus is a challenge requiring clinical and radiological assistance. It’s a rare cause of intestinal obstruction, accounts approximately 1-4%. Here we report a case of 56 years old lady presented with intestinal obstruction sign and symptoms. Per abdomen examination revealed generalised tenderness with sluggish bowel sound. Abdominal X-ray revealed prominent small bowel with presence of gas till rectum. CT abdomen noted intraluminal mass over distal small bowel loops mimickering intusseption. Exploratory laparotomy with small bowel enterotomy was performed. Intra-operative finding noted impacted gallstone measuring 2x3cm, 360cm from duodenal-jejunal flexure and 50cm from terminal ileum. Post-operative patient had speedy recovery and discharged home. Here we emphasize in elderly female patient presented with sign and symptoms of intestinal obstruction, diagnosis of gallstone ileus should be one of differential diagnosis.

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CASE OF DU PERFORATION WITH SECONDARY OMENTAL NECROSIS- A RARE CASE REPORT

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i11.757 ◽

2019 ◽

Vol 3 (11) ◽

Author(s):

Dr. Radha Krishna K ◽

Dr. Bushra Khan ◽

Dr. Atif Abdul Samee ◽

Dr. Syed Mujtaba Ibrahim

Keyword(s):

Rare Case ◽

Primary Repair ◽

Exploratory Laparotomy ◽

High Grade Fever ◽

Persistent Vomiting ◽

X Ray ◽

Omental Infarction ◽

Rare Case Report ◽

Abdominal Examination ◽

The Right

Introduction: The Omentum is rich in blood supply. Omental Infarction can be classified as primary or secondary depending on the pathogenesis. Aims and Objectives: To report a case of DU perforation with secondary Omental Infarction. Case Details: A 21 year old male patient came with complaints of generalized dull aching abdominal pain, associated with persistent vomiting and high grade fever since 3 days. On examination, he was drowsy, BP was not recordable and peripheral pulses were not palpable. Abdominal examination revealed guarding and rigidity. X-ray erect abdomen showed gas under the right dome of the diaphragm (pneumoperitoneum). The patient was taken up for an exploratory laparotomy. Intraoperatively, findings included: 1) A 0.5*0.5cm in size perforation over the anterior first part of the duodenum, 2) approximately 3L of haemorrhagic peritoneal fluid 3) necrosed omentum and 4) petechial patches over the parietal wall of peritoneum. Primary repair of the DU perforation with omental plug (modified graham’s repair) with omentectomy of the necrosed part of omentum was done. The HPE report of excised specimen of omentum was suggestive of intense congestion and necro-inflammatory reaction of the omentum with necrosis and netrophilic infiltrate. Conclusion: A rare case of DU perforation with secondary omental necrosis is being reported. Keywords: DU Perforation; Omental Necrosis; Omental Infarction; Modified Graham’s patch Abbreviations: OI- Omental Infarction, DU- Duodenum.

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Complete Intraluminal Migration of Surgical Sponge (Gossypiboma) With Complete Intestinal Obstruction

KYAMC Journal ◽

10.3329/kyamcj.v4i1.32264 ◽

2017 ◽

Vol 4 (1) ◽

pp. 362-365

Author(s):

Mohd Farid Hossain ◽

Anisur Rahman ◽

Abdur Rouf

Keyword(s):

Intestinal Obstruction ◽

Open Cholecystectomy ◽

Exploratory Laparotomy ◽

Internal Communication ◽

Surgical Sponge ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Intraluminal Mass ◽

Intraluminal Migration

A 33 years aged gentle lady presented with the features suggestive of acute intestinal obstruction due to complete intraluminal migration of a laparotomy sponge, five years after open cholecystectomy in a private clinic. Contrast enhanced CT scan of whole abdomen revealed an elongated intraluminal mass in the distal ileum causing intestinal obstruction. Exploratory laparotomy revealed circumvented loop of ileum with intraluminal mass sized around 6x12 cm in the terminal ileum. Enterotomy delivered a surgical sponge with no external or internal communication. Though intraluminal migration of retained surgical sponge has often been reported. But complete migration with features of intestinal obstruction is rare.KYAMC Journal Vol. 4, No.-1, July 2013, Page 362-365

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Rare case of midgut volvulus with malrotation in an elderly patient

International Surgery Journal ◽

10.18203/2349-2902.isj20195991 ◽

2019 ◽

Vol 7 (1) ◽

pp. 303

Author(s):

Mezhuneituo Raleng ◽

Anant Prakash Pore ◽

Vickey Katheria ◽

Worshim Khamrang ◽

R. S. Wungramthing

Keyword(s):

Elderly Patient ◽

Intestinal Obstruction ◽

Conservative Management ◽

Rare Case ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Midgut Volvulus ◽

History Of ◽

Subacute Intestinal Obstruction

A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced.

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