SURGICAL INDICATION IN TRANSIENT OR RECURRENT INTUSSUSCEPTION IN PAEDIATRIC PATIENTS – A DILEMMA FOR MANAGEMENT

2021 ◽  
pp. 41-43
Author(s):  
Pramila Sharma ◽  
Dinesh Kumar Barolia ◽  
Arka Chartterjee ◽  
Saurav Sultania ◽  
Arvind Kumar Shukla
Keyword(s):  
Early Childhood ◽  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Abdominal Distension ◽  
Paediatric Surgery ◽  
Abdominal Emergency ◽  
Paediatric Patients ◽  
Mother And Child ◽  
Classical Triad ◽  
Recurrent Intussusception

Background – Intussusception is one of the most common abdominal emergencies dealt in early childhood by Paediatric Surgeons. We paediatric surgeon dealt various abdominal emergency in early childhood, Intussusception is the one of them. The decision to operate on patients of intussusception may sometimes be difcult, such as when the patients have transient intussusception without features of intestinal obstruction, like abdominal distension. Decision for surgery in patients of intussusception is very difcult in some circumstances like patient have complaint of abdominal pain only or transient intussusception. No other sign and symptoms of intestinal obstruction, abdominal distention. So, we did this study in such circumstances. to study the patients of recurrent intussusception, trans Aims and objectives - ient intussusception or newly diagnosed intussusception without intestinal obstruction, who had abdominal pain either off and on or continuous for long time. this is a Methods – retrospective study. It was conducted between January 2020 to December 2020 at Department of Paediatric surgery, Sir Padampat Mother and Child health institute, S.M.S. Medical College, Jaipur. Patient of persiste Conclusion - nt abdominal pain due to recurrent transient intussusception with or without classical triad is the matter of surgical intervention in paediatric patients.

scholarly journals Diagnosis, Management and Outcomes of Intestinal Obstruction at an Urban Tertiary Hospital in Sub Saharan Africa: a Cross-Sectional Study.

2021 ◽  
Author(s):  
Arlene Muzira Nakanwagi ◽  
Stephen C Kijjambu ◽  
Tonny Stone Luggya
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Abdominal Distension ◽  
Sub Saharan Africa ◽  
Prolonged Hospital Stay ◽  
Bowel Sounds ◽  
Colicky Abdominal Pain ◽  
Validated Questionnaire ◽  
Prolonged Hospital

Abstract BACKGROUND: Intestinal Obstruction (IO) is among the commonest causes of acute abdomen worldwide and globally it remains a challenge because it is a major cause of morbidity and surgical financial expenditure. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis can be clinical but is confirmed usually by radiologic imaging. We studied the current diagnosis, management and outcomes of IO in Mulago HospitalMATERIALS AND METHODS: This was a Prospective Descriptive Study in all the surgical units of Mulago from January to May 2014. Ethical approval was got in line with Helsinki declaration and then a pretested and validated questionnaire was used to collect data. Informed consent was got with eligible and consenting/assenting patients recruited among those patients of all ages and sex presenting with suspected Intestinal Obstruction. Uni-variate and bi-variate of the variables plus measurements of associations were done.RESULTS: We enrolled 135 patients, excluded 25 and recruited 110 patient with more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were the 3 commonest symptoms with abdominal distension, increased bowel sounds and abdominal tenderness as commonest signs. Majority of the patients were diagnosed radiologically (51%) and the rest (48.2%) clinically diagnosed accounting. “Dilated bowel loops” was the most frequent radiological sign. Return of bowel sounds occurred within 5 days of the POD, while opening of bowels on average, occurred on the 3rd POD. The mean day of discharge was the 5th POD and 73% of the patients were discharged by the 7th Post-Operative Day. The commonest unfavourable management outcome noted was prolonged hospital stay followed by wound sepsis (Surgical Site Infection) and MortalityCONCLUSION: Majority of the patients were diagnosed radiologically (51%). surgical management was done for 72.7% of the cases and 27.3% conservatively managed. Prolonged hospital stay was the commonest unfavorable outcome of management

scholarly journals Acute Abdomen and Perforated Bowel with a Rare Pathology: Nonfamilial Visceral Myopathy

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Jakob Burcharth ◽  
Caroline Olsen ◽  
Jacob Rosenberg
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Colonic Obstruction ◽  
Abdominal Distension ◽  
Gastrointestinal Diseases ◽  
Sigmoid Volvulus ◽  
Prior History ◽  
Visceral Myopathy ◽  
Abdominal Ct Scan ◽  
History Of

Visceral myopathy is a rare chronic disease affecting the peristalsis of the bowel causing intermittent pseudoobstruction. We report an atypical case of an eighty-nine-year-old woman with no prior history of abdominal illness who was admitted to our hospital with 2 days of increasing nausea, abdominal distension, and abdominal pain. On arrival at the hospital, she was critically ill. Abdominal X-ray showed distended loops of the colon and liquid levels resembling colonic obstruction. A subsequent abdominal CT scan confirmed the colonic obstruction. A suspicion of sigmoid volvulus was raised, that is why a barium enema was performed but no lower colonic obstruction could be confirmed. Acute laparotomy showed perforated cecum without intestinal obstruction. Postoperatively, the patient became septic which was fatal for the patient. Pathology gave the diagnosis visceral myopathy. It is very difficult to make the diagnosis clinically and radiologically since visceral myopathy mimics other more common gastrointestinal diseases. It is important to consider visceral myopathy as a possible diagnosis in cases with recurrent episodes of abdominal pain, vomiting, and abdominal distension, but without actual intestinal obstruction.

L’invaginazione ileocolica

2021 ◽  
Vol 40 (1) ◽  
pp. 44-50
Author(s):  
Alessia G. Servidio ◽  
MIchele Mazzolai ◽  
Lorenzo Calligaris ◽  
Flora Maria Murru ◽  
Daniela Codrich ◽  
...  
Keyword(s):  
Early Childhood ◽  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Clinical Presentation ◽  
Bowel Perforation ◽  
Palpable Mass ◽  
Pneumatic Reduction ◽  
Air Enema ◽  
Prompt Diagnosis ◽  
Red Currant

Ileo-colic intussusception is a major cause of intestinal obstruction in early childhood. Diagnosis of this condition might be hampered by variability in clinical presentation. Indeed, the so-called “classic” symptoms, namely abdominal pain, red currant jelly stool, vomiting and palpable mass, may not be present. Nevertheless, prompt diagnosis and treatment are critical to prevent bowel perforation or necrosis and peritonitis. Pneumatic reduction of intussusception with an air enema is the usual treatment. The aim of this study is to highlight the main clinical features of ileo-colic intussusception and its management.

scholarly journals Outcomes of management of intestinal obstruction at an urban tertiary hospital in sub Saharan Africa: a cross-sectional study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arlene Muzira Nakanwagi ◽  
Stephen C. Kijjambu ◽  
Peter Ongom ◽  
Tonny Stone Luggya
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Hospital Stay ◽  
Abdominal Distension ◽  
Sub Saharan Africa ◽  
Prolonged Hospital Stay ◽  
Wound Sepsis ◽  
Bowel Sounds ◽  
Colicky Abdominal Pain ◽  
Prolonged Hospital

Abstract Background Intestinal obstruction (IO) is a common cause of acute abdomen globally, it remains challenging as it increases surgical financial expenditure while also causing major morbidity. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis, especially in resource limited settings, can be clinical but is usually confirmed radiologically. We studied the current diagnosis, management and outcomes of IO in Mulago Hospital. Materials and methods This was a prospective study done at all the surgical units of Mulago from January to May 2014 to assess general diagnosis and management of IO. Ethical approval was got in line with Helsinki declaration, we used pretested and validated questionnaires to collect data. Informed consent was got with eligible and consenting/assenting patients that fitted the inclusion criteria of age and presenting with suspected intestinal obstruction. Uni-variate and bi-variate variables analysis was done plus measures of association. Results We enrolled 135 patients, excluded 25 and recruited 110 patient. We had more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were commonest symptoms, then abdominal distension, increased bowel sounds and abdominal tenderness were the commonest signs. Most patients’ (51%) were diagnosed radiologically with a lesser number clinically diagnosed. “Dilated bowel loops” was the commonest radiological sign. Surgery was the main stay of management at 72.7% while 27.3% were conservatively managed. Postoperatively the bowels opened averagely on the 3rd post-operative day (POD) with return of bowel sounds occurring on 5th POD. Most discharges (73%) occurred by the 7th POD. Unfavourable outcomes were prolonged hospital stay followed by wound sepsis (surgical site infection) and then Mortality. Conclusion This study noted that In Mulago we mostly diagnosed patients radiologically with most surgically managed and which is similar to regional practices. Postoperatively bowel opening happening on third POD with return of bowel sounds on fifth POD. Prolonged hospital stay followed by wound sepsis and then mortality were commonest unfavorable management outcomes.

Acute abdomen in pregnancy: a retrospective study of pregnant patients hospitalised for abdominal pain

2020 ◽  
Vol 99 (3) ◽  
pp. 131-135
Keyword(s):  
Abdominal Pain ◽  
Clinical Signs ◽  
University Hospital ◽  
Diagnostic Process ◽  
Abdominal Emergency ◽  
Lower Abdominal Quadrant ◽  
Abdominal Emergencies ◽  
The Right ◽  
Abdominal Quadrant ◽  
In Pregnancy

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.

Hernia interna estrangulada por plastrón en el tercio distal del apéndice cecal

2019 ◽  
Vol 62 (6) ◽  
pp. 24-27
Author(s):  
Leslie M. Leyva Sotelo ◽  
José E. Telich Tarriba ◽  
Daniel Ángeles Gaspar ◽  
Osvaldo I. Guevara Valmaña ◽  
André Víctor Baldín ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Internal Hernia ◽  
Wide Spectrum ◽  
Internal Hernias ◽  
Mild Abdominal Pain ◽  
Made In

Internal hernias are an infrequent cause of intestinal obstruction with an incidence of 0.2-0.9%, therefore their early diagnosis represents a challenge. The most frequently herniated organ is the small bowel, which results in a wide spectrum of symptoms, varying from mild abdominal pain to acute abdomen. We present the case of an eight-year old patient with nonspecific digestive symptoms, a transoperative diagnosis was made in which an internal hernia was found strangulated by plastron in the distal third of the appendix. Appendectomy was performed and four days later the patient was discharged without complications.

scholarly journals Intestinal obstruction due to small bowel herniation through foramen of Winslow: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
P. K. B. S. C. Bandara ◽  
A. M. Viraj Rohana ◽  
Aloka Pathirana
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Intestinal Obstruction ◽  
Reflux Disease ◽  
Bowel Loop ◽  
Internal Herniation ◽  
Small Bowel Loop ◽  
Foramen Of Winslow

Abstract Background Intestinal obstruction due to internal herniation of the bowel is a rare clinical entity which is often overlooked in the differential diagnosis of patients with abdominal pain who have no previous history of abdominal surgery. Several sites of bowel internal herniation have been described, amongst which internal herniation through the foramen of Winslow accounts for about 8% of cases. These patients present with nonspecific abdominal pain associated with symptoms of gastroesophageal reflux disease, and hence the diagnosis is often overlooked. The usual symptoms of intestinal obstruction can be delayed, which results in a delay in diagnosis and gangrene of the herniated bowel segment. Abdominal radiographs and computed tomography are helpful in the diagnosis. Open reduction is the management of choice; however, laparoscopic reduction has also been attempted, with good results. Case presentation We report a case of a middle-aged Sri Lankan man who presented with features of gastroesophageal reflux disease, developed features of intestinal obstruction and was found to have a gangrenous small bowel loop which had herniated through the foramen of Winslow. Following needle aspiration and reduction of the herniated small bowel loop, the gangrenous part of the small bowel was resected and an ileoileal anastomosis performed. The large foramen of Winslow was partially closed with interrupted stitches. The patient made an uneventful recovery. Conclusion Since delayed diagnosis of bowel obstruction is detrimental, it is of utmost importance to diagnose it early. Because internal herniation of the small bowel through the foramen of Winslow presents with nonspecific symptoms including features of gastroesophageal reflux disease, as documented in several cases worldwide and also presented by our patient, there should be a high degree of suspicion of internal herniation of the bowel causing bowel obstruction and low threshold for extensive investigation of patients presenting with symptoms of gastroesophageal reflux disease which does not resolve with usual medication.

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

scholarly journals Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 73-75
Author(s):  
R Hamid ◽  
AH Shera ◽  
NA Bhat ◽  
A Baba ◽  
A Rashid
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Transverse Colon ◽  
Late Onset ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Colonic Stenosis ◽  
Colonic Atresia ◽  
Mucous Fistula

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446   J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75  

scholarly journals Hydatid Disease Simulating Acute Abdomen: A Case Report and Brief Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Georgios Lianos ◽  
Georgios Baltogiannis ◽  
Avrilios Lazaros ◽  
Konstantinos Vlachos
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Hydatid Disease ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
The Body ◽  
Parasitic Disease ◽  
Review Of The Literature ◽  
Diffuse Abdominal Pain ◽  
Operating Surgeon

Introduction. Hydatid disease is caused by the tapewormEchinococcus granulosusand is still a matter of public health in many regions of the world, where it is an endemic parasitic disease. Although the liver is the most involved organ, hydatidosis can be found anywhere in the human body. Rare forms of location may lead to diagnostic and therapeutic dilemmas.Case Report. Herein we report a rare case of acute abdominal pain and progressively increasing abdominal distension due to abdominal and multiple splenic echinococcosis in a 72-year-old Caucasian male. We also provide a brief review of the literature.Conclusion. Although hydatid disease is found most often in the liver and lungs, rarely any organ of the body can be involved by this zoonosis. Though rare, the possibility of unusual location of echinococcosis must always be considered by the operating surgeon, when dealing with diffuse abdominal pain in endemic areas, because any misinterpretation may result in unfavorable outcomes.

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