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1.
Nihon Shokakibyo Gakkai Zasshi ; 121(5): 400-406, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-38735748

RESUMO

A 47-year-old woman was referred to our hospital with recurring lower abdominal pain persisting for more than 2 weeks. Imaging modalities showed small bowel obstruction caused by a mass lesion in the terminal ileum. Despite undergoing fasting, rehydration, and decompression through an ileus tube, her symptoms persisted. Furthermore, the condition deteriorated on day 4, with the onset of her menstrual period. An emergency surgery was conducted on the 7th day after hospitalization. Surgical observations indicated severe stenosis around the ileocecal valve and ileal perforation approximately 40cm from the oral stricture. As a result, ileocecal resection was performed. Pathological examination revealed endometrial tissue infiltration through the mucosal lamina propria to the ileal subserosa. Thus, the patient was identified with intestinal endometriosis of the ileocecum. Endometriosis of the small bowel is an uncommon condition that eventually causes intractable bowel obstruction. Although preoperative diagnosis is considered challenging, intestinal endometriosis should be included in the differential diagnosis in cases of bowel obstruction in women of childbearing age.


Assuntos
Endometriose , Doenças do Íleo , Obstrução Intestinal , Perfuração Intestinal , Humanos , Feminino , Endometriose/complicações , Pessoa de Meia-Idade , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Obstrução Intestinal/diagnóstico por imagem , Perfuração Intestinal/cirurgia , Perfuração Intestinal/etiologia , Perfuração Intestinal/diagnóstico por imagem , Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Doenças do Íleo/diagnóstico por imagem
2.
Ugeskr Laeger ; 186(17)2024 Apr 22.
Artigo em Dinamarquês | MEDLINE | ID: mdl-38704706

RESUMO

A focused point-of-care abdominal ultrasound is an examination performed at the patient's location and interpreted within the clinical context. This review gives an overview of this examination modality. The objective is to rapidly address predefined dichotomised questions about the presence of an abdominal aortic aneurysm, gallstones, cholecystitis, hydronephrosis, urinary retention, free intraperitoneal fluid, and small bowel obstruction. FAUS is a valuable tool for emergency physicians to promptly confirm various conditions upon the patients' arrival, thus reducing the time to diagnosis and in some cases eliminating the need for other imaging.


Assuntos
Aneurisma da Aorta Abdominal , Hidronefrose , Ultrassonografia , Humanos , Ultrassonografia/métodos , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Hidronefrose/diagnóstico por imagem , Abdome/diagnóstico por imagem , Cálculos Biliares/diagnóstico por imagem , Colecistite/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Retenção Urinária/diagnóstico por imagem , Retenção Urinária/etiologia , Sistemas Automatizados de Assistência Junto ao Leito
3.
Ugeskr Laeger ; 186(17)2024 Apr 22.
Artigo em Dinamarquês | MEDLINE | ID: mdl-38704710

RESUMO

Meckel's diverticulum is the most common congenital gastrointestinal defect with a prevalence of 2%. It is mostly asymptomatic and it rarely causes acute abdomen in adults. In this case report, a 28-year-old male with no previous abdominal surgery presented with clinical symptoms of small bowel obstruction. Surgery revealed a Meckel's diverticulum adherent to the abdominal wall, causing internal herniation with small bowel obstruction. The diverticulum was openly resected and no post-operative complications occurred. Laparoscopy seems safe, and surgical removal of the symptomatic Meckel's diverticulum is recommended.


Assuntos
Íleus , Divertículo Ileal , Humanos , Divertículo Ileal/complicações , Divertículo Ileal/cirurgia , Divertículo Ileal/diagnóstico , Adulto , Masculino , Íleus/etiologia , Íleus/cirurgia , Tomografia Computadorizada por Raios X , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Obstrução Intestinal/diagnóstico por imagem
4.
Am J Case Rep ; 25: e943071, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38576141

RESUMO

BACKGROUND Meckel's diverticulum is a congenital remnant of the omphalomesenteric duct and is the most common congenital gastrointestinal malformation. Most patients are asymptomatic, but a rare presentation is with subacute small bowel obstruction (SBO) due to herniation of bowel loops through an internal hernia formed by the Meckel's diverticulum and adjacent mesentery that forms an internal hernia. This report is of a 15-year-old girl presenting as an emergency with vomiting and small bowel obstruction due to an internal hernia associated with Meckel's diverticulum. CASE REPORT We present a case of a 15-year-old girl who presented to the Children's Emergency (CE) department with persistent vomiting and abdominal distension and tenderness. X-rays demonstrated dilated small bowel loops, prompting admission under Pediatric Surgery (PAS). A subsequent computed tomography (CT) scan was performed, which demonstrated multiple dilated small bowel loops, confirming SBO, and a blind-ending "C-shaped" bowel loop at the region of the terminal ileum. A diagnostic laparotomy was performed, which confirmed the presence of a Meckel's diverticulum. The tip of the Meckel's diverticulum was adherent to part of the small bowel mesentery, forming an internal hernia defect through which a loop of proximal ileum had herniated, resulting in SBO. She then underwent a laparoscopy-assisted transumbilical Meckel's diverticulectomy (LATUM). The patient recovered uneventfully and was discharged on the 4th postoperative day. CONCLUSIONS In children presenting with SBO, the possibility of Meckel's diverticulum as an etiology should be considered as a differential diagnosis. Early diagnosis and prompt intervention will improve clinical outcomes and avoid complications.


Assuntos
Hérnia Abdominal , Obstrução Intestinal , Divertículo Ileal , Criança , Feminino , Humanos , Adolescente , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico por imagem , Divertículo Ileal/cirurgia , Hérnia Abdominal/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Hérnia Interna/complicações , Vômito
5.
Br J Hosp Med (Lond) ; 85(3): 1-9, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38557088

RESUMO

Volvulus describes the twisting of the intestine or colon around its mesentery. Intestinal obstruction and/or ischaemia are the most common complications of volvulus. Within the gastrointestinal tract, there is a preponderance towards colonic volvulus. The sigmoid is the most commonly affected segment, followed by the caecum, small intestine and stomach. Distinguishing between the differing anatomical locations of gastrointestinal volvulus can be challenging, but is important for the management and prognosis. This article focuses on the main anatomical sites of gastrointestinal volvulus encountered in clinical practice. The aetiology, presentation, radiological features and management options for each are discussed to highlight the key differences.


Assuntos
Obstrução Intestinal , Volvo Intestinal , Humanos , Volvo Intestinal/diagnóstico por imagem , Volvo Intestinal/terapia , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/terapia , Colo Sigmoide , Intestino Delgado , Radiografia
6.
Rev Med Liege ; 79(3): 129-130, 2024 Mar.
Artigo em Francês | MEDLINE | ID: mdl-38487904

RESUMO

Intussusception is rare in adults, accounting for 1 to 5 % of mechanical bowel obstructions. It is due to pathologic lead point within the bowel which is malignant in up to 77 % of cases. Benign lesions may also be responsible for intussusception (polyp, Meckel diverticulum). The lead point is pulled forward by normal peristaltism, prolapsing the affected segment of bowel into another segment. The most common presentation in adults is intermittent abdominal pain and bowel obstruction (nausea, vomiting, inability to pass gas or stools). Abdominal scanner is the key exam for the diagnosis and the treatment is always surgical resection.


Les invaginations grêles et coliques sont rares chez l'adulte, représentant 1 à 5 % des causes d'obstruction digestive mécanique. Elles sont le plus souvent causées par une masse intra-digestive, le péristaltisme entraînant un prolapsus du segment malade vers un segment intestinal adjacent. Elles sont généralement le reflet d'une pathologie maligne du tube digestif (tumeur maligne découverte dans plus de 77 % des cas), mais il peut également exister des causes béniqnes (polype, diverticule de Meckel, adénopathie) . Elles se manifestent sous forme de douleurs abdominales et d'occlusion (nausées, vomissements, arrêt des selles et des gaz). Le scanner abdominal est l'examen de choix pour poser le diagnostic. Le traitement est toujours une résection chirurgicale.


Assuntos
Cólica , Obstrução Intestinal , Intussuscepção , Divertículo Ileal , Neoplasias , Adulto , Humanos , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Cólica/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Divertículo Ileal/cirurgia
7.
Am J Case Rep ; 25: e943419, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38444155

RESUMO

BACKGROUND Congenital malformations of the alimentary tract constitute 5% to 6% of newborn anomalies, with congenital intestinal atresia being a common cause of alimentary tract obstruction. This study explores advanced ultrasound diagnostic possibilities, including 2D, HDlive, HDlive inversion, and HDlive silhouette imaging modes, through the analysis of 3 cases involving duodenal and intestinal obstructions. Congenital malformations of the alimentary tract often present challenges in prenatal diagnosis. The most prevalent defect is congenital intestinal atresia leading to alimentary tract obstruction, with an incidence of approximately 6 in 10 000 births. We focused on advanced ultrasound diagnostic techniques and their applications in 3 cases of duodenal and intestinal obstructions. CASE REPORT Three cases were examined using advanced ultrasound imaging modes. The first patient, diagnosed at week 35 of gestation, revealed stomach and duodenal dilatation. The second, identified at week 32, had the characteristic "double bubble" symptom. The third, at week 31, also had double bubble symptom and underwent repeated amnioreduction procedures. HDlive, HDlive inversion, and HDlive silhouette modes provided intricate visualizations of the affected organs. Prenatal diagnosis of alimentary tract obstruction relies on ultrasound examinations, with nearly 50% of cases being diagnosed before birth. CONCLUSIONS Advanced ultrasound imaging modes, particularly HDlive silhouette, play a crucial role in diagnosing fetal alimentary tract obstruction. These modes offer detailed visualizations and dynamic evaluations, providing essential insights for therapeutic decisions. The study emphasizes the importance of sustained fetal surveillance, a multidisciplinary approach, and delivery in a level III referral center to ensure specialized care for optimal outcomes.


Assuntos
Atresia Intestinal , Obstrução Intestinal , Recém-Nascido , Feminino , Gravidez , Humanos , Atresia Intestinal/diagnóstico por imagem , Cuidado Pré-Natal , Ultrassonografia , Diagnóstico Pré-Natal , Obstrução Intestinal/diagnóstico por imagem
8.
Ulus Travma Acil Cerrahi Derg ; 30(3): 226-228, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38506380

RESUMO

Internal herniation is an extremely rare cause of intestinal obstruction. Paraduodenal hernias result from abnormal rotation of the bowel. Symptoms that may range from recurrent abdominal pain to acute obstruction may occur. If it is not diagnosed and treated in time, the disease may result in intestinal ischemia. This article aimed to present the diagnosis and treatment process of a 47-year-old male presenting with acute abdomen symptoms by evaluating retrospectively with the accompaniment of literature. During the abdominal exploration of the patient, nearly all of the intestines were observed to be herniated from the right paraduodenal region to the posterior area. The opening of the hernial sac was repaired primarily by reducing the intestinal bowel loops into the intraperitoneal region. The patient undergoing anastomosis by performing resection of the ischemic part after reduction of herniated bowel loops was discharged uneventfully on the post-operative 10th day. Paraduodenal hernia is a condition that should be considered in patients with abdominal pain and intestinal obstruction symptoms. Early diagnosis is of vital importance to prevent the complications which can develop.


Assuntos
Duodenopatias , Obstrução Intestinal , Masculino , Humanos , Pessoa de Meia-Idade , Hérnia Paraduodenal/complicações , Estudos Retrospectivos , Duodenopatias/diagnóstico , Duodenopatias/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Hérnia/diagnóstico , Hérnia/diagnóstico por imagem , Dor Abdominal/etiologia
9.
Am J Case Rep ; 25: e942527, 2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38519985

RESUMO

BACKGROUND Diffuse intestinal lipomatosis is a rare condition that infiltrates mature fatty tissue into the intestinal submucosa and subserosa of the small or large intestine and can present with intestinal obstruction or torsion. This report is of the case of a 58-year-old woman who had acute torsion of the small bowel due to diffuse small intestinal lipomatosis. CASE REPORT A 58-year-old woman, who was otherwise in good health, arrived at our Emergency Department experiencing sudden, intense pain in the lower abdomen. She also reported abdominal swelling, feelings of nausea, vomiting, and reduced ability to defecate for at least 2 days. The next morning, contrast-enhanced abdominal computed tomography (CT) scan was performed, showing diffuse thickening of the small intestinal wall with hypodensity, fatty density, lumen narrowing, and wall thinning. The small intestine demonstrated a whirlpool-like distribution in the lower right abdomen and localized thickening of the small intestinal wall, suggesting acute intestinal torsion. An hour later, an emergency operation was performed to remove part of the small intestine. Three days later, pathological results showed a thin intestinal wall, expansion of the mucosal layer and submucosa, and hyperplasia of adipose tissue. CONCLUSIONS This report presents a rare case of torsion and small bowel obstruction caused by diffuse intestinal lipomatosis and focuses on the abdominal enhanced CT scan, which showed diffuse thickening of the small intestine, with multiple areas of fat density and torsion of the small intestine in the right lower abdomen. Histopathology is also presented, with the result showing intestinal lipomatosis.


Assuntos
Obstrução Intestinal , Lipomatose , Feminino , Humanos , Pessoa de Meia-Idade , Intestino Delgado/cirurgia , Intestino Delgado/patologia , Abdome , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Tomografia Computadorizada por Raios X , Lipomatose/diagnóstico , Lipomatose/diagnóstico por imagem
10.
Vet Radiol Ultrasound ; 65(3): 264-274, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38436052

RESUMO

Small intestinal obstruction in rabbits, although demonstrated to be common, is still poorly characterized. The objective of this study was to report features of small intestinal obstruction caused by trichobezoars in rabbits upon CT and their clinical outcomes. Rabbits with a diagnosis of intestinal obstruction that underwent CT scanning were included in this study. From each CT scan, obstruction location, appearance, Hounsfield units, size (mm), volume (mm3), distance from the stomach, and diameter of the small intestine proximal and distal to it, were extracted. Nine rabbits were included in the study. All rabbits presented for anorexia and had a distended or enlarged stomach (7) or abdomen (2). CT scan showed a non-contrast-enhancing, ovoid, smoothly marginated structure with a hyperattenuating rim, heterogeneous center, and variable amount of centrally located gas, in the duodenum (5), the jejunum (2), or the ileum (2). The density of the trichobezoars ranged from -156 to 58 HU (median, -44 HU) and volume ranged from 86.1 to 633.8 mm3 (median, 320.6 mm3). Three rabbits underwent medical management. Two of them survived, and one of them died. Six rabbits underwent surgery, of which three were successfully discharged from the hospital. CT proved to be a valuable imaging modality in rabbits with a suspected intestinal obstruction to provide the exact location of the obstruction and the characteristics of the obstructive material. The location and size of the trichobezoar may have relevant clinical implications.


Assuntos
Bezoares , Obstrução Intestinal , Intestino Delgado , Tomografia Computadorizada por Raios X , Animais , Coelhos , Obstrução Intestinal/veterinária , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Bezoares/veterinária , Bezoares/diagnóstico por imagem , Bezoares/complicações , Tomografia Computadorizada por Raios X/veterinária , Feminino , Intestino Delgado/diagnóstico por imagem , Masculino
11.
BMJ Case Rep ; 17(3)2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38442967

RESUMO

Small bowel obstruction (SBO) in pregnancy is exceedingly rare. Management of SBO in the third trimester may pose particular challenges, as clinicians must determine whether or not the delivery of the fetus is indicated. In this report, we review the case of a patient in her mid-20's with no prior surgical history who presented with nausea and vomiting at 34 weeks of gestation and was ultimately diagnosed with an SBO. Following expectant management during the initial 4 days of inpatient admission, the patient subsequently underwent an exploratory laparotomy at 35 weeks without concurrent delivery. She was monitored for the remainder of her pregnancy with non-stress tests to evaluate fetal status and eventually underwent induction of labour at 39 weeks, resulting in a successful vaginal delivery. Herein, we review the challenges related to the diagnosis and management of SBO in pregnancy, as well as the maternal-fetal outcomes in the setting of SBO in the third trimester.


Assuntos
Parto Obstétrico , Obstrução Intestinal , Feminino , Humanos , Gravidez , Feto , Hospitalização , Pacientes Internados , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Terceiro Trimestre da Gravidez , Adulto
13.
J Med Case Rep ; 18(1): 72, 2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38388472

RESUMO

BACKGROUND: Ileo-ileal knotting is a very rare cause of small bowel obstruction, and only a few reports have been published. Small bowel obstruction (SBO) is one of the most common emergency surgical conditions that require urgent evaluation and treatment and is one of the leading causes of emergency surgical admission. There are many causes of SBO that are known in general surgical practice, and these causes are different in the developing and developed worlds. CLINICAL PRESENTATION: In this article, we present a case of acute gangrenous SBO secondary to ileo-ileal knotting in a 37-year-old Ethiopian female patient after she presented with severe abdominal cramp, vomiting, and abdominal distension of 4 hours duration. The patient was operated on intraoperatively; she had gangrenous small bowel obstruction caused by ileo-ileal knotting. Later, the patient was discharged and improved after 12 days of hospital stay. CONCLUSION: Ileo-ileal knotting should always be considered in the differential diagnosis of acute small-bowel obstruction. The diagnostic difficulty and the need for urgent treatment of this condition to yield optimal results are discussed.


Assuntos
Doenças do Íleo , Obstrução Intestinal , Humanos , Feminino , Adulto , Doenças do Íleo/complicações , Doenças do Íleo/diagnóstico , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Doença Aguda , Hospitalização , Tempo de Internação , Gangrena/cirurgia , Gangrena/complicações
14.
Radiology ; 310(2): e231710, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38319165

RESUMO

Background Preoperative recognition of irreversible bowel necrosis is important, as it provides valuable guidance for surgical strategy selection but also may inform perioperative risk assessment and communication. Few studies have focused on the association between CT signs and bowel necrosis. Purpose To assess the diagnostic accuracy of CT signs to predict bowel necrosis in patients with closed-loop small bowel obstruction (CL-SBO). Materials and Methods This retrospective single-center study included patients who were surgically confirmed to have CL-SBO caused by adhesion or internal hernia between January 2016 and May 2022. Necrosis was determined based on surgical exploration and postoperative pathologic examination. Two radiologists independently reviewed CT signs by both subjective visual assessment and objective measurement. Disagreements were resolved in consensus with a third gastrointestinal radiologist. Univariable and multivariable analyses were used to assess the association between CT signs and bowel necrosis, and Cohen κ was used to assess interobserver agreement. Sensitivity and specificity were calculated for each CT sign. Results This study included 145 patients: 61 (42.1%) in the necrotic group (median age, 62 years [IQR, 51-71.5 years]; 37 [60.7%] women) and 84 (57.9%) in the nonnecrotic group (median age, 61.5 years [IQR, 51-68.8 years]; 51 [60.7%] women). Univariable analysis and multivariable analysis showed that increased attenuation of intestinal contents and increased attenuation of intestinal wall were independent predictors for bowel necrosis (odds ratio = 45.3 and 15.1; P = .001 and P < .001, respectively). Increased attenuation of intestinal contents and increased attenuation of intestinal wall had similar sensitivity (64% and 67%, respectively) and specificity (99% and 92%, respectively) for predicting bowel necrosis. However, interobserver agreement was better for assessing the contents than the wall (κ = 0.84 and 0.59, respectively). Conclusion Increased attenuation of intestinal contents was a highly specific CT sign with good reproducibility to predict bowel necrosis in CL-SBO. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Taourel and Zins in this issue.


Assuntos
Conteúdo Gastrointestinal , Obstrução Intestinal , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Necrose/diagnóstico por imagem , Tomografia Computadorizada por Raios X
16.
Eur J Radiol ; 173: 111363, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38367415

RESUMO

PURPOSE: To assess diagnostic performance and reproducibility of reduced bowel wall enhancement evaluated by quantitative methods using CT to identify bowel necrosis among closed-loop small bowel obstruction (CL-SBO) patients. METHODS: This retrospective single-center study included patients who diagnosed with CL-SBO caused by adhesion or internal hernia during January 2016 and May 2022. Patients were divided into necrotic group (n = 41) and non-necrotic group (n = 67) according to surgical exploration and postoperative pathology. Two doctors independently measured the attenuation of bowel wall and consensus was reached through panel discussion with a third gastrointestinal radiologist. Reduced bowel wall enhancement was assessed by four quantitative methods. Univariate analyses were used to evaluate the association between each method and bowel necrosis, and kappa/intraclass correlation coefficient values were used to assess interobserver agreement. Diagnostic performance parameters were calculated for each method. RESULTS: Reduced bowel wall enhancement in arterial phase (OR 8.98, P < 0.0001), reduced bowel wall enhancement in portal phase (OR 16.84, P < 0.001), adjusted reduced bowel wall enhancement in arterial phase (OR 29.48, P < 0.001), adjusted reduced bowel wall enhancement in portal phase (OR 145.69, P < 0.001) were significantly associated with bowel necrosis. Adjusted reduced bowel wall enhancement in portal phase had the best diagnostic performance (AUC: 0.92; Youden index: 0.84; specificity: 94.03 %) and interobserver agreement (kappa value of 0.59-0.73) to predict bowel necrosis. CONCLUSION: When assessing reduced bowel enhancement to predict bowel necrosis among CL-SBO patients, using unenhanced CT images and proximal dilated loop as standard references in portal phase is the most accurate quantitative method among those tested.


Assuntos
Traumatismos Abdominais , Obstrução Intestinal , Doenças Vasculares , Humanos , Tomografia Computadorizada por Raios X/métodos , Estudos Retrospectivos , Reprodutibilidade dos Testes , Intestino Delgado/diagnóstico por imagem , Sensibilidade e Especificidade , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Doenças Vasculares/patologia , Necrose/diagnóstico por imagem , Necrose/patologia , Traumatismos Abdominais/complicações
18.
Can Vet J ; 65(2): 173-176, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38304476

RESUMO

Objective: To describe a case of small intestinal obstruction secondary to kinetic sand ingestion in a dog. Animal: An 11-year-old neutered male shih tzu dog with a 2-day history of anorexia. Procedure: Abdominal radiographs revealed a small intestinal bowel loop dilated with radiopaque material, consistent with sand ingestion. The dog's only sand exposure was to kinetic sand. After 8 h of medical management, radiographs were consistent with a small intestinal obstruction. Results: The dog underwent exploratory laparotomy, which revealed distal jejunal and ileal distention with palpable soft foreign material that could not be milked into the colon. The sand was removed through a single enterotomy. The dog was discharged 4 d after surgery. Conclusion and clinical relevance: The hydrophobic properties of kinetic sand may make it more likely than regular sand to cause intestinal obstruction that requires surgery. With the increasing popularity and availability of kinetic sand for domestic use, clinicians should have a high index of suspicion for kinetic sand impaction and secondary intestinal obstruction.


Obstruction du petit intestin à la suite de l'ingestion de sable à modeler (Kinetic Sand) chez un chien. Objectif: Description d'un cas d'obstruction du petit intestin secondaire à l'ingestion de sable à modeler chez un chien. Animal: Chien shih tsu mâle castré âgé de 11 ans avec une historique d'anorexie depuis 2 jours. Procédure: Des radiographies abdominales ont révélé une anse du petit intestin dilatée avec du matériel radio-opaque, compatible avec une ingestion de sable. Une exposition à du sable à modeler était la seule exposition connue pour ce chien. Après 8 h de gestion médicale, les radiographies étaient compatibles avec une obstruction du petit intestin. Résultats: Une laparotomie exploratoire a révélé une distension du jéjunum distal et de l'iléon avec du matériel étranger mou palpable qui ne pouvait être transité dans le côlon. Le sable a été retiré à la suite d'une entérotomie simple. Le chien a obtenu sont congé médical 4 j après la chirurgie. Conclusion et signification clinique: Les propriétés hydrophobes du sable à modeler le rendent plus propice que le sable régulier à causer une obstruction intestinale et de nécessiter une chirurgie. Avec la popularité et disponibilité grandissante du sable à modeler pour usage domestique, les cliniciens devraient avoir un degré élevé de suspicion pour l'impaction par le sable à modeler et l'obstruction intestinale secondaire.(Traduit par Dr Serge Messier).


Assuntos
Doenças do Cão , Obstrução Intestinal , Animais , Cães , Masculino , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/etiologia , Doenças do Cão/cirurgia , Ingestão de Alimentos , Íleo , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Obstrução Intestinal/veterinária , Intestino Delgado/cirurgia , Areia
19.
BMJ Case Rep ; 17(2)2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38316488

RESUMO

Meckel's diverticulum is the most common congenital abnormality of the small bowel, present in about 2% of the population. A man in his 20s underwent a laparoscopic appendicectomy for acute appendicitis and recovered uneventfully. He presented to the emergency department 1 month later with features of acute small bowel obstruction. Emergency diagnostic laparoscopy revealed a band adhesion between the apex of a Meckel's diverticulum to the appendicectomy stump. Internal herniation of ileum under this band adhesion resulted in small bowel obstruction and ischaemic necrosis of the Meckel's diverticulum. The band adhesion was divided, and the Meckel's diverticulum was resected at the base with a linear cutting stapler. This complication has not been reported previously. A Meckel's diverticulum is an important differential diagnosis of acute appendicitis and should routinely be searched for among other pathologies. It can rarely cause a postoperative complication of internal hernia.


Assuntos
Apendicite , Hérnia Abdominal , Obstrução Intestinal , Divertículo Ileal , Masculino , Humanos , Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico por imagem , Divertículo Ileal/cirurgia , Apendicite/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Hérnia Abdominal/cirurgia , Hérnia Interna , Doença Aguda
20.
BMJ Case Rep ; 17(2)2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38383130

RESUMO

This report describes a case of a patient with active multiple myeloma who was started on bortezomib, cyclophosphamide and dexamethasone and subsequently presented to the emergency department with acute intestinal obstruction one week later. The patient underwent exploratory laparotomy, but no mechanical cause of the obstruction was found. The patient later developed sepsis and eventually died. The possible cause of the intestinal obstruction was attributed to bortezomib, and the paper discusses the potential mechanism of this side effect and its management based on available literature.


Assuntos
Íleus , Obstrução Intestinal , Mieloma Múltiplo , Humanos , Bortezomib/efeitos adversos , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/etiologia , Obstrução Intestinal/induzido quimicamente , Obstrução Intestinal/diagnóstico por imagem , Ciclofosfamida/efeitos adversos , Íleus/induzido quimicamente , Íleus/diagnóstico por imagem , Dexametasona/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
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