scholarly journals Presentation of Small Bowel Volvulus in East Africa

2021 ◽  
pp. 251-256
Author(s):  
Richard Wismayer
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Age Groups ◽  
Postoperative Recovery ◽  
Western World ◽  
Small Bowel Volvulus ◽  
Early Surgical Intervention

Introduction: A benign gastrointestinal surgical condition involving torsion of part or all of a segment of small bowel on its mesenteric axis is small bowel volvulus (SBV). The clinical presentation is similar to acute mesenteric ischaemia and hence a preoperative clinical diagnosis is difficult to obtain. In developing countries, as a presenting surgical cause of small bowel obstruction it has contributed to a significant burden. The aim of this case report was to discuss a typical case of small bowel volvulus in a developing country and highlight the importance of resuscitation and early surgical intervention. Presentation of case: A 35 year old lady admitted to hospital with a 3 day history of colicky central abdominal pain. She reported a long period of fasting and sudden ingestion of food. On physical examination her abdomen was moderately distended with minimal tenderness. Laboratory investigations were normal and a plain abdominal X-ray revealed features suggestive of small bowel obstruction. After resuscitation the patient was taken for a laparotomy where evidence of SBV was found. An omental band adhesion was divided, the volvulus untwisted and the small bowel was all viable. The patient made an uneventful postoperative recovery. Discussion: The incidence of SBV is higher in Africa, Asia and the Middle East compared to the Western world. Secondary SBV is more commonly found in older age groups however primary SBV is more common in children. The most common complaints of SBV includes abdominal pain, abdominal distention and vomiting. The mortality rate due to SBV has been found to be decreasing with early diagnosis due to abdominal CT scanning. This reduction in mortality is due to a reduction in the incidence of gangrene of the SBV. Conclusions: Due to the high mortality and variable presentation, surgeons must consider small bowel volvulus a probably diagnosis in a patient with abdominal pain and features of small bowel obstruction. Early surgical intervention is necessary to reduce the morbidity and mortality from SBV.

scholarly journals Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen

2019 ◽  
Vol 12 (7) ◽  
pp. e230496 ◽  
Author(s):  
Joseph Do Woong Choi ◽  
Michael Yunaev
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Oestrogen Receptor ◽  
Surgical Intervention ◽  
Prior History ◽  
Good Recovery ◽  
History Of

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

scholarly journals An Obstructing Small Bowel Phytobezoar in an Elderly Female Nigerian: A Case Report and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
O. S. Balogun ◽  
A. O. Osinowo ◽  
M. O. Afolayan ◽  
A. A. Adesanya
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Primary Closure ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Elderly Female ◽  
Insidious Onset

Small bowel obstruction secondary to phytobezoars is an unusual presentation in surgery. We present a case of an elderly female patient with an insidious onset of abdominal pain, abdominal distension, and bilious vomiting diagnosed radiologically to be small bowel obstruction. Exploratory laparotomy revealed a trapped mass of vegetable matter in the distal ileum. She had enterotomy with primary closure for removal of obstructing ileal phytobezoars. Her postoperative recovery was uneventful.

An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Bowel Wall ◽  
Haemodynamic Instability ◽  
Small Bowel Volvulus ◽  
General Surgeons ◽  
Heavy Infestation ◽  
Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

scholarly journals SMALL BOWEL OBSTRUCTION SECONDARY TO OBTURATOR HERNIA: A PRE-OPERATIVE DIAGNOSIS AT COMPUTED TOMOGRAPHY

2021 ◽  
Vol 6 (1) ◽  
pp. 46-49
Author(s):  
Marlina Tanty Ramli ◽  
Mohd Shukry Mohd Khalid ◽  
Kartini Rahmat
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Elderly Patients ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Obturator Hernia ◽  
Uneventful Recovery ◽  
Presenting Symptoms

Obturator hernia is rare, but it must be considered in elderly patients who present with small bowel obstruction. The diagnosis is challenging unless there is a high index of suspicion as the presenting symptoms and signs are usually non-specific. Presence of positive Howship-Romberg sign is considered pathognomonic. Early diagnosis and rapid surgical intervention will reduce the high morbidity and mortality associated with undiagnosed obturator hernia. We report a case of a 93-year-old female patient who was admitted to our surgical department with symptoms of intestinal obstruction of 3-days duration. Howship-Romberg sign was negative. Computed tomography (CT) demonstrated the presence of left obturator hernia with proximal small bowel obstruction and no sign of strangulation. The patient had emergency laparotomy post-CT where the incarcerated bowel loop was released and the obstructed bowel was decompressed without any complication. The hernial defect was close with a mesh and the patient had an uneventful recovery post-surgery. In this case, we highlight that diagnosis of obturator hernia must always be considered in elderly patients who present with intestinal obstruction. Urgent CT could establish a rapid pre-operative diagnosis and aids inappropriate surgical intervention planning which is crucial in optimising the outcome.

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 Association of Surgical Intervention for Adhesive Small-Bowel Obstruction With the Risk of Recurrence

JAMA Surgery ◽  
2019 ◽  
Vol 154 (5) ◽  
pp. 413 ◽  
Author(s):  
Ramy Behman ◽  
Avery B. Nathens ◽  
Stephanie Mason ◽  
James P. Byrne ◽  
Nicole Look Hong ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Adhesive Small Bowel Obstruction ◽  
Risk Of Recurrence

scholarly journals Small bowel volvulus versus adhesive small bowel obstruction: a diagnostic dilemma in a 19-year-old woman

2019 ◽  
Vol 12 (6) ◽  
pp. e229157
Author(s):  
Kay Tai Choy ◽  
Nathan Brunott
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Adhesive Small Bowel Obstruction ◽  
Diagnostic Study ◽  
Diagnostic Dilemma ◽  
Small Bowel Volvulus ◽  
Intraabdominal Adhesions ◽  
Preoperative Diagnostic ◽  
History Of

Small bowel volvulus (SBV) is often challenging to diagnose. Research suggests that the clinical presentation of this disease is often very similar to other more common causes of small bowel obstruction (SBO) such as intraabdominal adhesions and no single preoperative diagnostic study is sensitive or specific enough to identify this rare cause of mechanical SBO. This report describes a case of a 19-year-old woman who presented with irretractable vomiting and abdominal pain secondary to SBV. This case is unusual as her history of recurrent adhesive SBO presented a diagnostic dilemma that required a higher degree of clinical suspicion to tease these differential diagnoses apart. She underwent laparoscopy which facilitated successful detorsion and resection of the floppy tongue of jejunum. This report aims to increase the awareness among surgeons.

Small bowel obstruction and abdominal pain after robotic versus open radical prostatectomy

2016 ◽  
Vol 50 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Karl-Johan Lundström ◽  
Yasin Folkvaljon ◽  
Stacy Loeb ◽  
Anna Bill Axelson ◽  
Pär Stattin ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Radical Prostatectomy ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Open Radical Prostatectomy

scholarly journals Aspect of laparoscopic treatment of patients with adhesive small bowel obstruction (review of literature)

2020 ◽  
Vol 179 (2) ◽  
pp. 79-84
Author(s):  
M. I. Shkerdina ◽  
S. G. Antonyan ◽  
Yu. O. Zharikov
Keyword(s):  
Postoperative Complications ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Postoperative Recovery ◽  
Adhesive Small Bowel Obstruction ◽  
Laparoscopic Treatment ◽  
Clear Trend ◽  
Extensive Experience ◽  
Number Of Patients

Nowadays, adhesive small bowel obstruction (ASBO) is a disease characterized by the stable increase in the number of patients, a significant level of postoperative complications, and a high risk of disability and death. The objective of the article was the research and analysis of relevant data of video laparoscopic treatment of patients with ASBO and possible postoperative complications. A small percentage of complications in clinical centers with a large flow of patients of this profile and rapid postoperative recovery of patients promote the active introduction of laparoscopic adhesiolysis in practical medicine. The analysis of foreign and domestic literature showed that the faithful adherence of indications for application of the technique for resolving intestinal obstruction and restoring passage through the gastrointestinal tract allows to achieve better results and avoid iatrogenic and infectious complications. Thus, laparoscopic treatment can and should be the operation of choice only in a carefully selected group of patients (the first manifestation of ASBO, the absence of pronounced ischemic changes in the intestinal wall and (or) the predicted presence of a small number of peritoneal adhesions), in all other cases, the use of laparotomy is indicated. Currently, there is a clear trend towards an increasing recognition and use of laparoscopy in surgical practice. It is becoming the preferred choice in clinical centers with extensive experience in the treatment of patients with ASBO due to an insignificant percentage of complications and a rapid postoperative recovery.

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