scholarly journals Petersen's hernia after esophagectomy with antesternal jejunal reconstruction: Case report

2017 ◽  
Author(s):  
Kenji Kudo ◽  
Kosuke Narumiya ◽  
Yuji Shirai ◽  
Yosuke Yagawa ◽  
Masaho Ota ◽  
...  
Keyword(s):  
Small Intestine ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Jejunal Loop ◽  
Emergency Laparotomy ◽  
Abdominal Ct ◽  
Right Thoracotomy ◽  
Contrast Enhanced ◽  
Petersen’S Hernia ◽  
Low Density Area

Abstract Petersen's hernia after esophagectomy is quite rare. The patient was a 75-year-old man, who had undergone esophagectomy via right thoracotomy and reconstruction with a jejunal loop by the antesternal route in 2014. In March 2015, severe acute abdominal pain occurred after endoscopy. Contrast-enhanced abdominal CT revealed a diffuse low density area in the abdominal cavity and partial dilatation of the small intestine with torsion of the superior mesenteric artery. The patient underwent emergency laparotomy, revealing chyle-like ascites and pallor of almost the entire small intestine due to circulatory impairment because of strangulation after herniation through Petersen's defect. After strangulation was relieved, the color and motility of the small intestine recovered rapidly. Then we closed the defect between the jejunal pedicle and the transverse mesocolon. This is the first English report showing Petersen's hernia after esophagectomy.

scholarly journals Midgut malrotation with volvulus - a case report

2013 ◽  
Vol 02 (02) ◽  
pp. 082-085
Author(s):  
Pradipta Ray Choudhury ◽  
Prasant Sarda ◽  
Shobhit Singh ◽  
Prabahita Baruah ◽  
K. L. Talukdar
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Artery ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Recurrent Abdominal Pain ◽  
Midgut Malrotation ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

AbstractMidgut malrotation is a rare anatomic anomaly that complicates the diagnosis and management of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. A two years old boy was brought with recurrent abdominal pain and vomiting. On ultrasonography, the intestinal malrotation was suspected and thus contrast enhanced computed tomography (CECT) was done. On CECT, abnormal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV), colon on the left side of the abdominal cavity, 'Whirlpool sign' etc., were found. All findings were suggestive of midgut malrotation with volvulus. Detection of uncomplicated malrotation should not be trivialized because such patients might experience a future complication.

scholarly journals Acute Presentation of Large Size Clear Cell Ovarian Carcinoma as Double Torsed Ovarian Tumor

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 89
Author(s):  
Diana Bužinskienė ◽  
Vilius Rudaitis ◽  
Karolina Misevičiūtė
Keyword(s):  
Acute Abdominal Pain ◽  
Clear Cell ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Abdominal Ct ◽  
Large Size ◽  
Abdominal Ct Scan ◽  
Clear Cell Ovarian Carcinoma ◽  
The Right ◽  
Dark Blue

We report a 46-year-old patient who presented to the emergency department with complaints of acute abdominal pain, nausea, and vomiting. An abdominal CT scan revealed a large (207 × 155 × 182 mm) thin-walled inhomogeneous tumor connected to the uterus and right ovary. Emergency surgery laparotomy was performed. Inside the abdominal cavity, a 30 × 30 cm heterogenous, dark blue tumor in the right adnexa area, torsed two times, weighing 3700 g was found. Histological examination revealed right ovary clear cell carcinoma. We emphasize the rare nature of the histology and presentation of this case report. Ovarian clear cell carcinomas are relatively rare malignancies, presenting in 5 to 10% of ovarian malignant tumors in the west.

Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

scholarly journals Minilaparotomy a Good Option in Specific Cases: A Case Report of Bilateral Ovarian Germ Cell Tumor

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
D. Bolla ◽  
N. Deseö ◽  
A. Sturm ◽  
A. Schöning ◽  
C. Leimgruber
Keyword(s):  
Acute Abdominal Pain ◽  
Adnexal Mass ◽  
Past History ◽  
Ovarian Tissue ◽  
Abdominal Cavity ◽  
Operating Time ◽  
Expectant Management ◽  
Small Incision ◽  
Risk Of Rupture ◽  
The Right

Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.

Providing Comfort or Prolonging Death for a Baby with “Dead Gut Syndrome”?

1999 ◽  
Vol 8 (4) ◽  
pp. 538-538 ◽  
Author(s):  
MARK G. KUCZEWSKI
Keyword(s):  
Small Intestine ◽  
Prenatal Diagnosis ◽  
Abdominal Cavity ◽  
Length Of Gestation

The patient was born at 29 weeks gestation. There was a prenatal diagnosis that the child's small intestine had developed outside of the abdominal cavity. The length of gestation had made the initial prognosis good. But after birth, surgery to place the intestine back into the abdominal cavity found that the baby actually had very little small intestine and a diagnosis of “dead gut syndrome” was made. The amount of small intestine was not compatible with survival. The transplant service saw the baby twice and each time said the baby's profile did not meet the transplant protocol.

scholarly journals Ileal strangulation around mesovarium in a newborn foal

2019 ◽  
Vol 75 (08) ◽  
pp. 6288-2019
Author(s):  
ROLAND KUSY ◽  
BEATA NOWICKA ◽  
BEATA ŻYLIŃSKA ◽  
MARIOLA BOCHNIARZ ◽  
ROMAN DĄBROWSKI
Keyword(s):  
Small Intestine ◽  
Acute Abdominal Pain ◽  
Postoperative Recovery ◽  
Tube Placement ◽  
Oxygen Supplementation ◽  
Intratracheal Administration ◽  
Somatic Development ◽  
Endotracheal Tube Placement ◽  
The Right ◽  
Observation Period

The article presents a case of a newborn foal (32 hours of life) with an acute abdominal pain. The foal was sent to the clinic after 24 hours of conservative treatment in the field. Physical examination revealed acute obstruction of the small intestine. The patient was admitted for emergency surgery. General multimodal anaesthesia with endotracheal tube placement and oxygen supplementation was performed. During medial laparotomy, about one meter of necrotic small intestine was resected, and the right ovary was removed. This surgical procedure was performed under general infusion multimodal anaesthesia with intratracheal administration of a mixture of oxygen and air. Postoperative recovery was uneventful, and no complications were observed. During the 5-month observation period, no disturbances in the somatic development and general condition of the patient were found.

scholarly journals Neuroendocrine tumor of the small intestine diagnosed with trans-abdominal ultrasonography: A case report

2020 ◽  
Author(s):  
Kazuma Tsujimura ◽  
Yasukatsu Takushi ◽  
Atsushi Nakachi ◽  
Tsuyoshi Teruya ◽  
Kouji Iha
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Neuroendocrine Tumor ◽  
Clinical Symptoms ◽  
Abdominal Ultrasonography ◽  
Node Metastasis ◽  
Tumor Lesion ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography

Tumors of the small intestine are rare. In addition, clinical symptoms are nonspecific and neoplasm-related symptoms occur late. We report a case of neuroendocrine tumor (NET) of the small intestine that was diagnosed early with trans-abdominal ultrasonography (US). The patient was a 61-year-old man. Abdominal contrast-enhanced computed tomography (CT) was performed because the patient complained of abdominal pain. The CT showed a tumor lesion in the mesentery. Trans-abdominal US was undertaken to evaluate this tumor lesion, and a tumor lesion of the small intestine was found nearby. A diagnosis of lymph-node metastasis of a small-intestine tumor was made as a preoperative diagnosis. A laparotomy was performed with partial resection of the ileum, together with the small-intestine mesentery including an enlarged lymph node. Histological examination revealed NET of the ileum and lymph-node metastasis. Trans-abdominal US is useful in the diagnosis of small-intestine NET.

scholarly journals Perforated diverticulitis in a patient with very proximal jejunal diverticula

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Constantinos Avgoustou ◽  
Dimitrios Velecheris
Keyword(s):  
Abdominal Distension ◽  
Perforated Diverticulitis ◽  
Jejunal Loop ◽  
Emergency Laparotomy ◽  
Rebound Tenderness ◽  
Cardiac Arrythmias ◽  
Cardiopulmonary Support ◽  
Abdomen Ct ◽  
Fluid Levels ◽  
Jejunal Diverticulitis

Background: We report a case of an elderly with peritonitis due to perforated jejunal diverticulitis, and we highlight the diagnostic evaluation and treatment alternatives. Case presentation: A 92-year-old woman was transferred to the Emergency Dept. with abdominal pain and vomiting for the past 12 hours. Physical examination revealed diffuse pain, abdominal distension, rebound tenderness and bowel silence. She was febrile, tachycardic, tachypneic, hypotensive and anuric. Blood gas estimation showed metabolic acidosis. She fulfilled the criteria of septic shock. At presentation, she was mildly malnourished. From her medical history, she had cardiac arrythmias, hypertension and diabetes mellitus under proper medication, and laparoscopic cholecystectomy. Laboratory investigations revealed Hct 44.6%, WBC 12.500/dL, glucose 300 mg/dL, creatinine 2.8 mg/dL, CRP 405 mg/L, and electrolyte deficit. Abdominal X-ray showed gastric, small intestinal and colonic gas, with no pneumoperitoneum or air-fluid levels. Chest/abdomen CT showed thickening of proximal jejunal loop and adjacent mesentery, and an extraluminal air bubble, suggesting possible perforation. The patient was given intense resuscitation and broad-spectrum antibiotics and underwent emergency laparotomy. Results: Four jejunal diverticula, sized 1-3 cm, were confined to a segment 12 cm long, located 6 cm from the Treitz ligament; the proximal diverticula was inflamed and perforated. The adjacent mesentery was inflamed and thickened; the bowel lumen remained open. We performed one-layer full-thickness suturing of the perforated diverticulum and omental patch closure. The patient was transferred intubated to ICU. E. Coli was isolated from peritoneal fluid cultures and antibiotic therapy was adjusted to antibiogram. The patient had a first bowel movement at day 5 and was extubated at day 21. She needed mild cardiopulmonary support and was discharged at day 30. Conclusions: Jejunal diverticulitis is a challenging disorder since its rarity makes diagnosis difficult and, thus delayed. The perforation of jejunal diverticulitis requires emergent surgery and poses technical dilemmas.

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