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https://www.readbyqxmd.com/read/29769187/intraoperative-intraluminal-injection-of-n-acetylcysteine-allowing-treatment-of-distal-intestinal-obstruction-syndrome-without-the-need-for-enterotomy
#1
Nicholas Js Chilvers, James Wheeler
We describe a case of an 18-year-old man who suffers from cystic fibrosis and developed distal intestinal obstruction syndrome while being treated as an inpatient. Following failed medical management, we proceeded to laparotomy where the small bowel was decompressed with retrograde milking into the stomach, leaving a section of impacted stool in the distal ileum. N-acetylcysteine was injected into the bowel lumen proximal to the obstruction. This resulted in dissolution of the stool without the need for enterotomy and is, to our knowledge, the first successful example of this technique in the literature...
May 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29756678/current-management-of-adhesive-small-bowel-obstruction
#2
REVIEW
Jakob Köstenbauer, Philip G Truskett
Small bowel obstruction is a common and significant surgical presentation. Approximately 30% of presentations will require surgery during admission. The great challenge of adhesive small bowel obstruction (ASBO) management is the early detection of silent intestinal ischaemia in patients initially deemed suitable for conservative therapy. Recent literature emphasizes the effectiveness of computed tomography enterography and water-soluble contrast studies in the management of ASBO. Low-volume undiluted water-soluble contrast has been shown to have both triage and therapeutic value in the management of ASBO...
May 14, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29755909/malrotation-of-the-gut-in-adults-an-often-forgotten-entity
#3
Sushant Bhatia, Sudhir Jain, Chandra B Singh, Lovenish Bains, Rohit Kaushik, Nishant S Gowda
Malrotation of the gut is a common paediatric condition that usually presents in the first month of life. However, presentation in adults is rare, and as a diagnostic dilemma quite often surprises the surgeon intraoperatively. If this condition is not timely recognized, it may result in disastrous consequences, such as gangrene of the small gut. We present the case of a 21-year-old male who presented to the emergency room with recurrent episodes of colicky abdominal pain and bilious vomiting. Contrast-enhanced computerized tomography (CT) revealed malrotation of the gut...
March 12, 2018: Curēus
https://www.readbyqxmd.com/read/29755906/rare-forms-of-castleman-disease-mimicking-malignancy-mesenteric-and-pancreatic-involvement
#4
Mustafa Ozsoy, Zehra Ozsoy, Suleyman Sahin, Yuksel Arıkan
Castleman disease is a lymphoproliferative disorder with unknown etiology and pathogenesis. While the disease may involve all parts of the body, the mediastinum appears to be the most common part of involvement. In this study, we present two cases of Castleman disease with different localizations that mimicked malignancy. A 62-year-old female patient presented with jaundice. Laboratory analysis indicated aspartate aminotransferase: 250 U/L, total bilirubin: 4 mg/dl, and carbohydrate antigen (CA) 19-9: 900 U/ml...
March 12, 2018: Curēus
https://www.readbyqxmd.com/read/29755022/adult-multicentric-burkitt-lymphoma-with-bowel-obstruction-due-to-intussusception
#5
Ali Özant, Kalbim Arslan, Necdet Özçay, Hasan Besim
Primary malignant tumors of the small intestine are very rare, accounting for 2%-3% of all gastrointestinal malignancies. Lymphoma constitutes about 15%-20% of all small intestine neoplasms and 20%-30% of all primary gastrointestinal lymphomas. The ileum is the most common site for gastrointestinal lymphomas. Because the symptoms and physical findings are non-specific, the preoperative diagnosis is usually difficult. In this case report, we describe the highly unusual case of sporadic Burkitt lymphoma with complete intestinal obstruction due to intussusception of the proximal jejunum and discuss the treatment options...
May 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29741977/laparoscopic-pelvic-exenteration-for-locally-advanced-rectal-cancer-technique-and-short-term-outcomes
#6
Ashish Pokharkar, Praveen Kammar, Ashwin D'souza, Rahul Bhamre, Pavan Sugoor, Avanish Saklani
BACKGROUND: Since last two decades minimally invasive techniques have revolutionized surgical field. In 2003 Pomel first described laparoscopic pelvic exenteration, since then very few reports have described minimally invasive approaches for total pelvic exenteration. METHODS: We report the 10 cases of locally advanced rectal adenocarcinoma which were operated between the periods from March 1, 2017 to November 11, 2017 at the Tata Memorial Hospital, Mumbai. All male patients had lower rectal cancer with prostate involvement on magnetic resonance imaging (MRI)...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29732361/nonsteroidal-anti-inflammatory-drugs-induced-diaphragm-disease-a-report-of-3-cases-and-literature-review
#7
Chun-Seok Yang, Ji Y Park, Hye Ryeon Choi, Daedong Kim
Multiple strictures of small bowel induced by nonsteroidal anti-inflammatory drugs (NSAIDs), were known as diaphragm disease. The purpose of these case reports is to present 3 cases of diaphragm disease of small bowel and summarize the clinical features of this disease entity. A 34-year-old man, a 63-year-old man, and a 66-year-old woman were admitted to Daegu Catholic University Medical Center because of recurrent intestinal obstructions. Two of these patients had taken heavy NSAIDs use. Capsule endoscopy was performed in all cases and the all capsules were retained by circumferential strictures of the ileum...
May 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29732360/primary-malignant-melanoma-of-the-small-intestine-a-report-of-2-cases-and-a-review-of-the-literature
#8
Kwan Mo Yang, Chan Wook Kim, So-Woon Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
The majority of malignant melanomas in the small intestine are metastases from primary cutaneous lesions, it can also develop as a primary mucosal tumor in the gastrointestinal tract. In this report, we present rare cases of primary small bowel melanoma and review the current literature. A 78-year-old male presented with abdominal pain and CT enterography identified a ileal mass. A 79-year-old female presented with signs and symptoms of partial small bowel obstruction. Abdominopelvic CT and small bowel series revealed a obstructing mass in the distal jejunum...
May 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29729056/a-case-of-small-intestinal-bacterial-overgrowth-performed-capsule-and-double-balloon-endoscopy
#9
Ichiro Otani, Shiro Oka, Shinji Tanaka
A 67-year old woman who had received treatment with prednisolone for systemic scleroderma visited our hospital. She complained of mild abdominal pain, bloating, anorexia, watery stools (approximately three times a day). Abdominal computed tomography showed high contrast appearance and thickening of the entire small intestinal wall as well as accumulation of intestinal fluid with no mechanical obstruction (Figure 1). Capsule endoscopy (Figure 2a) and antegrade double-balloon endoscopy (Figure 2b) revealed retention of cloudy intestinal fluid throughout the entire small intestine with reddish and edematous mucosa...
May 5, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29725660/migrated-embolization-coil-causes-intestinal-obstruction
#10
W Preston Hewgley, David L Webb, H Edward Garrett
Visceral artery pseudoaneurysm is a rare, potentially fatal entity, but proper identification and management with coil embolization can lead to good outcomes. Embolization coils can migrate to various destinations, causing delayed complications in several case reports. A case of small bowel obstruction due to migrated embolization coils from a gastroduodenal pseudoaneurysm 6 years after initial treatment is presented.
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29718225/clinical-use-of-patency-capsule-a-comprehensive-review-of-the-literature
#11
Ioannis V Mitselos, Konstantinos Katsanos, Epameinondas V Tsianos, Rami Eliakim, Dimitrios Christodoulou
The patency capsule is a radiopaque, dissolvable diagnostic tool, similar in shape and size to small bowel capsule endoscopes. It was developed to offer a simple, safe, efficient, and accurate evaluation of small bowel functional patency. Although unable to provide direct visual information regarding the presence and location of strictures, masses, or luminal narrowing of the small bowel, a successful patency test minimizes the risk of retention and allows the safe administration of a capsule endoscope. However, its use entails a low risk of potentially harmful adverse events, which in their majority are indolent and resolve spontaneously...
April 28, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29690886/loss-of-alpha-smooth-muscle-actin-expression-associated-with-chronic-intestinal-pseudo-obstruction-in-a-young-miniature-bull-terrier
#12
Gian Enrico Magi, Francesca Mariotti, Sara Berardi, Andrea Piccinini, Cecilia Vullo, Angela Palumbo Piccionello, Giacomo Rossi
BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) is a rare clinical syndrome in veterinary medicine characterized by severe intestinal dysmotility without evidence of mechanical occlusion of the intestinal lumen. The exact pathogenesis of CIPO is unknown. CASE PRESENTATION: A 1-year-old male Miniature Bull Terrier dog was presented with a history of chronic weight loss, regurgitation, lethargy, vomiting and diarrhea. The dog was submitted for exploratory laparotomy...
April 24, 2018: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/29684805/detecting-a-rare-composite-small-bowel-lymphoma-by-magnetic-resonance-imaging-coincidentally-a-case-report-with-radiological-surgical-and-histopathological-features
#13
M Pezzella, B Brogna, A Romano, F Torelli, G Esposito, M Petrillo, F M Romano, N Di Martino, A Reginelli, R Grassi
INTRODUCTION: Diagnosing lymphoma continues to prove challenging in the clinical practice. Composite lymphoma (CL) is defined by the coexistence of different lymphoma subtypes in the same anatomical location. This condition has seldom been witnessed in the gastrointestinal (GI) tract. We weren't able to find previous cases in the literature about small bowel CL with follicular lymphoma (FL) and classical Hodgkin lymphoma (CHL). Surgery is the treatment of choice to obtain accurate histology, to manage and prevent acute complications...
April 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29682387/surgical-management-of-encapsulating-peritoneal-sclerosis-a-case-report-in-kidney-transplant-patient
#14
R Shahbazov, M Talanian, J L Alejo, F Azari, A Agarwal, K L Brayman
Introduction: Encapsulating peritoneal sclerosis (EPS) is a clinical syndrome of progressive fibrotic change in response to prolonged, repetitive, and typically severe insult to the peritoneal mesothelium, often occurring in the setting of peritoneal dialysis (PD). Clear guidelines for successful management remain elusive. We describe the successful surgical management of EPS in a 28-year-old male s/p deceased donor kidney transplant for end-stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis (FSGS)...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29676346/formal-saline-versus-honey-as-escharotic-in-the-conservative-management-of-major-omphaloceles
#15
Christopher O Bode, Adesoji O Ademuyiwa, Olumide A Elebute
Background: The use of honey as an escharotic agent in the conservative management of omphalocele major has not been widely explored in spite of its proven benefits in chronic wound management. We explored the use of local honey as an escharotic agent by comparing its use with 2.5% formal saline in the conservative management of major omphaloceles at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: From January 2006 to December 2009, 43 consecutive newborns with intact omphalocele major were alternately assigned into either Honey (H) or formal saline (FS) group...
January 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29675635/intussusception-after-roux-en-y-gastric-bypass-laparoscopic-management
#16
Enrico Facchiano, Emanuele Soricelli, Luca Leuratti, Viviana Caputo, Giovanni Quartararo, Marcello Lucchese
INTRODUCTION: Intussusception represents an uncommon cause of intestinal obstruction after Rouxen-Y gastric bypass. Symptoms are not specific and clinical presentation may vary from acute intestinal obstruction with or without bowel necrosis to intermittent or chronic pain. CT scan is the diagnostic test of choice. MATERIALS AND METHODS: A 38-year-old woman who had undergone RYGBP 5 months prior was admitted to our Emergency Department with acute abdominal pain, alimentary and bilious vomiting, and fever...
April 19, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29674396/laparoscopic-management-of-an-internal-hernia-in-a-pregnant-woman-with-roux-en-y-gastric-bypass
#17
Umashankkar Kannan, Ranjan Gupta, Brian F Gilchrist, Venkata N Kella
Management of abdominal pain in a pregnant patient with a history of Roux-en-Y gastric bypass presents unique challenges. A misdiagnosis or delay in management can result in lethal maternal-fetal outcomes. We present a 30-year-old woman at 21 weeks of pregnancy presented with abdominal pain. She had a history of laparoscopic Roux-en-Y gastric bypass performed 3 years earlier. The clinical examination was remarkable for epigastric pain and tenderness. The vital signs and laboratory examinations were unremarkable...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29649951/biliary-ascariasis-presenting-with-gangrenous-perforation-of-the-gall-bladder-report-of-a-case-and-brief-review-of-literature
#18
Ankush Sharma, Priyansh Jariwala, Navneet Kaur
The most common cause of gallbladder perforation is calculous cholecystitis. Rarer causes include trauma, iatrogenic injuries, biliary stasis and gall bladder ischemia. We report a case of gall bladder gangrene with perforation, secondary to extensive ascariasis. A 45-year-old woman presented with acute intestinal obstruction and jaundice. She had abdominal distension and right hypochondrial tenderness. Abdominal radiography showed dilated bowel loops and ultrasonogram showed worms in the small intestine and biliary tree...
January 1, 2018: Tropical Doctor
https://www.readbyqxmd.com/read/29644034/food-ileus-secondary-to-citrus-fruit-associated-with-a-meckel-s-diverticulum-a-case-report-and-review-of-the-literature
#19
Yukihiro Tatekawa
The case of an 11-year-old boy with an orange-associated ileus in the setting of a mesodiverticular band from a Meckel's diverticulum is reported herein. Computed tomography showed a small bowel feces sign. He underwent laparoscopic-assisted surgery, and intraoperative findings revealed a Meckel's diverticulum associated with a mesodiverticular band distal to dilated small bowel. After resection of the Meckel's diverticulum and inspection of the intestinal contents proximal to the obstruction, it was apparent that undigested food material was impacted proximal to the obstruction...
March 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29627774/acute-lower-limb-ischaemia-secondary-to-intestinal-occlusion
#20
Francois-Charles Malo, Philippe Acar, Véronique Lapie, Valérie Bédard
In general, acute lower limb ischaemia is caused by embolic, thrombotic or traumatic phenomena. Here, we describe the case of a 67-year-old woman in an emergency room setting who was initially assessed for paralysis and numbness of her lower left limb. On physical examination, the abdomen was distended and non-compressible. An abdominal AngioScan showed complete occlusion of the left iliac artery by extrinsic compression of the dilated small intestine. After a review of the literature, no case was found describing a lower limb ischaemia by extrinsic vascular compression secondary to a compartment syndrome caused by small bowel obstruction...
April 7, 2018: BMJ Case Reports
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