scholarly journals Jejuno-jejunal intussusception in adults secondary to submucosal leiomyoma

2005 ◽  
Vol 58 (7-8) ◽  
pp. 405-409
Author(s):  
Miroljub Draskovic ◽  
Sidor Misovic ◽  
Goran Kronja ◽  
Jovan Krsic ◽  
Aleksandar Tomic ◽  
...  
Keyword(s):  
Small Bowel ◽  
Older Patients ◽  
Rare Case ◽  
Histopathological Examination ◽  
Abdominal Discomfort ◽  
Intestinal Lumen ◽  
Treatment Delays ◽  
Surgical Ward ◽  
Recurrent Vomiting ◽  
Bowel Continuity

Introduction Intussusception is the invagionation of a segment of the intestine into itself. It is a serous condition that most commonly affects infants and children, but can also occur in adults. Intussusception in adults is usually caused by tumors, benign or malignant. Early diagnosis is essential to avoid treatment delays, which can increase morbidity and mortality. In older patients and adolescents the diagnosis can be complicated due to lower incidence and variable subacute symptoms. Case report We report a rare case of a 27-year-old patient with increasing abdominal discomfort over several weeks. The patient experienced increasing colics, recurrent vomiting, dehydration and weight loss. Finally he was transferred to the surgical ward of our hospital. Intussusception of the small bowel was diagnosed by CT examination. Laparotomy revealed a jejunojejunal intussusception caused by a small bowel tumor. Conclusion The tumor in the jejunum, almost completely obstructed the intestinal lumen and it was resected and bowel continuity was restored. Histopathological examination revealed a submucosal leiomyoma of the jejunum.

scholarly journals An Elusive Bullet in the Gastrointestinal Tract: A Rare Case of Bullet Embolism in the Gastrointestinal Tract and a Review of Relevant Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Saptarshi Biswas ◽  
Catherine Price ◽  
Sunil Abrol
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Rare Case ◽  
Gunshot Wound ◽  
Abdominal Cavity ◽  
Relevant Literature ◽  
Distal Colon ◽  
Late Presentation ◽  
Intestinal Lumen ◽  
Unique Case

Bullet embolism within the gastrointestinal system is extremely rare. Such bullet injuries are infrequently covered in the general literature, but the surgeon should be aware of the phenomenon. Smaller caliber bullets are more common in civilian gunshot wound (GSW) events. These bullets are able to tumble through the gastrointestinal tract and cause perforation of the intestinal lumen which is small enough to be easily missed. Bullets retained in the abdominal cavity should not be dismissed as fixed and should be carefully monitored to ensure that they do not embolize within the bowel and cause occult lesions during their migration. We present a unique case wherein a bullet caused a minute perforation in the small bowel, before migrating to the distal colon, which resulted in late presentation of sepsis secondary to peritonitis.

scholarly journals A parasitic myoma: clinicopathological study of a rare case

2017 ◽  
Vol 7 (1) ◽  
pp. 352
Author(s):  
Nanda J. Patil ◽  
Puja A. Pingle ◽  
Gayatri N. Patel
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Pelvic Mass ◽  
Abdominal Discomfort ◽  
Rare Entity ◽  
Imaging Studies ◽  
Fibrous Stroma ◽  
Clinicopathological Study ◽  
Pathologic Basis ◽  
Figo Classification

Leiomyoma is a benign tumour composed of smooth muscle cells with fibrous stroma and it is the commonest tumour amongst the tumours of uterus. As per FIGO classification system parasitic leiomyoma has no myometrial involvement or uterine attachment. These myomas get detached from the uterus and receive the blood supply from another source. The etiology and pathologic basis of these parasitic fibroids is not yet clearly understood. We report a rare case of parasitic myoma in a 29 years old female patient presented with abdominal discomfort and difficulty in micturition. Clinical examination and subsequent imaging studies revealed a pelvic mass. Histopathological examination of which proved it to be a parasitic myoma. Parasitic myoma is a rare entity which may be iatrogenically created after surgery particularly with morcellation technique. With increasing rates of laparoscopic procedures, surgeons should be aware of the possibility of formation of parasitic myoma and should take intraoperative precautions to minimise its formation.

A RARE CASE OF PERFORATED ILEAL GIST PRESENTING AS ACUTE ABDOMEN

2021 ◽  
pp. 22-23
Author(s):  
B. Santhi ◽  
Deepak Karanam ◽  
Shihrayio kayina
Keyword(s):  
Small Bowel ◽  
Acute Abdomen ◽  
Gastrointestinal Stromal Tumors ◽  
Rare Case ◽  
Histopathological Examination ◽  
R0 Resection ◽  
Emergency Laparotomy ◽  
Review Of The Literature ◽  
Ileal Loop ◽  
Stromal Tumors

A case of perforated gastrointestinal stromal tumor (GIST) of ileum causing acute abdomen is described, with a brief review of the literature. A male patient presented with symptoms of acute abdomen. After evaluation, a laparotomy was performed, where perforation of a tumor in the ileum was found. The tumor was attached to the ileal loop and also to the peritoneal attachment of the dome of urinary bladder. The tumor was resected with adjacent ileal loop and ileoileal anastomosis was done . On examining later revealed a perforation of small bowel at the site of tumor and histopathological examination showed that the tumor was GIST. Postoperative period was uneventful and the patient received treatment, using imatinib. Gastrointestinal stromal tumors are relatively rare and often present with vague symptoms. Their rst clinical manifestation as acute abdomen due to their perforation is extremely rare. In emergency laparotomy, a R0 resection is required and adjuvant therapy with imatinib must be considered.

scholarly journals A Rare Case of Large Impacted Stone in Jejunum Causing Obstruction in a Patient of Gallstone Ileus

2020 ◽  
Vol 27 (1) ◽  
pp. E202014
Author(s):  
Dawood Iqbal Wani ◽  
Satish Parihar ◽  
Ankit Prabhakar ◽  
Nasib Chand Digra ◽  
Ab Hamid Wani
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Therapeutic Management ◽  
Intestinal Lumen ◽  
Impacted Stone

Gallstone ileus is a rare complication of cholelithiasis that occurs as a result of occlusion of the intestinal lumen by a large sized gallstone accounting for 1-4% cases of small bowel obstruction. The aim of this work is to introduce a case report that emphasize the diagnostic and therapeutic management of gallstone ileus with an enterolith impacted in jejunum (an uncommon site).

Histological examination of rat small intestine after surgical removal of obturation small bowel obstruction and peptide stimulation of lymph flow

2018 ◽  
pp. 157-162
Author(s):  
А.А. Коваленко ◽  
Г.П. Титова ◽  
В.К. Хугаева
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Small Bowel ◽  
Goblet Cells ◽  
Intestinal Wall ◽  
Structure And Function ◽  
Lymph Flow ◽  
Intestinal Lumen ◽  
And Function

Оперативное лечение различных заболеваний кишечника сопровождается осложнениями в виде нарушений микроциркуляции в области анастомоза кишки. Ранее нами показана способность лимфостимуляторов пептидной природы восстанавливать нарушенную микроциркуляцию, что послужило основой для настоящего исследования. Цель работы - оценка влияния стимуляции лимфотока в стенке кишки на процессы восстановления микроциркуляции, структуры и функции тонкой кишки в области оперативного вмешательства. Методика. В экспериментах на наркотизированных крысах (хлоралгидрат в дозе 0,6 г/кг в 0,9% растворе NaCl) моделировали различные поражения тонкой кишки (наложение лигатуры, перевязка 1-3 брыжеечных артерий, перекрут петли кишки вокруг оси брыжейки, сочетание нескольких видов повреждений). Резекция поврежденного участка через 1 сут. с последующим созданием тонкокишечного анастомоза завершалась орошением операционного поля раствором пептида-стимулятора лимфотока (40 мкг/кг массы животного в 1 мл 0,9% раствора NaCl). На 7-е сут. после операции проводили гистологическое исследование фрагмента кишки в области анастомоза. Результаты. На 7-е сут. после резекции у выживших животных (летальность вследствие кишечной непроходимости составляла 30%) имеют место морфологические признаки острых сосудистых нарушений стенки кишки, изменений кровеносных и лимфатических микрососудов, интерстициальный отек всех слоев стенки кишки, дилатация просвета кишки, повреждение всасывающего эпителия ворсин с истончением щеточной каемки клеток, морфологические признаки гиперфункции бокаловидных клеток. Использование лимфостимулятора пептидной природы после операции увеличивало выживаемость животных на 24%. У части животных отмечалось уменьшение расширения просвета кишки, у других практически полная его нормализация. Восстанавливалась форма кишечных ворсин и распределение бокаловидных клеток. Отсутствовали признаки внутриклеточного и межмышечного отека. Отмечено умеренное полнокровие венул. Заключение. Использование лимфостимулятора при хирургическом лечении кишечной непроходимости увеличивает выживаемость животных на 24% по сравнению с контролем, способствует более раннему восстановлению структуры и функции тонкой кишки. Полученные результаты свидетельствуют о перспективности использования стимуляции лимфотока при операциях на кишечнике. Surgical treatment of bowel diseases is associated with complications that cause microcirculatory disturbances in the anastomosis area and may lead to a fatal outcome. This study was based on our previous finding that peptide-type lymphatic stimulators are able to restore impaired microcirculation. The aim of this work was stimulating the lymph flow in the intestinal wall to facilitate recovery of microcirculation, structure and function of the small intestine in the area of surgical intervention. Methods. In experiments on anesthetized rats (0.6 g/kg chloral hydrate in 0.9% NaCl), various small bowel lesions were modeled (bowel ligation, ligation of 1-3 mesenteric arteries, gut torsion, combination of several lesion types). In 24 h, the damaged area was resected, and a small intestine anastomosis was creased. The surgery was completed with irrigation of the operative field with a solution of lymph flow stimulating peptide (40 мg/kg body weight in 1 ml of 0.9% NaCl). A gut fragment from the anastomosis area was examined histologically on day 7 after the surgery. Results. On the 7th day after removing the intestinal obstruction, the surviving animals (lethality 30%) had morphological signs of acute vascular disorders in the intestinal wall; changes in blood and lymphatic microvessels; interstitial edema of all intestinal wall layers; dilatation of the intestinal lumen; damage to the absorptive epithelium of villi with thinning of the brush border, and hyperfunction of mucous (goblet) cells. The use of the peptide after surgery increased the survival rate of animals by 24% and provided a smaller dilatation of the intestinal lumen in some animals. In other animals, the lumen recovered. The shape of intestinal villi and distribution of goblet cells were restored. Signs of intracellular and intermuscular edema were absent. Moderate venular congestion was noticed. Conclusion. Using the lymphatic stimulator in surgical treatment of intestinal obstruction increases the survival rate of animals by 24% compared to the control, facilitates earlier restoration of the small intestine structure and function. The obtained results indicated the effectiveness of lymphatic stimulation in intestinal surgery.

A Rare Case: Primary Venous Malformation in Parietal Bone

2021 ◽  
pp. 1-4
Author(s):  
Serhat Yarar ◽  
Ilker Uyar ◽  
Mehmet Emin Cem Yildirim ◽  
Mehmet Dadacı ◽  
Bilsev Ince
Keyword(s):  
Vascular Malformation ◽  
Rare Case ◽  
Histopathological Examination ◽  
Vascular Malformations ◽  
Venous Malformation ◽  
Parietal Bone ◽  
Hair Density ◽  
Trichilemmal Cyst ◽  
Advancement Flaps ◽  
Rotation Advancement

Primary intraosseous vascular malformations (PIVMs) are rare intraosseous lesions, accounting for approximately 0.5–1% of all intraosseous tumours. In this case report, we aimed to present a rare case of intraosseous vascular malformation causing a large lytic area in the parietal bone. A 25-year-old male patient was admitted to the clinic with a mass on the parietal bone. On physical examination, it was observed that the hair density on the mass was decreased, the mass had a soft consistency, and there was no pain on palpation. The patient was operated under local anaesthesia with a provisional diagnosis of a trichilemmal cyst. However, intraoperative diagnosis was a vascular malformation. There was a 3-cm full-thickness defect on the parietal bone caused by the lesion. The mass was excised completely while preserving the integrity of the dura. The resulting defect was reconstructed with bilateral rotation advancement flaps. The calvarial defect was not reconstructed due to equipment inadequacy. No complications were encountered in the postoperative period. Ninety-three PIVM cases have been reported in the skull since 1845. In very few of these cases, the mass is located in the parietal bone. The pathogenesis of PIVMs is not completely understood. The definitive diagnosis is made by histopathological examination. The therapeutic gold standard is surgery. Surgeons should keep in mind that radiological examination before the operation could prevent undesirable complications.

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.

A RARE CASE OF HETEROTOPIC PANCREATIC TISSUE CAUSING SMALL BOWEL OBSTRUCTION

2021 ◽  
pp. 4-5
Author(s):  
B. Santhi ◽  
M. Annapoorani ◽  
Sharada bhavana
Keyword(s):  
Intestinal Obstruction ◽  
Rare Case ◽  
Histopathological Examination ◽  
Pancreatic Tissue ◽  
Acute Intestinal Obstruction ◽  
Emergency Laparotomy ◽  
Review Of Literature ◽  
Heterotopic Pancreatic Tissue ◽  
Small Growth ◽  
Upper Gastrointestinal

A Rare case of heterotopic pancreatic tissue of ileum causing acute intestinal obstruction has been described with a brief review of literature. A 42 yr old male patient presented to the emergency department with features of acute intestinal obstruction. After evaluation patient was taken up for emergency laparotomy which revealed a band to be arising from ileum. Furthermore, there was a small growth in the ileal wall at the site of origin of the band. Hence resection of the growth was done and followed by ileoileal anastomosis. Later on, histopathological examination of the growth revealed it to be heterotopic pancreatic tissue. Heterotopic pancreatic tissue is often an incidental nding encountered in upper gastrointestinal tract during endoscopy and surgeries. But Symptomatic ectopic pancreas of ileum is relatively rare and they very rarely present with acute symptoms as in this case

EP.FRI.543 A rare case of acute jejuno-jenual intussusception in a patient with Roux-en-Y bypass secondary to a benign polyp

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Armin Fardanesh ◽  
Jamie Powell ◽  
Maitham Al-Whouhayb
Keyword(s):  
Small Bowel ◽  
Rare Case ◽  
Exploratory Laparotomy ◽  
Lead Point ◽  
Benign Polyp ◽  
Small Bowel Intussusception ◽  
Pathological Lead Point ◽  
Malignant Lesions ◽  
Ectopic Pacemaker ◽  
Upper Abdominal

Abstract Introduction Roux-en-Y Gastric bypass (REYGB) amounts for a third of surgical bariatric interventions. Small bowel obstruction (SBO) is a long-term complication in REYGB and can be caused by intussusception of bowel, in approximately 0.5% of procedures.  Intussusception in REYBG is mostly attributed to dysmotility. This report demonstrates a rare case of intussusception in REYGB secondary to a benign polyp.  Case description A 45 year old female, three years post REYGB, presented to A&E with acute, extreme upper abdominal pain, with three days absolute constipation. She was tender on examination with normal blood tests. CT scan demonstrated small bowel intussusception. Initial concerns were of intussusception of the jejuno-jejunostomy anastomosis causing SBO.  She had an exploratory laparotomy, which confirmed intussusception, however this was 20cm distal to the jejuno-jejunostomy. Bowel was gently reduced, and deemed viable. On thorough run-through, a small segment at the transition point, was considered abnormal on palpation. This region was resected and a 1x1cm intraluminal polyp was identified as the causative lead point. The patient did well postoperatively.  Discussion Small bowel intussusception in adults is typically attributed to pathological lead point, such as benign or malignant lesions. Intussusception in REYBG is a rare but well-documented cause of intestinal obstruction, usually attributed to dysmotility, secondary to ectopic pacemaker cells particularly around anastomoses. In this case, the intussusception was caused by an unusual pathology separate from the jejuno-jejunal anastomosis. We recommend thorough examination of all adjacent bowel to exclude lesions, in this case a polyp, which could result in recurrence. 

scholarly journals A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

2016 ◽  
Vol 9 ◽  
pp. CPath.S31734 ◽  
Author(s):  
Magda H. A. Nasreldin ◽  
Eman A. Ibrahim ◽  
Somaia A. Saad El-Din
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Parathyroid Tissue ◽  
Thyroid Tumor ◽  
Cervical Lymph Nodes ◽  
Neck Masses ◽  
Malignant Thyroid Tumor ◽  
Branchial Arches ◽  
Thyroid Swelling ◽  
Solid Cell

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

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