Congenital Incomplete Rotation of the Colon With Adhesive Obstruction in an Adult

Intestinal obstruction is an entity commonly encountered by general and colorectal surgeons. Anatomic abnormalities account for only a small fraction of cases of complete or partial obstruction. This case report focuses on a 51-year-old female presenting with acute on chronic large bowel obstruction. Workup revealed an exceedingly rare anatomic abnormality: a medialized descending colon, traveling adjacent to the abdominal aorta, with a transition point and dense bands just distal to the splenic flexure. She underwent exploratory laparotomy with division of the constrictive bands and subsequently experienced near-complete resolution of her chronic obstructive symptoms.

Differential diagnosis of bovine intestinal diseases and their sequelae regarding ultrasonography and other diagnostic tools

Background and Aim: Intestinal disorders represented a large proportion of abdominal emergencies in bovine practice, and their definite diagnosis was a big challenge. The study described different intestinal disorders in cattle either in the small intestine (SI) or large intestine with their sequelae and peritonitis between SI loops. Materials and Methods: This study involved healthy (n=20) and diseased (n=40) cattle with intestinal disorders. All animals were undergoing clinical examination, laboratory analyses, and ultrasonographic examination. Results: Diseased cattle had monocytic leukocytosis as well as hypoproteinemia and hypoalbuminemia. The SI ileus of either proximal (n=12) or distal (n=15), intussusception (n=3), cecal, and/or colonal dilatation (n=10) were diagnosed by ultrasound and other diagnostic tools. Duodenum intussusception was imaged in cross-section as bull's eyes lesions. Animals with SI obstructions showed complete cessation (ileus with complete obstruction) or partial reduction of the peristaltic SI movement (ileus with partial obstruction), dilated duodenum (6.5-9.9 cm), and dilated jejunum and/or ileum (4.4-6.8 cm). Ultrasonography diagnosed SI ileus, due to either intestinal obstruction or peritonitis, and detected the ileus site, either proximal or distal. Cecal/colonal dilatation was detected using ultrasonography in which SI was not imaged and the peristaltic movements were completely reduced. The recorded intestinal disorders were associated with other disorders (e.g., liver cirrhosis or peritonitis). Conclusion: Ultrasonography played an important role in the differential diagnosis of intestinal disorders in cattle. Peritonitis between SI loops and cecal and/or colonal dilatation was also diagnosed.

Flexible Bronchoscopy Findings in Children with Congenital Lobar Emphysema: 8-Year Data from a Single Center Study

Introduction:Congenital lobar emphysema (CLE) is a rare developmental lung malformation that involves the hyperaeration of one or more lung lobes due to partial obstruction and occurs at a rate of 1/20,000–30,000 live births.Here,we aimed to retrospectively examine the clinical, radiological, and bronchoscopy findings of patients with CLE who were diagnosed and treated with surgical or conservative approaches in our clinic to compare our results with those in the literature. Method:We examined the clinical, and radiological data and FB findings of the patients with CLE aged 0–18 years at our center between 2013 and 2020.We also examined the symptoms and findings recorded during the patients’ follow-up. Results:.The median age of 20 patients with CLE at diagnosis was 3.2 years (range, 1 day–17 years).Respiratory distress and mediastinal shift were more prominent in the patients who underwent surgery than the patients who were followed up conservatively and diagnosed at an early age (p = 0.001, p = 0.049, p = 0.001, respectively). Discussion: In line with studies in the literature, the pulmonary symptoms and CLE-related imaging findings in our study regressed during the conservative follow-up.We recommend clinicians consider performing a detailed anamnesis for patients with unresolved respiratory symptoms and unilateral or bilateral increased ventilation,along with appropriate imaging tests and examinations, and should consider CLE in the diagnosis.

Relationship between Obstructive Sleep Apnea(OSA) and Orthodontic malocclusion in non-obese adults

INTRODUCTION:Obstructive Sleep Apnea (OSA)represents the complete or partial obstruction of the airway.Clinically OSA manifests as sleepness during the day,heavy snoring as well as waking up during the night dues the lack of air.Obesity,gender and orthodontic malocclusion are mentioned in the literature as the etiologic factor for Obstructive Sleep Apnea. AIM: The aim of this study was to find the relationship in the analyzed studies between the Obstructive Sleep Apnea and orthodontic malocclusion at non-obese adults. MATERIAL AND METHODS:The electornic search of the database was performed,using PubMed and Googlescholar,with the aim to find the relevante articles which correlate the OSA and orthodontic malocclusion.Keyword included:obstrucitve sleep apnea,orthodontic malocclusion,cephalometric analysis,impact,association,body mass index,obesity,adults,non obesity. Inclusion criteria were:nonobesity,orthodontic malocclusion,adults,articles published from 1999 to 2019,articles in English,full articles avaiable. RESULTS:Two hundred papers included keywords.The number of articles that included the fully set criteria was nine.These nine articles were analyzed in detail. CONCLUSION:Analyzed articles showed that there is relationship between the Obstructive Sleep Apnea and orthodontic malocclusion in non-obese adults.It was also showed that orthodontic malocclusion is etiological factor for OSA in non-obese adults.

Airway management in a patient with an intratracheal tumor near the carina by a two-stage operation

In patients with intratracheal tumors, airway management while maintaining oxygenation and providing surgical access to the airway can be challenging. Here, we present a case of a two-stage operation to remove an intratracheal tumor causing partial obstruction near the carina. In the otorhinolaryngology department, a biopsy was performed during apnea under high-flow nasal oxygenation support. A few days later, a thoracic surgeon performed tracheal resection after sternotomy under general anesthesia. Mechanical ventilation was performed by inserting a sterile endotracheal tube in the resected distal part of the trachea in the surgical field for tracheal end-to-end anastomosis. Airway was successfully secured through close communication between teams of anesthesiologists and surgeons.

Stone Formation on Suture Material Following Laparoscopic Pyeloplasty Causing Recurrent Puj Obstruction: A Case Report

Male patient 46 years of age presented with history of Laparoscopic A-H pyeloplasty with DJ stenting for left side hydronephrosis due to PUJ obstruction. After stent removed he experienced intermittent flank pain, discomfort with fullness sensation. On examination there was mild left renal angle tenderness. Urinalysis showed RBC. USG revealed moderate left hydronephrosis. CT urogram showed left side gross HDN with 5 mm PUJ stone. Tc-99m DTPA renal scan revealed partial obstruction. After counseled and exploration founded an impacted PUJ stone. During removal of PUJ stone, identified a suture material embedded by the stone. After removed the stone,PUJ still narrowed. Then A- H pyeloplasty done with placed a D-J stent in situ. The patient had a good post-operative recovery. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.164-165

Stridor

Key Points Stridor is typically heard on inspiration, resulting from partial obstruction of the extrathoracic airway.Stridor can range from mild to life-threatening.Priority is to ensure patency of airway before generating a differential diagnosis.Age and events surrounding onset can provide important clues to the diagnosis.