Not Everything Is Cordless Today—Case Report of Acute Intestinal Obstruction in a Neonate Due to Cord Clamping

We report a case of a 2-day-old neonate with bilious vomiting and abdominal distension. A small bowel obstruction with ileal perforation due to a misplaced clamping of the umbilical cord was apparent before laparotomy. This complication was a sequala after clamping the cord too close to the abdominal wall in a case where there was a hernia into the cord with intestinal content. A herniation of abdominal contents due to an omphalocele minor or a hernia must be taken into consideration during the inspection of the umbilical cord before clamping.

Proportion of colonic carcinoma in cases presenting with acute intestinal obstruction: a cross sectional study

Background: Acute intestinal obstruction is one of the most common emergencies encountered by the general surgeon in routine practice. Although historically, obstructed hernia has been the most common cause, recent studies have shown that adhesive intestinal obstruction is now the commonest reason. Malignant bowel obstruction is also on the rise especially with the change in dietary habits. This study aims at identifying the proportion of colonic carcinoma in cases presenting with acute intestinal obstruction.Methods: The patients with acute intestinal obstruction which was diagnosed clinically and radiologically were studied. Based on operative and clinical findings along with investigation results, the etiology was identified. The patients having colonic neoplasms were identified and the data was compared with other etiological factors to find out the proportion of colonic carcinoma in the cases.Results: The proportion of colon cancer in patients presenting with acute intestinal obstruction was around 15%. The most common cause was obstructed hernia followed by post-operative adhesions. Males were more commonly affected than females. Most of the cases underwent operative management. The most common age group affected was around 50-60 years.Conclusions: This study confirms that there is a definite rise in the number of cases of colon cancer presenting as acute intestinal obstruction. There is also a skewing of the age at presentation towards younger age groups. Small bowel obstructions were much more common mainly due to adhesions and obstructed herniae.

Study of acute intestinal obstruction management and its outcome

Background: Acute intestinal blockage (AIO) is a common abdominal emergency with a high morbidity and mortality rate. Early blockage diagnosis, skilled operative management, correct technique during surgery and intense postoperative therapy yield superior results. The aim was to study the aetiology, clinical presentation, therapy and outcomes of patients with IO who presented in the emergency department.Methods: This prospective study was conducted at the general surgery department from June 2019 to May 2021. The study comprised 60 patients with IO who presented to the OPD or emergency room and the data was analysed.Results: Among 60 patients with IO, peak incidence was observed in patients above 50 years of age, predominantly among males. Abdominal pain turned out to be the most common symptom of IO in our patients. Patients obstructed in the small intestine were found to be predominant. Post-operative adhesions were the most common cause of IO.Conclusions: Early diagnosis, proper preoperative hydration, fast investigations, and early operational intervention were found to increase survival in patients with intestinal obstruction in the current study.

Richter's type of obturator hernia with Howship Romberg sign: a case report

Obturator hernia is a rare type of pelvic hernia in which intraperitoneal contents protrude through the obturator foramen and is most commonly found in females. It accounts for about 1% of all abdominal hernias and possesses a great diagnostic challenge due to the non-specific symptoms and meagre clinical signs. Hereby we report a case of obturator hernia in an nonagenarian emaciated fragile old lady who presented with features of acute Intestinal obstruction and was diagnosed using computed tomography as right sided obturator hernia and eventually was taken up for emergency laparotomy. The herniated segment was resected and anastomosis was done with primary closure of the defect. Postoperative period was uneventful and the patient was discharged on postoperative day 7.

A RARE CASE OF HETEROTOPIC PANCREATIC TISSUE CAUSING SMALL BOWEL OBSTRUCTION

A Rare case of heterotopic pancreatic tissue of ileum causing acute intestinal obstruction has been described with a brief review of literature. A 42 yr old male patient presented to the emergency department with features of acute intestinal obstruction. After evaluation patient was taken up for emergency laparotomy which revealed a band to be arising from ileum. Furthermore, there was a small growth in the ileal wall at the site of origin of the band. Hence resection of the growth was done and followed by ileoileal anastomosis. Later on, histopathological examination of the growth revealed it to be heterotopic pancreatic tissue. Heterotopic pancreatic tissue is often an incidental nding encountered in upper gastrointestinal tract during endoscopy and surgeries. But Symptomatic ectopic pancreas of ileum is relatively rare and they very rarely present with acute symptoms as in this case

ASSESSMENT AND MANAGEMENT OF INTESTINAL OBSTRUCTION IN PATIENTS ATTENDING TERTIARY CARE INSTITUTE

Background and Aim: Bowel obstruction is the most common intra-abdominal problem faced by general surgeons in their practice. Therefore better understanding of pathophysiology, improvement in diagnostic techniques, fluid and electrolyte correction, much potent antibiotics and knowledge of intensive care is required. present study was undertaken to study the management and post-operative complications of intestinal obstruction. Material and Methods: This is a prospective study of 97 cases presenting with symptoms and signs suggestive of acute intestinal obstruction. All patients are subjected to required preoperative biochemical investigations. Patients who showed reduction in abdominal distention and improvement in general condition especially in individuals with postoperative adhesions, a chance of conservative management was taken (by extending the supportive treatment) for further 12 to 24 hours; those who showed improvement by moving bowels, reduction in pain and tenderness was decided for conservative treatment, such individuals were excluded in this study. Results: The occurrence of acute intestinal obstruction was common in male in comparison with female. The commonest presenting symptom was abdominal pain (100%) followed by vomiting (92.7%), distention of abdomen (87.6%) and absolute constipation (53.6%). In this study, Adhesive obstruction (56.7%) was the commonest cause of acute intestinal obstruction. Release of adhesions and bands was done in 43 cases. Resection and end-to-end anastomosis was done in 25 cases, which included cases of intussusceptions, adhesions, stricture, ileocaecal growth, colonic growth. Conclusion: Most common etiological factor for intestinal obstruction is postoperative adhesions. Obstructed Inguinal Hernia is second most common cause of intestinal obstruction. Clinic radiological and operative findings put together can bring about the best and accurate diagnosis of intestinal obstruction. Key Words: Abdominal pain, Adhesions, Bands, Bowel obstruction, Inguinal Hernia,