scholarly journals Total Colonic Expulsion with Part of Small Bowel per Vaginum due to Low-Flow Phenomenon and NOMI: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Suha Deen ◽  
Martin Powell
Keyword(s):  
Small Bowel ◽  
Large Bowel ◽  
Disease Process ◽  
Low Flow ◽  
Uneventful Recovery ◽  
Bowel Ischaemia ◽  
Intestinal Necrosis ◽  
Bowel Gangrene ◽  
High Level ◽  
Adequate Management

Introduction. Intestinal ischaemia is a devastating disease process that could lead to bowel gangrene and death if either not diagnosed early or left untreated; death is usually caused by irreversible shock, intestinal necrosis, or septicaemia. It is usually seen in elderly patients with atherosclerotic disease. The course of bowel ischaemia may affect variable lengths of the intestine and it is not unusual for the condition to be followed by uneventful recovery. Case presentation. We are reporting an unusually rare case where an elderly patient passed an extraordinarily long segment of bowel, including rectum, the whole of the large bowel, and part of the small bowel, through anus following an episode of nonobstructive mesenteric ischaemia (NOMI) complicating myocardial infarction. To our knowledge, there are only eight cases reported in the literature where the condition was diagnosed upon the passage of short segments of the large bowel particularly of the rectosigmoid segment through the anus. Conclusion. Physician should keep a high level of suspicion in order to prevent it or at least recognise it early on and offer adequate management and hence reducing morbidity and mortality.

scholarly journals Traumatic Small Bowel Injury: A Diagnosis Challenge

2021 ◽  
Vol 16 (2) ◽  
pp. 295-300
Author(s):  
Syed Abdul Kader Mohamed Saleem ◽  
Keyword(s):  
Small Bowel ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Rare Complication ◽  
Bowel Injury ◽  
Free Fluid ◽  
Small Bowel Injury ◽  
Bowel Ischaemia ◽  
High Level

Traumatic small bowel injury is rare complication following a blunt abdominal trauma. We encountered a case of small bowel injury following a motor vehicle accident that was initially missed during the first presentation due to unremarkable findings in examination. Patient re-presented five days later with bowel ischaemia and was managed accordingly. It is a challenge in diagnosing the injury due to its vague presentation. The usage of Focused Assessment with Sonography for Trauma (FAST) scan as a screening tool in Emergency Department to pick up intra-abdominal injury do have limitations especially in diagnosing small bowel perforation post blunt abdominal trauma. The early phase of small bowel injury post blunt abdominal trauma rarely produces significant free fluid during the FAST scan. It is paramount for the emergency doctors to have a high level of suspicion in high risk cases to provide early supportive treatment and early referral to surgical team. If left undiagnosed bowel ischaemia may lead to catastrophic complication affecting the patient’s morbidity and mortality. In conclusion, each case should be managed and risk stratify individually. Computed tomography abdomen is found to be more superior in detecting bowel injuries, hence, and investigation of choice compared to bedside ultrasonograpy in cases with high level of suspicaion.

scholarly journals A curious case of cololithiasis

2018 ◽  
Vol 100 (7) ◽  
pp. e188-e190 ◽  
Author(s):  
L Creedon ◽  
H Boyd-Carson ◽  
J Lund
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Obstruction ◽  
Bowel Preparation ◽  
Large Bowel ◽  
Gallstone Ileus ◽  
Expectant Management ◽  
Large Bowel Obstruction ◽  
Uneventful Recovery ◽  
Rectosigmoid Junction

Gallstone ileus is an uncommon cause of bowel obstruction that involves cholecystoenteric fistulation and resultant passage of gallstones into the bowel. In the vast majority of cases, the fistula forms between the gallbladder and duodenum leading to small bowel obstruction. We report a case of cholecystocolic fistulation and subsequent large-bowel obstruction in a 75-year-old woman who presented acutely after taking a bowel preparation for an outpatient colonoscopy during the course of an investigation of anaemia and nonspecific abdominal pain. Preintervention imaging revealed a giant gallstone at the rectosigmoid junction, in the presence of a cholecystocolic fistula, and subsequent large bowel obstruction. After a failed period of expectant management, laparotomy and Hartmann’s procedure were performed and the patient made an uneventful recovery.

scholarly journals THREE CASES OF BOWEL OBSTRUCTION BY BROAD LIGAMENT HERNIA

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Soto Dopazo ◽  
E Pérez Prudencio ◽  
A Arango Bravo ◽  
C Nuño Iglesias ◽  
C Mateos Palacios ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Broad Ligament ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Exploratory Laparotomy ◽  
X Rays ◽  
Intestinal Necrosis ◽  
Urgent Surgery ◽  
Internal Hernias

Abstract INTRODUCTION Internal hernias caused by broad ligament defects are an infrequent cause of bowel obstruction. These defects may be congenital or acquired mainly by gynecological antecedents. Small bowel is the most common affected and the diagnosis is difficult due to nonspecific symptoms and absences of characteristic radiological signs. MATERIAL AND METHODS We report the cases of three women aged from 43 to 56 years old, who came to the emergency with abdominal pain, vomiting and bloating of hours duration. One patient has a history of laparoscopic appendectomy, the rest of them with no surgical history. In all of the cases, x-rays showed dilatation of small bowel loops and air-fluid levels and the abdominal TC revealed a generalized distention of bowel loops with transition point in the terminal ileum with no identifiable cause compatible with small bowel obstruction. RESULTS We decided to perform an urgent surgery with an exploratory laparotomy in one case and the rest by laparoscopic approach, finding an internal hernia occasioned by incarceration of small bowel through a broad ligament defect. In all cases, the hernia content was liberated without evidence of ischemia with no need for intestinal resection, and the defect was closed. All patients had a favourable postoperative course without complications. DISCUSSION Broad ligament defects are a rare cause of internal hernias. These are difficult to diagnose clinically as well as radiologically for an absence of characteristic signs. A high level of clinical suspicion allows early diagnosis and the treatment should be performed as soon as possible to reduce the chances of intestinal necrosis.

Laparotomy for Abdominal Stab Wound With Combined Omental and Organ Evisceration: 10-Year Experience From a Major Trauma Centre in South Africa

2021 ◽  
pp. 000313482110318
Author(s):  
Victor Kong ◽  
Cynthia Cheung ◽  
Nigel Rajaretnam ◽  
Rohit Sarvepalli ◽  
William Xu ◽  
...  
Keyword(s):  
South Africa ◽  
Small Bowel ◽  
Large Bowel ◽  
Major Trauma ◽  
Stab Wound ◽  
Length Of Hospital Stay ◽  
Trauma Centre ◽  
Major Trauma Centre ◽  
The Mean ◽  
Overall Mortality

Introduction Combined omental and organ evisceration following anterior abdominal stab wound (SW) is uncommon and there is a paucity of literature describing the management and spectrum of injuries encountered at laparotomy. Methods A retrospective study was undertaken on all patients who presented with anterior abdominal SW involving combined omental and organ evisceration who underwent laparotomy over a 10-year period from January 2008 to January 2018 at a major trauma centre in South Africa. Results A total of 61 patients were eligible for inclusion and all underwent laparotomy: 87% male, mean age: 29 years. Ninety-two percent (56/61) had a positive laparotomy whilst 8% (5/61) underwent a negative procedure. Of the 56 positive laparotomies, 91% (51/56) were considered therapeutic and 9% (5/56) were non-therapeutic. In addition to omental evisceration, 59% (36/61) had eviscerated small bowel, 28% (17/61) had eviscerated colon and 13% (8/61) had eviscerated stomach. A total of 92 organ injuries were identified. The most commonly injured organs were small bowel, large bowel and stomach. The overall complication rate was 11%. Twelve percent (7/61) required intensive care unit admission. The mean length of hospital stay was 9 days. The overall mortality rate for all 61 patients was 2%. Conclusions The presence of combined omental and organ evisceration following abdominal SW mandates laparotomy. The small bowel, large bowel and stomach were the most commonly injured organs in this setting.

scholarly journals Jejunal diverticular disease: a report of three cases

2020 ◽  
Vol 2020 (11) ◽  
Author(s):  
Richard Ghandour ◽  
Georges Khalifeh ◽  
Nasr Bou Orm ◽  
Mohamad Rakka ◽  
Samer Dbouk ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Diverticular Disease ◽  
Bowel Obstruction ◽  
Giant Diverticulum ◽  
Medical Entity ◽  
Adequate Management

Abstract Jejunal diverticula (JD) are a rare medical entity. They are often unnoticed, until complications occur. We report herein three cases of such diverticula, analyzed retrospectively, and depicting some of these complications: small bowel obstruction due to enterolith in a giant diverticulum treated surgically, incidental intraoperative finding on an anastomotic jejunal limb affecting the surgical plan and diverticulitis with anemia. In all three cases, the diagnosis of JD was unexpected, which illustrates the importance of being familiar with this disease for adequate management.

scholarly journals Closed loop obstruction and adhesive intestinal obstruction in perineal hernia

2020 ◽  
Vol 13 (12) ◽  
pp. e238112
Author(s):  
Ramprasad Rajebhosale ◽  
Mohammad Miah ◽  
Fraser Currie ◽  
Pradeep Thomas
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Transition Point ◽  
Closed Loop ◽  
Abdominoperineal Excision ◽  
Perineal Hernia ◽  
Bowel Gangrene ◽  
Adhesive Intestinal Obstruction

Perineal hernia with bowel gangrene is uncommon but known complication of laparoscopic extralevator abdominoperineal excision (ELAPE). We present a rare case of closed loop small bowel obstruction with bowel gangrene secondary to an incarcerated perineal hernia that developed 7 years after an ELAPE. Intraoperatively, we found a definitive transition point due to adhesions in pelvis and a closed loop obstruction of the distal small bowel at different site with gangrenous intestine. She was managed successfully surgically with adhesiolysis and fixation of defect with biological mesh. Prevalence of perineal hernias will rise in future because of the increasing cases of ELAPE, in which no repair of pelvic floor is performed. The need of follow-up of these operations and more reporting of such cases are important in increasing awareness of these complications. Patients should be made aware of such complications and should seek urgent medical care.

Determinant of bacterial translocation in the newborn: Small bowel versus large bowel colonization

1995 ◽  
Vol 30 (6) ◽  
pp. 831-836 ◽  
Author(s):  
Masahiko Urao ◽  
Jason Moy ◽  
Joan Van Camp ◽  
Robert Drongowski ◽  
Maher Altabba ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bacterial Translocation ◽  
Large Bowel

scholarly journals Quantitative analysis of total macrophage content in adult mouse tissues. Immunochemical studies with monoclonal antibody F4/80.

1985 ◽  
Vol 161 (3) ◽  
pp. 475-489 ◽  
Author(s):  
S H Lee ◽  
P M Starkey ◽  
S Gordon
Keyword(s):  
Bone Marrow ◽  
Small Bowel ◽  
Lymph Nodes ◽  
Large Bowel ◽  
Adult Mouse ◽  
Specific Antigen ◽  
Lymphoid Tissues ◽  
Mesenteric Lymph Nodes ◽  
Mesenteric Lymph ◽  
Mouse Tissues

We have estimated the macrophage content of different tissues of the normal adult mouse using F4/80, a highly specific antigen marker for mature mouse macrophages. An absorption indirect binding assay was used to quantitate F4/80 antigen against a calibration standard made from the J774.2 macrophage-like cell line. The richest sources of tissue F4/80 antigen were found to be bone marrow, spleen, cervical and mesenteric lymph nodes, large bowel, liver, kidneys, and small bowel. The organs that have the highest total F4/80 antigen content are the liver, large bowel, small bowel, bone marrow, spleen, cervical and mesenteric lymph nodes, and kidney. We conclude that the mononuclear phagocyte system is mainly distributed in the gastrointestinal tract and liver, followed by hemopoietic and lymphoid tissues.

Jewish Holiday “Tu Bishvat” or Two Cases of Small Bowel Obstruction with Dried Apricot

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Kukeev I ◽  
◽  
Replyansky I ◽  
Czeiger D ◽  
Atias S ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gastric Bypass Surgery ◽  
Surgical Removal ◽  
Cellulose Content ◽  
Lead Point ◽  
First Case ◽  
Dried Fruit ◽  
High Level

Introduction: Small bowel obstruction caused by bezoars is rare. One of the causes of phytobezoars is dried fruits. We present two cases of small bowel obstruction caused by dried apricots during Jewish holiday “Tu BiShvat”. Case Presentation: Two men, 54 and 86 years old hospitalized with acute abdomen attributed to small bowel obstruction. In the first case - intoxicated patient, due to suspicion of mesenteric ischemia underwent laparotomy. A lead point caused obstruction was found and after enterotomy whole dried apricot was removed. The patient swallowed it whole three days before hospitalization. In the second case, edentulous patient with small bowel obstruction and peritonitis underwent laparotomy. The cause of obstruction was a dried apricot swallowed whole by the patient. Discussion: Presentation of bezoar with features of acute surgical abdomen is extremely rare, accounting for only 1% of the patients. The expansion of phytobezoar that is high in cellulose content can absorb a large amount of fluid causing an obstruction of the small bowel. The treatment of small bowel obstruction caused by bezoars varies from dissolving with cellulase, papain and even Coca-Cola, followed by endoscopic and surgical removal. Conclusion: A high level of suspicion needs to exist in the presence of a history of eating dried fruit, which can cause gastrointestinal obstruction. Especially on background gastric bypass surgery and inadequate mastication.

Cocaine-induced mesenteric ischaemia requiring small bowel resection

2021 ◽  
Vol 14 (1) ◽  
pp. e238593
Author(s):  
Asya Veloso Costa ◽  
Asiya Zhunus ◽  
Rehana Hafeez ◽  
Arsh Gupta
Keyword(s):  
Small Bowel ◽  
Social History ◽  
Bowel Resection ◽  
Early Recognition ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Mesenteric Ischaemia ◽  
Bowel Ischaemia ◽  
Systemic Complications ◽  
Gastrointestinal Complications

Cocaine use causes profound vasoconstriction leading to various systemic complications. Gastrointestinal complications such as mesenteric ischaemia are difficult to recognise and may result in serious consequences if not treated promptly. We report on the case of a 47-year-old man presenting with mesenteric ischaemia on a background of acute on chronic cocaine consumption, where diagnosis was not evident until second presentation. He underwent an emergency laparotomy with small bowel resection and jejunostomy formation and made a good recovery with eventual reversal surgery. The literature on cocaine-induced bowel ischaemia shows significant variability in presentation and outcome. Laboratory investigations are non-specific, and early recognition is vital. Given the increasing recreational use of cocaine in the UK, it is imperative to have a high clinical index of suspicion for mesenteric ischaemia in patients presenting with non-specific abdominal pain, and to ensure a detailed social history covering recreational drug use is not forgotten.

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