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Diagnosis of small bowel obstruction

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https://www.readbyqxmd.com/read/28806283/expanding-the-scope-of-quality-measurement-in-surgery-to-include-non-operative-care-results-from-the-acs-nsqip-emergency-general-surgery-pilot
#1
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28797559/utilization-of-ultrasound-for-the-evaluation-of-small-bowel-obstruction-a-systematic-review-and-meta-analysis
#2
Michael Gottlieb, Gary D Peksa, Ananda Vishnu Pandurangadu, Damali Nakitende, Sukhjit Takhar, Raghu R Seethala
INTRODUCTION: Small bowel obstruction (SBO) is a common presentation to the Emergency Department (ED). While computed tomography (CT) is frequently utilized to confirm the diagnosis, this modality is expensive, exposes patients to radiation, may lead to time delays, and is not universally available. This study aimed to determine the test characteristics of ultrasound for the diagnosis of SBO. METHODS: PubMed, CINAHL, Scopus, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were assessed for prospective trials evaluating the accuracy of ultrasound for the detection of SBO...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28797546/cell-free-deoxyribonucleic-acid-as-a-prognostic-marker-of-bowel-ischemia-in-patients-with-small-bowel-obstruction
#3
Uri Netz, Zvi Perry, Solly Mizrahi, Boris Kirshtein, David Czeiger, Gilbert Sebbag, Avraham Reshef, Amos Douvdevani
BACKGROUND: Patients with strangulation small bowel obstruction are at a high risk for serious morbidity and mortality due to ischemic bowel. Measuring serum, cell-free deoxyribonucleic acid levels could help recognize early cell death. Our hypothesis was that small bowel ischemia or necrosis is associated with increases in serum cell-free deoxyribonucleic acid and that recovery is associated with a decrease in cell-free deoxyribonucleic acid levels. METHODS: A prospective cohort study in addition to standard treatment of patients admitted with a diagnosis of small bowel obstruction...
August 7, 2017: Surgery
https://www.readbyqxmd.com/read/28764764/sclerosing-mesenteritis-in-a-5-year-old-chinese-boy-a-case-report
#4
Cui-Ping Liang, Min Yang, Pei-Yu Chen, Lan-Lan Geng, Ding-You Li, Si-Tang Gong
BACKGROUND: Sclerosing mesenteritis is a rare fibroinflammatory disorder of unknown etiology that primarily affects the mesentery of the small intestine during late adult life. Only about twenty pediatric cases have been reported to date, but none has been reported in Chinese children. CASE PRESENTATION: A 5-year-old Chinese male presented with a 4-week history of recurrent bloating, abdominal pain, anorexia and vomiting. On admission, physical examination showed a severely distended abdomen...
August 1, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28764244/a-rare-case-of-intestinal-malrotation-and-volvulus-of-jejunum-with-coexisting-carcinoid-tumour-of-appendix
#5
Priyanka Tiwari, Darshan Patel, Vimal Dhaduk, Prasanna Kumar Reddy, Jainudeen Khalander Abdul Jameel
Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. Patients may present with symptoms of acute bowel obstruction or chronic abdominal pain. Barium study, Contrast Enhanced Computed Tomography (CECT), Magnetic Resonance Imaging (MRI), diagnostic laparoscopy and sometimes explorative laparotomy are used for diagnosis. Ladd's procedure through the open approach has been the treatment of choice for complete malrotation of midgut, however there are reports on successful outcome for both complete and incomplete malrotation after laparoscopic approach as well...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28758041/an-unusual-cause-of-intestinal-obstruction-in-a-young-adult-patient-inflammatory-fibroid-polyp
#6
Meryem Rais, Hafsa Chahdi, Mohammed Elfahssi, Abderrahmane Albouzidi, Mohamed Oukabli
Inflammatory fibroid polyps are uncommon benign lesions that originate in the submucosa of the gastrointestinal tract. The stomach and the ileum are the most commonly affected sites. Although inflammatory fibroid polyp is one of the rare conditions leading to intestinal obstruction in adults, it should be considered as a possible diagnosis in obstructive tumors of the small bowel causing intussusceptions. We present one case of inflammatory fibroid polyp as a rare cause of intussusception in a young adult patient...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28745840/cyclic-vomiting-syndrome-is-a-prevalent-and-under-recognized-condition-in-the-gastroenterology-outpatient-clinic
#7
R C Sagar, R Sood, D J Gracie, M J Gold, N To, G R Law, A C Ford
BACKGROUND: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder (FGID) characterized by intermittent episodes of nausea and vomiting. Our aim was to report its prevalence and associated features. METHODS: Data concerning demographics, symptoms, and psychiatric comorbidity were collected. Symptoms compatible with CVS were classified as per Rome III criteria. We recorded whether a diagnosis of CVS was considered in patients after negative investigation...
July 26, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28743097/less-is-more-an-outcome-assessment-of-patients-operated-for-gallstone-ileus-without-fistula-treatment
#8
Dario Tartaglia, Sohail Bakkar, Lorenzo Piccini, Jessica Bronzoni, Luigi Cobuccio, Andrea Bertolucci, Christian Galatioto, Massimo Chiarugi
BACKGROUND: The treatment of gallstone ileus (GI) consists of surgical removal of the impacted bilestone with or without cholecystectomy and repair of the biliodigestive fistula. The objective of this study was to assess whether sparing patients a definitive biliary procedure adversely influenced the outcome. MATERIALS AND METHODS: Patients with a diagnosis of GI were reviewed. Two groups were identified: patients who underwent a definitive biliary procedure with relieving the intestinal obstruction (group 1/G1) and those who did not have a definitive biliary procedure (group 2/G2)...
July 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28735976/predictive-value-of-procalcitonin-for-intestinal-ischemia-and-or-necrosis-in-pediatric-patients-with-adhesive-small-bowel-obstruction-asbo
#9
Eduardo Bracho-Blanchet, Alfredo Dominguez-Muñoz, Emilio Fernandez-Portilla, Cristian Zalles-Vidal, Roberto Davila-Perez
PURPOSE: Evaluate serum procalcitonin (PCT) level as a predictor of intestinal ischemia or necrosis (IN) in patients with postoperative adhesive small bowel obstruction (ASBO). METHODS: Prospective cohort of consecutive patients with ASBO. Patients previously treated with antibiotics or septic were excluded. PCT was measured at the diagnosis of ASBO and every 24 h afterwards. MAIN OUTCOME: intestinal ischemia or necrosis (IN). RESULTS: Fifty-nine patients were included, 12 of whom were excluded; 47 patients remained in the study; male-to-female ratio = 1...
July 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28734992/endoscopic-muscle-biopsy-emb-of-the-duodenum-and-rectum-a-pilot-survival-study-in-a-porcine-model-to-detect-myenteric-neurons
#10
E Rajan, B Al-Bawardy, C J Gostout, L M Wong Kee Song, J L Deters, M A Knipschield, C E Bernard, G Farrugia
BACKGROUND AND AIMS: Small bowel and colorectal muscle biopsies require a surgical approach. Advancing our understanding of the pathophysiology of motility disorders, such as functional bowel disorders, intestinal pseudo-obstruction and slow transit constipation, is hindered by our inability to non-invasively obtain muscularis propria (MP) for evaluation of multiple cell types, including myenteric neurons. The aims of this study were to determine (1) technical feasibility, reproducibility and safety of performing duodenal endoscopic muscle biopsy (dEMB) and rectal endoscopic muscle biopsy (rEMB) using a clip-assist technique; and (2) presence of myenteric neurons in tissue samples...
July 19, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28712196/small-gut-volvulus-a-rare-twist-in-the-setting-of-an-even-rarer-entity-multiple-giant-jejuno-ileal-diverticula
#11
Ayesha Khan, Faheem Khan, Kashif Rafique, Sarwar Khan, Anam Majid, Khalid Khan, Asad Ullah
Small gut volvulus with multiple Jejuno-ileal diverticulosis is an unusual pathology of the small intestine with a scarce number of cases reported so far. It usually goes unnoticed because it is often asymptomatic but complications like diverticulitis, perforation, bleeding or intestinal obstruction can occur in 10-30% of the cases. Mechanical obstruction, if it occurs, can be caused by adhesions or stenosis due to diverticulitis, intussusception at the site of the diverticulum and volvulus of the segment containing the diverticula...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28700968/retrocecal-hernia-preoperatively-diagnosed-by-computed-tomography-a-case-report
#12
Shingo Ito, Ryohei Takeda, Ritsuo Kokubo, Yoshio Sakai, Hirokazu Matsuzawa, Kiichi Sugimoto, Makoto Takahashi, Yutaka Kojima, Michitoshi Goto, Yuichi Tomiki, Kazuhiro Sakamoto
INTRODUCTION: Retrocecal hernia is a rare type of pericecal hernia. Because it is difficult to diagnose preoperatively, it is often treated with emergency operation. CASE PRESENTATION: An 83-year-old male patient experienced sudden abdominal pain. Marked small bowel dilatation and intestinal obstruction were detected by abdominal computed tomography (CT). An enhanced CT scan also revealed a trapped cluster of small bowel loops behind the cecum and ascending colon...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28686923/rare-case-of-incarcerated-obturator-hernia-case-report-and-review-of-literature
#13
N C Sá, V C M Silva, P R L Carreiro, A S Matos Filho, I A Lombardi
INTRODUCTION: Obturator hernia is a rare condition accounting for less than 1% of all intra abdominal hernias. Clinical diagnosis is considered a challenge for most surgeons. It usually appears as an intestinal obstruction. Confirmation of diagnosis is carried out by means of imaging or during surgery. CASE REPORT: An 85-year-old female patient, with symptoms of intestinal obstruction of 24h duration was admitted to the emergency room of Unimed Hospital - Belo Horizonte...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28685139/ileocolic-intussusception-caused-by-a-lipoma-in-an-adult
#14
Dong Eun Lee, Jae Young Choe
Intussusception is rarely observed in adults. Adult cases account for only 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction cases. The etiology, presentation and management of intussusception in adults are different from those in children. The clinical presentation in adults often includes nonspecific signs and symptoms, thereby complicating differential diagnosis from other causes of abdominal pain. We report a 29-year-old Asian woman who visited our emergency department with complaints of fever associated with epigastric pain since one day...
June 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28685016/incarcerated-congenital-transmesenteric-hernia-in-an-adult-a-case-report
#15
Sam Alhayo, Preet Gosal, Anthony Shakeshaft
Transmesenteric hernia is a rare cause of bowel obstruction and strangulation. It can be due to iatrogenic injury, trauma, inflammatory and less likely congenital. We present a case of true congenital transmesenteric hernia in a 26-year-old male with no previous surgical history or trauma. The patient presented acutely with no prior symptoms. Investigations provided limited information towards the diagnosis of the hernia, but suggestive of mid-gut volvulus. Emergency laparotomy was performed to find >75% of small bowel herniating through a proximal jejunal mesenteric defect leading to incarceration and early strangulation...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28681372/two-cases-of-laparoscopic-diagnosis-and-treatment-of-intersigmoid-hernia
#16
Hajime Kayano, Eiji Nomura, Toru Kuramoto, Kentaro Yatabe, Hisamichi Yoshii, Daiki Yokoyama, Takashi Machida, Shuji Uda, Takuya Koike, Hideki Izumi, Sayuri Hasegawa, Masaya Mukai, Hiroyasu Makuuchi
We present two cases of intestinal obstruction due to intersigmoid hernia that were diagnosed and treated laparoscopically. The first case was a 42-year-old woman with no surgical history. She was treated conservatively with the insertion of an ileus tube. Although the intestinal obstruction improved temporarily, since it subsequently worsened, laparoscopic surgery was performed, which revealed incarceration of the ileum in the intersigmoid fossa. Although there were no signs of necrosis after intestinal release, partial resection of the small bowel was performed before the hernial orifice was closed due to the evidence of serous damage...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28661313/acute-appendicitis-after-kidney-transplantation-experience-at-a-tertiary-care-hospital-in-mexico-city
#17
Edgar Ortiz-Brizuela, Alejandro Quiroz-Compeán, Mario Vilatobá-Chapa, Josefina Alberú-Gómez
OBJECTIVES: Here, we describe the presentation, treatment, and outcomes of acute appendicitis in kidney transplant recipients at a tertiary care hospital in Mexico City. MATERIALS AND METHODS: We conducted a retrospective case series study at a tertiary care hospital in Mexico City from January 2000 to January 2015. RESULTS: During our study period, 1186 patients received a kidney transplant; among these patients, we identified 10 cases of acute appendicitis (0...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28655944/importance-of-second-look-endoscopy-on-an-empty-stomach-for-finding-gastric-bezoars-in-patients-with-gastric-ulcers
#18
Masaya Iwamuro, Shouichi Tanaka, Yuki Moritou, Tomoki Inaba, Reiji Higashi, Chiaki Kusumoto, Naoko Yunoki, Shin Ishikawa, Yuko Okamoto, Yoshinari Kawai, Ken-Ichi Kitada, Ryuta Takenaka, Tatsuya Toyokawa, Hiroyuki Okada
 Most gastric bezoars can be treated with endoscopic fragmentation combined with or without cola dissolution, whereas laparotomy or laparoscopic surgery is generally inevitable for small intestinal bezoars because they cause small bowel obstruction. Therefore, early diagnosis and management of gastric bezoars are necessary to prevent bezoar-induced ileus. To investigate the incidence of overlooked gastric bezoars during the initial esophagogastroduodenoscopy, we retrospectively reviewed the cases of 27 patients diagnosed with gastrointestinal bezoars...
June 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28638589/gastrocolic-fistula-presented-as-an-early-complication-of-gastric-surgery-in-a-42-year-old-man
#19
Mohammad Javad Zahedi, Sara Shafiei Pour, Masood Dehghani, Nazanin Eslami
Currently, surgery is less needed for the treatment of refractory peptic ulcer disease (PUD) or its complications. So, the complications of PUD surgery have been clearly declined. Here in, we present a 42-year-old man with chronic watery diarrhea and significant weight loss during 2 years after gastrojejunostomy for the treatment of obstructive PUD. Small bowel gastrointestinal series showed rapid transit without passage of contrast in the parts of small bowel. The patient was scheduled for exploratory laparotomy...
April 2017: Middle East Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28638005/sclerosing-mesenteritis-causing-chylous-ascites-and-small-bowel-perforation
#20
Huei-Wen Lim, Keith S Sultan
BACKGROUND Sclerosing mesenteritis (SM) is a rare idiopathic inflammation and fibrosis of the mesentery. Its etiology and pathogenesis remain unclear. It has been linked to abdominal trauma related to peritoneal dialysis, recent abdominal surgery, idiopathic inflammatory disorder, paraneoplastic syndrome, ischemia/infection, and autoimmunity. Abdominal CT is the most sensitive imaging modality, and diagnosis is usually confirmed by surgical biopsy. Patients most often present with abdominal pain, nausea, vomiting, diarrhea, and weight loss, and less commonly with chylous ascites and small bowel obstruction...
June 22, 2017: American Journal of Case Reports
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