scholarly journals A Surprising Finding of Ileal Intussusception Caused by Pleural Mesothelioma Metastases

2020 ◽  
pp. 1-3
Author(s):  
Stefania Tamburrini ◽  
Antonella Pesce ◽  
Ester Marra ◽  
Giuseppe Mercogliano ◽  
Giuseppe Militerno ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Malignant Pleural Mesothelioma ◽  
Bowel Obstruction ◽  
Clinical Condition ◽  
Acute Abdominal Pain ◽  
Pleural Mesothelioma ◽  
History Of

Background: Malignant pleural mesothelioma is an aggressive form of cancer originating in the pleural mesothelioma. It generally appears as a local disease in the affected hemithorax, and metastasis are rare. It is unusual for malignant pleural mesothelioma to manifest with gastrointestinal complications due to metastatic implants, but clinicians should be careful to take into consideration this hypothesis in patients with a history of malignant pleural mesothelioma referring to the Emergency Department with acute abdominal pain. Case Presentation: A 65-year-old man, with a medical history of pleural mesothelioma, presented to our emergency department for acute abdominal pain. The patient underwent abdominal ultrasound and abdominal Computed Tomography with intravenous contrast. At US examination a small bowel obstruction diagnosis was made, CT confirmed a mechanical small bowel obstruction due to an intussuscepted multiloculated mass in the terminal ileum, with CT’s signs of parietal damage; another peritoneal mass was reported adjacent to the posterior wall of the cecum and in contiguity with the iliopsoas muscle. Considering the acute medical presentation, the patient underwent surgery, with segmental bowel resection and a stapled side-by-side bowel anastomosis. Histopathology revealed metastasis of sarcomatoid pleural mesothelioma. The post-operative course was complicated by anastomotic leak treated with a conservative approach. The patient was discharged on the 24th post-operative day. Conclusion: Our case highlights the potential of pleural mesothelioma to metastasize within abdominal viscera, causing bowel obstruction. In presence of the patient’s critical clinical condition and advanced state of local disease, a surgical approach based on damage control procedure consisting in exploration, biopsies and ileostomy upstream the obstruction or, exploration and resection without anastomosis, carry on several advantages, solving the acute clinical condition, staging the disease and offering the possibility to proceed rapidly with supportive care (chemotherapy and/or surgery).

scholarly journals Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen

2019 ◽  
Vol 12 (7) ◽  
pp. e230496 ◽  
Author(s):  
Joseph Do Woong Choi ◽  
Michael Yunaev
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Oestrogen Receptor ◽  
Surgical Intervention ◽  
Prior History ◽  
Good Recovery ◽  
History Of

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

scholarly journals Point-of-care ultrasonography for the diagnosis of small bowel obstruction in the emergency department

CJEM ◽  
2015 ◽  
Vol 17 (2) ◽  
pp. 206-209 ◽  
Author(s):  
Joshua Guttman ◽  
Michael B. Stone ◽  
Heidi H. Kimberly ◽  
Joshua S. Rempell
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Plain Radiography ◽  
Common Cause ◽  
Point Of Care Ultrasonography

AbstractSmall bowel obstruction (SBO) is a common cause of acute abdominal pain presenting to the emergency department (ED). Although the literature is limited, point-of-care ultrasonography (POCUS) has been found to have superior diagnostic accuracy for SBO compared to plain radiography; however, it is rarely used in North America for this. We present the case of a middle-aged man who presented with abdominal pain where POCUS by the emergency physician early in the hospital course expedited the diagnosis of SBO and led to earlier surgical consultation. The application of POCUS for SBO is easily learned and applied in the ED. POCUS for SBO may obviate the need for plain radiography and expedite patient care.

scholarly journals Small Bowel Obstruction Due to a Gossypiboma: A Rare and Dreaded Sequel of a Trauma Laparotomy

2020 ◽  
pp. 1-3
Author(s):  
Arwa El Rifai ◽  
Arwa El Rifai ◽  
Ahmad Ghazal ◽  
George Abi Saad
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Operating Room ◽  
Bowel Obstruction ◽  
Blast Injury ◽  
History Of ◽  
Progressive Weight Loss ◽  
Orthopedic Injuries ◽  
Patient’S History

This is a case report of a 23-year-old male who presented to a hospital in Aleppo with a few months’ history of abdominal pain and diarrhea associated with progressive weight loss and ultimate cachexia. Patient’s history is significant for a trauma laparotomy due to a blast injury with management of a colonic and orthopedic injuries. Three months later he underwent a second laparotomy for reversal of the stoma after which his symptoms started and gradually became worse. The abdominal pain attacks were so severe unresponsive to analgesics and he had lost around 30 kg. He underwent CT scan on presentation which showed small bowel obstruction and was taken down to the operating room (OR) for exploration. In the operating room a hard mass was palpated in the small bowel and a small enterotomy was done overlying the mass with retrieval of a large surgical pad, gossypiboma, from the lumen. The enterotomy was closed primarily and the patient did well postoperatively and was discharged home.

Abdominal Pain

2018 ◽  
pp. 124-128
Author(s):  
Ali Kamran
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Key Management ◽  
Abdominal Ultrasound ◽  
Unclear Etiology

Small bowel obstruction is an important diagnosis to consider in an adult presenting with abdominal pain with previous risk factors. Abdominal pain of unclear etiology in the Emergency Department has an exhaustive differential, but key historical and physical exam findings can help narrow the differential considerably. Key management steps for a bowel obstruction include obtaining an appropriate history and physical examination, ordering necessary laboratory studies to exclude other diagnoses, making the patient nil per os, addressing any serious electrolyte derangements, obtaining necessary imaging and a surgical consult. Multidetector computed tomography of the abdomen provides the highest sensitivity for the diagnosis of a small bowel obstruction, but an abdominal X-ray or an abdominal ultrasound can be utilized to help make the diagnosis.

scholarly journals Internal double omental hernia: a rare cause of acute abdomen

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
André C Pacheco ◽  
Maria J Jervis ◽  
Joana Pimenta ◽  
Ricardo Escrevente ◽  
Fátima Caratão
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Internal Hernia ◽  
Acute Abdominal Pain ◽  
Epigastric Pain ◽  
Sudden Onset ◽  
Postoperative Adhesions ◽  
Common Causes

Abstract Small bowel obstruction is one of the most common causes for acute abdominal pain leading to surgical admissions, occurring most frequently due to postoperative adhesions. Although less common, internal hernia is also a possible etiology, in which a delay on its therapy may lead to a not so dismal morbidity and mortality. Here, we report the case of a 24 year old Caucasian man that was admitted in our emergency department with an inaugural episode of sudden-onset epigastric pain associated with vomiting. After observation and diagnostic workup, the patient underwent urgent laparotomy that revealed an ischemic small bowel due to a double omental hernia, being successfully treated without enteric resection.

scholarly journals Gallstone ileus: a rare cause of small intestine obstruction

2021 ◽  
Author(s):  
Levan Tchabashvili ◽  
Dimitris Kehagias ◽  
Charalampos Kaplanis ◽  
Elias Liolis ◽  
Ioannis Perdikaris ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus

A 77-year-old woman was admitted to our emergency department complaining of abdominal pain. Computed tomography was performed and showed aerobilila and a large 5.1 cm gallstone lodged in the small intestine. She underwent emergency surgery. Intraoperative findings noted small bowel obstruction caused by a large gallstone.

In the Era of Routine Use of CT Scan for Acute Abdominal Vain, Should All Adults with Small Bowel Intussusception Undergo Surgery?

2009 ◽  
Vol 75 (10) ◽  
pp. 958-961 ◽  
Author(s):  
Jaisa Olasky ◽  
Ashkan Moazzez ◽  
Kaylene Barrera ◽  
Tatyan Clarke ◽  
Jabi Shriki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Acute Abdominal Pain ◽  
Operative Management ◽  
Lead Point ◽  
Small Bowel Intussusception

In contrast to adult colonic intussusception in which malignancy is the dominant cause, small bowel intussusceptions are mostly benign. Although surgery is the accepted standard treatment, its necessity in small bowel intussusceptions identified by CT scan is unknown. Twenty-three patients from 2005 to 2008 (16 males; median age, 44 years) with acute abdominal pain and CT-proven small bowel intussusception were studied. Factors associated with the necessity for surgery were determined. Among 11 patients who were managed operatively, surgery was deemed unnecessary in two patients based on negative explorations. Follow up in 10 of 12 patients managed nonoperatively was not associated with any recurrence of intussusception or malignancy (median follow up, 14 months). The only predictor of the need for surgery was CT evidence of small bowel obstruction and/or a radiologically identified lead point, which was present in 7 of 9 (78%) patients having a necessary operation and absent in 12 of 14 (86%) with no indication for surgery (P = 0.008). All small bowel intussusceptions found on CT scan in patients with acute abdominal pain do not require operative management. CT findings of small bowel obstruction and/or presence of a lead point are indications for surgery.

563 A Rare Case of Small Bowel Obstruction Secondary to Peritoneal Encapsulation, Congenital Adhesional Band and Gallstone Ileus

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Gungadin ◽  
A Taib ◽  
M Ahmed ◽  
A Sultana
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Unusual Case ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Case Presentation ◽  
Peritoneal Encapsulation ◽  
History Of ◽  
Gall Stone Ileus

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.

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