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emergency laparotomy

S Shreshtha
A 70 year old lady presented to surgery emergency with small bowel obstruction without any obvious etiology. On exploration she was found to have an obstructed obturator hernia, which is a rare pelvic hernia with an incidence of 0.07-1.4% of all intra-abdominal hernias. Diagnosis is often delayed until laparotomy for bowel obstruction. Strangulation is frequent and mortality remains high (25%). Early diagnosis and surgical treatment contributes greatly to reduce the mortality and morbidity rates. A variety of techniques have been described, however surgical repair has not been standardized...
October 2016: Journal of Postgraduate Medicine
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
Meda Kondolot, Selim Doganay, Cüneyt Turan, Hasim Asil, Didem B Oztop, Caglar Ozdemir
Visceral injuries are not uncommon in nonaccidental trauma and often require emergent operative intervention. However, sometimes it can be difficult to assess the extent of injury. In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to our hospital as acute abdomen with intraperitoneal free fluid on ultrasonography. An exploratory laparotomy revealed the perforations and surgical repair was performed. The patient was evaluated by the Hospital Child Protective team and it was revealed that bladder and rectum perforations were due to insertion of rolling pin into the rectum by the stepmother...
October 4, 2016: Pediatric Emergency Care
Hayaki Uchino, Akira Kuriyama, John Bruce, Grant Laing, Damian Clarke, George Oosthuizen
Dog bites are a major cause of injury, especially in the pediatric population. Common anatomic sites of dog bites on children are the peripheries and the head and neck. The torso is reportedly injured less frequently, and only 2 cases of intra-abdominal injury secondary to dog bites have been reported. We recently encountered a 3-year-old boy presenting with peritonitis who had sustained multiple dog bites to his trunk and upper limbs. Emergency laparotomy was performed. Surgical findings revealed penetration of the peritoneum and single perforation of the anterior gastric wall with multiple tooth marks; thus, the gastric perforation was debrided and repaired...
September 30, 2016: Pediatric Emergency Care
Khaled Elbahrawy, Alaa El-Deeb
BACKGROUND: Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis, immediate anticoagulation, and intervention to restore mesenteric blood flow adequately. AIMS: To investigate the effect of rectus sheath block (RSB) for postoperative analgesia in patients with mesenteric vascular occlusion. SETTINGS AND DESIGN: Forty patients with mesenteric vascular occlusion, American Society of Anesthesiologists physical status I or II or III, scheduled for laparotomy were enrolled in this study...
September 2016: Anesthesia, Essays and Researches
Nariman A Nawar, Phyllis R Sawyer
BACKGROUND Segmental absence of intestinal musculature is a well described entity in premature infants. It presents with peritonitis, bowel perforation, and obstruction. The diagnosis is based on pathologic observation of absence of intestinal musculature. Researchers hypothesized that this entity is a result of a vascular accident during embryogenesis. However, segmental absence of intestinal musculature is no longer limited to the pediatric population. Recently, a few cases have been described in adults with and without significant vascular diseases...
October 17, 2016: American Journal of Case Reports
Mircea Beuran, Ionut Negoi, Ruxandra Irina Negoi, Sorin Hostiuc, Sorin Paun
A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition...
May 2016: Brazilian Journal of Cardiovascular Surgery
Atsushi Yamamoto, Yoshiaki Miyasaka, Kazushige Furuya, Hideki Watanabe, Masahiro Maruyama, Haruka Nakada, Atsushi Takano, Masao Hada, Hiroshi Nakagomi, Masao Omata, Toshio Oyama
We herein experienced a case with pseudo-Meigs' syndrome that developed both synchronous and metachronous metastases to the ovary from ascending colon cancer. A 57-year-old female visited a hospital for a 2-month history of abdominal distension and voiding difficulty. Massive pleural effusion on the right side and a small amount of left-sided pleural effusion were detected on CT. She underwent emergent laparotomy due to the severe symptom of abdominal distention. The tumor originated from the left ovary, and left-sided oophorectomy was performed...
December 2016: Surgical Case Reports
Maurizio Zizzo, Carolina Castro Ruiz, Lara Ugoletti, Alessandro Giunta, Stefano Bonacini, Lorenzo Manzini, Fabrizio Aguzzoli, Alberto Colognesi, Claudio Pedrazzoli
Colonoscopy is one of the most widely used procedures in medical practice for the diagnosis and treatment of many benign and malignant diseases of the colorectal tract. Colonscopy has become the reference procedure for screening and surveillance of colorectal cancer. The overall rate of adverse events is estimated to be about 2.8 per 1,000 procedures, while complications requiring hospitalization are about 1.9 per 1,000 colonoscopies. Mortality from all causes and colonoscopy-specific mortality are estimated to be 0...
May 2016: Case Reports in Gastroenterology
Jiro Kimura, Kenji Okumura, Hideki Katagiri, Alan Kawarai Lefor, Ken Mizokami, Tadao Kubota
INTRODUCTION: Omental hemorrhage results from rupture of the omental vessels. There are many causes of omental hemorrhage including trauma, aneurysm, and vasculitis. Idiopathic omental hemorrhage is a rare cause of an acute abdomen, which is potentially life-threatening. We report a patient with idiopathic omental hemorrhage, which may have been caused by overeating. CASE PRESENTATION: A 29-year-old man without a history of trauma, bleeding disorders, or other significant medical history, presented with left upper quadrant pain, which began after overeating the previous evening...
October 4, 2016: International Journal of Surgery Case Reports
Georgios C Pratilas, Panagiotis Chatzis, Nikolaos Panteleris, Kimon Chatzistamatiou, Leonidas Zeipiridis, Konstantinos Dinas
A woman presented at the gynecological emergency clinic with severe lower abdominal pain. Even though she reported normal menses and had no risk factors for ectopic pregnancy, pregnancy test was positive and vaginal sonogram indicated heterotopic pregnancy at 12 weeks of gestation, with rupture of the ectopic pregnancy. Laboratory results indicated significant blood loss, and emergency laparotomy with salpingo-ophorectomy was performed. The intrauterine pregnancy continued uneventfully. Interestingly, the previous month the patient had also undergone investigation for vague abdominal pain and anemia...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Kazuhiro Imamura, Kensuke Adachi, Ritsuko Sasaki, Satoko Monma, Sadaaki Shioiri, Yasuji Seyama, Masaru Miura, Yoshihiko Morikawa, Tetsuji Kaneko
BACKGROUND: The incisional surgical site infection (SSI) is an extremely common complication following open abdominal surgery and imposes a considerable treatment and cost burden. METHOD: We conducted a multicenter open-label randomized controlled trial at three Tokyo Metropolitan medical institutions. We enrolled adult patients who underwent either an elective or an emergency open laparotomy. Eligible patients were allocated preoperatively to undergo wound closure with either subcuticular sutures or staples...
October 3, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Bardia Bidarmaghz, Ashvini Shekhar, Rasika Hendahewa
INTRODUCTION: Endometriosis is usually a disease involving women of reproductive age. Colonic endometriosis is a rare sequelae. It usually presents vaguely with nonspecific abdominal pain, dyspareunia, fecal tenesmus, rectal bleeding or painful defecation. There are very few case reports of sigmoid endometriosis in the literature, more so ones involving post-menopausal women. Our report highlights such a case, mimicking a malignant rectosigmoid stricture leading to a large bowel obstruction...
September 22, 2016: International Journal of Surgery Case Reports
Vidya Ramasamy, Harvey Teo, Victor Samuel Rajadurai, Suresh Chandran
A female preterm infant was born to a non-consanguineous couple at 35 weeks of gestation. On day 8 of life, while on full feeds, she developed prolonged apnoea and bradycardia, requiring respiratory support. Her abdomen was soft with unremarkable serial abdominal X-rays. Her septic screen was negative. Metabolic acidosis was worsening despite treatment. Echocardiography showed evidence of high pulmonary pressures. With further deterioration, an ultrasound scan of the abdomen was requested in view of the rising suspicion of abdominal pathology in the absence of sepsis and metabolic disorders...
2016: BMJ Case Reports
Ryoga Hamura, Koichiro Haruki, Jun Tsutsumi, Sumio Takayama, Hiroaki Shiba, Katsuhiko Yanaga
Spontaneous biliary peritonitis is rare in adults. We herein report a case of spontaneous biliary peritonitis. An 84-year-old man was admitted to our hospital for abdominal pain for 5 days. He developed fever, jaundice, and abdominal rigidity. Computed tomography (CT) revealed massive ascites in the omental bursa and around the liver. The ascites obtained by diagnostic paracentesis was dark yellow-green in color, which implied bile leakage. With a diagnosis of bile peritonitis, the patient underwent emergency exploratory laparotomy...
December 2016: Surgical Case Reports
E Ray-Offor, S N Elenwo, P O Igwe, C Ngeribara
BACKGROUND: The cystic dilatation of the biliary tract is an uncommon anomaly. Choledochocele, a cystic dilatation of the distal common bile duct, rarely presents clinically as massive gastrointestinal bleeding. AIM: This is to report a very rare disease condition and highlight minimal access options in surgical care. CASE SUMMARY: A 13 year-old boy was referred with a day history of sudden onset of passage of bright red blood per rectum with a fainting episode...
September 13, 2016: International Journal of Surgery Case Reports
Simona Gurzu, Calin Molnar, Anca Otilia Contac, Annamaria Fetyko, Ioan Jung
Intestinal tuberculosis (TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical symptoms to differential diagnosis, unusual complications and therapy. The patient was admitted to the hospital with signs of acute abdomen as a result of a perforated terminal ileitis. Based on the skip lesions of the terminal ileum and cecum, Crohn's disease (CD) was clinically suspected. An emergency laparotomy and right colectomy with terminal ileum resection was performed and systematic antibiotherapy was prescribed...
September 16, 2016: World Journal of Clinical Cases
M O Eveleigh, T E Howes, C J Peden, T M Cook
Implementation of a quality improvement bundle for peri-operative management of emergency laparotomy (ELPQuIC) improved mortality in a previous study. We used data from one site that participated in that study to examine whether it was associated with the cost of care. We collected data from 396 patients: 144 before, 144 during and 108 after implementation of the bundle. We estimated costs incurred using previously published methodology based on the time the patient spent in hospital, in the operating theatre and in critical care...
November 2016: Anaesthesia
Lancelot Marique, Michel Wirtz, Arnaud Henkens, Emilie Delchambre, Monfred Rezaï, Christian Venet, Jean-Pierre Staudt
Trichotillomania and trichotillophagia can cause the formation of enormous intragastric hairballs. We report the case of a 13-year-old girl who was brought to the emergency service for evaluation of an acute abdomen. Abdominal CT scanner showed a giant gastric trichobezoar which had to be removed by susombilical laparotomy and transverse gastrotomy. This case illustrates the fairly uncommon perforation risk of these gastric bezoars.
September 22, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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