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1.
Pan Afr Med J ; 33: 214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692747

RESUMO

Primary melanoma of the small bowel is a rare clinical entity with a paucity of published reports in literature. Most cases of gastrointestinal melanomas are metastatic lesions arising from skin or ocular origins. This is a case report of a 63 year old female with adult intussusception with jejunal melanoma as the lead point. The index patient had a long history of abdominal pain associated with significant weight loss and presented with features of intestinal obstruction. The possibility of a regressed or unidentified extra-intestinal site cannot be absolutely excluded as the patient did not have a PET scan. Due to the vague nature of clinical symptoms and signs, the diagnosis of small bowel melanoma is difficult, especially in patients with no obvious cutaneous pathology. A high index of suspicion for melanoma as a malignant lead point for adult intussusception should always be entertained.


Assuntos
Intussuscepção/etiologia , Neoplasias do Jejuno/diagnóstico , Melanoma/diagnóstico , Dor Abdominal/etiologia , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Intussuscepção/diagnóstico , Neoplasias do Jejuno/complicações , Melanoma/complicações , Pessoa de Meia-Idade
2.
Pan Afr Med J ; 33: 153, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31558950

RESUMO

Acute intestinal intussusception occurs primarily in infants and young children. It uncommonly occurs in adults. It can have various causes. In the vast majority of cases, it is secondary to a benign or malignant tumor. Intestinal T-cell lymphoma revealed by intestinal intussusception is very rare. We report the case of a 43-year old patient admitted with intestinal occlusion to the Emergency Department at the University Hospital Hassan II, Fes, Morocco. Abdominal CT scan showed acute intestinal intussusception associated with incarcerated bowel loop with bowel wall thickening. Treatment was based on open carcinological resection. Anatomopathological and immunohistochemical examination of the surgical specimen showed large T-cell anaplastic lymphoma. After surgery, chemotherapy was indicated to improve prognosis and to avoid a potential relapse. Intestinal intussusception rarely occurs in adults. It most often leads to the detection of an organic cause such as a tumor. This study and literature review aim to highlight the clinical and diagnostic features as well as the therapeutic approaches for this rare disease.


Assuntos
Obstrução Intestinal/etiologia , Intussuscepção/etiologia , Linfoma Anaplásico de Células Grandes/diagnóstico , Doença Aguda , Adulto , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Linfoma Anaplásico de Células Grandes/complicações , Linfoma Anaplásico de Células Grandes/terapia , Masculino , Marrocos , Prognóstico , Tomografia Computadorizada por Raios X
3.
Dis Colon Rectum ; 62(9): 1028-1030, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31397752

RESUMO

CASE SUMMARY: An otherwise healthy 59-year-old man presented to the emergency department with 2 weeks of narrowed stools, 5 days of obstipation, and 1 day of abdominal pain, nausea, and vomiting. Computed tomography revealed an obstructing sigmoid mass without evidence of metastatic disease, and the CEA was 1.2 ng/mL. Flexible sigmoidoscopy confirmed a circumferentially obstructing distal sigmoid neoplasm. Endoscopic stent placement was immediately followed by a firm distended abdomen. An upright radiograph obtained following the procedure demonstrated free intraperitoneal air. An emergent Hartmann procedure was performed for iatrogenic colon perforation in a patient with malignant obstruction and chronic dilation of the proximal colon.


Assuntos
Doenças do Colo/cirurgia , Ileostomia/métodos , Obstrução Intestinal/cirurgia , Laparoscopia/métodos , Neoplasias do Colo Sigmoide/complicações , Sigmoidoscopia/métodos , Tomografia Computadorizada por Raios X/métodos , Doenças do Colo/diagnóstico , Doenças do Colo/etiologia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias do Colo Sigmoide/diagnóstico , Neoplasias do Colo Sigmoide/cirurgia
4.
Ethiop J Health Sci ; 29(4): 529-532, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447527

RESUMO

Background: A lipoma of the small bowel mesentery is a rare clinical entity. It rarely causes intestinal obstruction mainly due to volvulus. Case: We report a case of a 25 years old male who presented with acute exacerbation of abdominal pain, nausea and vomiting. Plain abdominal x-ray showed complete small bowel obstruction. At laparotomy, there was small bowel volvulus with a big yellow mass as an axis. Enbloc resection and end-to-end ileal anastomosis was done. Conclusion: Mesenteric lipoma are rare. They should be considered in cases of long standing abdominal pain.


Assuntos
Volvo Intestinal/etiologia , Lipoma/complicações , Mesentério , Neoplasias Peritoneais/complicações , Dor Abdominal/etiologia , Adulto , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/patologia , Obstrução Intestinal/cirurgia , Volvo Intestinal/diagnóstico , Volvo Intestinal/patologia , Volvo Intestinal/cirurgia , Lipoma/diagnóstico , Lipoma/patologia , Lipoma/cirurgia , Masculino , Mesentério/patologia , Mesentério/cirurgia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia
5.
S D Med ; 72(5): 226-231, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31454476

RESUMO

The conditions of small bowel obstruction and ileus are ones with a great deal of overlap with respect to presentation and differential diagnosis but vary substantially with respect to management. These disorders are frequently encountered by members of the healthcare team across almost every specialty in one way or another. Understanding safe and expeditious methods to identify and distinguish these conditions is important for all providers to understand. This article aims to compare both disorders, briefly discuss the pathophysiology and presentation, give a differential diagnosis for these disorders, and pursue a course of diagnosis and therapy in an appropriate, safe, and cost-effective manner.


Assuntos
Íleus , Obstrução Intestinal , Intestino Delgado/patologia , Diagnóstico Diferencial , Humanos , Íleus/diagnóstico , Obstrução Intestinal/diagnóstico
6.
BMC Surg ; 19(1): 74, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266497

RESUMO

BACKGROUND: Intussusception is a relatively common condition seen in children. In comparison, adult intussusception is rare and usually occurs as a complication in patients with organic diseases. It is responsible for 1% of all bowel obstructions, in most of intussusceptions a malignant tumor is involved. Herein, we present an extremely unusual case of intussusception that occurred as a complication at the site of a functional end-to-end anastomosis. CASE PRESENTATION: A 57-year-old female patient was diagnosed with tumors in the ascending and descending colon and was referred to our department. Laparoscopic hemicolectomy and laparoscopic descending colectomy were performed. The mechanical intestinal obstruction occurred on the 9th day postoperatively, and computed tomography scan revealed intussusception at the site of the ileocolic anastomosis. Endoscopic reduction was attempted, but the procedure was challenging. Surgery was then performed and revealed that the site of ileocolic anastomosis firmly adhered to the side wall and right retroperitoneum. However, the intestine in the oral side of the anastomosis was not fixed. Examination of the anastomotic site revealed that the ileum had passed through the anastomosis and prolapsed into the transverse colon. The ileocolic anastomosis was resected. End-to-end anastomosis was performed, and surgery was then completed. No neoplastic lesions were observed in the resected tissue of the lead point of intussusception. The postoperative clinical course was favorable, and the patient was discharged on the 11th day after the second round of surgery. CONCLUSIONS: There are no reports the anastomosis is involved as part of the intussception, as observed in the present case. Intussusception should thus be considered as one of the causes of postoperative mechanical intestinal obstruction.


Assuntos
Anastomose Cirúrgica/efeitos adversos , Colectomia/efeitos adversos , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Intussuscepção/etiologia , Colectomia/métodos , Colo/cirurgia , Feminino , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/cirurgia , Íleo/cirurgia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Laparoscopia , Pessoa de Meia-Idade
8.
World J Emerg Surg ; 14: 20, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31168315

RESUMO

Small and large bowel obstructions are responsible for approximately 15% of hospital admissions for acute abdominal pain in the USA and ~ 20% of cases needing acute surgical care. Starting from the analysis of a common clinical problem, we want to guide primary care physicians in the initial management of a patient presenting with acute abdominal pain associated with intestinal obstruction.


Assuntos
Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Dor Abdominal/etiologia , Idoso de 80 Anos ou mais , Feminino , Humanos , Obstrução Intestinal/complicações , Imagem por Ressonância Magnética/métodos , Radiografia/métodos , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodos
9.
BMJ Case Rep ; 12(5)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31154350

RESUMO

A 23-year-old man presented to the emergency department with a history of recurrent episodes of subacute intestinal obstruction. Palpation revealed a firm, non-tender, mobile, non-pulsatile mass of size 8-10 cm with indistinct margins and smooth surface in the hypogastrium. Contrast-enhanced CT scan of the abdomen showed clumping of the small bowel loops within a well-defined membrane-like structure without dilatation or thickening of bowel loops. The patient underwent a laparotomy with incision of the membrane and separation of all the small bowel loops inside the cocoon. Abdominal cocoon is the idiopathic variety of sclerosing encapsulating peritonitis and is an unusual cause of acute or subacute intestinal obstruction. Clinical diagnosis is difficult because of non-specific symptoms. CT has facilitated accurate preoperative diagnosis, long before the patient presents with full-fledged symptoms of acute intestinal obstruction. CT scan plays a significant role in excluding the secondary causes and helps in patient management.


Assuntos
Adenocarcinoma/diagnóstico , Obstrução Intestinal/diagnóstico , Neoplasias Peritoneais/diagnóstico , Dor Abdominal/etiologia , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Laparoscopia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/cirurgia , Período Pré-Operatório , Tomografia Computadorizada por Raios X
11.
BMC Surg ; 19(1): 59, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174520

RESUMO

BACKGROUND: Bezoars are rare but may cause gastrointestinal obstruction and ulcers. To the best of our knowledge, only two cases of bezoars in the reconstructed gastric conduit have been reported, but there has been no report on reconstructed gastric conduit obstruction due to bezoars. CASE PRESENTATION: A 60-year-old man presented to our clinic with abdominal pain and vomiting that occurred suddenly after dinner. Three years before presentation, he had undergone radical thoracoscopic esophagectomy followed by reconstruction of the gastric conduit through the posterior sternum, for esophageal cancer. Enhanced computed tomography scans showed distension of only the gastric conduit without ischemia and distension of the small intestine. According to our findings, we initially diagnosed the patient with postoperative intestinal obstruction caused by adhesions. After conservative treatment failed, the patient underwent an endoscopic study that showed a bezoar at the pylorus ring. We initially failed to remove the bezoar endoscopically because of its large size; hence, we attempted enzymatic dissolution. Three days after the first endoscopic study, the bezoar was disintegrated using a snare and extracted during a second endoscopy. The patient recovered uneventfully and presented with no complications during the 1-year follow-up interval. CONCLUSION: In cases wherein the discharge of materials in the reconstructed gastric conduit is delayed, bezoars should be considered in the differential diagnosis, and an endoscopic study should be performed to verify the cause of obstruction.


Assuntos
Bezoares/diagnóstico , Endoscopia/métodos , Esofagectomia/métodos , Obstrução Intestinal/diagnóstico , Dor Abdominal/etiologia , Bezoares/cirurgia , Diagnóstico Diferencial , Humanos , Intestino Delgado/patologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Estômago/cirurgia , Vômito/etiologia
12.
Anticancer Res ; 39(6): 3185-3189, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177165

RESUMO

BACKGROUND: Bowel obstruction is commonly encountered in patients with advanced colorectal cancer; however, the cause of obstruction remains unknown. This study aimed to clarify a predictor of bowel obstruction due to colorectal cancer growth. MATERIALS AND METHODS: Between January 2005 and December 2013, the medical records of 140 patients with T3 or T4 colorectal cancer who underwent curative resection (R0) at our Hospital were investigated retrospectively. This study consisted of 26 patients with obstructive colorectal cancer (OCC) and 114 patients with non-obstructive colon cancer (non-OCC). RESULTS: Significant differences in clinicopathological factors including age, gender, T category, stage, primary tumor site, tumor diameter, macroscopic type, pathological type, lymphatic invasion, venous invasion, and lymph node metastasis were not observed between the two groups. Preoperative hematological/biochemical parameters including leukocyte count (p=0.004), neutrophil count (p=0.003), C-reactive protein (CRP) level (0.001), and neutrophil-to-lymphocyte ratio (NLR) (p=0.001) were significantly higher in the OCC group than in the non-OCC group. However, a significant difference in lymphocyte count was not observed between the two groups (p=0.634). Significant differences in the levels of the serum tumor markers CEA and CA19-9 were not observed between the two groups. CONCLUSION: Preoperative NLR seems to be a useful predictor of bowel obstruction due to colorectal cancer growth.


Assuntos
Adenocarcinoma/sangue , Adenocarcinoma/complicações , Proliferação de Células , Neoplasias Colorretais/sangue , Neoplasias Colorretais/complicações , Obstrução Intestinal/etiologia , Linfócitos , Neutrófilos , Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colectomia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Progressão da Doença , Intervalo Livre de Doença , Feminino , Humanos , Obstrução Intestinal/sangue , Obstrução Intestinal/diagnóstico , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
13.
Curr Med Sci ; 39(3): 415-418, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31209812

RESUMO

The colon is an alternative graft organ for esophageal reconstruction. The present study reviewed our experience with the colon interposition for esophageal replacement following corrosive ingestion, to evaluate the outcomes of colon interposition based on our surgical experience. The clinical data of 119 patients who underwent colon interposition for esophageal replacement from January 2005 to March 2017 were retrospectively analyzed. The routes of the colon interposition were retrosternal in 119 (100%). The median operative time was 390 min (range: 290-610 min) and the median blood loss was 615 mL (range: 270-2500 mL). Of these 119 patients, the cervical anastomosis was performed at the hypopharynx (n=20, 16.8%), the larynx (n=3, 2.5%), and the cervical esophagus (n=96, 80.7%). Five patients experienced cervical anastomotic leakage (4 cases for esophagus-colon, and one for hypopharynx-colon). One patient experienced wound infection of the abdominal wall. Three patients had injury of recurrent laryngeal nerve and hoarseness. Three patients had stress ulcer with bleeding and treated with octreotide. Two patients suffered from incomplete intestinal obstruction. The postoperative follow-up was made for 12 months in all patients and all of them were alive. In conclusion, The colon is well-suited for esophageal reconstruction. The selection of the colon graft should be flexible and be based on the inspection of blood supply and the length needed. We must therefore make every effort to reduce the number of postoperative complications, and improve the quality of life for patients.


Assuntos
Colo/cirurgia , Estenose Esofágica/cirurgia , Esôfago/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Transplante Autólogo/métodos , Adolescente , Adulto , Idoso , Anastomose Cirúrgica/métodos , Criança , Pré-Escolar , Colo/fisiologia , Traumatismos dos Nervos Cranianos/diagnóstico , Traumatismos dos Nervos Cranianos/etiologia , Traumatismos dos Nervos Cranianos/fisiopatologia , Estenose Esofágica/fisiopatologia , Esôfago/fisiopatologia , Feminino , Seguimentos , Hemorragia/diagnóstico , Hemorragia/etiologia , Hemorragia/fisiopatologia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/fisiopatologia , Nervos Laríngeos/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Resultado do Tratamento
14.
Chirurgia (Bucur) ; 114(2): 290-294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31060663

RESUMO

Peritoneal encapsulation (PE) is a rare anatomic anomaly which occurs due to an accessory peritoneal sac covering the small bowel which can cause chronic recurrent abdominal pain and even small bowel obstruction, most often in children or patients with no previous surgical history. The diagnosis is usually made during surgery, but recently it has been suggested that mindful examination of the abdominal CT may be helpful in considering PE beforehand. We present the case of a 21-year old patient who was admitted due to intense abdominal pain, asymmetrical abdominal distension, air fluid levels on the abdominal X-ray, but no specific findings on the abdominal CT. He underwent emergency surgery and PE was found and the peritoneal sac was excised. The postoperative course was uneventful. Histopathologic examination of the specimen confirmed the diagnosis. PE is often misdiagnosed as abdominal cocoon or sclerosing encapsulating peritonitis, but it is a pathology with a much lower rate of recurrence and postoperative complications, which can be treated successfully if the surgeon is aware of this pathology when making the differential diagnosis.


Assuntos
Obstrução Intestinal/cirurgia , Intestino Delgado , Doenças Peritoneais/congênito , Doenças Peritoneais/cirurgia , Peritônio/anormalidades , Peritônio/cirurgia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Intestino Delgado/cirurgia , Masculino , Doenças Peritoneais/complicações , Doenças Peritoneais/diagnóstico , Peritônio/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
15.
Nihon Shokakibyo Gakkai Zasshi ; 116(5): 412-418, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31080221

RESUMO

In order to improve the diagnostic accuracy and treatment strategy for small bowel obstruction, we developed a non-emergency small bowel obstruction scoring system (0-4). We performed a retrospective analysis on 94 patients diagnosed with mechanical small bowel obstruction at our hospital. Anterior adhesion, small bowel feces sign, scoring system, and the usefulness of small bowel feces subtypes were examined. When the non-emergency small bowel obstruction scores 3-4, 99% were non-emergency obstructions, with the exclusion of strangulated small bowel obstruction. On the contrary, when the non-emergency small bowel obstruction scores 0-1, 47.5% were strangulated small bowel obstruction. As the effectiveness of withholding food and fluids (NPO) or short tube is high (about 70%) when small bowel feces are dry, placing a long tube may not be needed.


Assuntos
Obstrução Intestinal/diagnóstico , Tomografia Computadorizada por Raios X , Fezes , Humanos , Intestino Delgado , Estudos Retrospectivos
16.
Pan Afr Med J ; 32: 48, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31143353

RESUMO

Internal hernias are a rare cause of acute intestinal obstruction. Hernias through the falciform ligament is uncommon. Diagnosis is often made intraoperatively. Abdominal CT scan, performed in an emergency situation, can enable preoperative diagnosis and guide the therapeutic approach. In this respect, we here report a case whose data were collected in the Department of Visceral Surgery at the University Hospital Hassan II in Fez. The study involved a 48-year old patient, with no particular previous history, admitted to the Emergency Department with occlusion evolving over 4 days. Abdominal x-ray without treatment objectified multiple hydroaeric levels in small bowel some of which projected towards the hepatic region as well as the presence of a flat intestinal loop in continuity with distended intestinal segment. Abdominal CT scan was not performed due to altered renal function. The patient then underwent emergency surgery after stabilization of his condition and the diagnosis of internal hernias through the falciform ligament was made intraoperatively. In adults, internal hernia through the falciform ligament is a rare cause of acute intestinal obstruction in our daily practice. The diagnosis is most often made intraoperatively. It is necessary to suspect it in young patients with no history of abdominal surgery or intraperitoneal infectious process and with hydroaeric levels in the right upper quadrant.


Assuntos
Hérnia Abdominal/diagnóstico , Obstrução Intestinal/etiologia , Ligamentos/patologia , Hérnia Abdominal/complicações , Hérnia Abdominal/cirurgia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Intestino Delgado/patologia , Masculino , Pessoa de Meia-Idade , Radiografia Abdominal
17.
J Med Case Rep ; 13(1): 156, 2019 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-31126322

RESUMO

BACKGROUND: Transverse colon volvulus is an uncommon cause of bowel obstruction. The total number of cases reported in the literature is 100. It constitutes a surgical emergency since it can lead to bowel infarction, peritonitis, and death if not diagnosed at once. It seemed appropriate to report this case that was treated at the Department of Visceral Surgery A, University Hospital Center Hassan II of Fez in Morocco. CASE PRESENTATION: We report a rare case of transverse colon volvulus in a 42-year-old Arabic man, with no particular history, who presented to our emergency department with a 5-day history of constipation, progressive abdominal pain, nausea, and vomiting. His last bowel movement had been 3 days ago. Abdominal radiography showed a large bowel obstruction with a "U-shaped" loop in the left upper abdomen. Abdominal computed tomography was not performed because of impaired renal function. He was operated on urgently after conditioning and the diagnosis of a transverse colon volvulus was done intraoperatively. Rotated in a 360° clockwise direction on its mesentery, the bowel was intact without signs of ischemia. An extended right hemicolectomy was carried out with end-to-side ileocolic anastomosis. Through this case, we will try to discuss its physiopathology, etiologies, diagnosis, and management in emergencies. CONCLUSION: This case is unusual because no etiological factor has been found. Its diagnosis can be difficult and management effectiveness remains controversial. It is important to highlight this case and those of the literature, as many surgeons may have never seen a case of transverse colon volvulus. Volvulus of the transverse colon may therefore not be considered in the differential diagnosis of recurrent intermittent abdominal pain or acute intestinal obstruction. Prompt recognition with emergency intervention constitutes the key to a successful outcome.


Assuntos
Colo Transverso/cirurgia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/cirurgia , Volvo Intestinal/diagnóstico , Volvo Intestinal/cirurgia , Adulto , Árabes , Colectomia/métodos , Colo Transverso/diagnóstico por imagem , Humanos , Masculino , Marrocos , Resultado do Tratamento
18.
BMJ Case Rep ; 12(5)2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-31126929

RESUMO

Intramesosigmoid hernias are a rare cause of small bowel obstruction. Here, we present such a case with learning points derived from diagnostic dilemma, shared decision making in consent and the management of a rare cause of a common surgical emergency.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias do Íleo/diagnóstico , Obstrução Intestinal/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Idoso , Diagnóstico Diferencial , Humanos , Neoplasias do Íleo/secundário , Neoplasias do Íleo/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Masculino , Metástase Neoplásica , Neoplasias Gástricas/patologia
19.
BMJ Case Rep ; 12(4)2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975778

RESUMO

Abdominal cocoon syndrome (ACS), also known as idiopathic sclerosing peritonitis and primary sclerosing peritonitis, is a rare condition causing small bowel obstruction first described in 1978 by Foo et al It is characterised by total or partial encasement of the small bowel in a fibrocollagenous cocoon-like sac accompanied by extensive intrinsic small bowel adhesions. While the aetiology of this condition remains largely unknown, ACS can be divided into two subtypes: primary or idiopathic, which is often accompanied by cryptorchidism, and secondary to another cause such as congenital dysplasia or medications. Definitive diagnosis can only be achieved following laparotomy with extensive lysis of adhesions to alleviate the obstruction. However, preoperative diagnosis is possible if clinicians are aware of the condition and its radiologic signs.


Assuntos
Criptorquidismo , Obstrução Intestinal/diagnóstico , Intestino Delgado/diagnóstico por imagem , Aderências Teciduais/diagnóstico por imagem , Dor Abdominal/etiologia , Idoso , Diagnóstico Diferencial , Humanos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Intestino Delgado/cirurgia , Masculino , Aderências Teciduais/cirurgia , Tomografia Computadorizada por Raios X
20.
J Pak Med Assoc ; 69(4): 580-583, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31000867

RESUMO

Small bowel cancers are a rare group of cancers of the gastrointestinal tract. Adenocarcinoma of ileum is an even rarer pathology to come across. We had a case of small bowel adenocarcinoma (SBA) who presented with recurrent abdominal pain and vomiting to different local hospitals. Abdominal ultrasound showed dilated bowel 4.7cm in size with sluggish movement. Patient was treated symptomatically for 3 months with poor outcome. Then patient presented in our hospital as an e m e r g e n c y w i t h i n t e s t i n a l o b s t r u c t i o n a n dhaemodynamic instability. Exploratory laprotomy was performed after initial optimization. A hard stricture was found in ileum. The segment of ileum with suitable margins was resected and loop ileostomy was performed. Histopathology findings indicated an adenocarcinoma of ileum. Our rationale to report this case is to raise awareness among physicians about SBA in patients with vague abdominal pain and vomiting, and the fact that negligence in diagnosing this rare cancer can turn it into a surgical emergency which increases the morbidity and mortality in patients.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias do Íleo/diagnóstico , Obstrução Intestinal/diagnóstico , Dor Abdominal/etiologia , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Erros de Diagnóstico , Emergências , Humanos , Neoplasias do Íleo/complicações , Neoplasias do Íleo/patologia , Neoplasias do Íleo/cirurgia , Ileostomia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Vômito/etiologia , Perda de Peso
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