scholarly journals Effective Treatment for Incarcerated Obturator Hernia With Bowel Dilatation by Combined Laparoscopy and Preperitoneal Approach: A Case Report

2020 ◽  
Vol 104 (3-4) ◽  
pp. 155-158
Author(s):  
Mizunori Yaegashi ◽  
Chihiro Tono ◽  
Yukihiro Minagawa ◽  
Hideki Ishioka ◽  
Yuya Nakamura ◽  
...  
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Obturator Hernia ◽  
Preperitoneal Space ◽  
Preperitoneal Approach ◽  
Incarcerated Obturator Hernia ◽  
Median Incision ◽  
Space Approach

Background: We report a case of a 90-year-old woman with intestinal obstruction due to left-sided incarcerated obturator hernia, which was revealed using computed tomography. Methods: Emergency surgerywas performed using laparoscopy, which showed a dilated small intestine and bilateral obturator hernia in the intraperitoneal space. After reducing incarceration of the small intestine using laparoscopy, we approached the bilateral preperitoneal space and inserted a Kugel patch via a small lower abdominal median incision (approximately 4 cm). Results: The patient was discharged on postoperative day 10 and showed no recurrence at the 18-month follow-up. Although relatively rare, obturator hernia can significantly cause intestinal obstruction. It has no specific clinical symptoms and is thus often difficult to diagnose. Treating obturator hernia is essential; however, mesh infection, recurrence, and opposite side of the obturator hernia should be carefully monitored. Conclusions: Although laparoscopy is used for treating obturator hernia, it may be difficult in patients with intestinal obstruction. In this case, a surgical technique combining laparoscopy and preperitoneal space approach via a small lower abdominal median incision was used to effectively treat an incarcerated occult bilateral obturator hernia.

Incarcerated obturator hernia treated using a hybrid laparoscopic and anterior preperitoneal approach: A case report

2018 ◽  
Vol 11 (3) ◽  
pp. 277-279 ◽  
Author(s):  
Yuta Yamazaki ◽  
Yasunori Otowa ◽  
Shunsuke Kusano ◽  
Koichi Nakajima ◽  
Shinsuke Satake ◽  
...  
Keyword(s):  
Case Report ◽  
Obturator Hernia ◽  
Preperitoneal Approach ◽  
Incarcerated Obturator Hernia

scholarly journals Ileal duplication cyst: a rare cause of intestinal obstruction in infants

2020 ◽  
Vol 7 (3) ◽  
pp. 713
Author(s):  
Aniruddha Basak ◽  
Arindam Ghosh ◽  
Prafulla Kumar Mishra
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Primary Anastomosis ◽  
Duplication Cyst ◽  
Imaging Method ◽  
Diagnostic Dilemma ◽  
X Ray ◽  
Post Operative Period ◽  
Ileal Duplication

Ileal duplication cyst (IDC) is a rare congenital anomaly where there is an abnormal portion of intestine attached to or intrinsic with the normal bowel. A 6-month-old male child presented with obstipation and bilious vomiting at emergency. X-ray abdomen showed multiple air fluid level suggestive of intestinal obstruction. Laparotomy was performed. Diagnosis of IDC was made and resection with primary anastomosis was done. Post-operative period was uneventful, and patient did well during 3 month follow-up checkup. IDC is a rare cause of intestinal obstruction which can present with different clinical symptoms posing a diagnostic dilemma. Diagnostic laparotomy is a suitable approach for both diagnosis and treatment to avoid delays in treatment where imaging method is unavailable for exact diagnosis.

scholarly journals Ectopia of the pancreas in the loop of the small intestine in an 8-y-o child

2020 ◽  
Vol 10 (3) ◽  
pp. 309-313
Author(s):  
Aslamhon M. Sharipov ◽  
Kholnazar A. Giesov ◽  
Holmurod Z. Zaripov ◽  
Imatihudo D. Sayfulloev ◽  
Imatihudo D. Sayfulloev ◽  
...  
Keyword(s):  
Small Intestine ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Clinical Observation ◽  
Normal Growth ◽  
Pancreatic Tissue ◽  
Contrast Study ◽  
Normal Pancreatic Tissue ◽  
One Year

Ectopia of the pancreas in children is a rare congenital malformation in which normal pancreatic tissue develops in other organs, without communication with the main gland in the wall of the stomach, intestines, liver, gallbladder, Meckel's diverticulum, and the spleen. In this article, the authors cite a rare case of ectopia of the pancreas in the loop of the small intestine, which led to the development of intestinal obstruction. Girl B., eight years old, was admitted to the hospital on an emergency basis with paroxysmal abdominal pain. There was no nausea or vomiting. A contrast study of the gastrointestinal tract with barium sulfate was performed, which revealed a violation of the evacuation of the contrast medium. A laparoscopy was performed with the clinic for low intestinal obstruction. Revision of the intestine revealed a tumor-like formation measuring 6 4 cm at 60 cm from the ileocecal angle. A minilaporotomy was performed, a 10 cm section of the ileum was resected, bearing a tumor-like formation with an end-to-end anastomosis. The postoperative period is favorable. The girl was discharged from the hospital on the eighth postoperative day. On histological examination, pancreatic tissue was found in the wall of the small intestine, with duct ectasia. At the follow-up examination after one year. the patient had no complaints with normal growth and development. This clinical observation demonstrates the nonspecificity of the clinical picture and the difficulty of diagnosing pancreatic ectopia, and the advantages of minimally invasive interventions that allow diagnosing a rare pathology and its timely adequate correction.

scholarly journals Preperitoneal approach via a lower abdominal median incision for obturator hernia

2013 ◽  
Vol 74 (3) ◽  
pp. 632-635
Author(s):  
Hiroyuki KUMATA ◽  
Keisuke ONISHI ◽  
Saijiro MURAYAMA ◽  
Yoshihiro NIHEI ◽  
Yukio IGARASHI ◽  
...  
Keyword(s):  
Obturator Hernia ◽  
Preperitoneal Approach ◽  
Median Incision

scholarly journals A case report of intestinal obstruction caused by cryptogenic multifocal ulcerous stenosing enteritis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cheng Chang ◽  
Chen Jiang ◽  
Yaoyao Miao ◽  
Bin Fang ◽  
Lili Zhang
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Rare Disease ◽  
Male Patient ◽  
Unknown Origin ◽  
Case Presentation ◽  
The Future

Abstract Background Cryptogenic multifocal ulcer stenosing enteritis (CMUSE) is a rare disease characterized by multiple superficial ulcers, stenosis, and obstruction of the small intestine of unknown origin, and the course can recur. Case presentation We encountered a 62-year-old male patient with intestinal obstruction. The patient was admitted to the hospital for surgical treatment due to intestinal obstruction, and was diagnosed with cryptogenic multifocal ulcer stenosis enteritis due to comprehensive surgery and postoperative pathological considerations. Conclusion In the future, we will continue to follow up the patient. The present study aims to remind clinicians of this disease, and reduce the incidence of misdiagnosis.

OBTURATOR HERNIA: A CASE REPORT

2016 ◽  
pp. 106-109
Author(s):  
Hoang Minh Thi Nguyen ◽  
Huu Tri Nguyen ◽  
Thanh Thao Nguyen
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Intestinal Obstruction ◽  
Key Words ◽  
Clinical Manifestation ◽  
Elderly Women ◽  
Obturator Hernia ◽  
Abdominal Hernia ◽  
Mechanical Obstruction

Obturator hernia is a rare pelvic hernia which accounts for 1% of all abdominal hernia. Clinical manifestation is ussually unspecific. Obturator hernia is often diagnosed by computed tomography or ultrasound. We present a case of obturator hernia in an elderly women who was successfully diagnosed and treated at Hue Univeristy of Medicine and Pharmacy. Key words: obturator hernia, mechanical obstruction, intestinal obstruction, Richter obturator hernia, strangulation

CHANGES IN SMALL INTESTINE MICROFLORA IN PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

2020 ◽  
pp. 16-18
Author(s):  
V. M. Lykhman ◽  
O. M. Shevchenko ◽  
Ye. O. Bilodid ◽  
Igor Vladimirovich Volchenko ◽  
I. A. Kulyk ◽  
...  
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Species Composition ◽  
Intestinal Obstruction ◽  
Bacterial Flora ◽  
Anaerobic Bacteria ◽  
Acute Intestinal Obstruction ◽  
Gram Positive ◽  
Mechanical Intestinal Obstruction ◽  
Facultative Anaerobic Bacteria

Among urgent surgical diseases of abdominal cavity, an acute intestinal obstruction is the most difficult to be diagnosed and treated. Leading factor, determining the development of pathophysiological processes is considered to be the progressive manifestations of enteric insufficiency syndrome, resulting in intestinal barrier impairment, negative changes in ecology of intestinal flora, increased endotoxins. To identify the small intestine microflora in acute intestinal obstruction and determine the role of dysbiotic disorders in clinical manifestations of main pathological process, a study was conducted in 60 patients with mechanical intestinal obstruction. The small intestine has a relatively rare microflora, consisting mainly of gram−positive facultative aerobic microorganisms, streptococci, lactobacilli. The distal ileum in nearly 30−55 % of healthy people contains scanty microflora, and yet the flora of this area differs from the microbial population of the higher gastrointestinal tract due to higher concentration of gram−negative bacteria. Optional−anaerobic coliform bacilli, anaerobic bifidobacteria and fusobacteria, bacteroids, the number of which starts exceeding the one of gram−positive species, are presented in significant quantities. Distal to the ileocecal valve there are significant changes in the microflora quantitative and species composition. Obligatory anaerobic bacteria become the predominant part of microflora, exceeding the number of aerobic and facultative anaerobic bacteria. The bacterial flora in different parts of gastrointestinal tract has its own specifics and is quite constant, as a result of the interaction of many factors, regulating the bacterial population in small intestine. The most important among them are: acidity of gastric juice, normal peristaltic activity of the intestine, bacterial interactions and immune mechanisms. Disorders of the intestine motor and evacuation function with its obstruction lead to slow passage of the chyme and contamination of the upper gastrointestinal tract with new types of microbes. There is a syndrome of small intestine excessive colonization, which means an increased concentration of bacterial populations in it, similar in species composition to the colon microflora. Pathological intra−intestinal contents become a source of endogenous infection and re−infection of the patient, leads to internal digestive disorders, which is manifested by syndrome of malabsorption of proteins, carbohydrates and vitamins. Key words: acute intestinal obstruction, small intestinal microflora, conditionally pathogenic microorganisms, intestinal biocenosis.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

scholarly journals Chinese Herbal Medicine Dingji Fumai Decoction for Ventricular Premature Contraction: A Real-World Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Bo Liang ◽  
Fei-Hu Zou ◽  
Ling Fu ◽  
Hui-Ling Liao
Keyword(s):  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Clinical Symptoms ◽  
Medication Compliance ◽  
Controlled Trial ◽  
Ventricular Premature Contraction ◽  
Traditional Chinese Medicine Syndrome ◽  
Chinese Herbal ◽  
Double Blinded

Background. Chinese herbal medicine Dingji Fumai Decoction (DFD) is widely clinically used for ventricular premature contraction (VPC). This real-word trial was designed to assess the safety and effectiveness of DFD for VPC. Methods. This was a double-blinded, randomized placebo-controlled trial. Patients with VPC were randomized (1 : 1) to treatment with DFD combined with metoprolol (DFD arm) or metoprolol combined with placebo (MET arm). A primary end point was a composite of clinical symptoms and signs determined by the traditionalChinese medicine syndrome score and the number of VPC determined by the Holter examination. Second outcomes were adverse events, medication compliance, and laboratory examination. Results. 144 patients were randomized to DFD arm (76 patients) or MET arm (68 patients), and 136 cases (71 in DFD arm and 65 in MET arm) finally completed this trial. After a 12-week follow-up, DFD arm significantly decreased traditional Chinese medicine syndrome score and the number of VPC compared with MET arm (P=0.003 and 0.034, respectively). There was no adverse drug effect and patient medication compliance was good. Conclusions. Superiority with DFD arm for VPC was demonstrated over MET arm for both the safety and effectiveness end points.

scholarly journals A long-term survivor of clear cell sarcoma-like tumor of the gastrointestinal tract with liver metastasis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takuhisa Okada ◽  
Yasumitsu Hirano ◽  
Shintaro Ishikawa ◽  
Hiroka Kondo ◽  
Toshimasa Ishii ◽  
...  
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Gastrointestinal Tract ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Clear Cell ◽  
Clear Cell Sarcoma ◽  
Cell Sarcoma

Abstract Background Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLTGT) is extremely rare. It is a mesenchymal neoplasm that usually forms in the small intestine of adolescents and young adults, is prone to local recurrence and metastasis, and has a high mortality rate. We report a patient with CCSLTGT with lymph node- and liver metastases, who continues to survive 6 years after initial surgical resection. Case presentation A 38-year-old woman presented with lightheadedness. Laboratory analysis revealed anemia (hemoglobin, 6.7 g/dL), and enhanced computed tomography (CT) demonstrated a mass in the small intestine, about 6 cm in diameter, with swelling of 2 regional lymph nodes. Double-balloon small intestine endoscopic examination revealed a tumor accompanied by an ulcer; the biopsy findings suggested a primary cancer of the small intestine. She was admitted, and we then performed a laparotomy for partial resection of the small intestine with lymph node dissection. Pathologic examination revealed CCSLTGT with regional lymph node metastases. About 3 years later, follow-up CT revealed a single liver metastasis. Consequently, she underwent a laparoscopic partial liver resection. Histopathologic examination confirmed that the liver metastasis was consistent with CCSLTGT. It has now been 3 years without a recurrence. Conclusion Repeated radical surgical resection with close follow-up may be the only way to achieve long-term survival in patients with CCLSTGT.

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