In utero ileal volvulus and intestinal perforation associated with enteric duplication cyst presenting with preterm labour and acute abdomen in newborn.

Enteric duplication cysts are a rare cause of intestinal obstruction in the neonatal period. We present the unusual case of an in utero ileal volvulus secondary to an enteric duplication cyst causing an acute abdomen in a 35-week estimated gestational age newborn female delivered to a mother in preterm labour.

Double simultaneous intussusception caused by Meckel's diverticulum and intestinal duplication in a child.

Intussusception is common in children. Double simultaneous intussusception is a peculiar variety of intussusception with only 14 previously reported cases. We report a unique case of a child who suffered from double simultaneous intussusception with two lead points (Meckel's diverticulum and intestinal duplication). The patient was successfully treated with manual reduction along with resection of Meckel's diverticulum and intestinal duplication. The child recovered well.

Unusual Ileal Anomalies Associated with Omphalomesenteric Duct Remnants.

The association between omphalomesenteric duct remnants and other digestive tract malformations is not rare. Most associated anomalies are reported with Meckel's diverticulum. We report two associated anomalies which were never reported: an ileal stenosis and an ileal duplication. Surgeons must be aware of associated anomalies to prevent post-operative complications.

Mesenteric Defect with Internal Herniation: A Rare Cause of Bowel Obstruction in Newborn.

Herniation through a congenital mesenteric defect is a rare cause of intestinal obstruction in the newborn. Early diagnosis and surgical treatment improves the prognosis. We present a case of a full-term infant who presented with respiratory distress at birth. Enteral feeding was not started because abdominal distension and delayed passage of meconium. Bowel obstruction was suspected. Radiological investigation did not provide a clear diagnosis. Surgical exploration revealed transmesenteric congenital hernia. After surgical repair, enteral feeding was tolerated and patient was discharged with an uneventful outcome. Diagnostic difficulties were discussed.

Neonatal intestinal obstruction secondary to a small bowel duplication cyst.

A 3-week-old neonate developed abdominal distension and vomiting which subsided after conservative management. However, there was a recurrence of symptoms for which a lower gastrointestinal tract contrast study was performed. The infant had a filling defect in the area of the transverse colon. A CT scan was performed, showing a duplication cyst arising from the small bowel and indenting the transverse colon. Resection of the duplication cyst and end-to-end anastomosis of the bowel was performed. The duplication cyst was of tubular type, and a sealed perforation was noted in the cyst wall.

A completely isolated intestinal duplication cyst mimicking ovarian cyst torsion in an adult.

Intestinal duplications are rare congenital anomalies that can occur anywhere in the gastrointestinal tract. They are most commonly located in the ileum and are usually detected in infancy or early childhood. Duplicated segments are usually firmly attached to and sometimes communicate with the normal gastrointestinal tract. Rarely, intestinal duplications are completely isolated, thus not associated at all with any part of the gastrointestinal tract. Such duplications do not share a common blood supply with the adjacent normal intestinal segment, unlike the usual form of duplication, but rather have a separate vascular pedicle. Reports of completely isolated duplication cysts in adults are extremely rare; we found only five such reports in the English-language medical literature. Here, we report a case of a completely isolated duplication cyst 12 cm long in an adult female. The cyst had no connection to any part of the intestinal tract and had a dedicated vascular pedicle.

Jejunal atresia in a neonate due to intrauterine intussusception.

We report a female neonate, who presented with abdominal distension and failure to pass meconium. Antenatal ultrasound at 32 weeks gestation and postnatal ultrasound on day1 suggested intestinal obstruction. During laparatomy, atresia of distal jejunum was found. The lumen of the distal segment contained an intussusceptum. Resection of the blind ends was done and end-to-end anastomosis was performed.

Rare case of disseminated neonatal zygomycosis mimicking necrotizing enterocolitis with necrotizing fasciitis.

A set of monochorionic male twins presented with intestinal perforation. The smaller twin was diagnosed with necrotizing enterocolitis followed by sepsis, disseminated intravascular coagulation, and necrotizing fasciitis of the abdominal wall. The infant died on the fourth day after surgery, 16 days after birth. Surgical specimens and autopsy revealed a disseminated zygomycotic infection. Gastrointestinal zygomycosis followed by necrotizing fasciitis in premature infants is a rare condition and mimics necrotizing enterocolitis clinically. Necrotizing fasciitis after gastrointestinal zygomycosis in premature infants is considered a poor prognostic sign. Gastrointestinal zygomycosis should be considered in the differential diagnosis of necrotizing enterocolitis.

Incidental congenital transmesenteric hernia in an adult.

Transmesenteric hernia is a rare type of internal hernia. We report a case of a 45 year old lady who was found to have an incidental congenital transmesenteric hernia of ileum caused by a congenital mesenteric defect during radical cystectomy done for muscle invasive transitional cell carcinoma of urinary bladder.

Ileocaecal valve: how important is it?

PURPOSE: Our aim was to investigate the importance of the ileocaecal valve and its reconstruction in patients that are not suffering from short bowel syndrome and Crohn's disease. METHODS: Casenotes of 99 children with hemicolectomy and 24 children with terminal ileal resection were reviewed and sorted into three groups. Group 1: ileocaecal valve resection (limited hemicolectomy), Group 2: hemicolectomy, Group 3: terminal ileal resection between 10 and 25 cm. Patients with Crohn's, short bowel syndrome and incomplete follow-up were excluded. RESULTS: Chronic diarrhoea was documented in 7/26 cases (27%) in Group 1, 6/23 patients (26%) in Group 2, and none of the 13 patients had diarrhoea in Group 3. Pearson Chi-square test showed significant difference between Group 1 and Group 3 (p = 0.038) and between Group 2 and Group 3 (p = 0.043). But there was no significant difference between Group 1 and Group 2 (p = 0.947). CONCLUSION: Chronic diarrhoea is a significant complication after limited hemicolectomy not only in Crohn's disease and short bowel syndrome. This is likely to originate from the loss of the ileocaecal valve itself rather than the loss of the ileal or colonic segment. Our results justify attempts to reconstruct the ileocaecal valve.

Prolapse of bowel via patent vitello intestinal duct--a rare occurrence.

This report describes the presentation of prolapse of small bowel through the patent omphalomesenteric or vitello intestinal duct in a child. In spite of diagnosing the anomaly earlier, there was delay in surgical intervention that led to prolapse of the small bowel through patent remnants, which was life threatening. The patient presented to us with questionable viability of prolapsed bowel. Early surgery is recommended for this entity. As this is a very rare occurrence, it is being reported with a brief review of the relevant literature.

Segmental ileal obstruction in neonates--a rare entity.

Congenital segmental dilatation of a portion of the small intestine in neonates causing intestinal obstruction is quite uncommon. We hereby report 2 such cases. In both infants, there was localized dilatation of the ileum with collapse of the distal bowel and functional intestinal obstruction without loss of continuity of the bowel wall or lack of ganglion cells.

Noncommunicating isolated enteric duplication cyst in childhood.

Duplications of the alimentary tract are spherical or tubular structures lined by epithelium similar to intestine that are firmly attached to or share the wall of the alimentary tract and have a common blood supply with the adjacent segment of the bowel. Completely isolated duplication cysts are an extremely rare variety of gastrointestinal duplications with their own exclusive blood supply and do not communicate with the intestine. There are only 4 cases reported in the English literature-3 in childhood and 1 in an adult, and all are male. We report a case of noncommunicating isolated ileal duplication cyst in a 3-year-old female child that presented as a mass in the right iliac fossa, mimicking an intussusception. The duplication had its own blood supply arising from the terminal ileal mesentery. This report describes the first female patient with this condition and reviews the English literature.

Isolated enteric duplication cyst with respiratory epithelium: case report and review of the literature.

Enteric duplication cysts are uncommon congenital abnormalities. We report a case of an enteric cyst duplication located a few centimeters proximal to the ileocecal valve in a patient with vague abdominal symptoms. Histological examination showed an ileal duplication cyst lined with ciliated bronchial epithelium. Duplication cysts of the alimentary tract are uncommon, and their epithelial lining varies. Bronchial respiratory epithelium is extremely rare at the terminal ileum. Our case is only the second case described in the literature.

Segmental defect of intestinal musculature: a rare cause of intestinal obstruction in children.

A 3 years old female child was brought to the emergency department with acute abdomen. Laparotomy disclosed multiple segmental dilatations in the middle third of the ileum which was resected and anastomosed. Post-operative recovery was uneventful. Histopathological findings showed lack of smooth and longitudinal muscles in dilated segments of the intestine with intact mucosa without any evidence of necrosis and inflammation.

Multiple ileal polyps associated with gastrointestinal perforation in a 2-day-old neonate.

We experienced a very rare case of a gastrointestinal perforation due to multiple ileal polyps. The patient was a 2-day-old boy who weighed 1,430 g at birth. At neonatal day 2 subdiaphragmatic free air was noted and an emergency operation was performed. During surgery a distended ileum approximately 5 cm in size was found approximately 40 cm distal from the ileocecum, and a perforation was discovered in the distended portion of the intestine. Approximately 8 cm of the ileum was resected, including the distended portion of the intestine, and an ileostomy was performed. Examination of the resected specimen revealed three pedunculated polyps with a perforation proximal to the polyps.

Hindgut duplication--case report and literature review.

Colonic duplication is a rare congenital abnormality that can present diagnostic difficulties. A case of duplication of the entire large bowel and terminal ileum is presented, and a framework for diagnostic work-up and treatment options in these patients is discussed.