scholarly journals Recurrent Enterolithiasis Small Bowel Obstruction: A Case Seldom Described

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ashish Lal Shrestha ◽  
Pradita Shrestha
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Exploratory Laparotomy ◽  
Diffuse Abdominal Pain ◽  
Case Presentation ◽  
Rare Phenomenon ◽  
Significant Clinical Improvement ◽  
History Of ◽  
High Index Of Suspicion

Background. Enterolithiasis of the small bowel is a rare phenomenon in humans although it has been frequently described in equines. Primary enteroliths have been described including those occurring secondary to conditions like Crohn’s disease, small bowel diverticula, tuberculous or postoperative strictures, and blind loops but those occurring in an otherwise normal gut are exceedingly rare. Of even greater rarity is a recurrent small bowel enterolith presenting with obstruction. This may be the first report of such kind.Case Presentation. A 70-year-old man undergoing treatment for stable alcoholic liver disease presented to the emergency with gradually progressive diffuse abdominal pain associated with vomiting and constipation for 7 days. He had gaseous abdominal distention but was not obstipated. He had a history of 2 laparotomies in the past for small bowel obstruction secondary to enterolith impaction. He was initially managed conservatively but since there was no significant clinical improvement, he underwent an exploratory laparotomy. A recurrent enterolith 5 × 5 cm in size was found impacted in the mid ileum with multiple dense serosal adhesions and bands. Adhesiolysis and enterotomy with removal of enterolith were performed.Conclusion. Recurrent enterolithiasis of the small bowel is a rare phenomenon and may present with recurrent obstruction. Definitive preoperative diagnosis is not always possible and a high index of suspicion is required to avoid table misdiagnosis. Surgery is the mainstay of treatment once conservative measures fail. Laparoscopic methods may help in diagnosis and avoid possibility of a subsequent adhesive bowel obstruction but are associated with technical challenges.

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 Diagnosis and Management of a Postpyloric Foreign Body Causing Small Bowel Obstruction in an Infant

2017 ◽  
Vol 10 ◽  
pp. 117954761771924
Author(s):  
Victoria Bradford ◽  
Marissa Vadi ◽  
Harmony Carter
Keyword(s):  
Foreign Body ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Pediatric Population ◽  
Exploratory Laparotomy ◽  
Foreign Body Ingestion ◽  
Common Occurrence ◽  
Diagnosis And Management ◽  
History Of

Foreign body ingestion is a common occurrence in the pediatric population and most ingestions resolve with little morbidity. Although radiopaque objects are easily identified on biplane radiographs, radiolucent objects may elude detection, delaying diagnosis. We report a case of a healthy 10-month-old infant who presented with a 5-day history of postprandial vomiting and imaging consistent with small bowel obstruction. On exploratory laparotomy, she was discovered to have a postpyloric foreign body requiring removal through an enterotomy.

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.

scholarly journals Internal hernia - a rare cause of small bowel obstruction: a case report

2016 ◽  
Vol 4 (1) ◽  
pp. 427 ◽  
Author(s):  
Samir U. Rambhia ◽  
Premjeet Madhukar
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Previous History ◽  
Exploratory Laparotomy ◽  
Internal Hernias ◽  
Post Surgery ◽  
History Of ◽  
Acute Small Bowel Obstruction

Internal hernia means a protrusion into pouches or openings in the peritoneum or mesentry in contrast to the hernias through defects in the retaining walls of the abdomen. Internal hernias are of many varieties with different classifications and can be congenital or acquired post-surgery. We present a case of a 55 year old female who presented with symptoms of acute small bowel obstruction with previous history of exploratory laparotomy 20 years back for reasons not known to her. Routine blood investigations, chest and abdomen skiagram and a CECT abdomen were performed (which gave no significant clue to diagnosis) and after a failed conservative trial patient was taken for exploration. Intra operatively a gangrenous loop of small bowel was found herniating through a band between the small bowel mesentry and the sigmoid mesocolon, forming a closed loop obstruction. Resection anastomosis of the gangrenous segment along with band transection was performed. The post-operative course was uneventful. Internal herniation as a cause of bowel obstruction should always be kept in mind as a differential.

scholarly journals Primary ileal volvulus: a rare twist in an elderly patient—case report

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Srikant Agrawal ◽  
Ashwini Ranjan Yadav ◽  
Bikash Nepal ◽  
Pramod Kumar Upadhyay
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Predisposing Factors ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Abstract Background Small bowel volvulus is a rare entity and it is even rarer for the ileum to undergo torsion without any known predisposing factors. It presents as acute abdomen with features of intestinal obstruction. As it is a life-threatening condition, it should be kept as a differential for small bowel obstruction despite its rarity. Therefore, we report this case. Case report A 60-year-old gentleman presented to our emergency department with a 2-day history of worsening abdominal pain, vomiting, abdominal distension and obstipation. Exploratory laparotomy was done which revealed ileal volvulus with no predisposing factors. Derotation of the segment was done. The postoperative period was uneventful and on follow up after a month, he had a satisfying recovery. Conclusion Though primary ileal volvulus is a rare diagnosis, it should be kept in mind in any patient with small bowel obstruction with pain out of proportion and resistant to opioid management. Early diagnosis and urgent surgical intervention is the key to prevent bowel necrosis and associated morbidity and mortality.

scholarly journals Meckel’s diverticulum: a rare cause of small bowel obstruction in an adult

2021 ◽  
Vol 8 (4) ◽  
pp. 1289
Author(s):  
Nusrat Jabeen ◽  
Hussain Adnan Abdulla ◽  
Asma Alqaseer ◽  
Mohamed Ayed Abushwemeh ◽  
Amal Alrayes
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Congenital Abnormality ◽  
Rare Case ◽  
Primary Anastomosis ◽  
Meckel’S Diverticulum ◽  
Exploratory Laparotomy ◽  
Meckel's Diverticulum ◽  
High Index Of Suspicion

Meckel’s diverticulum is the most common congenital abnormality of the gastrointestinal tract. Complications involving Meckel’s diverticulum include bleeding, bowel obstruction and inflammation. We present a rare case of small bowel obstruction caused by Meckel’s diverticulum. A 50-year-old male presented to the emergency department with abdominal pain and vomiting. Computed tomography (CT) abdomen showed dilated small bowel loops with transition zone at the mid ileum, consistent with small bowel obstruction. The patient was taken to the operating theatre for exploratory laparotomy and was found to have a Meckel’s diverticulum causing mechanical small bowel obstruction, which was resected with primary anastomosis. The patient recovered with no postoperative complications and was discharged home. Meckel’s diverticulum is difficult to diagnose preoperatively since most patients are asymptomatic and requires a high index of suspicion. In patients presenting with an acute abdomen, it may be overlooked because of nonspecific symptoms. In the case of small bowel obstruction, Meckel’s diverticulum should be kept in mind as part of the differential diagnosis.

scholarly journals Intramural Bowel Hematoma Presenting as Small Bowel Obstruction in a Patient on Low-Molecular-Weight Heparin

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Beatrix Hyemin Choi ◽  
Michael Koeckert ◽  
Sandra Tomita
Keyword(s):  
Molecular Weight ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Low Molecular Weight Heparin ◽  
Exploratory Laparotomy ◽  
Bleeding Risk ◽  
Low Molecular Weight ◽  
Spontaneous Bleeding ◽  
High Index Of Suspicion

There is increasing use of low-molecular-weight heparin (LMWH) for treatment of pediatric thromboembolic disease as it has been shown to be safe and effective. It has several advantages over unfractionated heparin, such as reduced need for monitoring, easier route of administration, decreased risk of heparin-induced thrombocytopenia, and lack of drug-drug interactions. Nevertheless, LMWH still poses a bleeding risk as with any anticoagulant therapy. We present the case of a 4-year-old boy who was placed on LMWH for a catheter-related deep venous thrombosis in the setting of intractable seizures and subsequently developed a small bowel obstruction secondary to a suspected intussusception. He underwent exploratory laparotomy and was found to have an intramural bowel hematoma. Prior to this bleed, the patient had been monitored daily, and his anti-Xa levels were found to be in the therapeutic range. This case highlights the need for a high index of suspicion for spontaneous bleeding even in the setting of therapeutic anti-Xa levels.

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.

An interesting case of left paraduodenal hernia.

2021 ◽  
Vol 28 (05) ◽  
pp. 755-758
Author(s):  
Sahar Saeed ◽  
Abeera Butt ◽  
Syed Asghar Naqi ◽  
Muhammad Mohsin Ali
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Interesting Case ◽  
Paraduodenal Hernia ◽  
Absorbable Suture ◽  
Internal Hernias ◽  
Plain Abdominal Radiography ◽  
History Of ◽  
Operative Recovery

Paraduodenal fossa hernias (PDFHs) represent 53% of all congenital internal hernias and 0.2-0.9% of all small bowel obstructions. Most of these hernias are diagnosed incidentally on laparotomy, and carry up to 50% lifetime risk of development of small bowel obstruction. We present our experience in diagnosing and treating a case of a massive left paraduodenal fossa hernia in a 17 year male, containing over 30% of the small bowel (jejunum and ileum), presenting with a history of recurrent incomplete small bowel obstruction. Plain abdominal radiography showed distended loops of jejunum and few air fluid levels. After laparotomy and identification of hernia, small gut was reduced and examined, which was found to be structurally and functionally intact with normal vascularity. The defect was closed with continuous absorbable suture (Vicryl 2-0) sparing the inferior mesenteric vessels. Patient’s post-operative recovery remained uneventful and he was discharged on 4th post-operative day.

Predictors of Ischemic Bowel in Patients with Small Bowel Obstruction

2016 ◽  
Vol 82 (10) ◽  
pp. 992-994 ◽  
Author(s):  
Michael P. O'Leary ◽  
Angela L. Neville ◽  
Jessica A. Keeley ◽  
Dennis Y. Kim ◽  
Christian De Virgilio ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Ischemia ◽  
Wall Thickening ◽  
Ischemic Bowel ◽  
Operative Exploration ◽  
Common Etiology ◽  
History Of ◽  
Exploratory Laparoscopy

Preoperative diagnosis of ischemic bowel in patients with small bowel obstruction (SBO) is a clinical challenge. The aim of this study was to identify preoperative variables associated with ischemic bowel found at operative exploration. We performed a 5-year retrospective review of patients admitted to a university affiliated, county funded hospital who underwent exploratory laparoscopy or laparotomy for SBO. Patients were excluded if they had a known preoperative malignancy or hernia on physical examination. Multivariate logistic regression was used to determine factors independently associated with bowel ischemia or ischemic perforation. One hundred and sixteen patients underwent exploratory surgery for SBO. Mean age was 52 ± 14 years and most were male [64 (55.2%)]. Adhesions [92 (79.3%)] were the most common etiology of obstruction. Leukocytosis ( P = 0.304) and acidosis ( P = 0.151) were not significantly associated with ischemia or ischemic perforation. In addition, history of prior SBO ( P = 0.618), tachycardia ( P = 0.111), fever ( P = 0.859), and time from admission to operation ( P = 0.383) were not predictive of ischemic bowel. However, hyponatremia (≤134 mmol/L) and CT scan findings of wall thickening or a suspected closed loop were independently associated with bowel ischemia. Awareness of these predictors should heighten the concern for ischemic bowel in patients presenting with SBO.

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