Hepatic portal vein gas in gastric outlet obstruction

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Kan Radeesri ◽  
◽  
Suphakarn Techapongsatorn ◽  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Abdominal Distension ◽  
Abdominal Radiograph ◽  
Upper Gastrointestinal Endoscopy ◽  
Peptic Ulcer Perforation ◽  
Peptic Ulcers ◽  
History Of ◽  
Hepatic Portal ◽  
Upper Abdomen

A 55-year-old man presented to an emergency department with a history of abdominal pain and vomiting for one week. He had a history of having peptic ulcer perforation surgery. He appeared weak and frustration from pain, abdominal distension at upper abdomen without peritonitis sign on physical examination. Initial abdominal radiograph revealed pneumoperitoneum under both hemidiaphragms with markedly distension of stomach containing food content. Further computed tomography demonstrated evidence of gastric outlet obstruction without intra or extraluminal mass. There is also massive amount of portal venous gas in both lobes of liver. After patient resuscitation with intravenous fluid and nasogastric intubation for gastric decompression, his condition returned to normal, with no sign of peritonitis nor sepsis. Therefore, the upper gastrointestinal endoscopy showed gastric outlet obstruction from chronic peptic ulcers. The endoscopic balloon dilatation of the obstruction part was successful, and he was discharged home with full recovery in one week.

scholarly journals Medication Bezoar Causing acute Gastric Outlet Obstruction: A Case Report

2016 ◽  
Vol 33 (3) ◽  
pp. 177-180 ◽  
Author(s):  
Md Abdul Mazid
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Uneventful Recovery ◽  
Upper Gastrointestinal Endoscopy ◽  
Abdominal Ultrasonography ◽  
Life Threatening ◽  
History Of ◽  
Upper Gastrointestinal ◽  
Made In

Medication bezoars are rare and are composed of medications and/or medication vehicles. Rarely, medication bezoars can cause serious problems due to complications such as perforation, obstruction, haemorrhage. A 60 years old woman presented with 10 days history of epigastric pain, weakness and postprandial non-bilious vomiting. Her abdominal ultrasonography showed strong post acoustic shadow noted within 1st part of duodenum possibly foreign body. Upper gastrointestinal endoscopy was performed and a bezoar of tablet of aluminum hydroxide was extracted. The patient had uneventful recovery. Acute gastric outlet obstruction is relatively uncommon and mostly due to foreign bodies related to food impaction, with meat being the most frequent culprit. The diagnostic approach to acute gastric outlet obstruction is similar to other cause of GOO. However, therapeutic options differ for each patient. The diagnosis should be made in prompt time to prevent life threatening complications due obstruction and/or effect of medication forming bezoar.J Bangladesh Coll Phys Surg 2015; 33(3): 177-180

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

Bouveret syndrome: a rare cause of gastric outlet obstruction

2021 ◽  
Vol 14 (4) ◽  
pp. e240236
Author(s):  
Christopher Smith ◽  
Shailendra Singh ◽  
Paul Vulliamy ◽  
Samrat Mukherjee
Keyword(s):  
Abdominal Pain ◽  
Gastric Outlet Obstruction ◽  
Gallstone Disease ◽  
Outlet Obstruction ◽  
Chronic Cholecystitis ◽  
Fistula Formation ◽  
Bladder Drainage ◽  
Blood Tests ◽  
History Of ◽  
Bouveret Syndrome

Bouveret syndrome is a rare cause of gastric outlet obstruction. It is characterised by the presence of an obstructing gallstone in the pylorus or proximal duodenum, which has travelled to its obstructing position via an acquired fistula. Our case involves a 73-year-old man presenting to the acute surgical take with a 2-day history of right-sided abdominal pain and vomiting. His medical history included perforated cholecystitis treated with antibiotics and percutaneous gall bladder drainage, 1 year earlier. Examination and blood tests were suggestive of gastric outlet obstruction. CT abdomen and pelvis demonstrated a large gallstone obstructing the duodenum, confirming a diagnosis of Bouveret syndrome. The patient improved following gastrolithotomy, and was discharged 2 weeks postoperatively. Fistula formation is a complication of chronic cholecystitis and therefore Bouveret syndrome should be considered in patients with a background of gallstone disease presenting with gastric outlet obstruction.

scholarly journals Gastric outlet obstruction with an elevated serum pancreatic lipase secondary to an infraumbilical hernia

2013 ◽  
Vol 95 (7) ◽  
pp. e16-e18
Author(s):  
WKB Ranasinghe ◽  
M Smith
Keyword(s):  
Ventral Hernia ◽  
Gastric Outlet Obstruction ◽  
Pancreatic Lipase ◽  
Elevated Serum ◽  
Outlet Obstruction ◽  
Serum Biochemistry ◽  
Uneventful Recovery ◽  
Large Ventral Hernia ◽  
History Of ◽  
Symptoms And Signs

We report the case of a 68-year-old woman who presented with symptoms and signs of gastric outlet obstruction with a history of a ventral hernia. Clinical examination revealed a large ventral hernia with visible peristalsis of the herniated viscera.Initial serum biochemistry revealed a markedly elevated lipase level and deranged renal function.Computed tomography demonstrated an infraumbilical hernia with herniation of the stomach through the ventral defect and distortion of the pancreatic anatomy. The hernia was reduced operatively and repaired, leading to an uneventful recovery.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

scholarly journals An uncommon case of small bowel obstruction due to phytobezoar in a known case of tubercular abdomen: a decisional dilemma

2017 ◽  
Vol 4 (8) ◽  
pp. 2868
Author(s):  
Mayank Mishra ◽  
Neeraj Sharma ◽  
Vivekanand Rai ◽  
Alok Tripathi ◽  
Anil Kumar Keshri
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Distension ◽  
Bowel Loop ◽  
Delay In Diagnosis ◽  
History Of ◽  
To Come ◽  
Mango Seed ◽  
Upper Abdomen

Study report the case of middle aged male who was presented with abdomen pain and diagnosed of small bowel obstruction caused by bezoar in a case of tubercular abdomen and review the literature. The initial presentation was generalised pain with nausea and vomiting and abdominal distension. Plain abdomen film showed diffuse dilated bowel loop in upper abdomen. Patient had similar recurrent episode 12 months back when he was managed conservatively and diagnosed as tubercular abdomen and he had taken ATT for 3 months. At this time patient managed conservatively, but did not respond. Later a CECT whole abdomen was done and patient diagnosed as cocoon abdomen with mass or a foreign body impacted at distal jejunal region with proximal bowel dilatation. Later patient revealed ingestion of a large mango seed 4 months back. Later patient was explored, adhesionolysis and enterotomy was done and phytobezoar was removed. Early history of recurrent tubercular obstruction with non- specific symptoms. Later recognition of condition by typical imaging and leading questions induced history image play an important role in to come to a diagnosis, with significant delay in diagnosis; and increase the morbidity and mortality. 

scholarly journals Rare cause of gastric outlet obstruction: incarcerated pylorus within an inguinal hernia

2012 ◽  
Vol 94 (2) ◽  
pp. e46-e48 ◽  
Author(s):  
I Kerschaever ◽  
S Poelmans ◽  
J Vankeirsbilck ◽  
M Vandewoude
Keyword(s):  
Inguinal Hernia ◽  
Emergency Room ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Abdominal Distension ◽  
Portal System ◽  
Gastric Emphysema

We present the case of a 79-year-old man admitted to the emergency room. Having anorexia and vomiting as main complaints, combined with abdominal distension and discomfort, diagnostic examination revealed a giant left inguinal hernia containing the antrum and pylorus of a dilated stomach, creating an outlet obstruction. This was complicated with free peritoneal air, gastric emphysema and air in the portal system due to ischaemia.

Bouveret-szindróma

2021 ◽  
Vol 162 (49) ◽  
pp. 1982-1986
Keyword(s):  
Gastric Outlet Obstruction ◽  
Elderly Women ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Abdominal Ultrasound ◽  
Therapeutic Options ◽  
Upper Gastrointestinal Endoscopy ◽  
Rare Form ◽  
Bouveret Syndrome ◽  
Upper Gastrointestinal

Összefoglaló. A Bouveret-szindróma egy bilioenteralis fistulán keresztül a vékonybélbe – az esetek 85%-ában a duodenumba – jutó nagy epekő okozta bélelzáródást jelenti. Leggyakrabban idős nők körében fordul elő. Jelen közleményünk célja e kórkép tüneteinek, diagnosztikájának és terápiás lehetőségeinek ismertetése egy esetbemutatás kapcsán. A 79 éves nőbeteg felvételi hasi panaszainak hátterében típusos gyomorkimenet-obstrukciós szindrómát okozó, a duodenumban beékelődött epekő, Bouveret-szindróma igazolódott. A diagnózist az elvégzett natív hasi röntgen és hasi ultrahangvizsgálatok már felvetették, de megerősítésére további képalkotó vizsgálatot (hasi CT) és endoszkópos beavatkozást végeztünk. Ezt követően sebészeti beavatkozás történt, melynek során a cholecystoduodenalis fistula zárása és az epekő eltávolítása után a beteg gyógyultan távozott. Közleményünkben a diagnózisfelállítás idejének fontosságáról, illetve a terápiás lehetőségekről számolunk be, valamint szeretnénk felhívni a figyelmet az epekő okozta gyomorürülési zavar ezen ritka formájára. Orv Hetil. 2021; 162(49): 1982–1986. Summary. Bouveret syndrome is a rare form of bowel obstruction resulting to the small intestine – in 85% of the cases to the duodenum – caused by a gallstone from a bilioenteral fistula. It occurs most commonly in elderly women. The aim of the present study is to describe the symptoms, diagnostic and therapeutic options of Bouveret syndrome due to our case report. The background of epigastric pain of the 79-year-old woman was the typical gastric outlet obstruction syndrome caused by Bouveret syndrome with an impacted gallstone into the duodenum. This diagnosis was suggested by abdominal X-ray and abdominal ultrasound; however, it was confirmed with abdominal computer tomography and upper gastrointestinal endoscopy. This was followed by surgical intervention to close the cholecystoduodenal fistula and remove the gallstone, finally the cured patient was discharged. In our study, we summarize the importance of timely diagnosis and therapeutic options, respectively, furthermore, draw attention to this rare form of gallstone-caused gastric outlet obstruction syndrome. Orv Hetil. 2021; 162(49): 1982–1986.

scholarly journals Highly selective vagotomy and gastrojejunostomy in the treatment of peptic ulcer induced gastric outlet obstruction

2014 ◽  
Vol 71 (11) ◽  
pp. 1013-1017 ◽  
Author(s):  
Nebojsa Radovanovic ◽  
Aleksandar Simic ◽  
Ognjan Skrobic ◽  
Milutin Kotarac ◽  
Nenad Ivanovic
Keyword(s):  
Peptic Ulcer ◽  
Gastric Outlet Obstruction ◽  
Intraoperative Complications ◽  
Outlet Obstruction ◽  
Upper Gastrointestinal Endoscopy ◽  
Ulcer Recurrence ◽  
Selective Vagotomy ◽  
Highly Selective Vagotomy ◽  
Retrospective Clinical Study

Background/Aim. The incidence of peptic ulcer-induced gastric outlet obstruction is constantly declining. The aim of this study was to present our results in the treatment of gastric outlet obstruction with highly selective vagotomy and gastrojejunostomy. Methods. This retrospective clinical study included 13 patients with peptic ulcer - induced gastric outlet obstruction operated with higly selective vagotomy and gastrojejunostomy. A 3-year follow-up was conducted including clinical interview and upper gastrointestinal endoscopy on 1 and 3 years after the surgery. Results. The most common preoperative symptom was vomiting (in 92.3% of patients). The mean preoperative body mass index was 16.3 ? 3.1 kg/m2, with 9 patients classified preoperatively as underweight. There were no intraoperative complications, nor mortality. At a 3-year follow-up there was no ulcer recurrence. Delayed gastric emptying was present in 1, bile reflux in 2, and erosive gastritis in 1 patient. Two patients suffered from mild ?dumping? syndrome. Conclusion. Higly selective vagotomy combined with gastrojejunostomy is a safe and easily feasible surgical solution of gastric outlet obstruction induced by peptic ulcer. Good functional results and low rate of complications can be expected at a long-term follow-up.

scholarly journals Capsule-strip- An Unusual Cause of Acute Gastric Outlet Obstruction: A Case-Report

2013 ◽  
Vol 5 (1) ◽  
pp. 67-68
Author(s):  
AHM Rowshon ◽  
AKM Rafique Uddin
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Pyloric Ring ◽  
Gi Endoscopy ◽  
Blood Tests ◽  
History Of ◽  
Colicky Pain ◽  
Upper Gastrointestinal

A male patient presented with seven days history of severe epigastric colicky pain and vomiting. The patient was anxious and dehydrated. Blood tests and ultrasound reports were unremarkable. . Upper Gastrointestinal (GI) Endoscopy revealed a strip of capsule impacted at pyloric ring which was removed endoscopically and the patient became symptom free. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16252 J Shaheed Suhrawardy Med Coll, 2013;5(1):67-68

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