scholarly journals Multiple, Pan-Enteric Perforation Secondary to Intestinal Tuberculosis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Irfan Masood ◽  
Zain Majid ◽  
Ali Rafiq ◽  
Waqas Rind ◽  
Aisha Zia ◽  
...  
Keyword(s):  
Small Bowel ◽  
Terminal Ileum ◽  
Intestinal Tuberculosis ◽  
Exploratory Laparotomy ◽  
Common Site ◽  
Free Perforation ◽  
Generalized Peritonitis ◽  
Enteric Perforation

Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Herein, we describe a case of a 25-year-old male who presented with generalized peritonitis requiring an emergency exploratory laparotomy, which revealed pan-enteric perforation characterized by multiple perforations of the small bowel extending 10–15 cm from the DJ flexure up to the terminal ileum. The perforations were primarily closed, while 6–8 cm of the diseased terminal ileum was resected and the two ends were brought out as double-barreled ostomy. To the best of our knowledge, such an extensive tuberculous perforation of the small bowel has not been previously reported in the literature before.

scholarly journals Acute Spontaneous Multiple Ileal Tuberculosis Perforation: A Case Report

2017 ◽  
Vol 3 (2) ◽  
pp. 52-54
Author(s):  
Md Aminullah ◽  
Fahmida Akter Rima ◽  
Jamal Abdul Naser ◽  
Farzana Kabir ◽  
Waliullah Fuad ◽  
...  
Keyword(s):  
Lymph Node ◽  
Terminal Ileum ◽  
Histopathological Examination ◽  
Good Condition ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Exploratory Laparotomy ◽  
Excisional Biopsy ◽  
Free Perforation ◽  
Diffuse Abdominal Pain

A 18 years old boy presented with severe diffuse abdominal pain, constipation, abdominal distention, fever and diagnosed as a case of perforation as free gas noted under both dome of the diaphragm. After resuscitation, exploratory laparotomy was done and diagnosed as a case of multiple spontaneous leaky perforations of jejunum and ileum 25 to 30 cm from duodeno-Jejunal flexure (DJ) up to terminal ileum. Peritoneal toileting and excisional biopsy of the mesenteric lymph node were done. Operative and postoperative period were uneventful. Histopathological examination of the resected lymph node revealed granulomatous inflammation compatible with tuberculosis. Anti-tubercular therapy was started and continued for 6 months. Patient was discharged on the 12th postoperative day in a good condition. At 3 months of follow up the patient was asymptomatic and thriving well. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. Bangladesh Journal of Infectious Diseases 2016;3(2):52-54

scholarly journals T-shaped Meckel’s diverticulum: a rare anatomical variant complicating small bowel volvulus

2018 ◽  
Vol 5 (8) ◽  
pp. 2929
Author(s):  
Vergis Paul ◽  
Ramu R. ◽  
Kocheril Sheryl Mathews ◽  
Ashly Thomas ◽  
Reesha P. A. ◽  
...  
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Terminal Ileum ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
Anatomical Variant ◽  
Small Bowel Volvulus ◽  
Common Presentation ◽  
Congenital Diverticulum

The Meckel's diverticulum is a congenital diverticulum arising from the terminal ileum and is the unobliterated proximal portion of the vitellointestinal duct. Intestinal obstruction due to Meckel’s diverticulum is the most common presentation in adults and is the second most common presentation in children. We present a case of a 58-year-old gentleman presented with acute abdomen who was later found to have Giant T- shaped Meckel’s Diverticulum complicating small bowel volvulus on exploratory laparotomy. A T-shaped Meckel's diverticulum has not yet been described.

scholarly journals A rare complication of the great mimicker: free tubercular ileal perforation

2021 ◽  
Vol 8 (4) ◽  
pp. 1366
Author(s):  
S. P. Gayathre ◽  
Kudiyarasu . ◽  
R. Kannan ◽  
N. Shajini
Keyword(s):  
Small Bowel ◽  
Rare Complication ◽  
Bowel Perforation ◽  
Adhesion Formation ◽  
Intestinal Tuberculosis ◽  
Abdominal Tuberculosis ◽  
Emergency Setting ◽  
Elderly Male ◽  
Free Perforation ◽  
Diagnostic Modality

Primary intestinal tuberculosis is an uncommon form of extra-pulmonary tuberculosis. With non-specific manifestations, unusual presentations and no proven superior diagnostic modality, differentiation and diagnosis of abdominal tuberculosis is a difficult scenario. Undiagnosed, untreated cases may present with complications. Free perforation of small bowel due to tuberculosis is a rare complication (1-2%) because of adhesion formation and reactive peritoneal thickening; however, when it occurs is most feared for its association with high mortality. We report a case of an elderly male who presented with features of intestinal perforation, treated with emergency surgery and diversion ostomy for small bowel perforation which was diagnosed post-operatively to be of tubercular etiology. Acute care surgeons may be trapped in diagnosing such cases with its non-specific imaging findings, and hence must maintain a low threshold for surgical intervention in the emergency setting.

scholarly journals A Rare Case of Pneumoperitoneum in Pregnancy: Perforation of Tubercular ileal Ulcer

2021 ◽  
Vol 5 (8) ◽  
pp. 01-04
Author(s):  
Richmond Ronald Gomes
Keyword(s):  
Terminal Ileum ◽  
Wedge Resection ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Tuberculosis Patient ◽  
Free Perforation ◽  
Ileal Perforation ◽  
Migrant Communities ◽  
Inflammatory Bowel ◽  
Anti Tubercular Therapy

The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of intestinal tuberculosis can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. We present a 25 year old 17 weeks primi presented with peritonitis with solitary perforation of terminal ileum with miscarriage of fetus and subsequent surgical wedge resection of ileum and ileo-ileal anastomosis. Histology revealed presence of Langerhan’s cell with caseating granulomatous inflammation. There was no radiological evidence of pulmonary tuberculosis. Patient was started on anti-tubercular therapy and responded well. This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition.

scholarly journals Galinės klubinės žarnos obstrukcinis užspaudimas kirmėlinės ataugos kilpa

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Eglė Zakarauskaitė ◽  
Raimundas Lunevičius
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Terminal Ileum ◽  
Closed Loop ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Vermiform Appendix ◽  
Clinical Report ◽  
Vilnius University ◽  
The Right

Eglė Zakarauskaitė, Raimundas LunevičiusVilniaus universitetas, Gastroenterologijos, chirurgijos ir nefrourologijos klinikosBendrosios chirurgijos centras, Vilniaus universitetinė greitosios pagalbos ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Tikslas Aprašyti ir įvertinti visišką klubinės žarnos galinės dalies obstrukcinį nepraeinamumą dėl jos užspaudimo atipinės padėties kirmėlinės ataugos kilpa suaugusiam pacientui. Klinikinis atvejis Ligonis B. A., 71 metų, dėl sąrėmių pobūdžio skausmų visame pilvo plote, pilvo pūtimo ir pykinimo skubos tvarka hospitalizuotas į pilvo chirurgijos skyrių. Pacientas anksčiau nė karto nebuvo operuotas. Objektyvaus tyrimo rezultatai: pilvas išsipūtęs, skausmingas, maksimalaus skausmingumo ir pilvaplėvės dirginimo vieta – dešinioji klubinė sritis, auskultuojant žarnyną girdėti kliūtinė peristaltika. Apžvalginėje pilvo rentgenogramoje matyti daug Kloiberio dubenėlių išsipūtusioje plonojoje žarnoje. Diagnozavus konservatyviam gydymui atsparų visišką mechaninį žarnyno nepraeinamumą, atlikta vidurinė laparotomija. Operaciniai radiniai: stipriai išsipūtusi, iki galinės dalies perpildyta skysčių ir dujų plonoji žarna. Priežastis – apie galinę klubinės žarnos dalį kilpa apsisukusi, ją visiškai užspaudusi ir prie jos priekinės dalies pasaito prisitvirtinusi kirmėlinė atauga. Atlikta apendektomija, plonoji žarna intubuota peroraliniu enterodekompresiniu zondu. Kirmėlinės ataugos histologiniu tyrimu nustatyti antrinio uždegimo požymiai: paviršinis apendicitas ir hemoraginis periapendicitas. Pooperacinis laikotarpis buvo sklandus. Išvada Šis klinikinis atvejis patvirtina, jog galima labai reta komplikacija dėl atipinės kirmėlinės ataugos padėties: klubinės žarnos galinės dalies obstrukcinis užspaudimas kirmėlinės ataugos kilpa. Pagrindiniai žodžiai: apendiksas, atipinė padėtis, klubinės žarnos obstrukcija Strangulated terminal ileal obstruction due to closed-loop appendix Eglė Zakarauskaitė, Raimundas LunevičiusVilnius University, General Surgery Center of Clinic of Gastroenterology,Nephrourology and Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Objective To describe and estimate a strangulated (by atypical appendix) closed-loop obstruction of the terminal ileum in an adult. Case report 71-year-old male was admitted because of crampy abdominal pain associated with nausea. There was no history of previous intraabdominal operations. On examination, the patient had obvious abdominal distention with peritoneal signs localized in the right iliocecal region. Bowel sounds were decreased. X-ray films showed multiple air fluid levels in the small intestine. Small-bowel obstruction was diagnosed and exploratory laparotomy was performed. The small intestine was heavily dilatated, overflowed by fluids and air because of a vermiform appendix wrapped around the terminal ileum and its mesenterium, and by its tip adhered to the ileocecal recessus. An appendectomy was performed, the small bowel was intubated using an enterodecompressive probe. Histopathology confirmed the diagnosis of secondary superficial appendicitis and hemorrhagic periappendicitis. The convalescence was not delayed. There were no postoperative complications. Conclusions This clinical report shows an unusual but possible very rare complication of atypically located appendix in an adult: a strangulated closed-loop obstruction of the terminal ileum. Key words: appendix, atypical positioning, acute ileal obstruction

scholarly journals Synchronic Pulmonary and Intestinal Tuberculosis in an Elderly Patient

2020 ◽  
Vol I (3) ◽  
pp. 40-42
Author(s):  
Tirado-Peraza AI
Keyword(s):  
Elderly Patient ◽  
Mycobacterium Tuberculosis ◽  
Acute Abdomen ◽  
Terminal Ileum ◽  
Elderly Woman ◽  
Intestinal Tuberculosis ◽  
Free Perforation ◽  
Gastrointestinal Tuberculosis

We present the case of an elderly woman who presented to the ER with acute abdomen. During surgery, a free perforation in terminal ileum was found so ileostomy and resection were made. Pathology examination reported intestinal tuberculosis, and plain thorax radiography showed a classic Ghon complex. We present a brief report of this uncommon entity. Keywords: Gastrointestinal Tuberculosis; Mycobacterium tuberculosis Infections; Ileostomy

scholarly journals Asymptomatic Ileal Neuroendocrine “Carcinoid” Tumor Incidentally Diagnosed on Colorectal Cancer Screening Colonoscopy: Does Routine TI Intubation Matter?

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ali Zakaria ◽  
Lynna Alnimer ◽  
Gregory Byrd ◽  
Marc Piper ◽  
Michael Raphael ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Small Bowel ◽  
Terminal Ileum ◽  
Case Series ◽  
Screening Colonoscopy ◽  
Common Site ◽  
Critical Question ◽  
Intubation Technique ◽  
Asymptomatic Patients ◽  
Definition Of

Gastrointestinal neuroendocrine tumors (GINETs) (also known as “carcinoids”) are rare tumors with reported incidence of up to 6.98 per 100,000 which has increased significantly due to the increased detection on imaging and endoscopy. They are most commonly located in the small bowel, particularly the terminal ileum. Patients with small bowel NETs may present with abdominal pain, diarrhea, or carcinoid syndrome. However, the disease is mostly asymptomatic, and patients are usually diagnosed incidentally during routine colonoscopy. Although the ileum is the most common site for GINETs, terminal ileal (TI) intubation is not always completed during routine colonoscopy. With terminal ileum intubation being successful in at least 70% of colonoscopies and the rate of neuroendocrine tumor detection 0.1–1% of those intubations, one critical question remains unanswered: should terminal ileal intubation be considered a part of the definition of a complete colonoscopy? Herein, we present nine cases of NETs found incidentally on routine colon cancer screening colonoscopy in asymptomatic patients. This case series adds to the sparse literature and highlights the importance of TI intubation technique in early detection of small bowel NETs which could potentially affect the outcome.

scholarly journals Clinicopathological study of Ileal perforation: study in tertiary center

2017 ◽  
Vol 4 (2) ◽  
pp. 543 ◽  
Author(s):  
Rangappa Poornima ◽  
K. L. Venkatesh ◽  
Goutham M. V. ◽  
. Nirmala ◽  
Noorulla Hassan
Keyword(s):  
Typhoid Fever ◽  
Terminal Ileum ◽  
Enteric Fever ◽  
Intestinal Tuberculosis ◽  
Exploratory Laparotomy ◽  
Hollow Viscus ◽  
Ileal Perforation ◽  
Tertiary Center ◽  
Nonspecific Inflammation ◽  
Hollow Viscus Perforation

Background: The objective of this study was to evaluate the clinicopathological characteristics in Ileal perforations because of confusion and controversy over the diagnosis and optimal surgical treatment of terminal Ileal perforation -a cause of obscure peritonitis. Perforation of terminal ileum is a cause for obscure peritonitis with severe toxic state, there may be obscured clinical features with resultant delays in diagnosis and adequate surgical intervention.Methods: A prospective study was conducted in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College and Research Institute over a period of 5 years from June 2011 to May 2015. A total of 136 patients presented in this period with hollow viscus perforation and out of these 64 patients had Ileal perforation alone on exploratory laparotomy. Ileal perforations account for about 20 percent of all cases of hollow viscus perforation. Emergency exploratory laparotomy was done and perforation was identified, edge biopsy was taken in all cases and the perforation was closed in two layers and resection anastomosis was done in stricture with perforation. Histopathological report was reviewed following surgery.Results: A total of 64 patients with Ileal perforation were included in the study of which 52 were males and 12 were females accounting for 81.25 percent and 18.75 percent respectively. The causes for perforation were enteric fever (82.81%), nonspecific inflammation (9.38%), and tuberculosis (7.81%). Simple closure of the perforation (74.58%) and the remaining primary resection and anastomosis were the mainstay of the surgical management.Conclusions: The common pathology of Ileal perforation is Typhoid or Enteric fever, Non-specific ulcer, Tuberculosis and others. Intestinal complications of typhoid fever are quite common in developing countries. Nonspecific inflammation of the terminal ileum was other predominant cause operative findings were similar to that of typhoid fever but no laboratory evidence of the disease was found. Intestinal tuberculosis can mimic many conditions.

scholarly journals Spontaneous Perforation of Common Bile Duct: A Rare Presentation of Gall Stones Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Duminda Subasinghe ◽  
Edippuli Arachchige Don Udayakumara ◽  
Upul Somathilaka ◽  
Milinda Huruggamuwa
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Exploratory Laparotomy ◽  
Spontaneous Perforation ◽  
Rare Presentation ◽  
Free Perforation ◽  
Generalized Peritonitis ◽  
Gall Stones ◽  
Upper Abdominal

Background. Spontaneous perforation of the extrahepatic biliary system is a rare presentation of gall stones. Very few cases of bile duct perforation have been reported in adults. It is rarely suspected or correctly diagnosed preoperatively.Case Presentation. A 66-year-old female presented at the surgical emergency with 3 days’ history of severe upper abdominal pain with distension and repeated episodes of vomiting, as she had evidence of generalized peritonitis and underwent an exploratory laparotomy. A single 0.5 cm×0.5 cm free perforation was present on the anterolateral surface of the common bile duct at the junction of cystic duct. A cholecystectomy and the CBD exploration were performed.Conclusion. Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of gall stones in adults. Therefore, awareness of the clinical presentation, expert ultrasound examination, and surgery are important aspects in the management.

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

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