Successful management of adhesion related small bowel ischemia without intestinal resection: A case report and review of literature

Abstract Background Multiple small-bowel diverticulosis comprises a rare entity with probable underestimated incidence, and that may be the reason why it is sometimes overlooked when managing cases with peritonitis. Case report In the present paper, we report the case of a 76-year-old male presenting abdominal pain and fever in an acute setting. Computed tomography (CT) scans revealed jejunal thickening and numerous images of saccular addition that were interpreted as jejunoileal diverticulitis. After an initial period of clinical treatment, surgical management was indicated based on a worsening clinical picture and the presence of an extraluminal focus of gas detected in a subsequent CT scan. Through a laparoscopic approach, multiple small-bowel diverticula and a tamponade perforation were found. A segmental intestinal resection was performed, and the patient was discharged after a ten days. Conclusions Multiple jejunal diverticulosis is a rare condition that should be remembered in the setting of an acute abdomen. As it prevails among older patients, early diagnosis with radiological aid is crucial to establish the most adequate management, including intestinal resection, if necessary.

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Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature

American Journal of Case Reports ◽

10.12659/ajcr.894180 ◽

2015 ◽

Vol 16 ◽

pp. 496-500 ◽

Cited By ~ 5

Author(s):

Larry W. Cohen

Keyword(s):

Case Report ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Peritoneal Mesothelioma ◽

Review Of Literature

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Invasive Gastrointestinal and Cutaneous Mucormycosis in Deceased Donor Small Bowel Transplantation: Case Report and Review of Literature

The Journal of the Korean Society for Transplantation ◽

10.4285/jkstn.2009.23.2.172 ◽

2009 ◽

Vol 23 (2) ◽

pp. 172 ◽

Cited By ~ 1

Author(s):

Jung Min Huh ◽

Gum O Jung ◽

Choon Hyuck Kwon ◽

Jae-Won Joh ◽

Sung-Joo Kim ◽

...

Keyword(s):

Case Report ◽

Small Bowel ◽

Small Bowel Transplantation ◽

Deceased Donor ◽

Review Of Literature ◽

Cutaneous Mucormycosis

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Small Bowel Ischemia after Roux-en-Y Gastric Bypass Complicated by Pregnancy: A Case Report

The American Surgeon ◽

10.1177/000313480507100312 ◽

2005 ◽

Vol 71 (3) ◽

pp. 231-234 ◽

Cited By ~ 8

Author(s):

Anthony Charles ◽

Shirley Domingo ◽

Aaron Goldfadden ◽

Jason Fader ◽

Richard Lampmann ◽

...

Keyword(s):

Morbid Obesity ◽

Gastric Bypass ◽

Case Report ◽

Small Bowel ◽

Bowel Ischemia ◽

Unusual Complication ◽

Childbearing Age ◽

Diffuse Abdominal Pain ◽

Gastric Bypass Procedure ◽

History Of

Small bowel obstruction is an unusual complication of pregnancy. Its occurrence after Roux- en-Y gastric bypass (RYGB) for morbid obesity complicated by pregnancy is rare. Morbid obesity describes body weight at least 100 lb over the ideal weight, or a body mass index (BMI) ≥40. Surgery offers the only viable treatment option with long-term weight loss and maintenance. This case report involves a 23-year-old female at 25 weeks gestation with a 1-day history of diffuse abdominal pain and vomiting. She had a RYGB with a 15 cc micropouch 6 months prior to the commencement of this pregnancy. All radiologic investigations were normal. Esophagogastroscopy was performed revealing an ischemic Roux limb of the gastric bypass. At laparotomy, an internal hernia involving the afferent limb was identified at the site of the Roux anastomosis compromising portions of both the afferent and Roux limbs. Nonviable portions of both the afferent and Roux limbs were resected. Gastrointestinal continuity was achieved by fashioning a gastro-gastrostomy and a jejuno-jejunostomy, thus reversing the original gastric bypass procedure. The immediate postoperative period was complicated by fetal demise. With the increase in bariatric surgery, small bowel ischemia after Roux- en-Y gastric bypass will most likely become more prevalent, particularly in women of childbearing age.

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