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Diagnosis of small bowel obstruction

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https://www.readbyqxmd.com/read/28624050/impact-of-hospital-volume-on-outcomes-for-laparoscopic-adhesiolysis-for-small-bowel-obstruction
#1
Raymond A Jean, Kathleen M O'Neill, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Volume-to-outcome data have been studied in several complex surgical procedures, demonstrating improved outcomes at higher volume centers. Laparoscopic lysis of adhesions (LLOA) for small bowel obstruction (SBO) may result in better outcomes, but there is no information on the learning curve for this potentially complex case. This study evaluates the effect of institutional procedural volume on length of stay (LOS), outcomes, and costs in LLOA for SBOs. MATERIALS AND METHODS: The Nationwide Inpatient Sample data set between 2000 and 2013 was queried for discharges for a diagnosis of SBO involving LLOA in adult patients...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28589045/recurrent-enterolithiasis-small-bowel-obstruction-a-case-seldom-described
#2
Ashish Lal Shrestha, Pradita Shrestha
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...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28571210/meckel-s-diverticulum-enterolith-an-extremely-rare-cause-of-intestinal-obstruction
#3
Nikolaos Symeonidis, Athanasios Kofinas, Kyriakos Psarras, Efstathios Pavlidis, Theodoros Pavlidis
Meckel's diverticulum is usually asymptomatic but occasionally presents with complications. Formation of an enterolith inside a Meckel's diverticulum is very uncommon and dislodgement of such a stone causing obstruction is extremely rare. We herein present a case of a 48-year-old man who presented with small bowel obstruction. Preoperative radiologic studies revealed a stone-like lesion in the right lower quadrant. Upon laparotomy, an inflamed Meckel's diverticulum was found as well as a 2.5 cm stone obstructing the terminal ileum...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567378/capsule-retention-prevention-diagnosis-and-management
#4
REVIEW
Emanuele Rondonotti
Capsule retention (CR) has been defined as capsule remaining in the digestive tract for a minimum of two weeks. CR occurs approximately in 2% of all patients undergoing small bowel capsule endoscopy (CE). Prompt diagnosis of CR is important, as it has relevant clinical implications. CR should be suspected in (I) all asymptomatic patients who do not report capsule excretion within 15 days from capsule ingestion; and (II) patients with obstructive or perforation-related symptoms in which the capsule has not been excreted, regardless of the time between the onset of symptoms and capsule ingestion...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28560024/neuroendocrine-carcinoma-as-a-rare-cause-of-jejunal-intussusception-in-an-adult-management-and-literature-review
#5
Georgios Sahsamanis, Georgios Mitsopoulos, Titos Deverakis, Alexandra Terzoglou, Paschalis Evangelidis, Georgios Dimitrakopoulos
Intussusception of the small bowel is an uncommon condition, with the majority of cases being observed during infancy. A number of points are responsible, with benign and malignant lesions of the small intestine being the most common. Herein, we present the case of a 75-year-old male patient with vague abdominal pain and black stool during defecation, who underwent surgery due to jejunal intussusception. Pathology report demonstrated a neuroendocrine carcinoma as the underlying cause for his condition, with no additional metastases during the initial diagnosis...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28560018/internal-hernia-after-laparoscopic-right-hemicolectomy-report-of-a-case
#6
Hiroki Sugita, Takahiko Akiyama, Naoya Daitoku, Rumiko Tashima, Hiroshi Tanaka, Shinobu Honda, Tetsumasa Arita, Yasushi Yagi, Masahiko Hirota
Mesenteric defects are often not closed in laparoscopic colectomy. We herein report a case of an internal hernia projecting through a mesenteric defect following laparoscopy-assisted right hemicolectomy. A 74-year-old woman was hospitalized for the surgical treatment of double colon cancer. Preoperative colonoscopy demonstrated the presence of ascending colon and transverse colon cancers. A laparoscopic-assisted right hemicolectomy was performed. The mesenteric defect resulting from the colectomy was not closed...
May 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28546717/intussusception-a-rare-complication-after-feeding-jejunostomy-a-case-report
#7
Shreyas Dholaria, Kamal Kishor Lakhera, Sanjeev Patni
Feeding jejunostomy (FJ) is a commonly done surgical procedure for enteral nutrition. Intussusception is one of the rare complications of FJ. Clinical presentation may be similar to other causes of small bowel obstruction. Intussusception should be suspected if a patient with jejunostomy tube develops upper gastrointestinal obstructive symptoms, which are relieved by nasogastric tube drainage. CT or ultrasonography (USG) can help to confirm the diagnosis. It can be relieved spontaneously or sometimes requires laparotomy...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28540052/a-unique-case-of-massive-gastrointestinal-bleeding
#8
Akihiko Kida, Koichiro Matsuda, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
OBJECTIVES: Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation. METHODS/RESULTS: We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28539037/small-bowel-obstruction-caused-by-aloe-vera-bezoars-a-case-report
#9
In Taik Hong, Jae Myung Cha, Hye Jin Ki, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Jung Won Jeoun, Sung Il Choi
Small bowel obstruction is a clinical condition commonly caused by postoperative adhesion, volvulus, intussusceptions, and hernia. Small bowel obstruction due to bezoars is clinically uncommon, accounting for approximately 2-4% of all obstructions. Computed tomography (CT) is a useful method in diagnosing the cause of small bowel obstruction. However, small bowel obstruction caused by bezoars may not be detected by an abdominal CT examination. Herein, we report a rare case of small bowel obstruction by Aloe vera bezoars, which were undetected by an abdominal CT...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28539036/a-case-of-tuberculous-peritonitis-presenting-as-small-bowel-obstruction
#10
Hae Koo Kim, Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Yong Jin Nam
The peritoneum is one of the common extrapulmonary sites of tuberculosis infection. Patients with underlying end-stage renal or liver disease are frequently complicated by tuberculous peritonitis; however, the diagnosis of the tuberculous peritonitis is difficult due to its insidious nature, well as its variability in presentation and limitation of available diagnostic tests. Once diagnosed, the preferred treatment is usually antituberculous therapy in uncomplicated cases. However, surgical treatment may also be required for complicated cases, such as small bowel obstruction or perforation...
May 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28523367/-a-67-year-old-man-with-epigastric-pain
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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