Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.324
Filtrar
1.
PLoS One ; 15(7): e0236421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32716958

RESUMO

BACKGROUND: NOD2 variants are the strongest genetic predictors for susceptibility to Crohn's disease (CD). However, the clinical value of NOD2 on an individual patient level remains controversial. We aimed to define the predictive power of the major NOD2 mutations regarding complicated CD in a large single center cohort. METHODS: 1076 CD patients were prospectively genotyped for the three common CD-associated NOD2 mutations rs2066844, rs2066845, and rs2066847, followed by detailed genotype-phenotype analyses. RESULTS: Overall, 434 CD patients (40.3%) carried at least one of the three main NOD2 mutations. A significantly higher minor allele frequency (15.6%) of the NOD2 frameshift mutation p.Leu1007fsX1008 (rs2066847) was seen in patients with aggressive disease compared to 8.2% in patients with mild disease (p = 2.6 x 10-5). Moreover, a total of 54 CD patients (5.0%) were homozygous for this NOD2 frameshift mutation. 100% of these patients had ileal disease compared to 82% of NOD2 wild-type carriers (p<0.0001). In homozygous carriers of the NOD2 frameshift mutation, 87% presented with ileal stenosis, 68.5% had fistulas, and 72.2% required CD-related surgery despite immunosuppressive therapy in 87% of these patients. All homozygous carriers of the 1007fs mutation who were active smokers had ileal stenosis and required CD-related surgery. CONCLUSION: Homozygosity for Leu1007fsX1008 is an excellent biomarker for predicting complicated CD on an individual patient level. Active smoking and homozygosity for this mutation is associated with a 100% risk for developing ileal stenosis requiring CD-related surgery. In these patients, smoking cessation and early initiation of immunosuppressive strategies may be beneficial.


Assuntos
Doença de Crohn/genética , Doença de Crohn/patologia , Doenças do Íleo/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Mutação/genética , Proteína Adaptadora de Sinalização NOD2/genética , Fumar/efeitos adversos , Adolescente , Adulto , Estudos de Coortes , Doença de Crohn/complicações , Feminino , Dosagem de Genes , Frequência do Gene/genética , Marcadores Genéticos , Predisposição Genética para Doença , Heterozigoto , Homozigoto , Humanos , Doenças do Íleo/etiologia , Modelos Logísticos , Masculino , Fenótipo , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
2.
Am Surg ; 86(6): 675-684, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683979

RESUMO

Gallstone ileus is an unusual complication of cholelithiasis. Classically, a stone is impacted at the terminal ileum originating from a cholecystoduodenal fistula. Exceptions to this pathophysiology have been noted at each step. In this systematic review, we document a comprehensive review of postcholecystectomy gallstone ileus inclusive of 49 separate cases and report 8 different mechanisms leading to this unusual complication. The most common mechanism is a lost stone during cholecystectomy that then erodes through the intestinal wall leading to bowel obstruction. Our review showed an older, female predominance (64.0%) at an average age of 68.0 years, patients typically had a burden of comorbidities. Delay in diagnosis was common (64% of cases) with the correct diagnosis made in 37.5% of patients during admission. Pneumobilia was commonly reported (29.0%). There was a wide range in the amount of time between cholecystectomy and gallstone ileus, from 10 days to 50 years (mean 12.4 years). Postcholecystectomy gallstone ileus is an unusual complication of cholelithiasis, which mandates surgery. Retrieval of stones should be undertaken if they are spilled during cholecystectomy. Owing to the increasing age of the American patient population, it is likely that a higher number of patients with this condition will be encountered.


Assuntos
Colecistectomia/efeitos adversos , Colelitíase/complicações , Cálculos Biliares/complicações , Doenças do Íleo/etiologia , Fatores Etários , Humanos , Obstrução Intestinal/etiologia , Fatores de Risco , Fatores Sexuais
3.
Ann R Coll Surg Engl ; 102(9): e1-e3, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32508109

RESUMO

Splenosis is the autotransplantation of splenic tissue into abnormal locations due to trauma or iatrogenically. Usually, this causes no symptoms, but in rare cases the mass effect of the transplanted nodules can cause small bowel obstruction. Resection of the culprit splenic tissue is recommended, but not more extensive dissection of non-involved nodules. Our patient presented at 43 years of age with abdominal pain, distention and bilious vomiting. He had undergone a splenectomy at the age of 13 years due to splenic rupture after a motor vehicle collision. Computed tomography demonstrated a small bowel obstruction with multiple nodules suspicious of splenosis. The obstructing mass and compromised bowels. were resected. Final pathology confirmed the diagnosis. Splenosis is an uncommon aetiology of small bowel obstruction and must be considered in patients who had previous splenic trauma or surgery.


Assuntos
Obstrução Intestinal/etiologia , Esplenectomia/efeitos adversos , Esplenose/complicações , Adulto , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Valva Ileocecal/diagnóstico por imagem , Valva Ileocecal/cirurgia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Masculino , Radiografia Abdominal , Esplenose/etiologia , Fatores de Tempo , Tomografia Computadorizada por Raios X
5.
Am J Case Rep ; 21: e920438, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32102989

RESUMO

BACKGROUND Intussusception is not very common in adults, and acute intestinal obstruction with intussusception due to inflammatory myofibroblastic tumor (IMT) is extremely rare. IMT is an uncommon lesion and has no single defined cause. It predominantly affects the pediatric age group and commonly involves the lungs. Here we present a case of IMT causing ileocolic intussusception leading to acute intestinal obstruction in an adult. CASE REPORT A 40-year-old female came to the emergency department with severe colicky pain in her abdomen, and reported 6 to 7 episodes of vomiting with bilious contents, along with an inability to pass feces and flatus for 3 days. An x-ray of her abdomen in erect posture revealed multiple air-fluid levels. Because she had a previous history of tuberculosis, a possible tubercular stricture as the cause of her acute obstruction was considered; an exploratory laparotomy was performed showing her bowel loops were dilated with ileocolic intussusception. The lead point of intussusception (a well-defined 4×4×3.5 cm solid mass), was found at 15 cm proximal to the ileocecal junction. A right hemicolectomy with ileo-transverse anastomosis was performed. The histopathological examination confirmed the presence of IMT. CONCLUSIONS IMT causing ileocolic intussusception with acute intestinal obstruction is an extremely rare presentation of an uncommon entity in adults. High index of suspicion, and appropriate investigations (x-ray abdomen, ultrasound, computed tomography, and colonoscopy) depending on presentation and clinical condition of the patient can result in prompt diagnosis and early management.


Assuntos
Doenças do Íleo/etiologia , Doenças do Íleo/cirurgia , Obstrução Intestinal/etiologia , Intussuscepção/complicações , Intussuscepção/cirurgia , Neoplasias de Tecido Muscular/complicações , Doença Aguda , Adulto , Feminino , Humanos , Obstrução Intestinal/cirurgia , Laparotomia
6.
Cir Cir ; 88(1): 88-90, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31967605

RESUMO

Background: Postoperative intussusception is an unusual complication in children; the incidence is 0.01-0.25%. Clinical Case: Female of 11 months who underwent colostomy, 48 h later presents abdominal pain, vomiting gastrobiliar and abdominal distension. A laparotomy was performed, finding a double ileo-ileal invagination 60 cm from the ileocecal valve. Discussion: The postoperative intestinal invaginations are extremely rare and most of them occur within the first 7 days. The etiology of postoperative intussusception is unknown. Conclusions: Postoperative children with intestinal occlusion, intussusception should be suspected and an immediate laparotomy should be performed.


Assuntos
Colostomia/efeitos adversos , Valva Ileocecal , Intussuscepção/etiologia , Complicações Pós-Operatórias/etiologia , Dor Abdominal/etiologia , Feminino , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/etiologia , Valva Ileocecal/diagnóstico por imagem , Lactente , Intussuscepção/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Prolapso , Reoperação
7.
J Crohns Colitis ; 14(2): 205-215, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-31282946

RESUMO

BACKGROUND AND AIMS: Based on genetics and natural history, Crohn's disease can be separated into two entities, an ileal and a colonic disease. Protein-based approaches are needed to elucidate whether such subphenotypes are related to distinct pathophysiological processes. METHODS: The proteome of ulcer edges was compared with that of paired control tissue samples [n = 32 biopsies] by differential proteomics in the ileum and the colon of Crohn's disease patients [n = 16]. The results were analysed using a hypothesis-driven approach [based on the literature] and a hypothesis-free approach [pathway enrichment analyses] to determine common and segment-specific pathophysiological processes associated with ileal and colonic CD ulcer edges. To confirm the involvement of a key pathway highlighted by proteomics, two proteins were also studied by immunochemistry. RESULTS: In the ileum and the colon, 4428 and 5204 proteins, respectively, were identified and quantified. Ileal and colonic ulcer edges differed in having a distinct distribution of proteins associated with epithelial-mesenchymal transition, neutrophil degranulation, and ribosomes. Ileal and colonic ulcer edges were similarly characterized by an increase in the proteins implicated in the endoplasmic reticulum protein-processing pathway and a decrease in mitochondrial proteins. Immunochemistry confirmed the presence of endoplasmic reticulum stress in the mucosa of ileal and colonic ulcer edges. CONCLUSION: This study provides protein-based evidence for partially distinct pathophysiological processes being associated with ileal and colonic ulcer edges in Crohn's disease patients. This could constitute a first step toward the development of gut segment-specific diagnostic markers and therapeutics.


Assuntos
Doenças do Colo/etiologia , Doença de Crohn/complicações , Doenças do Íleo/etiologia , Úlcera/etiologia , Adulto , Idoso , Colo/metabolismo , Colo/fisiopatologia , Doenças do Colo/metabolismo , Doenças do Colo/fisiopatologia , Doença de Crohn/metabolismo , Doença de Crohn/fisiopatologia , Feminino , Humanos , Doenças do Íleo/metabolismo , Doenças do Íleo/fisiopatologia , Íleo/metabolismo , Íleo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Proteômica/métodos , Úlcera/metabolismo , Úlcera/fisiopatologia
10.
Pediatr Emerg Care ; 35(11): e203-e205, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31688804

RESUMO

Familial Mediterranean fever (FMF) is a recurrent disease with autosomal recessive trait and fever that is generally self-limiting. Clinical manifestations are pain in the abdomen, chest, and joints as a result of inflammation in the serous surfaces. No case of multiple intestinal perforations has been reported in children with FMF, whereas cases with a single intestinal perforation have been encountered, although very rarely. In addition, co-occurrence of FMF and inflammatory bowel disease is a situation that is very rarely reported in the literature. Here, we report a case of a 5-year-old girl who was being followed up with the diagnosis of FMF and who also had inflammatory bowel disease, which was complicated with multiple ileal perforations. Our aim is to point out a rarely encountered co-occurrence and also the importance of evaluation of additional diseases with FMF that are unresponsive to treatment so as to prevent complications.


Assuntos
Febre Familiar do Mediterrâneo/complicações , Doenças do Íleo/etiologia , Doenças Inflamatórias Intestinais/complicações , Perfuração Intestinal/etiologia , Pré-Escolar , Colchicina/efeitos adversos , Febre Familiar do Mediterrâneo/tratamento farmacológico , Feminino , Humanos , Doenças do Íleo/patologia , Doenças do Íleo/cirurgia , Perfuração Intestinal/cirurgia
11.
Ann R Coll Surg Engl ; 101(8): e172-e177, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31672034

RESUMO

Intragastric balloons have been used as an invasive non-surgical treatment for obesity for over 30 years. Within the last 37 years, we have found only 27 cases reported in the literature of intestinal obstruction caused by a migrated intragastric balloon. We report the laparoscopic management of such a case and make observations from similar case presentations published in the literature. A 26-year-old woman had an intragastric balloon placed endoscopically for weight control 13 months previously. She presented to the emergency department with a four-day history of intermittent abdominal cramps and vomiting. Contrast enhanced computed tomography confirmed the presence of the intragastric balloon within the small bowel. At laparoscopic retrieval, the deflated intragastric balloon was found impacted in the terminal ileum approximately 15 cm from the ileocaecal valve. The balloon was retrieved by enterotomy and primary closure of the ileum without event. The risk of balloon deflation and subsequent migration increases over time but several published cases demonstrate that this complication can occur within six months of insertion. The initial approach to the treatment of migrated intragastric balloons causing small bowel obstruction should be determined by the location of impaction, severity of obstruction and the available skill set of the attending radiologist, endoscopist and/or surgeon. Balloons causing obstruction in the duodenum are likely amenable to endoscopic retrieval whereas impaction within the jejunum or ileum could be managed by percutaneous needle aspiration (in selected cases), endoscopy (double-balloon enteroscopy), laparoscopy or open surgery.


Assuntos
Migração de Corpo Estranho/cirurgia , Balão Gástrico/efeitos adversos , Doenças do Íleo/cirurgia , Obstrução Intestinal/cirurgia , Laparoscopia/métodos , Adulto , Feminino , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/etiologia , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/etiologia , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Obesidade/cirurgia , Tomografia Computadorizada por Raios X
12.
Ethiop J Health Sci ; 29(5): 653-655, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31666788

RESUMO

Background: Typhoid fever afflicts people of low socioeconomic status in developing nations. Although ileal perforation is a common complication of typhoid fever in tropical Africa, caecal perforations related to typhoid fever are uncommon. They present atypically in children under of five years old. Such presentation could include cough and caecal perforation. Clinical Description: We report a two-year old girl with intraoperative and histopathological evidence of a perforated typhoid caecitis who had right hemicolectomy. Conclusion: Caecal perforations may occur in children as young as two years of age following enteric fever. High index of suspicion is needed for early detection.


Assuntos
Doenças do Íleo/etiologia , Perfuração Intestinal/etiologia , Febre Tifoide/complicações , África , Pré-Escolar , Feminino , Humanos
15.
BMJ Case Rep ; 12(10)2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653627

RESUMO

Apixaban (Eliquis) is a direct acting oral anticoagulant (DOAC) indicated for treatment of deep vein thrombosis, non-valvular atrial fibrillation, pulmonary embolism and postoperative venous thromboprophylaxis following hip or knee replacement. Complications are minimal and include, but are not limited to, bleeding and intracranial haemorrhage, and haematoma formation. Our patient is a 73-year-old woman who presented with clinical and radiographic findings of small bowel obstruction. She was found to be taking apixaban for atrial fibrillation. CT scan showed small bowel intussusception. She underwent an exploratory laparotomy and resection of the small bowel intussusception with primary side-to-side anastomosis. Histopathological examination showed that the intussusception was caused by an intramural haematoma. This case presents a rare instance of adult intussusception caused by a DOAC. To our knowledge, no case of intussusception caused by apixaban has yet been found in literature.


Assuntos
Hematoma/induzido quimicamente , Doenças do Íleo/etiologia , Intestino Delgado/patologia , Intussuscepção/etiologia , Pirazóis/efeitos adversos , Piridonas/efeitos adversos , Idoso , Fibrilação Atrial , Diagnóstico Diferencial , Feminino , Hematoma/complicações , Hematoma/cirurgia , Humanos , Doenças do Íleo/cirurgia , Intestino Delgado/cirurgia , Intussuscepção/cirurgia
16.
BMJ Case Rep ; 12(10)2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653632

RESUMO

A 52-year-old man with known hereditary angio-oedema (HAE) presented with a 2-day history of progressive severe abdominal pain, distension, nausea, vomiting and constipation. CT of his abdomen and pelvis showed small-bowel obstruction and ascites. HAE is a rare autosomal dominant disorder caused by a C1 esterase deficiency and involves episodic oedema of subcutaneous and mucosal tissues. It commonly affects the face and limbs, causing deformity; the respiratory tract, causing life-threatening laryngeal swelling; and the gastrointestinal tract, causing small-bowel obstruction. An infusion of a C1 esterase inhibitor was given to the patient. His symptoms resolved within 6 hours, and a repeat CT showed complete resolution 24 hours later. Small-bowel obstruction in HAE is often misdiagnosed, leading to ineffective treatment and unnecessary surgery. Therefore, this should be suspected in patients with HAE presenting with an acute abdomen, and clinicians should understand the unique treatment required.


Assuntos
Angioedemas Hereditários/complicações , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Dor Abdominal , Angioedemas Hereditários/tratamento farmacológico , Proteína Inibidora do Complemento C1/uso terapêutico , Inativadores do Complemento/uso terapêutico , Diagnóstico Diferencial , Humanos , Doenças do Íleo/tratamento farmacológico , Obstrução Intestinal/tratamento farmacológico , Masculino , Pessoa de Meia-Idade
17.
Cir Cir ; 87(S1): 48-52, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31501631

RESUMO

Background: The retention of the endoscopic capsule (EC) is a serious complication and exceptionally, acute intestinal obstruction is conditioned. Clinical case: 64 years-old man, previously treated by gastroenterology for Crohn's disease. With good initial response to pharmacological treatment for 6 weeks, subsequently with the onset of pain and symptoms not explained by colonoscopy. EC was performed, presenting at 48 hours bowel obstruction symptoms with data of systemic inflammatory response and peritoneal irritation. Exploratory laparotomy with bowel resection and side-to-side stapled anastomosis was performed, histopathology report confirmed obstruction of the bowel lumen due to impacted EC in ileal stenosis area. In the immediate postoperative period with good evolution. At 8 weeks of the procedure, he went for an enterocutaneous fistula, which had a good response to conservative treatment. Conclusion: The rate of retention of CE in Crohn's disease is 5-6%, prior to its use, it is recommended to perform imaging studies to evaluate the bowel permeability, however negative studies do not exclude the presence of stenosis. In cases where intestinal resection is indicated, it is recommended to be wide with side-to-side stapled anastomosis to reduce the risk of recurrence of the disease.


Assuntos
Endoscopia por Cápsula/efeitos adversos , Doença de Crohn/complicações , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Tratamento Conservador , Doença de Crohn/diagnóstico por imagem , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/cirurgia , Fístula Intestinal/terapia , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/terapia
18.
Dis Colon Rectum ; 62(10): 1222-1230, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31490831

RESUMO

BACKGROUND: Surgical treatment of ileosigmoid fistulas in Crohn's disease is poorly characterized. OBJECTIVE: The purpose of this study was to identify differences in patient postoperative outcomes for isolated ileosigmoid fistulas by surgical approach (laparoscopic versus open) and sigmoid colon repair type (sigmoid resection versus primary repair). DESIGN: Using a prospectively collected database, we gathered perioperative data from chart reviews to calculate differences and associations between treatment groups. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: Patients with Crohn's disease who underwent surgery for isolated ileosigmoid fistulas between July 1, 2010, and June 30, 2016 were included. RESULTS: We identified 84 patients, with an average age of 37 years. A total of 51 were men and 33 were women; 34 underwent a sigmoid resection, whereas 50 had a primary repair of the sigmoid. All of the patients underwent an ileocolic resection. A total of 67 surgeries were initially attempted laparoscopically, of which 17 (25.4%) were converted to open, with 50 (59.5%) completed laparoscopically. There were no significant differences in length of stay or incidence of postoperative complications by surgical approach (laparoscopic versus open). For patients who underwent a primary sigmoid repair versus a sigmoid resection, there were no significant differences in postoperative complications, but there was a significant difference in the length of stay (6.36 vs 9.56 d for primary repair versus resection; multivariate p value of 0.022). MAIN OUTCOME MEASURES: Postoperative complications and length of stay were measured. LIMITATIONS: The study was limited by its small sample size, cross-sectional nature of the data, and limited information about preoperative outpatient medical treatment. CONCLUSIONS: Laparoscopic surgery for isolated ileosigmoid fistulas in Crohn's disease is safe and does not result in a different length of stay or incidence of postoperative complications. Primary repair (rather than resection) of the sigmoid colon in these cases, when feasible, appears to be safe and is likely to be cost-effective given the reduced length of stay. See Video Abstract at http://links.lww.com/DCR/A993. TÉCNICAS QUIRÚRGICAS Y DIFERENCIAS EN LOS RESULTADOS POSTOPERATORIOS PARA LOS PACIENTES CON ENFERMEDAD DE CROHN CON FÍSTULAS ILEO-SIGMOIDEAS: UNA EXPERIENCIA EN UNA SOLA INSTITUCIÓN, 2010-2016: El tratamiento quirúrgico de las fístulas ileo-sigmoideas en la enfermedad de Crohn está mal caracterizado. OBJETIVO: Identificar las diferencias en los resultados postoperatorios de los pacientes para las fístulas ileo-sigmoideas aisladas por abordaje quirúrgico (laparoscópica versus abierta) y tipo de reparación de colon sigmoide (resección sigmoidea versus reparación primaria). DISEÑO:: Utilizando una base de datos recopilada de forma prospectiva, se recopilaron datos perioperatorios de las revisiones de los gráficos para calcular las diferencias y las asociaciones entre los grupos de tratamiento. AJUSTE: Un solo centro de atención terciaria. PACIENTES: Pacientes con enfermedad de Crohn que se sometieron a una cirugía para fístulas ileo-sigmoideas aisladas entre el 1 de julio de 2010 y el 30 de junio de 2016. RESULTADOS: Se identificaron 84 pacientes, con una edad promedio de 37 años. Un total de 51 eran hombres y 33 mujeres; 34 se sometieron a una resección sigmoidea, mientras que 50 tuvieron una reparación primaria del sigmoide. Todos los pacientes fueron sometidos a resección ileocólica. Inicialmente, un total de 67 círugias se intentaron por vía laparoscópica, de las cuales 17 (25,4%) se convirtieron en cirugías abiertas, y 50 (59,5%) se completaron por vía laparoscópica. No hubo diferencias significativas en la duración de la estancia o la incidencia de complicaciones postoperatorias por abordaje quirúrgico (laparoscópica versus abierta). Para los pacientes que se sometieron a una reparación sigmoidea primaria versus una resección sigmoidea, no hubo diferencias significativas en las complicaciones postoperatorias, pero sí hubo una diferencia significativa en la duración de la estancia hospitalaria (6,36 versus a 9,56 días para la reparación primaria frente a la resección; p multivariable -valor de 0.022). PRINCIPALES MEDIDAS DE RESULTADOS: Complicaciones postoperatorias y duración de la estancia. LIMITACIONES: Tamaño de muestra pequeño, naturaleza transversal de los datos e información limitada sobre el tratamiento médico ambulatorio preoperatorio del paciente. CONCLUSIONES: La cirugía laparoscópica para fístulas ileo-sigmoideas aisladas en la enfermedad de Crohn es segura y no ocasiona una duración diferente de la estancia hospitalaria ni una incidencia diferente de complicaciones postoperatorias. La reparación primaria (en lugar de la resección) del colon sigmoide en estos casos, cuando es posible, parece ser segura y es probable que sea rentable, dada la duración reducida de la estancia. Vea el Resumen del Video en http://links.lww.com/DCR/A993.


Assuntos
Colectomia/métodos , Doença de Crohn/cirurgia , Doenças do Íleo/cirurgia , Fístula Intestinal/cirurgia , Laparoscopia/métodos , Complicações Pós-Operatórias/epidemiologia , Doenças do Colo Sigmoide/cirurgia , Adulto , Doença de Crohn/complicações , Estudos Transversais , Feminino , Humanos , Doenças do Íleo/etiologia , Incidência , Fístula Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças do Colo Sigmoide/etiologia , Resultado do Tratamento , Estados Unidos/epidemiologia , Adulto Jovem
19.
BMJ Case Rep ; 12(9)2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511265

RESUMO

Colonic duplication cyst is an uncommon cause of intussusception in adults. We report a case of caecal duplication cyst in a 24-year-old adult with a 3-year history of recurrent abdominal pain mainly in the periumbilical region. CT and MRI of the abdomen showed a lesion suggesting an caecal duplication cyst within an intussuception. The patient underwent diagnostic laparoscopy and was found to have a caecal duplication cyst acting as a lead point for the intusseception for which laparoscopic-assisted resection was performed. The histological examination confirmed the presence of intestinal duplication cyst without any underlying malignancy.


Assuntos
Ceco/anormalidades , Doenças do Íleo/etiologia , Intussuscepção/etiologia , Ceco/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/cirurgia , Intussuscepção/diagnóstico por imagem , Intussuscepção/cirurgia , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X , Adulto Jovem
20.
BMJ Case Rep ; 12(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31420425

RESUMO

Mantle cell lymphoma is a type of B-cell non-Hodgkin's lymphoma (NHL) and accounts for 3%-6% of all adult NHL.1 2 Bowel intussusception secondary to lymphoma is rare in adults, accounting for only 4% of all cases.3The authors present the case of a 53-year-old man, recently diagnosed with mantle cell lymphoma, who presented with sudden onset right-sided abdominal pain and was found to have ileocolic intussusception up to the hepatic flexure on abdominal CT. He underwent an emergency right hemicolectomy and intraoperatively, the terminal ileum could be seen telescoping into the caecum, up to the hepatic flexure. Although intussusception is uncommon in the adult population, an underlying bowel pathology should always be considered and prompt imaging should be organised to confirm the diagnosis and allow initiation of management in a timely manner.


Assuntos
Doenças do Íleo/etiologia , Intussuscepção/etiologia , Linfoma de Célula do Manto/complicações , Humanos , Masculino , Pessoa de Meia-Idade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA