Radiolucent gallstone ileus masquerading as closed loop small bowel obstruction

2020 ◽  
Author(s):  
Shaneel Bappayya ◽  
Hao‐Hsuan Tsai ◽  
Neil Jayasuriya
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Gallstone Ileus

563 A Rare Case of Small Bowel Obstruction Secondary to Peritoneal Encapsulation, Congenital Adhesional Band and Gallstone Ileus

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Gungadin ◽  
A Taib ◽  
M Ahmed ◽  
A Sultana
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Unusual Case ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Case Presentation ◽  
Peritoneal Encapsulation ◽  
History Of ◽  
Gall Stone Ileus

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.

scholarly journals Transmesenteric hernia with closed-loop small bowel obstruction: A case report

2022 ◽  
pp. 103256
Author(s):  
Bibek Man Shrestha ◽  
Suraj Shrestha ◽  
Shiva Aryal ◽  
Susan Pradhan ◽  
Romi Dahal ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Transmesenteric Hernia

scholarly journals Closed loop bowel obstruction secondary to left paraduodenal hernia (of Landzert)

2019 ◽  
Vol 12 (12) ◽  
pp. e232134
Author(s):  
Yeo Min Cho ◽  
Gamze Aksakal ◽  
Mohamed Ahmed Tawfik Ashour ◽  
Suzanne Moore
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Closed Loop ◽  
Flank Pain ◽  
Paraduodenal Hernia ◽  
Good Recovery ◽  
Left Colic Artery ◽  
Unusual Phenomenon

A 34-year-old man presented with acute severe left-sided abdominal and flank pain with associated postprandial nausea and vomiting. CT imaging revealed findings suspicious for a closed loop small bowel obstruction. Intraoperative findings were that of a left paraduodenal hernia (of Landzert) secondary to a mesenteric defect immediately posterior to the ascending branch of the left colic artery. The defect was closed via minilaparotomy. Unfortunately, his postoperative course was complicated by small bowel obstruction which required further laparotomy and adhesiolysis. The patient eventually made a good recovery. Here, we present a rare case of intestinal obstruction and discuss the aetiologies and management of this unusual phenomenon.

Correlation of CT findings with intra-operative outcome in closed-loop small bowel obstruction (CL-SBO)

2021 ◽  
pp. 109844
Author(s):  
Bente M. de Kok ◽  
Masja K. Toneman ◽  
Stanley Oei ◽  
Marinke Westerterp ◽  
Gijs J.D. van Acker ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
Ct Findings ◽  
Operative Outcome

scholarly journals Gallstone Ileus: An Unlikely Cause of Mechanical Small Bowel Obstruction

2017 ◽  
Vol 11 (2) ◽  
pp. 389-395 ◽  
Author(s):  
Estela Abich ◽  
Daniel Glotzer ◽  
Edward Murphy
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Abdominal Distension ◽  
Acute Onset ◽  
Female Population ◽  
Coffee Ground ◽  
Intestinal Obstructions ◽  
Emergent Laparotomy

Gallstone ileus is a rare disease that accounts for 1–4% of intestinal obstructions. Almost exclusively a condition in the older female population, it is a difficult diagnosis to make. We report the case of gallstone ileus in a 94-year-old Caucasian female, who presented to the emergency department with acute-onset nausea, coffee-ground emesis, lack of bowel movement, and abdominal distension. On CT scan, the diagnosis of gallstone ileus was made by the presence of a cholecystoduodenal fistula, pneumobilia, and small bowel obstruction. Emergent laparotomy with a one-stage procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. The postoperative course was uneventful until postoperative day 4 when the patient was found tachycardic, lethargic, and unresponsive. We reviewed the literature on the diagnosis and treatment of gallstone ileus.

scholarly journals EP.TU.193Omental band - A unusual cause of mechanical small bowel obstruction in a virgin abdomen

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Santhosh Loganathan ◽  
Adam O'Connor ◽  
Amal Singh ◽  
Mazyar Fani
Keyword(s):  
Small Bowel ◽  
Abdominal Surgery ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Closed Loop ◽  
White Blood Cells ◽  
Serum Lactate ◽  
Proximal Small Bowel ◽  
Constriction Band ◽  
Common Causes

Abstract Introduction The small bowel obstruction in a non-operated abdomen is rare, and the most common causes are hernia and neoplasm. The complete mechanical small bowel obstruction due to an omental band in a patient with no previous abdominal surgery is rare, and less than five cases have been reported in the literature. Case presentation We report a 65 year old male patient presented to the emergency department with complaints of abdominal pain, distension, vomiting and obstipation for four days. On clinical examination, his abdomen was distended, diffusely tender, guarding. The blood investigations showed elevated White blood cells and neutrophils with normal CRP and the Serum lactate. The Abdominal X-ray was suggestive of SBO. The Computed tomography of the abdomen and pelvis showed marked dilatation of the jejunum, the ileum is entirely collapsed, the impression of a double beak sign in the mid-abdomen which would suggest closed-loop obstruction due to a possible internal hernia. We proceeded with emergency diagnostic laparoscopy converted to laparotomy, which showed omental band causing closed-loop proximal small bowel obstruction. The bowel loops appeared congested with the constriction band due to omental band. The omental band was divided, and the obstruction was relieved. Postoperatively patient recovered well and was discharged on day three post-op. Discussion The timely diagnosis and intervention could prevent complications like strangulation, ischemia and gangrene. Though the omental band is rare, it should still be suspected as an aetiology in patients without prior abdominal surgery.

scholarly journals Gallstone Ileus: An Improbable Cause of Mechanical Small Bowel Obstruction

Cureus ◽  
2020 ◽  
Author(s):  
Sara Lourenço ◽  
Ana Marta Pereira ◽  
Jose Reis ◽  
Marta Guimarães ◽  
Mário Nora
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gallstone Ileus

scholarly journals P-B03 Gastric Band Tubing Causing Small Bowel Obstruction

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Kashif Halim ◽  
Ana Lee ◽  
Stephen Odogwu ◽  
Amir Khan
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Gastric Banding ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Closed Loop ◽  
Gastric Band ◽  
Laparoscopic Gastric Banding ◽  
Gastric Bands

Abstract Background Laparoscopically adjustable gastric bands (LAGB) have been widely employed as a means of weight loss in bariatric surgery over the past two decades. Although now largely superseded by other bariatric surgical techniques, complications from gastric bands continue to be encountered in surgical practice. We report an unusual case of small bowel obstruction due to an internal hernia caused by gastric band tubing resulting in closed loop small bowel obstruction. This is  not  commonly encountered and emergency general surgeons need to have a high index of suspicion for this condition as a possible cause for small bowel obstruction. Methods A 40 year old male presented with abdominal pain, vomiting and failure to open bowels or pass flatus for nine days. Twelve years previously (2008) he had had Roux n Y gastric bypass (RYGB), followed by by laparoscopic gastric banding of the RYGB about two years later (2010) also in the private sector. He had a soft but distended abdomen, and empty rectum on rectal examination. CT scan abdomen reported as: Multiple loops of distended small bowel demonstrated. No air seen in rectum, indicative of small bowel obstruction. No pneumoperitoneum. There is dilatation of the mid and distal small bowel seen to an apparent transition point in the mid abdomen where a loop is noted associated with the tubing for the inflation device for the gastric band. This appears to be centred on the cause of obstruction and appears tied around the base of mesentery and may be creating a closed loop obstruction, by having created an internal hernia. This patient had an internal hernia around  loop of the gastric band tubing with resultant closed loop small bowel obstruction. The patient underwent diagnostic laparoscopy with ileo-caecal resection and primary anastomosis. He made successful recovery. Deflated gastric band remains in-situ. Results While small bowel obstruction is most commonly due to adhesions in individuals who have had previous laparotomy, it is important to bear in mind other causes such as internal hernias particularly in cases of those with history of previous gastric banding or Roux n Y gastric bypass. Early intervention may be necessary to reduce the  likelihood of bowel ischaemia and bowel resection. Laparoscopy is a useful tool in the management of small bowel obstruction. Keywords: gastric band, small bowel obstruction, closed loop, emergency surgery, laparoscopy Conclusions Connection tubing causing small bowel obstruction and colonic erosion as a rare complication after laparoscopic gastric banding: a case report. Liza BK Tan, Jimmy BY So, and Asim Shabbir - J Med Case Reports. 2012; 6: 9.  Acute small bowel obstruction due to the connecting tube of a gastric band. Federico Oppliger, M.D. Gonzalo Wiedmaier, M.D. Juan. Published April 07 2017. https://doi.org/10.1016/j.soard.2014.03.021 An unusual complication of gastric banding: recurrent small bowel obstruction caused by the connecting tube. M A Zappa, E Lattuada, E Mozzi, M Francese, I Antonini, S Radaelli, G Roviaro. Obes Surg . 2006 Jul;16(7):939-41.  doi: 10.1381/096089206777822250 Total small bowel herniation through the space between the connecting tube of gastric band and abdominal wall: A case report of a surgical emergency. Tarek Hashem, Soliman M Soliman, Sherif Wagih 2. Int J Surg Case Rep. 2017;30:66-68.  doi: 10.1016/j.ijscr.2016.11.021.  Epub 2016 Nov 17

scholarly journals Gallstone Ileus Decades after Cholecystectomy and Pylorus-Preserving Whipples

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Miho Mugino ◽  
Takako Eva Yabe ◽  
Bruce Ashford
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Literature Review ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Transition Point ◽  
Gallstone Ileus ◽  
Whipple Procedure ◽  
Stone Analysis ◽  
Intraluminal Mass

We report a case of small bowel obstruction due to gallstone ileus found in a patient with previous pancreaticoduodenectomy (Whipple procedure). Investigation by computed tomography of the abdomen showed a transition point in the midjejunum due to a radioopaque intraluminal mass. Following resuscitation, the patient underwent laparotomy to remove the offending mass from the midjejunum. Subsequent stone analysis confirmed a cholesterol-rich gallstone. This is thus the first description of gallstone ileus following Whipple procedure. The rarity of this presentation and a literature review is presented.

scholarly journals Bile Salt Enterolith: An Unusual Etiology Mimicking Gallstone Ileus

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Dana Ferrari-Light ◽  
Ariel Shuchleib ◽  
Joel Ricci-Gorbea
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gallstone Ileus ◽  
Duodenal Diverticulum ◽  
Multiple Risk Factors ◽  
History Of ◽  
High Index Of Suspicion ◽  
Distal Jejunum

Primary enterolithiasis is a relatively uncommon but important cause of small bowel obstruction. We present a case of a 69-year-old male with a history of laparoscopic Roux-en-Y gastric bypass and asymptomatic duodenal diverticulum diagnosed with small bowel obstruction. CT imaging showed an obstruction distal to the jejunojejunostomy, and surgical intervention was warranted. A 4.5 cm enterolith removed from the distal jejunum was found to contain 100% bile salts, consistent with a primary enterolith. Clinicians should retain a high index of suspicion for enteroliths as a cause of small bowel obstruction, especially if multiple risk factors for enterolith formation are present.

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