Ileosigmoidian knot about an observation at the Donka CHU National Hospital in Conakry

Introduction: The ileosigmoid node is a double volvulus involving the sigmoid and the small intestine. The preoperative diagnosis is difficult in our practice setting. We report a case of ileosigmoid node that we discuss with data from the literature. Observation: This was a 40-year-old man admitted for diffuse abdominal pain of progressive onset, paroxysmal, accompanied by cessation of materials and gas, profuse vomiting of food and hiccups, progressing for 24 hours. With a history of persistent constipation and episodes of sub-occlusion, clinical examination noted pain, abdominal distension and dullness of the flanks and inaudible peristalsis. The digital rectal examination noted an emptiness of the rectal bulb and a bulging of the Douglas. The biological assessment was unremarkable. The ASP showed an arched image. Confirmation was intraoperative with a small bowel volvulus around the sigmoid in the form of a node producing double ileal and sigmoid necrosis. We performed an ileo-ileal anastomosis resection and a left iliac colostomy using the Hartman technique. The postoperative follow-up was simple, the patient was discharged on D10 postoperative. Six weeks later the patient was readmitted for restoration of colonic continuity. Five months later, no complaints were reported. Conclusion: The ileo-sigmoid node is a rare cause of intestinal obstruction, difficult to diagnose preoperatively in our exercise setting, the progression is rapid towards digestive necrosis. The availability of emergency CT examinations and early management of this condition would improve the prognosis.

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Unusual presentation of vitamin D3-dependent rickets type II in a kitten

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116920910278 ◽

2020 ◽

Vol 6 (1) ◽

pp. 205511692091027

Author(s):

Florent Duplan ◽

Christina Maunder

Keyword(s):

Vitamin D ◽

Positive Response ◽

Abdominal Distension ◽

Response To Treatment ◽

Type I ◽

Type Ii ◽

Different Types ◽

History Of ◽

Radiographic Changes

Case summary A 15-week-old kitten presented with a 1-month history of intermittent generalised tremors and abdominal distension. Hypocalcaemia associated with increased 1,25-vitamin D3 was consistent with vitamin D3-dependent rickets type II. The bone appearance on CT scan was most consistent with the changes typically seen with nutritional secondary hyperparathyroidism and less typical of the changes seen with rickets. Our patient had a positive response to high vitamin D3 therapy as it remained normocalcaemic 16 months after diagnosis, supporting the diagnosis of rickets. Relevance and novel information This case report is an unusual and interesting presentation of rickets in a kitten. Despite the characteristic vitamin D3 disturbance for rickets type II, the atypical radiographic changes have not been previously reported. In the literature, a positive response to treatment is not commonly seen or follow-up is short. Our case responded well to treatment and was followed for 16 months from the time of diagnosis. This emphasises that the pathophysiology of the condition is not well understood, and that different types of vitamin D3-dependent rickets type II may exist. Although the genetic defects responsible for some cases of rickets type I have been identified, this has still not been determined for rickets type II.

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Anastomotic Leaks after Colorectal Anastomosis Occurring More than 30 Days Postoperatively: A Single-institution Evaluation

The American Surgeon ◽

10.1177/000313481408000919 ◽

2014 ◽

Vol 80 (9) ◽

pp. 868-872 ◽

Cited By ~ 5

Author(s):

Wei Phin Tan ◽

En Yaw Hong ◽

Benjamin Phillips ◽

Gerald A. Isenberg ◽

Scott D. Goldstein

Keyword(s):

Risk Factors ◽

Interventional Radiology ◽

Colorectal Anastomosis ◽

Anastomotic Leaks ◽

Single Institution ◽

National Hospital ◽

Elective Colorectal Surgery ◽

History Of ◽

Prospective Database

National hospital registries only report colorectal anastomotic leaks (ALs) within 30 days post-operatively. The aim of our study was to determine the incidence and significance of ALs that occur beyond 30 days postoperatively. We performed a retrospective review of our prospective database from June 2008 to August 2012. A total of 504 patients were included. These patients were operated on by two surgeons. Any clinical or radiographic abnormalities were considered to be an anastomotic imperfection. A total of 504 patients were reviewed with a total of 18 (3.6%) anastomotic leaks. Six leaks (31.6% of leaks) were diagnosed more than 30 days postoperatively ( P < 0.001). Of the 18 leaks, interventional radiology drainage was performed for four cases and 14 patients required reoperation. All six delayed leaks required reoperation. There was one leak that occurred under 30 days, which was discovered on autopsy. The median follow-up was 12 months (range, 1 to 4 months). All the delayed leak patients presented with fistulas, whereas 58 per cent of typical leak patients presented with the triad of leukocytosis, fever, and abdominal pain. Colorectal anastomotic leaks can occur after the 30-day postoperative period. In patients with vague and atypical abdominal findings, anastomotic leak must be suspected. More systematic, prospective studies are required to help us further understand the risk factors and natural history of anastomotic failures in elective colorectal surgery.

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1399 Anorectal Melanoma: Can Be an Unexpected Diagnosis - A Case Report

British Journal of Surgery ◽

10.1093/bjs/znab259.374 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Hagiga ◽

M Shaaban ◽

M Gultiaeva

Keyword(s):

Digital Rectal Examination ◽

Dentate Line ◽

Progressive Increase ◽

Incisional Biopsy ◽

Anorectal Melanoma ◽

Rare Tumour ◽

History Of ◽

Bleeding Per Rectum ◽

Erectile Dysfunction Patient

Abstract Anorectal melanoma is a rare tumour. Few cases are reported in the literature. We report a case of 51 years old male complained of anal induration, itching and bloody and suppurative discharge. Patient had symptoms for 2 years. However, patient expected his symptoms are due to recurrence of haemorrhoids. Therefore, he presented late. Then, he had noticed a progressive increase in size, discharge and two opposing ulcers. Patient had no history of abdominal pain, change in bowel habits, bleeding per rectum, history of groin lumps, incontinence nor erectile dysfunction. Patient underwent haemorrhoidectomy about 11 years ago. On examination, there was a circumferential single ulcer eroding the anus extending deep to the dentate line reaching the rectum on digital rectal examination. Also, there was no inguinal lymphadenopathy detected on exam. Incisional biopsy of the ulcer showed anorectal melanoma. Patient had abdominoperineal resection (APR) with adjuvant radiotherapy. At 12 months follow up, there were no signs of recurrence.

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Giant Extraluminal Leiomyoma of the Colon: Rare Cause of Symptomatic Pelvic Mass

International Surgery ◽

10.9738/intsurg-d-14-00054.1 ◽

2015 ◽

Vol 100 (5) ◽

pp. 805-808 ◽

Cited By ~ 4

Author(s):

Andrea Sagnotta ◽

Alessandra Sparagna ◽

Stefania Uccini ◽

Paolo Mercantini

Keyword(s):

Small Intestine ◽

Sigmoid Colon ◽

Abdominal Mass ◽

Pelvic Mass ◽

Abdominal Distension ◽

Colon Resection ◽

Life Threatening ◽

History Of ◽

Palpable Abdominal Mass

Leiomyomas (LMs) may appear throughout the entire gastrointestinal tract but are rarely seen in the colon-rectum and only 5 of those measured greater than 15 cm in diameter. Pain and palpable abdominal mass are the most common symptoms. Surgical resection is the treatment of choice for most LMs. We here describe a case of a 46-year-old woman who presented with a 3-month history of abdominal pain associated with worsening constipation and abdominal distension. A pelvic solid, polylobulate, left-sided mass was noted on examination. Preoperative findings revealed a dishomogeneous sigmoid mass with calcified spots compressing small intestine and bladder. At laparotomy, a large polylobulate and well-circumscribed mass arising from the descending colon mesentery and displacing small intestine, uterus, and ovaries. A segmental colon resection was performed. An extraluminal 18- × 12- × 5-cm paucicellular sigmoid colon leiomyoma was histologically diagnosed. Our case is one of the few giant (>15 cm) sigmoid colon LMs reported in the literature. Although rare and benign in nature, LMs of the colon can cause life-threatening complications that could require emergency treatment and they should be included in the differential diagnosis of large abdominopelvic masses. Follow-up after surgery is necessary for tumors with any atypia or mitotic activity.

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Natural history of helicobacter pylori infection from infancy to adulthood: A 21-year follow-up cohort study

Gastroenterology ◽

10.1016/s0016-5085(01)80628-4 ◽

2001 ◽

Vol 120 (5) ◽

pp. A128-A128 ◽

Cited By ~ 1

Author(s):

H MALATY ◽

D GRAHAM ◽

A ELKASABANY ◽

S REDDY ◽

S SRINIVASAN ◽

...

Keyword(s):

Helicobacter Pylori ◽

Cohort Study ◽

Natural History ◽

Helicobacter Pylori Infection ◽

History Of

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Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽

10.1024/0301-1526/a000023 ◽

2010 ◽

Vol 39 (2) ◽

pp. 169-174 ◽

Cited By ~ 7

Author(s):

Reich-Schupke ◽

Weyer ◽

Altmeyer ◽

Stücker

Keyword(s):

Scientific Evidence ◽

Daily Practice ◽

Severe Adverse Effect ◽

Safe Procedure ◽

Efficacy And Safety ◽

Foam Sclerotherapy ◽

History Of ◽

One Year ◽

Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

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Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716857 ◽

2020 ◽

Author(s):

Adam Lee ◽

Adam Bajinting ◽

Abby Lunneen ◽

Colleen M. Fitzpatrick ◽

Gustavo A. Villalona

Keyword(s):

Literature Review ◽

Retrospective Review ◽

Review Of The Literature ◽

Rare Presentation ◽

Spontaneous Pneumomediastinum ◽

Nonaccidental Trauma ◽

Comprehensive Literature Review ◽

Healthy Infants ◽

History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

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Lingual Dystonia Treated with Botulinum Toxin - A Case Report

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v24i2.152 ◽

1970 ◽

Vol 24 (2) ◽

pp. 75-78

Author(s):

MA Hayee ◽

QD Mohammad ◽

H Rahman ◽

M Hakim ◽

SM Kibria

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin A ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

X Ray ◽

Medical College ◽

Lingual Dystonia ◽

History Of ◽

Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

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