Obstructive Ileus Secondary to Acute Mesenteric Ischaemia: Internal Medicine Perspective

Acute mesenteric ischemia (AMI) could be a rare but potentially life-threatening condition due to poor understanding of the clinical presentation of abdominal pain and the differential diagnosis when it is not suspected and partly because of an unacceptable delay in making the diagnosis. A 59 years old man was brought to the hospital with abdominal pain, accompanied by obstructive ileus and sepsis. An urgent CT-scan showed the feature of intestinal infarction and portal vein thrombus. After giving fluid resuscitation and antibiotic injection, he was consulted to the surgery division and had jejunum resection. Since the etiology of the disease was suspected to be acute mesenteric venous thrombosis, he was given intravenous anticoagulants postoperatively and the condition improved. The clinical diagnosis of acute mesenteric ischemia is troublesome, and in most cases, abdominal pain is the main symptom. Ileus and sepsis are two complications that may mask the initial signs and symptoms of AMI. From the internal medicine’s point of view, the proper treatment of this disease is early diagnosis, the rebuilding of blood flows with anticoagulants, surgery division discussion, and post-operative supportive care. The underlying cause should be established to determine long-term management essential to anticipate a repeat.

Differences Characteristics of Partial Bowel Obstruction and Total Bowel Obstruction in Ileus Patients at Dr. Soegiri Lamongan Hospital

Background: Across all age ranges, one in a thousand people is diagnosed with ileus annually. Ileus is categorized into two types, obstructive ileus, and paralytic ileus. Obstructive ileus is a condition where intestinal passage disorder occurs as a result of a mechanical blockage. There are 7,024 obstructive ileus without hernia in Indonesia and 7,059 paralytic ileus cases in 2004.Purpose: To understand the comparison of characteristics of obstructive ileus patients.Method: This analytic descriptive research use the cross-sectional method. Samples are diagnosed with ileus based on the laparotomy result from RSUD Dr. Soegiri, Lamongan. The sampling method is total sampling based on 2015-2019 data. The samples were also using secondary data from medical records, from December 2019 to January 2020.Result: Respondents are mostly male with ages 65 years and over, less than ten days treatment duration, 39 minutes in the average length of partial bowel obstruction surgery duration, 42 minutes in the average length of total bowel obstruction surgery duration, less than two days treatment duration before surgery, percentage of ICU admission as high as 51.5 %, and blood transfusion percentage on 6.1%. There are significant differences in the characteristics of ileus patient’s age (p-value 0,021).Conclusion: Based on this study, it can be concluded that there are differences based on age in the characteristics of partial bowel obstruction and total bowel obstruction on ileus patients, whereas gender, treatment duration, treatment duration before surgery, and surgery duration did not deliver any differences.

Diagnosis of gastrointestinal obstruction in dogs and cats using ultrasound – a retrospective study of 38 cases

GI obstruction often leads to intractable vomiting, the consequences of which can be life-threatening. For diagnosing, an ileus clinical examination with abdominal radiographs or ultrasonographs are chosen routinely. The purpose of the study was to determine the incidence of GI obstruction among animals with gastrointestinal symptoms and to define ultrasonographic accuracy in detecting these GI obstructions. 38 animals (31 dogs and 7 cats) were included in the study. At the first consultation they presented gastrointestinal symptoms. A clinical examination with palpation of the abdomen was made. An ultrasound examination was made by an experienced radiologist. 17 of the 38 animals were diagnosed with obstructive ileus. In 15 of these 17 the ileus was confirmed, and in the remaining 2 only functional obstruction and enteritis was found. For the other 21 of the 38 animals the ileus was excluded. The animals with GI obstruction accounted for 39.5% of all animals with GI symptoms. The ultrasound examination was effective in 88.2% of cases. Intestinal obstruction is common in patients with gastrointestinal symptoms. Vomiting, diarrhoea and constipation are the main symptoms. Abdomen pain is rare. Ultrasound is a valuable and safe method for detecting GI obstructions. In only 2 animals was ileus misdiagnosed.

Paralytic and Obstructive Ileus

Ileus is the most common manifestation of acute gastrointestinal injury which exhibits grades of severity in the critically ill. Appropriate characterization of ileus as adynamic or mechanical in origin determines its management. This chapter discusses the most important causes, clinical and radiologic findings, and appropriate management of ileus that develops in patients in the intensive care unit.

Seorang Wanita Muda dengan Tuberkulosis Usus Menyerupai Apendiksitis Akut

Background: Tuberculosis has become a global health problem, with increasing numbers of cases in line with the increasing number of immunocompromised patients. Intestinal of tuberculosis is believed to be a form of extrapulmonary tuberculosis which will occur most often in the future . Case: This case presents a young woman, 20 years old, suspected of acute appendicitis with suspected perforation, had right abdominal pain since 1 month and getting worse since 5 days PTA (prior to admission). The abdomen enlarges and feels hard on the right abdomen after being treated for 3 days. Fever,body weaknes,decreased of appetite, decreased of body weight approximately 7 kg since 2 months PTA. There are nausea, vomiting, diarea with runny mucus since 2 weeks PTA. The chest x-ray, abdominal ultrasound, endoscopy was normal result and plain abdominal radiograph showed that intestinal dilatation and step ladder features suspicious obstructive ileus. Discussion: After 2 months of therapy abdominal symptoms improved and weight began to gradually increase. Intestinal of tuberculosis is a challenge for clinicians to diagnose despite using modern medical techniques because the clinical and laboratory features are not specific especially when active pulmonary infection is absent and there are similarities with other abdominal diseases. The histological features will provide a diagnose. The delay in diagnosis will lead to more severe complications. Conclusion: At present a combination of clinical, radiological and pathological features continues to be the key to diagnosing intestinal tuberculosis. Medical management with antituberculosis drugs will produce a significant resolution of symptoms.