RICHTER'S HERNIA: A DECEPTIVE CLINICAL ENTITY PRESENTING AS INTESTINAL OBSTRUCTION.

2021 ◽  
pp. 1-2
Author(s):  
Dibyasingh Meher ◽  
Suvendu Sekhar Jena ◽  
Manas Ranjan Mallick
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Entity ◽  
Morbidity And Mortality ◽  
Richter’S Hernia ◽  
Mortality Case ◽  
Perforation Peritonitis ◽  
Richter's Hernia ◽  
The Common ◽  
Time Diagnosis ◽  
Tomography Scan

Introduction: Richter's hernia is a rare entity representing a small percentage of all hernia cases. These are small fascial defects that entrap partial circumference of the bowel and vary in presentation with associated increases in morbidity and mortality. Case Report: A 78-year male presented with Richter's hernia of the umbilical region which was diagnosed intra-operatively. The content was the ileal wall with pre-gangrenous changes. Because of doubtful viability resection of the segment and end-to-end anastomosis was done. The postoperative period was uneventful. Discussion: In female and old age patients, Richter's hernia is common with the femoral and inguinal regions being the common sites. The presentation may vary from vague pain abdomen and swelling to gangrene and perforation peritonitis. Some patients present as intestinal obstruction while in some cases the presentation mimics acute gastroenteritis. Radiological investigations like X-ray, ultrasonography (USG), and CT (computed tomography) scan aid in diagnosis but most of the time diagnosis is made intraoperatively. Surgical reduction or resection is often warranted depending on the viability of entrapped segment. Conclusion: To diagnose and manage this deceptive clinical entity experience and expertise is required. Timely taken decision and intervention helps to reduce morbidity and mortality associated with it

Early Detection and Successful Release of Richter's Hernia in a 5-mm Laparoscopic Port Site

2015 ◽  
Vol 31 (4) ◽  
pp. 232-234 ◽  
Author(s):  
Jessica J. Wade ◽  
Ruth Cameron-Jeffs ◽  
Orla M. McNally
Keyword(s):  
Early Detection ◽  
Port Site ◽  
Richter’S Hernia ◽  
Laparoscopic Port ◽  
Richter's Hernia

Richter's hernia after colonoscopy: a rare complication

2006 ◽  
Vol 63 (1) ◽  
pp. 177-178
Author(s):  
Pascale Fluri ◽  
Walther Keller ◽  
Peter Nussbaumer
Keyword(s):  
Rare Complication ◽  
Richter’S Hernia ◽  
Richter's Hernia

scholarly journals Are morbidity and mortality case review practices in Scottish intensive care units aligned to national standards?

2017 ◽  
Vol 19 (3) ◽  
pp. 264-268
Author(s):  
Mohammed(Mo) Faik Al-Haddad ◽  
Andrew Cadamy ◽  
Euan Black ◽  
Kate Slade
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
National Standards ◽  
Morbidity And Mortality ◽  
Case Review ◽  
Allied Health Professionals ◽  
Telephone Interviews ◽  
Significant Events ◽  
Mortality Case ◽  
Cardiac Intensive Care

Introduction Both Scottish and UK standards guidelines recommend that intensive care units should hold regular, structured, multidisciplinary morbidity and mortality meetings. The aim of this survey was to ascertain the nature of current practice with regards to morbidity and mortality case reviews and meetings in all intensive care units in Scotland. Methods Semi-structured telephone interviews were conducted with a consultant from all Scottish intensive care units. A list of intensive care units in Scotland was obtained from the Scottish Intensive Care Society Audit Group annual report. Results All 24 intensive care units (100%) in Scotland were surveyed. The interviews took an average of 20 min. The three cardiac intensive care units were excluded from analysis. All other intensive care units had morbidity and mortality meetings and 18 units had a morbidity and mortality clinical lead. Nineteen intensive care units held joint morbidity and mortality meetings, eight of which were regular. In all intensive care units, meetings were attended by consultants and trainees. In 14 intensive care units, meetings were attended by nurses, seven by allied health professionals, 1 by a manager and 11 by other professionals. All mortality cases in intensive care unit were discussed in 19 intensive care units, in the other two intensive care units, 10–20% of mortality cases were discussed. Conclusion There is a wide variation in the processes of reviewing mortality cases and significant events in intensive care units across Scotland, and in the way morbidity and mortality meetings are organised and held. Based on this survey, there is scope for improving the consistency of approach to morbidity and mortality case reviews and meetings in order to improve education and facilitate shared learning.

scholarly journals Sub-Acute Intestinal Obstruction – A Rare Complication in a patient with Autosomal Dominant Polycystic Kidney Disease

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Nazish Naseer ◽  
Sonia Yaqub
Keyword(s):  
Intestinal Obstruction ◽  
Rare Complication ◽  
Acute Intestinal Obstruction ◽  
Polycystic Kidney ◽  
Radiological Findings ◽  
X Ray ◽  
Distended Abdomen ◽  
X Ray Computed ◽  
Autosomal Dominant Polycystic Kidney ◽  
Tomography Scan

associated with vomiting and constipation. On examination he was an obese, ill looking male with a distended abdomen and bilateral palpable flank masses. Gut sounds were sluggish. Small and large bowel loops were found to be dilated on abdominal x-ray. Computed tomography scan of the abdomen showed grossly enlarged kidneys occupying almost whole of the abdomen pushing small bowel loops anteriorly. Based on clinical and radiological findings a diagnosis of sub-acute intestinal obstruction was made. Patient was managed conservatively (i.e. with NG tube and rectal decompression). This case highlights intestinal obstruction as a rare complication of ADPKD.

scholarly journals Endovascular Treatment in a Case of Phelgmasia Cerulean Doleans

2019 ◽  
pp. 1-3
Author(s):  
Yuxin Guo ◽  
Darius Aw Kang Lie ◽  
Jack Kian Chng ◽  
Yuxin Guo
Keyword(s):  
Neuroendocrine Tumour ◽  
Morbidity And Mortality ◽  
Treatment Modalities ◽  
Good Effect ◽  
Mortality Case ◽  
Severe Manifestation ◽  
Venous Gangrene ◽  
Venous Outflow Obstruction ◽  
Massive Fluid ◽  
High Degree

Background: Phlegmasia cerulean dolens (PCD) is an uncommon and severe manifestation of massive proximal venous thrombosis of the lower extremities associated with a high degree of morbidity and mortality. Case: We describe a case of a 67-year-old gentleman with metastatic gastric neuroendocrine tumour, who developed PCD of his left lower limb. He underwent endovascular thrombectomy with thrombolysis and stent placement with good effect. Discussion: Characterised by severe venous outflow obstruction, marked limb swelling, pain and discolouration, PCD can lead to venous gangrene, congestion with massive fluid sequestration and circulatory collapse if left untreated. Various treatment modalities were reported with varying outcomes, morbidity and mortality. Conclusion: A multifaceted approach to PCD may be required for successful limb salvage, taking into account the risks and benefits of each treatment modality.

scholarly journals Tuberculous Abdominal cocoon in childern– A Single Centre Study in remote area in northern India

2017 ◽  
Vol 90 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Rikki Singal ◽  
Satyashree B ◽  
Amit Mittal ◽  
Bhanu Pratap Sharma ◽  
Samita Singal ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Medical Sciences ◽  
Abdominal Cocoon ◽  
Northern India ◽  
Single Centre Study ◽  
Encapsulating Peritonitis ◽  
Operative Findings ◽  
A Prospective Study ◽  
Tomography Scan

Background. Amongst the numerous causes of intestinal obstruction listed in the literature, sclerosing encapsulating peritonitis also called Abdominal Cocoon (AC) is one of the rarest entities. Its characteristic feature is a thick fibrotic membrane encasing varying lengths of the small and large gut in a cocoon. In India, there is an increasing incidence of tuberculosis, especially in the rural areas.Aims and objectives. The aim of this study was to investigate the clinical presentation and evaluate the operative findings of tuberculous AC. We also evaluated the outcomes and response to anti tuberculous treatment (ATT) in all the patients diagnosed with this condition.Material and methods. This study was carried out at M.M. Institute of Medical Sciences and Research, Mullana, Ambala, India between April 2013 – March 2016 in the Department of Pediatric Surgery. This is a prospective study. A total of 17 patients diagnosed with abdominal cocoon secondary to tuberculosis have been included in the study.Results. A total of 17 patients presented to the emergency ward with features of acute intestinal obstruction. The average age was 15.3 years (range 9 years to 16 years). There were 14 females and 3 males. All patients presented with abdominal pain, bilious vomiting, constipation and abdominal distention. The patients were operated in our hospital and relieved of their obstruction. Based on their operative findings and after histopathological confirmation, patients were given ATT. In the follow-up, all patients did well, without recurrence of tuberculosis or intestinal obstruction. Conclusion. Tuberculosis as a cause of childhood AC is rather common in developing countries and is potentially a fatal condition. A strong clinical suspicion, sonographic and computed tomography scan findings help establish a pre-operative diagnosis. Tuberculous AC has a strong prevalence in females.  Surgery is the mainstay of treatment followed by anti-tuberculous drugs.

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