1/4. CT in acute mesenteric ischaemia.Enhanced computed tomography (CT) is frequently performed for possible bowel ischaemia. It has the distinct advantage of possible detection of the causes of ischaemia. Radiologists therefore need to be familiar with the spectrum of diagnostic CT signs. We present the CT imaging findings in surgically proven cases of small bowel ischaemia. In addition to signs pertaining to the underlying aetiological pathology, bowel dilatation, bowel wall thickening, mural gas, occlusion of mesenteric vessels, ascites and infarct of other abdominal organs were observed.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |
2/4. Acute abdomen in a 15-year-old patient with peutz-jeghers syndrome. Surgical approach.The natural history of peutz-jeghers syndrome (PJS) is characterized by gastrointestinal complications (occlusion, invagination or bleeding), often the first clinical manifestation in young patients. Surgical treatment consists of treating the complication, exploring the bowel and cleaning out all polyps to prevent further emergency operations at brief intervals. For this purpose both the laparotomic and laparoscopic approaches have been proposed, especially in young patients. A 15-year-old girl was admitted for investigation of colicky abdominal pains. When she was 5 years old, PJS was diagnosed. On admission to our department, the patient underwent emergency esophagogastroduodenoscopy and colonoscopy, both negative. At 24 hours after admission peritonitis developed. Given her clinical history, we rejected the laparoscopic approach proposed at admission and decided for an open laparotomy. laparotomy disclosed a long jejunoileal invagination that caused irreversible ischemic damage of the bowel. We resected about 130 cm of the ileum and did an end-to-end ileo-ileal anastomosis. Meticulous palpation and transillumination of the residual bowel identified no other polyps. In young patients with acute abdomen and with proven or suspected PJS instead of laparoscopy, open laparotomy is a unique occasion to explore the residual bowel thoroughly, manually and, if possible, endoscopically.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |
3/4. Solitary infantile gastrointestinal myofibroma: case report.We report a case of a 7-year-old child who required emergency surgery for acute abdomen and suspected acute appendicitis. During surgery a tumor located in the small bowel that caused intestinal occlusion was found. Histopathologic analysis showed a solitary gastrointestinal myofibroma. This is a very rare tumor, especially as a single lesion, because in world literature, there are less than 10 cases reported.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |
4/4. Massive intestinal infarction in young women: complication of use of oral contraceptives?Massive intestinal infarction due to occlusion of the celiac, superior mesenteric and inferior mesenteric arteries occurred in two young women, one of who subsequently died. Both were smokers. They had ingested oral contraceptives for 5 and 8 years, respectively, but this therapy could not be proven to be a causative factor in their ischemic bowel disease; although such an association is uncommon, it should be considered in young women with abdominal pain.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |