Migrating Gallstone: From Bouveret's Syndrome to Distal Small Bowel Obstruction

2006 ◽  
Vol 16 (3) ◽  
pp. 256-260 ◽  
Author(s):  
Kwok-Kay Yau ◽  
Wing-Tai Siu ◽  
Ka-Kin Tsui
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bouveret’S Syndrome ◽  
Distal Small Bowel ◽  
Bouveret's Syndrome

scholarly journals Bouveret’s syndrome treated with endoscopic electrohydraulic lithotripsy

2019 ◽  
Vol 12 (2) ◽  
pp. e228316
Author(s):  
Aysun Avci ◽  
Ismail Gögenur ◽  
Mustafa Bulut
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Neuroendocrine Tumour ◽  
Treatment Options ◽  
Bouveret’S Syndrome ◽  
Biliary Stone ◽  
Electrohydraulic Lithotripsy ◽  
Bilioenteric Fistula ◽  
Bouveret's Syndrome

Bouveret’s syndrome is a rare form of small bowel obstruction caused by a large biliary stone entering the lumen of the duodenum or the stomach through a bilioenteric fistula. Treatment options include various surgical techniques. However, recent advances in endoscopy also allow non-surgical endoscopic treatment options. We report a 68-year-old man, with a disseminated small intestinal neuroendocrine tumour, presenting with Bouveret’s syndrome without any previously reported biliary disease. He experienced a number of symptoms 1 month prior to his admittance, which were difficult to differentiate from other infectious diseases and complications due to his neuroendocrine tumour. Abdominal CT showed a biliary stone impacted in the duodenal bulb, small bowel obstruction, pneumobilia and a bilioenteric fistula. The patient was treated with endoscopic electrohydraulic lithotripsy to fragment the large gallstone in smaller retractable pieces. The patient avoided major surgery and was discharged the following day.

scholarly journals A wolf in sheep’s clothing: concomitant appendicitis with occult cecal adenocarcinoma

2021 ◽  
Vol 8 (7) ◽  
pp. 2154
Author(s):  
Jonathan Mejia ◽  
Roland Haj ◽  
Sutasinee Nithisoontorn ◽  
Martine A. Louis ◽  
Nageswara Mandava
Keyword(s):  
Differential Diagnosis ◽  
Small Bowel ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Delayed Presentation ◽  
Ct Guided ◽  
Distal Small Bowel ◽  
Risk Of Cancer

We present the case of an 89-years-old female with an atypical presentation of an obstructive acute appendicitis secondary to a cecal carcinoma. The physical exam revealed a distended abdomen with bilateral lower quadrants tenderness without rebound or rigidity.  CT scan demonstrated distal small bowel obstruction and ruptured acute appendicitis. Patient was treated conservatively with nasogastric decompression, intravenous fluids, and antibiotics. She later underwent CT guided drainage of a rim-enhancing fluid collection and her symptoms eventually resolved. She returned a week later and a CT imaging showed high grade distal small bowel obstruction, and findings were a 4.5 cm diameter cecal mass. She underwent an exploratory laparotomy and modified right hemicolectomy with ileostomy for. She had an uneventful postoperative course. Pathology revealed poorly differentiated adenocarcinoma of the cecum stage III T4N1Mx. Appendectomy for appendicitis is the most commonly performed emergency operation in the world. Appendicitis are often rare in elderly, with atypical or delayed presentation and expanded differential diagnosis, making preoperative diagnosis challenging. With the increase overall risk of cancer in this age group, occult colonic carcinoma should be high in the differential diagnosis. Three mechanisms potentially leading to obstruction of the appendiceal lumen by the tumor includes: immediate proximity to the lumen, inflammatory changes from the tumor, back pressure on the cecum causing obstruction of the appendix. Despite advances in imaging, local inflammation, collections, and masses may be misleading. The diagnostic accuracy of CT scan reportedly can be as low as 54% for cecal tumors.

Small Bowel Obstruction in Children: Usefulness of CT for Diagnosis and Localization

2007 ◽  
Vol 57 (6) ◽  
pp. 571
Author(s):  
Young Cheol Lee ◽  
Young Tong Kim ◽  
Won Kyung Bae ◽  
Il Young Kim
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction

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.

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