Detrimental Pneumoperitoneum and Bowel Necrosis Secondary to Dilatation and Curettage: Necessitating the Importance of Healthcare Awareness

Abstract Background In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. Case presentation We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. Conclusions Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.

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A rocky situation: Judicious management of gallstone ileus complicated by bowel necrosis and perforation

ANZ Journal of Surgery ◽

10.1111/ans.17115 ◽

2021 ◽

Author(s):

Rufi Chen ◽

Magdalena Sejka ◽

Ian Campbell

Keyword(s):

Gallstone Ileus ◽

Bowel Necrosis

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A case of portal venous gas after obstructive transverse colon cancer surgery

Surgical Case Reports ◽

10.1186/s40792-019-0729-z ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Yuichiro Furutani ◽

Chikashi Hiranuma ◽

Masakazu Hattori ◽

Kenji Doden ◽

Yasuo Hashizume

Keyword(s):

Colon Cancer ◽

Conservative Treatment ◽

Anastomotic Leakage ◽

Transverse Colon ◽

Cancer Surgery ◽

Transverse Colon Cancer ◽

Bowel Necrosis ◽

Entire Area ◽

Portal Venous Gas ◽

Colon Cancer Surgery

Abstract Background Portal venous gas has traditionally been considered an inevitable harbinger of death due to its association with bowel necrosis. Recently, an increasing number of cases of portal venous gas have been reported in patients with various clinical conditions and without bowel necrosis. We herein report the case of a patient in whom portal venous gas developed after transverse colon cancer surgery. Case presentation A 69-year-old man who had transverse colon cancer underwent insertion of a transanal ileus tube for decompression. Transverse colon resection was performed on the 11th day after the insertion of the transanal ileus tube. The patient had a high fever on the 6th day after the operation. Computed tomography showed portal venous gas over the entire area of the liver and pneumatosis intestinalis in the wall of the ascending colon. There were no signs of anastomotic leakage or bowel necrosis, so we decided to use conservative therapy with fasting and antibiotics. The portal venous gas disappeared on the 19th day after the operation. The patient was discharged in good condition on the 29th day after the operation. Conclusions Conservative treatment for portal venous gas is reasonable for patients without signs of anastomotic leakage or bowel necrosis. However, it is important to carefully observe patients with portal venous gas during conservative treatment because portal venous gas may be life-threatening.

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Imaging of endometrial osseous metaplasia—an uncommon but treatable cause of infertility

Middle East Fertility Society Journal ◽

10.1186/s43043-020-00045-0 ◽

2020 ◽

Vol 25 (1) ◽

Author(s):

Abdul Haseeb Wani ◽

Arshed Hussain Parry ◽

Imza Feroz ◽

Majid Jehangir ◽

Masarat Rashid

Keyword(s):

Inflammatory Cells ◽

Osseous Metaplasia ◽

Dystrophic Calcification ◽

Non Invasive ◽

Dilatation And Curettage ◽

Clinical Scenarios ◽

Uncommon Condition ◽

Urinary Tuberculosis ◽

Hypointense Signal ◽

Metaplastic Ossification

Abstract Background Endometrial osseous metaplasia (EOM) is an uncommon condition characterised by metaplastic transformation of endometrial tissue into osteoblasts (mature or immature bone in the endometrium). Etiopathogenesis of EOM is explained by multiple putative mechanisms like dystrophic calcification, metaplastic ossification, retained foetal bones after abortions and genito-urinary tuberculosis. EOM has varied clinical presentation ranging from patient being asymptomatic to secondary infertility. Although hysteroscopy is the gold standard for its diagnosis and treatment, non-invasive imaging comprising chiefly of ultrasonography (USG) is increasingly becoming the mainstay of diagnosis. We aim to present the imaging findings in EOM to acquaint radiologists and gynaecologists with this condition to avert misdiagnosis of this uncommon yet treatable cause of infertility. Results Mean age of patients was 31.4 ± 5.4 (S.D) years. USG revealed linear or tubular densely echogenic endometrium with posterior acoustic shadowing in all the 14 patients. MRI in 3 patients revealed diffuse or patchy areas of T1W and T2W hypointense signal intensity with unilateral (n = 2) and bilateral (n = 1) ovarian cysts. One patient who underwent CT scan revealed dense endometrial calcification. Histopathologic examination (HPE) revealed lamellar (n = 6) or trabecular (n = 4) bone within endometrium (EOM) and inflammatory cells with calcification in four patients (calcific endometritis). Twelve patients conceived after dilatation and curettage within 15 months. Conclusion Familiarity with the imaging appearances of EOM is indispensable to clinch this diagnosis and avert misdiagnosis of this rare but potentially treatable cause of infertility. USG is usually sufficient for diagnosis. MRI and CT are only supplementary tools in difficult clinical scenarios.

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Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v12i1.22608 ◽

2019 ◽

Vol 12 (1) ◽

pp. 25-30

Author(s):

B Parajuli ◽

G Pun ◽

S Ranabhat ◽

S Poudel

Keyword(s):

Histopathological Examination ◽

Hydatidiform Mole ◽

College Teaching ◽

Histopathological Diagnosis ◽

Age Group ◽

Medical College ◽

Dilatation And Curettage ◽

Partial Mole ◽

Proliferative Endometrium ◽

The Common

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

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