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Diagnosis of small bowel obstruction

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https://www.readbyqxmd.com/read/28523367/-a-67-year-old-man-with-epigastric-pain
#1
A Greger, W Hamelmann, M Konermann
A 67-year-old man suffering from epigastric pain showed a phytobezoar in the endoscopy. Therapy with Coca Cola® and enzymes was initiated. The (partial) lysis led to a migration of the bezoar into the ileum, resulting in a small bowel obstruction. After removal of the remaining bezoar via ileotomy a secondary pneumatosis intestinalis occurred. As a rare finding the (phyto-)bezoar should be considered as a differential diagnosis of abdominal pain - especially considering the rising numbers of bariatric surgery, which is a potential risk factor...
May 18, 2017: Der Internist
https://www.readbyqxmd.com/read/28480186/postoperative-mechanical-small-bowel-obstruction-induced-by-v-loc-barbed-absorbable-suture-after-laparoscopic-distal-gastrectomy
#2
Sung Ho Jang, Yun Kyung Jung, Sung Ji Choi, Tae Kyung Ha
When performing laparoscopic gastrectomy, suturing the intestinal anastomosis presents one of the greatest challenges. The V-Loc unidirectional barbed suture has been introduced to eliminate the need to tie knots during closure. This device offers a fast, secure, and effective alternative to conventional suture repair during laparoscopic surgery. However, there have been reported cases of surgical complications associated with the use of barbed suture devices. We describe here a case of small bowel obstruction resulting from improper use of barbed suture during total laparoscopic distal gastrectomy performed for gastric cancer...
May 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28480123/large-bowel-obstruction-in-the-emergency-department-imaging-spectrum-of-common-and-uncommon-causes
#3
REVIEW
Subramaniyan Ramanathan, Vijayanadh Ojili, Ravi Vassa, Arpit Nagar
Although large bowel obstruction (LBO) is less common than small bowel obstruction, it is associated with high morbidity and mortality due to delayed diagnosis and/or treatment. Plain radiographs are sufficient to diagnose LBO in a majority of patients. However, further evaluation with multidetector computed tomography (MDCT) has become the standard of care to identify the site, severity, and etiology of obstruction. In this comprehensive review, we illustrate the various causes of LBO emphasizing the role of MDCT in the initial diagnosis and detection of complications along with the tips to differentiate from disease which can mimic LBO...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28467579/primary-small-intestinal-non-hodgkin-lymphoma-diagnosed-after-emergency-surgery
#4
Tevfik Avcı, Hakan Yabanoğlu, İlker Murat Arer, Nazım Emrah Koçer, Kenan Çalışkan, Pelin Börcek, Yahya Ekici
BACKGROUND: The aim of this study was to investigate clinical manifestation, diagnosis, treatment, and prognosis of patients with primary gastrointestinal non-Hodgkin lymphoma (PGI NHL), whose initial presentation was bowel obstruction or perforation. METHODS: Data of patients who underwent surgical intervention due to radiological evidence of perforation or intestinal obstruction and were subsequently diagnosed with intestinal lymphoma at Baskent University hospitals between January 2007 and November 2014 were examined retrospectively...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28465689/reversible-inferolateral-st-segment-elevation-associated-with-small-bowel-obstruction
#5
Ankit Upadhyay, Sudheer Chauhan, Umair Jangda, Vipul Bodar, Ahmed Al-Chalabi
ST-segment elevation is an important and alarming electrocardiographic sign that necessitates immediate attention but does not always indicate that the primary pathology is cardiac in origin. It needs to be interpreted in the clinical context as several pathological conditions involving especially gastrointestinal tract may lead to delayed diagnosis and treatment as well as complications from invasive unnecessary interventions. We present two patients, a 64-year-old male and a 71-year-old female, who were admitted to the emergency room of a community-based hospital with similar complaints of worsening epigastric abdominal pain and were diagnosed later with small bowel obstruction...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28462483/clinical-potential-of-retrospective-on-demand-spectral-analysis-using-dual-layer-spectral-detector-computed-tomography-in-ischemia-complicating-small-bowel-obstruction
#6
Seitaro Oda, Takeshi Nakaura, Daisuke Utsunomiya, Yoshinori Funama, Narumi Taguchi, Masanori Imuta, Yasunori Nagayama, Yasuyuki Yamashita
We describe a case of ischemia complicating acute small-bowel obstruction in which retrospective on-demand spectral analysis using dual-layer spectral detector computed tomography (CT) provided a higher degree of confidence pertaining to the diagnosis. Dual-layer spectral detector CT enables retrospective on-demand spectral analysis, including virtual monochromatic imaging, iodine mapping, and determining the effective atomic number Z, without the need of a pre-scan setting requiring a special protocol, particularly facilitating emergency situations...
May 1, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28458850/extensive-small-bowel-intramural-haematoma-secondary-to-warfarin
#7
Alexandra M Limmer, Zackariah Clement
Intramural haematoma is a rare complication of oral anticoagulant therapy, occurring in  1 in 2500 patients treated with warfarin. This report describes a 71-year-old gentleman who presented with tachycardia, vomiting and abdominal distension on a background of anticoagulation for a metallic aortic valve. He was found to have a supratherapeutic international normalized ratio (INR) of 9.9 with an extensive small bowel intramural haematoma and secondary small bowel obstruction. He was successfully managed non-operatively with fluid resuscitation, INR reversal, bowel rest and nasogastric decompression...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28458829/distant-melanoma-causing-small-bowel-obstruction
#8
Justin M Hintze, Donal B O'Connor, Peter Molony, Paul C Neary
Small bowel obstructions (SBOs) are common. Adhesions make up the majority of cases at 84.9%, followed by abdominal herniae and malignancies. A 71-year-old female presented with total constipation, abdominal distension, on a background of resected cutaneous melanoma nine years prior. A CT-scan showed small bowel intussusception and disseminated mucosal-enhancing lesions consistent with metastases. She was brought to the operating theatre where six areas of intussusception were identified and manually reduced...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28458597/gastrointestinal-involvement-of-recurrent-renal-cell-carcinoma-ct-findings-and-clinicopathologic-features
#9
Hyo Jung Park, Hyun Jin Kim, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Hyun Kwon Ha
OBJECTIVE: To retrospectively evaluate the CT findings and clinicopathologic features in patients with gastrointestinal (GI) involvement of recurrent renal cell carcinoma (RCC). MATERIALS AND METHODS: The medical records were reviewed for 15 patients with 19 pathologically proven GI tract metastases of RCC. The CT findings were analyzed to determine the involved sites and type of involvement; lesion size, morphology, and contrast enhancement pattern; and occurrence of lymphadenopathy, ascites and other complications...
May 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28439845/a-systematic-review-of-the-clinical-presentation-diagnosis-and-treatment-of-small-bowel-obstruction
#10
REVIEW
Srinivas R Rami Reddy, Mitchell S Cappell
PURPOSE OF REVIEW: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy. RECENT FINDINGS: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and secondarily from intraluminal fluid accumulation. Dilatation increases mural tension, decreases mucosal perfusion, causes bacterial proliferation, and decreases mural tensile strength that increases bowel perforation risks...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28438753/complicated-small-bowel-diverticular-disease-a-case-series
#11
Linden Karas, Mohammed Asif, Victor Chun, Farrukh A Khan
Small bowel diverticulosis of the jejunum and ileum is an uncommon finding with a prevalence rate of 0.2% to 1.3% at autopsy and 0.3% to 1.9% on small bowel studies. Diagnosis can be difficult because there are no pathognomonic features or clinical symptoms that are specific for small bowel diverticulosis. Though rare, it is critical to keep the possibility of small bowel diverticulosis in mind when evaluating cases of malabsorption, chronic abdominal pain, haemorrhage, perforation and intestinal obstruction, especially in patients with connective tissue disorders, a family history of diverticula and a personal history of colonic diverticulosis...
April 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28426721/diagnosis-treatment-and-prognosis-of-small-bowel-volvulus-in-adults-a-monocentric-summary-of-a-rare-small-intestinal-obstruction
#12
Xiaohang Li, Jialin Zhang, Baifeng Li, Dehui Yi, Chengshuo Zhang, Ning Sun, Wu Lv, Ao Jiao
OBJECTIVES: Small bowel volvulus is a rare disease, which is also challenging to diagnose. The aims of this study were to characterize the clinical and radiological features associated with small bowel volvulus and treatment and to identify risk factors for associated small bowel necrosis. METHODS: Patients with small bowel volvulus who underwent operations from January 2001 to December 2015 at the First Affiliated Hospital of China Medical University (Shenyang, China) were reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28424736/a-case-of-xanthogranulomatous-pyelonephritis-associated-with-renoduodenal-fistula
#13
R Conor Holton-Burke, Mini Varughese
Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis associated with repeated infection, chronic inflammation, and obstruction. Various fistulas, including those to the intestine, are a known association with XGP. Here, a 55-year-old woman with a history of multiple previous renal calculi presented with dysuria and back pain. Contrast-enhanced computed tomography (CT) revealed a soft tissue density in her renal pelvis and perirenal space consistent with XGP along with a tract connecting the upper pole of her right kidney to the second portion of the duodenum...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28421339/small-bowel-adenocarcinoma-complicating-crohn-s-disease-a-single-centre-experience-emphasizing-the-importance-of-screening-for-dysplasia
#14
Chloé Grolleau, Nicolas M Pote, Nathalie S Guedj, Magaly Zappa, Nathalie Theou-Anton, Yoram Bouhnik, Yves Panis, Dominique L Cazals-Hatem
Small bowel adenocarcinoma (SBA) complicating Crohn's disease (CD) is rare and generally found incidentally on surgical specimens. We report our experience in CD-associated SBA observed this last decade in a tertiary referral centre in order to update its incidence, clinical presentation and pathological features. All SBAs diagnosed in patients who underwent surgery for CD between 2006 and 2016 were retrospectively included. Clinico-pathological characteristics were reviewed, and follow-up was updated. SBA was diagnosed in 9 (1...
April 18, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28420518/acute-small-bowel-obstruction-caused-by-barbed-suture-on-the-second-day-after-laparoscopic-hysterosacropexy-a-case-report-and-literature-review
#15
Hsuan Chen, Mun-Kun Hong, Dah-Ching Ding
OBJECTIVE: To report a case of small bowel obstruction caused by barbed suture applied in hysterosacropexy, and possible solutions. CASE REPORT: A 57-year-old woman underwent laparoscopic hysterosacropexy for a Stage 2 uterine prolapse, presenting with acute abdominal pain and a bowel obstruction syndrome 2 days following the surgery. Conservative treatment was given, but the symptoms did not improve and gradually became worse. Diagnostic laparoscopy was performed on the 7(th) day after the hysterosacropexy, and the volvulus was found...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28406887/hospitalizations-for-crohn-s-disease-united-states-2003-2013
#16
Christopher A Malarcher, Anne G Wheaton, Yong Liu, Sujay F Greenlund, Suraj J Greenlund, Hua Lu, Janet B Croft
In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization and surgeries of the small intestine, colon, or rectum (2). Hospital discharge data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) were used to estimate U...
April 14, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28386950/gastrointestinal-disorders-in-curry-jones-syndrome-clinical-and-molecular-insights-from-an-affected-newborn
#17
Kristen Wigby, Stephen R F Twigg, Ryan Broderick, Katherine P Davenport, Andrew O M Wilkie, Stephen W Bickler, Marilyn C Jones
Curry-Jones syndrome (CJS) is a pattern of malformation that includes craniosynostosis, pre-axial polysyndactyly, agenesis of the corpus callosum, cutaneous and gastrointestinal abnormalities. A recurrent, mosaic mutation of SMO (c.1234 C>T; p.Leu412Phe) causes CJS. This report describes the gastrointestinal and surgical findings in a baby with CJS who presented with abdominal obstruction and reviews the spectrum of gastrointestinal malformations in this rare disorder. A 41-week, 4,165 g, female presented with craniosynostosis, pre-axial polysyndactyly, and cutaneous findings consistent with a clinical diagnosis of CJS...
April 6, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28386490/an-uncommon-cause-of-a-small-bowel-obstruction
#18
Ali Zakaria, Bayan Al Share, Issam Turk, Samira Ahsan, Waseem Farra
Sarcoidosis is a systemic granulomatous disease of unknown etiology, characterized by the formation of noncaseating granulomas. Gastrointestinal (GI) system involvement that is clinically recognizable occurs in less than 0.9% of patients with sarcoidosis, with data revealing small intestine involvement in 0.03% of the cases. A high index of suspension is required in patients presenting with small-bowel obstruction and previous history of sarcoidosis. Establishing a definitive diagnosis of GI sarcoidosis depends on biopsy evidence of noncaseating granulomas, exclusion of other causes of granulomatous disease, and evidence of sarcoidosis in at least one other organ system...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28376626/waldmann-s-disease-a-rare-cause-of-protein-losing-enteropathy-in-an-adult-patient
#19
Cláudio Rodrigues Martins, Alice Gagnaire, Florian Rostain, Come Lepage
Primary intestinal lymphangiectasia or Waldmann's disease is an uncommon cause of protein losing enteropathy with an unknown etiology and is usually diagnosed during childhood. It is characterized by dilation and leakage of intestinal lymph vessels leading to hypoalbuminemia, hypogammaglobulinemia and lymphopenia. Differential diagnosis should include erosive and non-erosive gastrointestinal disorders, conditions involving mesenteric lymphatic obstruction and cardiovascular disorders that increase central venous pressure...
May 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28376419/superior-mesenteric-artery-syndrome-a-diagnosis-to-be-kept-in-mind-case-report-and-literature-review
#20
Ali Salem, Labib Al Ozaibi, Suad Mohamed Maher Nassif, Rufaida Abdel Gadir Satti Osman, Nisreen Mohammed Al Abed, Faisal Mohmmed Badri
INTRODUCTION: Superior mesenteric artery (SMA) syndrome or what is called Wiklie's syndrome is one of the rare causes of small bowel obstruction. Its exact incidence is not known. It is due to decrease in Aortomesenteric angle. CASE PRESENTATION: A thirty-Four-year old male patient presented to our accident and emergency (department) with 3days history of epigastric pain, which was not radiating anywhere. It had no aggravating or relieving factors. Patient complained of repeated attack of vomiting as well...
2017: International Journal of Surgery Case Reports
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