Meconium obstruction of prematurity diagnosed by exploratory laparotomy on the day of birth

In today’s mechanized world, Blunt Abdominal Trauma (BAT) is a common emergency which is associated with considerable morbidity and mortality. More than 75% of abdominal traumas are blunt in nature and liver and spleen are the commonest organs to be injured as a result of BAT. The aim is to analyse and compare two groups of patient of blunt abdominal trauma managed conservatively with drainage and one by exploratory laparotomy. 50 cases of blunt abdominal trauma were taken. The patient were studied which includes age ,sex, mode of injury, initial vitals on presentation, Mortality in each group, duration of hospital stay, pre interventions and post interventions state and requirements, complications and follow up. It was observed 48% of patients were in between age group ranging from 10 to 30. Overall in terms of sex ratio, males dominated the no. of cases. RTA was most common mode of trauma. Liver and spleen was most common organ to be injured. Patients managed by laparotomy had higher mortality rate, duration of hospital stay was more, and complication were more. Early diagnosis and repeated clinical examination and use of appropriate investigation form the key in managing blunt injury abdomen patients. Keywords: Blunt Abdominal Trauma, Haemoperitoneum , laparotomy , Abdominal Drainage.

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Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-020-02485-8 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Chunfeng Yang ◽

Jianqi Li ◽

Yuanyuan Zhang ◽

Hanzhen Xiong ◽

Xiujie Sheng

Keyword(s):

Abdominal Wall ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Unknown Origin ◽

Exploratory Laparotomy ◽

Cesarean Scar ◽

Trophoblastic Tumor ◽

Epithelioid Trophoblastic Tumor ◽

Trophoblastic Tumors ◽

Wall Lesion

Abstract Background Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence. Case presentation Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar. Conclusions It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.

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Emergency Surgery during COVID-19: Lessons Learned

The Surgery Journal ◽

10.1055/s-0040-1716335 ◽

2020 ◽

Vol 06 (03) ◽

pp. e167-e170

Author(s):

Hemanga K. Bhattacharjee ◽

Shafneed Chaliyadan ◽

Eshan Verma ◽

Keerthi Kumaran ◽

Priyank Bhargava ◽

...

Keyword(s):

Stable Condition ◽

Exploratory Laparotomy ◽

Sigmoid Volvulus ◽

Lessons Learned ◽

Suspected Case ◽

Surgical Emergencies ◽

Viral Particles ◽

Hospital Patients ◽

Perforation Peritonitis ◽

Precautionary Measures

Abstract Introduction The ongoing coronavirus disease-2019 (COVID-19) pandemic has disrupted health services throughout the world. It has brought in several new challenges to deal with surgical emergencies. Herein, we report two suspected cases of COVID-19 that were operated during this “lockdown” period and highlight the protocols we followed and lessons we learned from this situation. Result Two patients from “red zones” for COVID-19 pandemic presented with acute abdomen, one a 64-year male, who presented with perforation peritonitis and another, a 57-year male with acute intestinal obstruction due to sigmoid volvulus. They also had associated COVID-19 symptoms. COVID-19 test could not be done at the time of their presentation to the hospital. Patients underwent emergency exploratory laparotomy assuming them to be positive for the infection. Surgical team was donned with full coverall personal protective equipment. Sudden and uncontrolled egression intraperitoneal free gas was avoided, Echelon flex 60 staplers were used to resect the volvulus without allowing the gas from the volvulus to escape; mesocolon was divided using vascular reload of the stapler, no electrosurgical devices were used to avoid the aerosolization of viral particles. Colostomy was done in both the patients. Both the patients turned out to be negative for COVID-19 subsequently and discharged from hospital in stable condition. Conclusion Surgeons need to adapt to safely execute emergency surgical procedures during this period of COVID-19 pandemic. Preparedness is of paramount importance. Full precautionary measures should be taken when dealing with any suspected case.

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Diagnostic usefulness of laparoscopy versus exploratory laparotomy for dogs with suspected gastrointestinal obstruction

Journal of the American Veterinary Medical Association ◽

10.2460/javma.251.3.307 ◽

2017 ◽

Vol 251 (3) ◽

pp. 307-314 ◽

Cited By ~ 5

Author(s):

Katie S. Barry ◽

J. Brad Case ◽

Matthew D. Winter ◽

Fernando L. Garcia-Pereira ◽

Gareth Buckley ◽

...

Keyword(s):

Exploratory Laparotomy ◽

Gastrointestinal Obstruction ◽

Diagnostic Usefulness

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Delayed bowel perforation after instilling over warmed peritoneal dialysate

BMC Nephrology ◽

10.1186/s12882-021-02343-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xueli Lai ◽

Mingming Nie ◽

Xiaodong Xu ◽

Yuanjie Chen ◽

Zhiyong Guo

Keyword(s):

Peritoneal Dialysis ◽

Bowel Perforation ◽

Exploratory Laparotomy ◽

Peritoneal Dialysis Patient ◽

Case Presentation ◽

Abdominal Organs ◽

Home Based ◽

Dialysis Solution ◽

Stage Renal Disease ◽

End Stage

Abstract Background Peritoneal dialysis (PD) is a safe and home-based treatment for end-stage renal disease (ESRD) patients. The direct thermal damage of abdominal organs is very rare. Case presentation We report a peritoneal dialysis patient presented abdominal pain and feculent effluent 3 weeks after he instilled hot dialysis solution. In spite of emergency exploratory laparotomy and active treatment, the patient died of septic shock. Biopsy revealed necrosis and perforation of the intestines. Conclusions Delayed bowel perforation by hot fluid is very rare. Standardized performance is of the first importance for peritoneal dialysis patients.

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

Veterinary Sciences ◽

10.3390/vetsci8050083 ◽

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.

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THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

British Journal of Surgery ◽

10.1093/bjs/znab160.017 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

M Soto Dopazo ◽

E Pérez Prudencio ◽

A Arango Bravo ◽

C Nuño Iglesias ◽

C Mateos Palacios ◽

...

Keyword(s):

Small Bowel ◽

Bowel Obstruction ◽

Broad Ligament ◽

Intestinal Resection ◽

Laparoscopic Approach ◽

Exploratory Laparotomy ◽

X Rays ◽

Intestinal Necrosis ◽

Urgent Surgery ◽

Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

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Successful pregnancy after localized resection of perforated uterus in choriocarcinoma and a literature review

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200602001-00084 ◽

2006 ◽

Vol 16 (Suppl 1) ◽

pp. 445-448 ◽

Cited By ~ 4

Author(s):

N. Behtash ◽

S. Ansari ◽

F. Sarvi

Keyword(s):

Acute Abdominal Pain ◽

Young Patients ◽

Rare Event ◽

Myometrial Invasion ◽

Exploratory Laparotomy ◽

The Body ◽

Uterine Perforation ◽

Term Pregnancy ◽

Successful Pregnancy ◽

Future Fertility

Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. Rapid growth and myometrial invasion may be followed by uterine perforation. In this study, we present the cases of two young patients (18 and 19 years of age) with acute abdominal pain and shock, while they were under chemotherapy due to persistent trophoblastic disease. During emergent exploratory laparotomy, localized resection of uterus was performed. They had their first successful term pregnancy 5 and 4 years after surgery, respectively. Uterine perforation following choriocarcinoma is a rare event. Hysterectomy is recommended in emergency conditions, but localized resection of uterus should be considered in women who are desirous of future fertility.

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Intraperitoneal Urinary Bladder Rupture as a Cause of Pneumoperitoneum

The American Surgeon ◽

10.1177/00031348211025765 ◽

2021 ◽

pp. 000313482110257

Author(s):

Dar Parvez M ◽

Kour Supreet ◽

Sharma Ajay ◽

Kumar Subodh

Keyword(s):

Urinary Bladder ◽

Primary Repair ◽

Exploratory Laparotomy ◽

Pelvic Trauma ◽

Bladder Rupture ◽

Abdominal Pressure ◽

Trauma Patients ◽

Hollow Viscus ◽

Sudden Rise ◽

Intraperitoneal Bladder Rupture

The most common cause of pneumoperitoneum in trauma patients is hollow viscus injury; however, in patients with pneumoperitoneum on imaging and normal hollow viscus during the laparotomy, other rare causes of pneumoperitoneum like intraperitoneal urinary bladder rupture should be ruled out. Urinary bladder can rupture either extraperitoneally or intraperitoneally or both. Rupture of the urinary bladder is commonly seen in patients with abdominal trauma; however, pneumoperitoneum is usually not seen in patients with traumatic bladder rupture. Intraperitoneal bladder rupture is usually due to the sudden rise in intra-abdominal pressure following abdominal or pelvic trauma. However, it is a rare cause of pneumoperitoneum and is managed by surgical repair. We present a case of blunt trauma abdomen with pneumoperitoneum due to isolated intraperitoneal bladder rupture who was managed by exploratory laparotomy and primary repair of the urinary bladder.

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Duodenal Obstruction in a Patient Previously Treated With EndoVascular Aneurysm Sealing System Repair

Vascular and Endovascular Surgery ◽

10.1177/15385744211012566 ◽

2021 ◽

pp. 153857442110125

Author(s):

Carlo Biddau ◽

Carlo Nagliati ◽

Michele Graziano ◽

Lorenzo Cereser ◽

Giovanni Terrosu ◽

...

Keyword(s):

Duodenal Obstruction ◽

Acute Abdominal Pain ◽

Exploratory Laparotomy ◽

Biomedical Literature ◽

Aortic Aneurysms ◽

Extensive Search ◽

Novel Approach ◽

Abdominal Aortic ◽

Recurrent Vomiting ◽

Previously Treated

The Nellix® endovascular aneurysm sealing system (EVAS) is a relatively novel approach for the treatment of abdominal aortic aneurysms (AAAs). We present herein a case of duodenal obstruction (DO) which occurred following an EVAS treatment for the repair of an AAA. A 77-year old man was admitted to our hospital with acute abdominal pain and recurrent vomiting. Computed tomography (CT) revealed a retroperitoneal 66 × 59 × 90 mm (antero-posterior, AP; latero-lateral, LL; cranio-caudal: CC) solid mass located in the epigastrium, corresponding to the infrarenal abdominal aortic aneurysm sac, previously treated by EVAS. An exploratory laparotomy was performed, which revealed a retroperitoneal mass compressing the third and fourth parts of the duodenum. A gastroenteroanastomosis was performed in order to bypass the duodenal obstruction. An extensive search of biomedical literature databases was conducted to identify similar cases. To our knowledge, this is the first reported case of DO following an AAA repair with EVAS.

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