scholarly journals Fatal attraction: A case of multiple magnet ingestion in an infant

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Neehar Patil ◽  
◽  
Abhishek Chaturvedi ◽  
Padmalatha S Kadamba ◽  
Jeevak Shetty ◽  
...  
Keyword(s):  
Small Bowel ◽  
Young Children ◽  
Foreign Bodies ◽  
Magnetic Beads ◽  
Loop Ileostomy ◽  
Exploratory Laparotomy ◽  
Case Presentation ◽  
Fatal Attraction ◽  
Magnet Ingestion

Background: Foreign body ingestion is common amongst young children, and they tend to pass spontaneously in most. Multiple magnet ingestion, though not very common, requires early intervention to avoid serious complications. Case presentation: A 1 year old infant was brought to us with symptoms of bilious vomiting and abdominal pain. A plain abdominal x ray revealed presence of multiple radio opaque foreign bodies adherent to each other, lying in the small bowel. This raised the suspicion of accidental ingestion of multiple magnets, which was confirmed on detailed interrogation of the parents. An exploratory laparotomy revealed volvulus with pressure necrosis causing multiple perforations of the small bowel, for which a bowel resection with anastomosis and a loop ileostomy was performed, also all the magnetic beads were removed intact. The stoma was reversed after 4 weeks. At follow up the child has grown well with no residual complaints. Conclusion: The importance of early detection and intervention in a case of multiple magnet ingestion in children should be emphasised amongst the parents of young children. Spread of awareness by the primary paediatricians would help in reducing the morbidity and mortality. Keywords: multiple magnets; intestinal obstruction; perforation.

scholarly journals Double Magnet Ingestion Causing Intestinal Perforation with Peritonitis: Case Report and Review of the Literature

2022 ◽  
Vol 2022 ◽  
pp. 1-4
Author(s):  
Yousef S. Abuzneid ◽  
Hussam I. A. Alzeerelhouseini ◽  
Abdelrahman Rabee ◽  
Wafa Aqel ◽  
Rawan F. Ayyad ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Exploratory Laparotomy ◽  
Fistula Formation ◽  
Uneventful Recovery ◽  
Lower Quadrant ◽  
Case Presentation ◽  
Magnet Ingestion ◽  
The Right ◽  
Right Lower Quadrant

Introduction. Foreign body ingestion is a common pediatric complain, and most can be passed spontaneously; however, magnetic object ingestion is rather rare, and they can cause severe complications when multiple magnets are ingested, as they lead to entrapment of bowel walls between them, causing ischemia, pressure necrosis, perforation, and fistula formation. Case Presentation. Herein, we present a case of a 16-month-old female patient presented to our department complaining of continuous vomiting for two days along with fever and irritability. X-ray revealed dilated bowel loops with a radioopaque foreign body in the right lower quadrant. After discussing with the parents, exploratory laparotomy was done, showing two bowel perforations at the site of the magnets. Affected bowel was resected with anastomosis. The patient was discharged after 3 days with an uneventful recovery. Discussion. The diagnosis and management of magnet ingestion differ from those of small foreign bodies, which are usually managed conservatively by watchful waiting. Usually, the diagnosis is done due to complications such as peritonitis and death. On the other hand, management depends on the number, size, magnetic field, and shape of the magnet, and whether it has passed the pylorus or not. Conclusion. It is important to establish the diagnosis of this condition as early as possible to prevent complications. Despite the efforts that were made to try to prevent and minimize the risk of magnet ingestion, more investigations are required to reach a common and united strategy for management of such conditions.

scholarly journals The Presentation of Multiple Perforations in the Small Bowel as Cytomegalovirus Related Immune Reconstitution Inflammatory Syndrome in an HIV-infected Patient: a Case Report

2021 ◽  
Author(s):  
Wang Yanli ◽  
Xuyong Lin ◽  
Yuji Li ◽  
Ying Wen
Keyword(s):  
Small Bowel ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Exploratory Laparotomy ◽  
Pathological Examination ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract Background: Multiple perforations in the small bowel as cytomegalovirus (CMV) related immune reconstitution inflammatory syndrome (IRIS) in an human immunodeficiency virus (HIV)-infected patient is very rare. Up to now, only five IRIS-associated cases including our case were reported. We performed pathological examination, metagenomic next-generation sequencing (mNGS), CMV and immune cells immunohistochemical staining for rapid diagnosis and differential diagnosis.Case presentation: We describe a case with multiple perforations in the small bowel as CMV related IRIS in an HIV-infected patient. The patient appeared multiple perforations in the small bowel after 26 days of antiretroviral therapy (ART). The patient underwent exploratory laparotomy. Partial resection and surgical repair of small intestine were performed. CMV enteritis was confirmed by immunohistochemistry staining and other opportunistic infections were excluded by mNGS. However, he died from intestinal obstruction and septic shock at 55 days after surgery. Conclusions: Perforations due to CMV related IRIS are very rare, and usually lack the prodromal period symptoms of abdominal pain and diarrhea. It is not easily foreseen and appears shortly after ART. The condition of intestinal perforations is lethal, and early identification and surgical treatment are lifesaving.

scholarly journals Brown Bowel Syndrome Is a Rare and Commonly Missed Disease: A Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Joaquin Ponce-Zepeda ◽  
Wenchang Guo ◽  
Giorgioni Carmen ◽  
Daniel Moon Kim ◽  
Gregory C. Albers ◽  
...  
Keyword(s):  
Vitamin E ◽  
Small Bowel ◽  
Chronic Diarrhea ◽  
Muscularis Propria ◽  
Mitochondrial Damage ◽  
Vitamin E Deficiency ◽  
Case Presentation ◽  
History Of ◽  
Resected Small Bowel

Background. Brown bowel syndrome (BBS) is a rare gastrointestinal condition, and vitamin E deficiency has been considered to be a main contributor. However, vitamin E deficiency has been found in only a few patients throughout the published literature studies and its cutoff lab value for diagnosis is not entirely clarified. Case Presentation. A 56-year-old female patient with a history of congenital bowel obstruction (repaired at birth) presented with bloating, abdominal pain, and chronic diarrhea. Endoscopy identified unremarkable gastrointestinal mucosa except a few small polyps in the colon. A partial obstruction was detected by a small bowel follow-through series and then confirmed by CT scan. The resected small bowel was significantly dilated with a thickened brown wall and extensive serosal adhesion. Microscopic examination revealed unremarkable mucosa, but dense granular brown pigments were identified in the cytoplasm of the smooth muscle cells in the muscularis propria. These deposits resulted to be lipofuscin, and BBS was diagnosed. The patient was asymptomatic at 9-month follow-up after surgery without vitamin E supplement. Conclusion. Mitochondrial damage with lipofuscin deposition is at the root of BBS pathogenesis. Any etiology associated with mitochondrial damage can cause this disease, and vitamin E deficiency is just one of them. Dysmotility from extensive serosal adhesion could be a possible etiology for this patient. Due to overlapping symptoms, lipofuscin deposition primarily in the muscularis propria, and unclear serum value of vitamin E, this syndrome is often missed in routine clinical practice from the superficial biopsy. A transmural biopsy is necessary for a definite diagnosis.

EP.FRI.614 An Atypical Case of Small Bowel Obstruction in the Virgin Abdomen: Case Presentation and Literature Review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tarak Chouari ◽  
Hamza Khan ◽  
Tanzeela Gala ◽  
Serena Ceraldi
Keyword(s):  
Small Bowel ◽  
Literature Review ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Treatment Algorithm ◽  
Operative Management ◽  
Case Presentation ◽  
Atypical Case ◽  
Low Threshold

Abstract Aims The management of post-operative adhesional small bowel obstruction (SBO) has shifted from the historical motto of “the sun should never rise and set on a complete SBO” to a non operative approach in selected patients. Despite this shift, the operative management of patients with SBO with a virgin abdomen is still encouraged.  Methods We present an atypical case of SBO managed conservatively with resolution, without surgical intervention. A literature review is conducted and our case compared with the current literature. A treatment algorithm is presented.  Results A 57 year old with a virgin abdomen presented with vomiting and abdominal pain. Computed tomography was consistent with mid to distal SBO proximal to the terminal ileum, in the context of a high riding caecum. He was managed conservatively. Symptoms resolved within 12 hours without gastrograffin. Gastrograffin was subsequently given to ensure contrast was present in the large bowel. At 6 month follow up he remains symptom free. Discussion Many advocate surgery is the cornerstone of the management of SBO in the virgin abdomen. There is little evidence to support this. Recent emerging evidence challenges this view. Ultimately the clinical evaluation of the patient is paramount in selecting which patients can be managed conservatively. A longer interval to operation may carry greater risk of ischaemia and bowel resection. Therefore careful patient selection and serial examination is vital and one should have a low threshold for early operative intervention in the patient which isn't settling. Follow up should be tailored to each patient.

scholarly journals Obscure gastrointestinal bleeding caused by congenital enteropathy in a Chinese young child-a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Youhong Fang ◽  
Weizhong Gu ◽  
Youyou Luo ◽  
Jie Chen
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Occult Blood ◽  
Albumin Level ◽  
Obscure Gastrointestinal Bleeding ◽  
Compound Heterozygous ◽  
Case Presentation ◽  
Exclusive Enteral Nutrition ◽  
Precise Diagnosis

Abstract Background SLCO2A1 was recently reported to cause nonspecific ulcers at small bowel, it was named as chronic enteropathy associated with SLCO2A1 (CEAS). It was rarely reported beyond the Japanese population. Case presentation A 4-year-5-month old girl presented with intractable anemia since 1-year-3-month. Her stool occult blood test was positive and the result of esophagogastroduodenoscopy and colonoscopy were normal. She was considered as obscure gastrointestinal bleeding. The magnetic resonance enterography and ultrasound of small intestinal revealed segmental thickening of small bowel. The capsule endoscopy detected ulcers, erosion and slightly stenosis near the site of junction of jejunum and ileum. She was considered chronic non-specific multiple ulcers of the small intestine and was advised to have whole exon sequencing. She was treated with exclusive enteral nutrition and iron supplement for two months. However, she was not responsive to this treatment, then she had three doses of infliximab. At the same time, the next-generation sequencing of this patient revealed two novel compound heterozygous mutations in SLCO2A1. She was diagnosed with CEAS and was treated with oral mercaptopurine. Her hemoglobin level was stable and the serum albumin level was slightly decreased during the follow up. Conclusion CEAS may present as nonspecific small bowel ulcers, and misinterpret as small bowel Crohn’s disease. Genetic tests may help with the precise diagnosis of small bowel ulcers.

scholarly journals Open surgery retrieval of a missing guidewire causing cerebral infarctions after cerebral angiography: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Cerebral Angiography ◽  
Open Surgery ◽  
Foreign Bodies ◽  
Treatment Options ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Long Time ◽  
Multiple Cerebral Infarctions ◽  
Selection Of

Abstract Background Intra-aortic foreign body (IAFB) is uncommon, which is usually caused by a rupture of the catheter or guidewire. IAFB can cause catastrophic complications, including arrhythmia, embolization of guidewire fragments, intravascular clipping of the guidewire and vascular perforation. However, there are still no guidelines on removal and management of IAFB. Here, we present a rare case of fractured cerebral angiographic guidewires in the aorta that resulted in multiple cerebral infarctions. Case presentation A 50-year-old man experienced new cerebral infarction after cerebral angiography. Computed tomography and echocardiography demonstrated foreign bodies in his ascending aorta and aortic arch. Open surgery was successfully performed to retrieve the guidewires. The postoperation and follow-up was uneventful. Conclusion It is very important for interventional radiologists to check the catheter and guidewire after operation and perform ultrasound or radiograph to prevent IAFB. Additionally, the effective management of IAFB requires the early detection and the selection of appropriate treatment options, as well as long-time follow up.

scholarly journals HAZARDS OF MULTIPLE MAGNET INGESTION IN CHILDREN;

2013 ◽  
Vol 20 (04) ◽  
pp. 634-637
Author(s):  
MUHAMMAD ALI SHEIKH ◽  
TARIQ LATIF ◽  
MASOOM ALI SHAH ◽  
Jamil AKHTAR ◽  
Abdul Qayuum
Keyword(s):  
Foreign Body ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Clinical Features ◽  
Exploratory Laparotomy ◽  
Paediatric Population ◽  
Foreign Body Ingestion ◽  
Magnet Ingestion ◽  
Pass Through ◽  
Subacute Intestinal Obstruction

Foreign body ingestion is relatively common in the paediatric population and most object pass through the gastrointestinaltract spontaneously. With the popularity of small magnetic toys, there have been numerous reports of magnet ingestion with morbidityand even mortality. We report a case of 3-years old boy who presented with clinical features of subacute intestinal obstruction with nohistory of foreign body ingestion. On exploratory laparotomy, he was found to have multiple small bowel perforations due to two smallmagnets. Magnets were removed and perforations repaired. The aim of this report is to awarepaediatricians of the importance of earlysurgical referral in case of magnet ingestion, to prevent severe complications.

scholarly journals Tuberculous Perforation of Meckel’s Diverticulum

2021 ◽  
Author(s):  
JB Dharmesh ◽  
Abhishek Mahna ◽  
Parth M Khanpara ◽  
Marmik Sheth ◽  
Vanshika Munjal
Keyword(s):  
Loop Ileostomy ◽  
Meckel’S Diverticulum ◽  
Intestinal Tuberculosis ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Meckel's Diverticulum ◽  
Rebound Tenderness ◽  
Antitubercular Treatment ◽  
Uncommon Complication

Meckel’s Diverticulum (MD) is an example of a true diverticulum, consisting of all the three layers of small intestine. It is a remnant of omphalomesenteric (vitellointestinal) duct found on the antimesenteric side of the ileum. Perforation of MD is an uncommon complication of an effectively uncommon abnormality, which regularly mimics an appendicular perforation clinically. Although intestinal tuberculosis is a major issue in many parts of the world, a handful of cases of tubercular perforation of MD have been reported in the literature till date. This case of tubercular perforation of MD was reported due to the rarity of the condition and presence of fairly less literature on the topic. A 30-year-old male patient presented with abdominal pain, fever, vomiting. On examination, tachycardia, guarding, rigidity and rebound tenderness were observed. Exploratory laparotomy revealed perforation of MD with inflammation of ileum and caecum with dense adhesions. Proximal loop ileostomy was made. Histopathology showed features of tuberculosis. Postoperative recovery was uneventful and patient was started on antitubercular treatment and 4 kgs weight gain on follow-up after one month.

scholarly journals Recurrent Enterolithiasis Small Bowel Obstruction: A Case Seldom Described

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ashish Lal Shrestha ◽  
Pradita Shrestha
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Diffuse Abdominal Pain ◽  
Case Presentation ◽  
Rare Phenomenon ◽  
Significant Clinical Improvement ◽  
History Of ◽  
High Index Of Suspicion

Background. Enterolithiasis of the small bowel is a rare phenomenon in humans although it has been frequently described in equines. Primary enteroliths have been described including those occurring secondary to conditions like Crohn’s disease, small bowel diverticula, tuberculous or postoperative strictures, and blind loops but those occurring in an otherwise normal gut are exceedingly rare. Of even greater rarity is a recurrent small bowel enterolith presenting with obstruction. This may be the first report of such kind.Case Presentation. A 70-year-old man undergoing treatment for stable alcoholic liver disease presented to the emergency with gradually progressive diffuse abdominal pain associated with vomiting and constipation for 7 days. He had gaseous abdominal distention but was not obstipated. He had a history of 2 laparotomies in the past for small bowel obstruction secondary to enterolith impaction. He was initially managed conservatively but since there was no significant clinical improvement, he underwent an exploratory laparotomy. A recurrent enterolith 5 × 5 cm in size was found impacted in the mid ileum with multiple dense serosal adhesions and bands. Adhesiolysis and enterotomy with removal of enterolith were performed.Conclusion. Recurrent enterolithiasis of the small bowel is a rare phenomenon and may present with recurrent obstruction. Definitive preoperative diagnosis is not always possible and a high index of suspicion is required to avoid table misdiagnosis. Surgery is the mainstay of treatment once conservative measures fail. Laparoscopic methods may help in diagnosis and avoid possibility of a subsequent adhesive bowel obstruction but are associated with technical challenges.

scholarly journals Male Sexual Assault – A Case Report of Foreign Body in the Rectum from Sexual Assault by Female Partner

2020 ◽  
pp. 186
Author(s):  
Keyword(s):  
Sexual Assault ◽  
Foreign Bodies ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Female Partner ◽  
Male Sexual Assault ◽  
Rectal Foreign Bodies ◽  
Depth Study ◽  
History Of

Most rectal foreign bodies (FB) are a result of insertion for sexual gratification. FB in the rectum as. result of sexual assault in males by the female partner is rare. A 32-year-ol man presented with a 6-day history of deep anal pain and lower abdominal pain, following an assault by a female partner while he was drunk. Physical examination and plain radiography confirmed a FB in the rectum. The FB was removed at exploratory laparotomy following failed attempt at trans rectal removal under spinal anaesthesia. The FB was confirmed to be a perfume canister. The patient has remained well at two months of follow up. Male sexual assault by female is not uncommon and can lead to disastrous effects. The female sexual assault on male is underreported and reported usually when there are complications. There is need to do more in-depth study to investigate the incidence of this.

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