scholarly journals Preoperative identification of bleeding site caused by angiodysplasia of the small bowel by means of selective arteriography and application of methylene blue

2010 ◽  
Vol 67 (12) ◽  
pp. 1029-1032
Author(s):  
Goran Stanojeviċ ◽  
Petar Bosnjakovic ◽  
Miroslav Stojanoviċ ◽  
Milan Jovanoviċ ◽  
Branko Brankovic ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Small Bowel ◽  
Urgent Care ◽  
Jejunal Loop ◽  
Bleeding Site ◽  
Bleeding Events ◽  
Contrast Extravasation ◽  
Bowel Surgery ◽  
Urgent Surgery ◽  
Selective Arteriography

Background. Small bowel hemorrhages are rare and account for 2-10% of all gastrointestinal bleedings. In case that surgery is necessary, identification of the bleeding site is the most important problem. Case report. We presented here the case of a 65-year old man, admitted for urgent care of massive lower gastrointestinal bleeding. After reanimation and normalization of vital parameters, selective arteriography was done. A contrast extravasation site was identified at the level of jejunal branches of a. mesenterica superior and labeled by means of methylene blue application. Immediately after we performed conservative resection of the labeled jejunal loop in 10 cm length and terminoterminal anastomosis. The preparation was sent for histopathologic examination - small bowel angiodysplasia was identified. The patient was monitored in three month intervals in the next two years and new bleeding events were not observed. Conclusion. Bleeding caused by small bowel angiodysplasia is a significant diagnostic problem in cases in whom urgent surgery is required. Combined preoperative selective arteriography and methylene blue application make possible precise identification of the bleeding site as well as conservative small bowel surgery, avoiding thus the risk and danger of malabsorption syndrome.

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.

scholarly journals Experience of serious intestinal hemorrhage and perforation in small bowel lymphoma: a case report

2021 ◽  
Vol 17 (2) ◽  
pp. 126-130
Author(s):  
Seo Ree Kim ◽  
Sang Hoon Chun ◽  
Jong Youl Jin ◽  
Tae-Geun Gweon ◽  
Hayemin Lee ◽  
...  
Keyword(s):  
Small Bowel ◽  
B Cell ◽  
Cell Lymphoma ◽  
Wound Dehiscence ◽  
B Cell Lymphoma ◽  
Distal Ileum ◽  
Intestinal Bleeding ◽  
Urgent Surgery ◽  
Large B Cell Lymphoma ◽  
Large B Cell

There have been several reports of complications of small bowel lymphoma, such as bleeding, obstruction, and perforation, often require emergency surgery. It is hardly showed complications of bleeding and wound dehiscence for diffuse large B cell lymphoma with distal ileum involvement, which needed urgent surgery and medical management. A 65-year-old man with diffuse large B-cell lymphoma with distal ileum involvement experienced both intestinal bleeding and perforation during the course of treatment. As the patient was diagnosed with stage III disease, resection before chemotherapy was not considered due to the resulting delay in chemotherapy, which necessitated sufficient tissue healing. Chemotherapy is important when treating small bowel lymphoma, complications such as bleeding and perforation should always be considered for the treatment of small bowel lymphoma, and surgery is necessary in this situation. After surgery of the small bowel, subsequent chemotherapy could cause wound dehiscence and perforation; therefore, adequate recovery time should be given before chemotherapy.

Anastomotic insufficiency in small bowel surgery ?incidence and treatment

1986 ◽  
Vol 368 (2) ◽  
pp. 105-111 ◽  
Author(s):  
W. L. E. M. Hesp ◽  
E. J. C. Lubbers ◽  
H. H. M. Boer ◽  
Th. Hendriks
Keyword(s):  
Small Bowel ◽  
Anastomotic Insufficiency ◽  
Bowel Surgery ◽  
Small Bowel Surgery ◽  
Surgery Incidence

scholarly journals CT diagnosis of a post-embolization ischemic diverticulitis of Meckel

2014 ◽  
Vol 3 (9) ◽  
pp. 204798161453195 ◽  
Author(s):  
Tom De Beule ◽  
Katya Op de Beeck ◽  
Gert De Hertogh ◽  
Gregory Sergeant ◽  
Geert Maleux
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Hypovolemic Shock ◽  
Small Bowel Resection ◽  
Ct Diagnosis ◽  
Contrast Extravasation ◽  
Diffuse Abdominal Pain ◽  
Bleeding Point ◽  
Pathologic Analysis ◽  
Endoscopic Investigation

A 23-year-old man presented with hypovolemic shock due to a lower gastrointestinal bleeding. Radiological and endoscopic investigation did not reveal the bleeding site. Emergency visceral angiography showed contrast extravasation at a right-sided branch of the superior mesenteric artery (SMA). Embolization of the bleeding point was performed, resulting in bleeding cessation. One week later, the patient presented with a new episode of moderate anal blood loss associated with diffuse abdominal pain. Computed tomography (CT) revealed an ischemic small bowel diverticulum that was treated by a laparoscopically-assisted segmental small bowel resection. Intraoperative and pathologic analysis confirmed a post-embolization ischemic diverticulitis of Meckel.

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