An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

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Small bowel obstruction caused by bowel wall hematoma after PEG

Gastrointestinal Endoscopy ◽

10.1067/mge.2003.45 ◽

2003 ◽

Vol 57 (2) ◽

pp. 273-274 ◽

Cited By ~ 7

Author(s):

Ernest Williams ◽

David A. Sabol ◽

Mark DeLegge

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Wall

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Increased Unenhanced Bowel-Wall Attenuation at Multidetector CT Is Highly Specific of Ischemia Complicating Small-Bowel Obstruction

Radiology ◽

10.1148/radiol.13122654 ◽

2014 ◽

Vol 270 (1) ◽

pp. 159-167 ◽

Cited By ~ 58

Author(s):

Yann Geffroy ◽

Isabelle Boulay-Coletta ◽

Marie-Christine Jullès ◽

Serge Nakache ◽

Patrice Taourel ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Wall ◽

Multidetector Ct

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Small bowel volvulus versus adhesive small bowel obstruction: a diagnostic dilemma in a 19-year-old woman

BMJ Case Reports ◽

10.1136/bcr-2018-229157 ◽

2019 ◽

Vol 12 (6) ◽

pp. e229157

Author(s):

Kay Tai Choy ◽

Nathan Brunott

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Adhesive Small Bowel Obstruction ◽

Diagnostic Study ◽

Diagnostic Dilemma ◽

Small Bowel Volvulus ◽

Intraabdominal Adhesions ◽

Preoperative Diagnostic ◽

History Of

Small bowel volvulus (SBV) is often challenging to diagnose. Research suggests that the clinical presentation of this disease is often very similar to other more common causes of small bowel obstruction (SBO) such as intraabdominal adhesions and no single preoperative diagnostic study is sensitive or specific enough to identify this rare cause of mechanical SBO. This report describes a case of a 19-year-old woman who presented with irretractable vomiting and abdominal pain secondary to SBV. This case is unusual as her history of recurrent adhesive SBO presented a diagnostic dilemma that required a higher degree of clinical suspicion to tease these differential diagnoses apart. She underwent laparoscopy which facilitated successful detorsion and resection of the floppy tongue of jejunum. This report aims to increase the awareness among surgeons.

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Case presentation on a rare cause of small bowel obstruction- trichobezoar: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20212728 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2172

Author(s):

Ganesh Ashok Swami ◽

Ashwini Babanrao Binorkar ◽

Ganesh Radhesham Asawa ◽

Chandrashekhar S. Halnikar

Keyword(s):

Case Report ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Acute Abdomen ◽

Digestive Tract ◽

Bowel Obstruction ◽

Psychiatric Illness ◽

Acute Obstruction ◽

Case Presentation ◽

Young Females

Trichobezoars are concretions of swallowed hairs retained within the digestive tract, most commonly stomach. Most common in young females and with psychiatric illness. Trichobezoar may be a cause of acute abdomen when it is complicated with acute obstruction or perforation. In this report we present a case of young girl who presented as an acute obstruction due to two large ileal trichobezoars.

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Non-therapeutic Management of Adhesive Small Bowel Obstruction: A Descriptive Map of Practice Patterns among General Surgeons in Saudi Arabia

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45673.14078 ◽

2020 ◽

Author(s):

Nasser Alzerwi

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Management Practices ◽

Practice Patterns ◽

National Standard ◽

Therapeutic Management ◽

Adhesive Small Bowel Obstruction ◽

Cross Sectional ◽

General Surgeons

Introduction: Adhesive Small Bowel Obstruction (ASBO) is a common postoperative complication, and its management is challenging and controversial. Published guidelines for management are inconsistent and therefore, management practices vary based on institutions and individual surgeons. Aim: To evaluate variation of practice patterns among general surgeons and residents in investigation and non-therapeutic management of ASBO. Materials and Methods: This descriptive multi-centric cross-sectional study was done on 250 general surgery trainees and practitioners who were selected to be part of the study between January-February 2020 by simple random sampling. The participants were evaluated by questionnaire method which included standard of care, current practices and variability in non-therapeutic management of ASBO. Results: In total, 198 (79.2%) participants with mean (SD) age and duration of practice 36.5 (7.70) and 9.40 (7.26) years, responded, the majority (60%) of the respondents agreed on the use of routine abdominal Contrast-Enhanced Computed Tomography (CECT) for suspected ASBO. Resuscitation as per haemodynamics was preferred over positive fluid balance by 64.6%; nasogastric drainage was considered mandatory by 76.3% and the passage of flatus was considered the most important determinant of clinical resolution of the obstructive episode by 55.1% of respondents. Around a third of the respondents (36.4%) were of the opinion that resumption of oral intake should begin with sips of water and another 47.5% thought that 48 hours is the maximum waiting period for Non-operative Management (NOM). Conclusion: This study demonstrates that there is high variability between general surgeons in most aspects of ASBO non-therapeutic management. The findings underscore the need for developing national standard consensus-based guidelines to allow timely and effective management of this complex and potentially life-threatening condition.

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Small Bowel Volvulus (SBV) in Northcentral Ethiopia

10.21203/rs.3.rs-33522/v1 ◽

2020 ◽

Author(s):

Atalel Fentahun Awedew ◽

Woldemariam Beka Belay ◽

Bedemariam Tadesse Amsalu ◽

Dawit Zerihun Yalewu

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Occurrence Rate ◽

Morbidity Rate ◽

Cross Sectional ◽

Small Bowel Volvulus ◽

Mortality And Morbidity ◽

Debre Tabor ◽

Epidemiological Profile

Abstract Background: Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia Method: The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV.Result: There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within four years. The annual occurrence rate of SBV was 35cases per year. Small bowel volvulus represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority of SBV were males (N=125, 84.5%) and females were (N=23, 15.5%). The age ranged from 15-78years.The mean age was 41.14±(SD=15.4) .The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR=2).The mean duration of illness before hospital admission was 2days (± SD=1.4) and median was 1 day (± IQR=2). The morbidity rate was 5.4% (N=8) and the mortality rate was 3.4 %( N=5) Conclusion: Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.

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Small bowel volvulus (SBV) in Northcentral Ethiopia

10.21203/rs.3.rs-33522/v2 ◽

2020 ◽

Author(s):

Atalel Fentahun Awedew ◽

Woldemariam Beka Belay ◽

Bedemariam Tadesse Amsalu ◽

Dawit Zerihun Yalewu

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Occurrence Rate ◽

Morbidity Rate ◽

Cross Sectional ◽

Small Bowel Volvulus ◽

Mortality And Morbidity ◽

The Mean ◽

Epidemiological Profile

Abstract Background: Small bowel volvulus (SBV) is a benign gastrointestinal surgical condition in which there is a torsion of all or parts of a segment of small bowel on its mesenteric axis. It has been contributed significant burden of surgical emergency as cause of small bowel obstruction in developing countries. The main objective this study was to explore clinical and epidemiological profile of Small bowel volvulus in Northcentral Ethiopia Method: The study was conducted at Debre Tabor General Hospital, South Gondar in Northcentral Ethiopia. The medical records of patients with a discharge diagnosis of small bowel volvulus were reviewed. The patients were seen for a 4-year period from Jan1, 2016-Dec31, 2019. The study was hospital-based retrospective cross-sectional and data were collected with a standardized structure questioner tool. The collected data checked for any inconsistency, code, and enter SPSS version 23 for data processing and analysis. Descriptive analyses were represented as frequency, percent, mean ± standard deviation for normal distribution, and Median ± Interquartile range for skewed data. Cross tabulation analysis was done for risk factors contributed for mortality and morbidity of SBV.Result: There were 148 patients with Small bowel volvulus as a cause of small bowel obstruction was admitted within four years. The annual occurrence rate was 35cases per year. It represented 59% of small bowel obstruction and 36.3% of bowel obstruction. The majority were males (N=125, 84.5%) and females were (N=23, 15.5%). The age ranged from 15-78 years. The mean age was 41.14±(SD=15.4) .The most common clinical presentation was abdominal pain 98% and vomiting 91.2%. The median time of hospital stay was 5 days (± IQR=2).The mean duration of illness before hospital admission was 2 days (± SD=1.4) and median was 1 day (± IQR=2). The morbidity rate was 5.4% (N=8) and the mortality rate was 3.4 %( N=5) Conclusion: Annual occurrence of SBV was 37 cases per year. The prevalence of SBV was 59% of small bowel obstruction and 36.3% of bowel obstruction respectively.

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Targeted helical CT of the acute abdomen: Appendicitis, diverticulitis, and small bowel obstruction

Seminars in Ultrasound CT and MRI ◽

10.1016/s0887-2171(00)90011-8 ◽

2000 ◽

Vol 21 (1) ◽

pp. 20-39 ◽

Cited By ~ 23

Author(s):

Bruce A Urban ◽

Elliot K Fishman

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Acute Abdomen ◽

Bowel Obstruction ◽

Helical Ct

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Diverticulitis of isolated jejunal diverticulum complicated by small bowel obstruction secondary to de novo enterolith formation

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz151 ◽

2019 ◽

Vol 2019 (5) ◽

Cited By ~ 1

Author(s):

Ivan O Aispuro ◽

Nazhone P Yazzie

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Acute Abdomen ◽

Computerized Tomography ◽

Bowel Obstruction ◽

De Novo ◽

Ct Imaging ◽

Jejunal Diverticulum ◽

Uncommon Condition

ABSTRACT Jejunoileal diverticula (JD) are an uncommon condition most prevalent in the sixth and seventh decade of life. Although mostly asymptomatic, JD can be complicated by perforation, diverticulitis, abscess, bleeding, fistula, and small bowel obstruction (SBO) secondary to enterolith formation. There are a limited number of cases describing JD complicated by SBO secondary to enterolith formation. Most of these cases are not associated with diverticulitis and multiple JD are present in all but one previously reported case. We present a case of diverticulitis of a large, isolated jejunal diverticulum complicated by de novo enterolith-induced SBO initially diagnosed as intussusception based on computerized tomography (CT) imaging. Our main objective is to increase awareness that isolated JD are not as readily evident on imaging as cases presenting with multiple JD, but nevertheless should be considered as possible etiology of acute abdomen.

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