scholarly journals Sudden Unexpected Death Associated with Ileocecal Duplication Cyst and Clinical Review

2010 ◽  
Vol 4 ◽  
pp. CMPed.S4850 ◽  
Author(s):  
Y Kashiwagi ◽  
S. Suzuki ◽  
K. Watanabe ◽  
S. Nishimata ◽  
H. Kawashima ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Duplication Cyst ◽  
Multiple Organ ◽  
Watery Diarrhea ◽  
Abdominal Radiograph ◽  
Unexpected Death ◽  
Plain Abdominal Radiograph ◽  
Abdominal Symptoms

Duplications of the alimentary tract are very rare. A one-month-old female presented with symptoms of anorexia, vomiting and continuous watery diarrhea. The plain abdominal radiograph showed thickened intestinal wall and signs of small bowel obstruction. The fevers, vomiting, and continuous wartery diarrhea persisted despite antibiotics, and worsened. The patient failed to respond to medical managements, 27 hours after admission, the patient died due to multiple organ failures. The autopsy was performed, small bowel obstruction due to an ileocecal duplication cyst (3 × 3 cm) was recognized. The ileocecal duplication cyst was attached to the ileum which was changed edematous and necrotic. This potential diagnosis should be borne in mind for a patient who complains of abdominal symptoms with an unknown cause, and duplication cyst should be recognized as a fatal cause in infant.

scholarly journals Small bowel obstruction due to phytobezoar and adhesions following laparoscopic cholecystectomy

2015 ◽  
Vol 3 (2) ◽  
pp. 63
Author(s):  
Nidal Abu jkeim ◽  
Ahmad Al hazmi ◽  
Awad Alawad ◽  
Rashid Ibrahim ◽  
Ahmad Abu damis ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
History Of ◽  
Metallic Clip ◽  
Fluid Levels ◽  
Gallbladder Fossa

<p>We report a case of 51 –year-old female with history of laparoscopic cholecystectomy presented with abdominal pain and diagnosed as small bowel obstruction caused by adhesions. The initial presentation was periumbilical pain with nausea and vomiting. Plain abdominal radiograph showed dilated small bowel loops and multiple air fluid levels. Due to failure of conservative treatment, laparotomy was performed. An open metallic clip was adhering the bowel to the gallbladder fossa causing sharp angulation. A phytobezoar proximal to this angulation was exteriorized through enterotomy. The patient was recovered smoothly and discharged from our hospital.</p>

Accuracy of Computed Tomography in Small Bowel Obstruction

2013 ◽  
Vol 79 (6) ◽  
pp. 641-643 ◽  
Author(s):  
Rebecca E. Barnett ◽  
Jason Younga ◽  
Brady Harris ◽  
Robert C. Keskey ◽  
Daryl Nisbett ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Abdominal Radiograph ◽  
Plain Abdominal Radiograph ◽  
Ischemic Bowel

Small bowel obstruction is a common clinical occurrence, primarily caused by adhesions. The diagnosis is usually made on the clinical findings and the presence of dilated bowel loops on plain abdominal radiograph. Computed tomography (CT) is increasingly used to diagnose the cause and location of the obstruction to aid in the timing of surgical intervention. We used a retrospective chart review to identify patients with a diagnosis of small bowel obstruction between 2009 and 2012. We compared the findings on CT with the findings at operative intervention. Sixty patients had abdominal CT and subsequent surgical intervention. Eighty-three per cent of CTs were correct for small intestine involvement and 80 per cent for colon involvement. The presence of adhesions or perforation was correctly identified in 21 and 50 per cent, respectively. Sixty-four per cent correctly identified a transition point. The presence of a mass was correctly identified in 69 per cent. Twenty per cent of the patients who had ischemic small bowel at surgery were identified on CT. CT has a role in the clinical assessment of patients with small bowel obstruction, identifying with reasonable accuracy the extent of bowel involvement and the presence of masses and transition points. It is less reliable at identifying adhesions, perforations, or ischemic bowel.

scholarly journals Breath Hydrogen Gas Concentration Linked to Intestinal Gas Distribution and Malabsorption in Patients with Small-bowel Pseudo-obstruction

2009 ◽  
Vol 4 ◽  
pp. BMI.S2139 ◽  
Author(s):  
Yoshihisa Urita ◽  
Toshiyasu Watanabe ◽  
Tadashi Maeda ◽  
Yosuke Sasaki ◽  
Susumu Ishihara ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Close Association ◽  
Bacterial Overgrowth ◽  
Hydrogen Gas ◽  
Abdominal Radiograph ◽  
Breath Hydrogen ◽  
Plain Abdominal Radiograph ◽  
Intestinal Gas

Summary Background The patient with colonic obstruction may frequently have bacterial overgrowth and increased breath hydrogen (H2) levels because the bacterium can contact with food residues for longer time. We experienced two cases with intestinal obstruction whose breath H2 concentrations were measured continuously. Case 1 A 70-year-old woman with small bowel obstruction was treated with a gastric tube. When small bowel gas decreased and colonic gas was demonstrated on the plain abdominal radiograph, the breath H2 concentration increased to 6 ppm and reduced again shortly. Case 2 A 41-year-old man with functional small bowel obstruction after surgical treatment was treated with intravenous administration of erythromycin. Although the plain abdominal radiograph demonstrated a decrease of small-bowel gas, the breath H2 gas kept the low level. After a clear-liquid meal was supplied, fasting breath H2 concentration increased rapidly to 22 ppm and gradually decreased to 9 ppm despite the fact that the intestinal gas was unchanged on X-ray. A rapid increase of breath H2 concentration may reflect the movement of small bowel contents to the colon in patients with small-bowel pseudo-obstruction or malabsorption following diet progression. Conclusions Change in breath H2 concentration had a close association with distribution and movement of intestinal gas.

scholarly journals Superior Mesenteric Venous Thrombosis after Laparoscopic Exploration for Small Bowel Obstruction

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hideki Katagiri ◽  
Shozo Kunizaki ◽  
Mayu Shimaguchi ◽  
Yasuo Yoshinaga ◽  
Yukihiro Kanda ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Abdominal Surgery ◽  
Venous Thrombosis ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Anticoagulation Therapy ◽  
Mesenteric Venous Thrombosis ◽  
Laparoscopic Exploration ◽  
Abdominal Symptoms

Mesenteric venous thrombosis is a rare cause of intestinal ischemia which is potentially life-threatening because it can lead to intestinal infarction. Mesenteric venous thrombosis rarely develops after abdominal surgery and is usually associated with coagulation disorders. Associated symptoms are generally subtle or nonspecific, often resulting in delayed diagnosis. A 68-year-old woman underwent laparoscopic exploration for small bowel obstruction, secondary to adhesions. During the procedure, an intestinal perforation was identified and repaired. Postoperatively, the abdominal pain persisted and repeat exploration was undertaken. At repeat exploration, a perforation was identified in the small bowel with a surrounding abscess. After the second operation, the abdominal pain improved but anorexia persisted. Contrast enhanced abdominal computed tomography was performed which revealed superior mesenteric venous thrombosis. Anticoagulation therapy with heparin was started immediately and the thrombus resolved over the next 6 days. Although rare, this complication must be considered in patients after abdominal surgery with unexplained abdominal symptoms.

scholarly journals Поліорганна дисфункція у хворих на гостру непрохідність тонкої кишки з синдромом ентеральної недостатності в стадії декомпенсації

2015 ◽  
Author(s):  
К. Г. Поляцко
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Organ Dysfunction ◽  
Bowel Obstruction ◽  
Multiple Organ ◽  
Small Intestinal Mucosa ◽  
Multiple Organ Dysfunction ◽  
Acute Small Bowel Obstruction ◽  
Small Intestinal ◽  
Level I

ПОЛІОРГАННА ДИСФУНКЦІЯ У ХВОРИХ НА ГОСТРУ НЕПРОХІДНІСТЬ ТОНКОЇ КИШКИ З СИНДРОМОМ ЕНТЕРАЛЬНОЇ НЕДОСТАТНОСТІ В СТАДІЇ ДЕКОМПЕНСАЦІЇ - Вивчено активність некротичних процесів слизової оболонки тонкої кишки за рівнем I-FABP, особливості розвитку поліорганної дисфункції за модифікованою шкалою G. R. Bernard у хворих на гостру непрохідність тонкої кишки з синдромом ентеральної недостатності в стадії декомпенсації при одномоментній декомпресії тонкої кишки та назоінтестинальній інтубації. Отримані результати дозволяють рекомендувати розширення показання до одномоментної декомпресії через ентеротомний доступ, особливо в осіб похилого та старечого віку.<br />ПОЛИОРГАННАЯ ДИСФУНКЦИЯ В БОЛЬНЫХ ОСТРОЙ НЕПРОХОДИМОСТЬЮ ТОНКОЙ КИШКИ С СИНДРОМОМ ЭНТЕРАЛЬНОЙ НЕДОСТАТОЧНОСТИ В СТАДИИ ДЕКОМПЕНСАЦИИ - Изучена активность некротических процессов слизистой оболочки тонкой кишки по уровню I-FABP, особенности развития полиорганной дисфункции по модифицированной шкале G. R. Bernard у больных острой непроходимостью тонкой кишки с синдромом энтеральной недостаточности в стадии декомпенсации при одномоментной декомпрессии тонкой кишки и назоинтестинальной интубации. Полученные результаты позволяют рекомендовать расширение показания к одномоментной декомпрессии через энтеротомный доступ, особенно у лиц пожилого и старческого возраста.<br />MULTIPLE ORGAN DYSFUNCTION IN PATIENTS WITH ACUTE SMALL BOWEL OBSTRUCTION WITH SYNDROME OF ENTERAL INSUFFICIENCY IN DECOMPENSATED STAGE - Studied the activity of necrotic processes of small intestinal mucosa by level I-FABP, especially the development of multiple organ dysfunction on a modified scale G. R. Bernard in patients with acute small bowel obstruction with syndrome of enteral insufficiency in decompensated at one stage decompression of the small intestine and nazointestynalniy intubation. The results allow us to recommend expanding the indications for decompression-stage through enterotomnyy access, especially in elderly and senile patients.<br />Ключові слова: непрохідність тонкої кишки, енте- ральна недостатність, вибір методу інтубації.<br />Ключевые слова: непроходимость тонкой кишки, энтеральная недостаточность, выбор метода интубации.<br />Key words: small bowel obstruction, enteral failure, choice of method intubation.

scholarly journals Atypical Presentation of Celiac Disease: Recurrent Acute Small Bowel Obstruction

2021 ◽  
Vol 14 ◽  
pp. 117954762098615
Author(s):  
El Qadiry R ◽  
Lalaoui A ◽  
Nassih H ◽  
Aitsab I ◽  
Bourrahouat A
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Tissue Transglutaminase ◽  
Intestinal Tuberculosis ◽  
Abdominal Ultrasound ◽  
Normal Serum ◽  
Watery Diarrhea ◽  
Recurrent Intussusception

Context: Intussusception is the most common cause of small bowel obstruction in children under 4 years of age. Intussusception is not a widely recognized complication of celiac disease. Case Report: We present a clinical case of a 23-month-old boy with a 1-month history of watery diarrhea complicated by 2 episodes of intestinal obstruction, both had required surgery. He presented with acute and severe abdominal distention with bilious vomiting, and an appearance of intussusception on abdominal ultrasound. Upon further investigation, the diarrhea was found to be malabsorptive. The diagnosis of celiac disease was confirmed by the presence of specific serum autoantibodies (IgA Tissue transglutaminase and endomysium Antibodies >200 UI/ml with normal serum IgA level). He started a gluten-free diet and his symptoms were almost completely resolved. Conclusion: Recurrent intussusception may be associated with celiac disease, so celiac serology is recommended in children with recurrent intussusceptions. However, intestinal tuberculosis and lymphoma associated with enteropathy should be considered in the differential diagnosis. Intussusception in celiac disease is usually transient and should be managed expectantly rather than early surgical reduction.

Spontaneous Resolution of Small Bowel Obstruction in a Child following Rupture of a Small Bowel Duplication Cyst

Ultrasound ◽  
2011 ◽  
Vol 19 (4) ◽  
pp. 221-223
Author(s):  
K Patel ◽  
J Jacob ◽  
J Flavill ◽  
M Sellars
Keyword(s):  
Differential Diagnosis ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Paediatric Population ◽  
Duplication Cyst ◽  
Spontaneous Resolution ◽  
Enteric Duplication

Duplication cysts are rare congenital malformations that can present with a variety of symptoms that may change during the course of an acute admission. We report a case in which a four-year-old boy presented with signs of small bowel obstruction that following imaging were found to be secondary to bowel compression by a large duplication cyst. The symptoms changed when the cyst ruptured. We highlight the importance of ultrasound in establishing the diagnosis of enteric duplication cysts in the symptomatic paediatric population. We also explore the differential diagnosis and complications that can be caused by these congenital anomalies.

scholarly journals A Rare Case of Endometriosis of the Small Bowel

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Moisés R. Zepeda ◽  
Su K. Win
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Clinical Condition ◽  
Rare Case ◽  
High Index ◽  
Clinical Event ◽  
Clinical Encounters ◽  
Abdominal Symptoms ◽  
High Index Of Suspicion

Endometriosis of the small bowel is a rare clinical event. The clinical condition presents with vague abdominal symptoms and is usually not diagnosed acutely, unless clinicians have a high index of suspicion. Most patients are diagnosed after multiple clinical encounters. We present a case of endometriosis causing small bowel obstruction diagnosed postsurgically.

scholarly journals Improved Transnasal Ileus Tube Technique for Intractable Adhesive Small Bowel Obstruction

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 222s-222s
Author(s):  
E.-S. Li
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Multiple Organ ◽  
Full Recovery ◽  
Tube Placement ◽  
Adhesive Small Bowel Obstruction

Background: Although up to 90% of patients experienced full recovery following long-tube decompression, without the need for surgical intervention, the remaining patients do not yield any benefit from the use of long nasointestinal tubes and require surgical intervention. Aim: To introduce an improved transnasal ileus tube technique for intractable adhesive small bowel obstruction (ASBO), and evaluated its efficacy in the management of intractable ASBO. Methods: 54 patients with intractable ASBO were treated with the improved transnasal ileus tube technique. The obstructions were passed through by balloon relay, and the adhesions were resolved by repeated to-and-fro movements of the ileus tube. Enterographic results were categorized as complete or incomplete resolution of the obstructions. Data on the technical success, final enterographic results, mortality, morbidity, and the final clinical outcome were collected, and follow up was performed at 1, 3, 6, and 12 months, and then yearly after the procedure. Results: Transnasal ileus tube placement was successful in all patients. Navigation and passage of the ileus tube through the obstructions to the colon were successful in 87% of the attempted tubes (47/54) and failure in 7 patients (4 patients due to severe obstruction and 3 patients due to the presence of a true stricture in the small bowel). Follow-up enterograms over 3-38 months indicated smooth passage of the contrast medium through the small bowel, without any difficulty, in 48 patients. Full recovery from ASBO was achieved in 48 patients (mean duration, 20.16 ± 10.04 months; range, 6-45 months). Six patients died of multiple organ failure without recurrent ASBO, and the clinical symptoms of small bowel obstruction recurred 2 patients. Conclusion: The improved transnasal ileus tube technique is a novel, safe, and effective technique that enables intractable ASBO resolution.

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