1/29. Bezoar: an uncommon cause of intestinal obstruction.bezoars or undigested food concretions in the gastrointestinal tract are mostly due to ingestion of a stringent immature fruits following gastric surgery and can lead to the serious complication of acute small bowel obstructions. We are reporting a case of complete jejunal obstruction in a 60 year old female, 15 years following bilateral vagotomy and gastrojejunostomy for pyloric obstruction. Important clinical and pathological features are emphasised to increase the awareness of this rather uncommon cause of intestinal obstruction.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
2/29. Ulcerative disease of the colon proximal to partially obstructive lesions: report of two cases and review of the literature.carcinoma complicating idiopathic ulcerative colitis is well known. Conversely, acute colitis complicating obstructing carcinomas and other partially obstructing lesions of the colon has not been recognized until recently. The present study reports two cases of colitis secondary to obstruction: 1) a giant ulcer with colitis proximal to partially obstruction diverticulitis of the sigmoid colon, and 2) colitis proximal to obstructing carcinoma of the sigmoid colon. The purpose of this report is to document these cases and review the literature on this variety of colitis to facilitate its recognition and subsequent correct treatment. An unawareness of this entity prejudices the anastomosis and results in anastomotic complications (approximately 25 per cent), with significant morbidity and mortality.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
3/29. Small-bowel obstruction secondary to subcutaneous small-bowel entrapment: a late complication of laparostomy for necrotizing pancreatitis.Laparostomy is a well recognized strategy for the management of patients who have necrotizing pancreatitis and may require multiple re-intervention. The open wound can be left to heal through a process of granulation and contraction. This article describes intestinal obstruction secondary to entrapment of a loop of small bowel within the cicatrix of the contracting cutaneous scar. An awareness of the potential for entrapment of the small bowel in the healing scar is critical for clinicians using laparostomy in the management of acute necrotizing pancreatitis.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
4/29. Mesenteric lymphangioma causing bowel obstruction: report of one case.A 6-year-old female was sent to our ER due to nausea, vomiting and abdominal distension for 2 days. This child had a history of constipation and failed intermittent medical treatment for 2 years. Her plain abdominal X-ray showed multiple intestinal loops and under the impression of acute abdomen with mechanical intestinal obstruction, an exploratory laparotomy was performed. A huge mesenteric tumor was discovered to be the cause of the intestinal obstruction; the involved bowel and the mesenteric lymphangioma were resected and primary anastomosis was done. Mesenteric cystic lymphangioma is a rare cause of bowel obstruction; preoperative diagnosis is difficult due to silent clinical course and lack of awareness of the clinical and morphological features of this disease. The case is presented along with a review of literature with the conclusion that a high index of suspicion is recommended. An abdominal ultrasonography may be recommended to evaluate a long-term constipated child to ascertain that any cystic lesion will not be missed.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
5/29. Conundrum of the cocoon: report of a case and review of the literature.Idiopathic, sclerosing, encapsulating peritonitis, or abdominal cocoon, is a rare cause of bowel obstruction in the elderly. A 65-year-old male patient presented with acute bowel obstruction caused by torsion of the encapsulated small bowel. He was treated successfully with subtotal excision of the fibrocollagenous membrane and small bowel resection. Despite anecdotal reports of a preoperative diagnosis, in the majority of cases, sclerosing, encapsulating peritonitis is a fortuitous finding. A better awareness of this condition may facilitate preoperative diagnosis.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
6/29. Volvulus of the sigmoid colon in paediatric patients: report of two cases.Two cases of volvulus of the sigmoid colon in paediatric patients are presented. The condition is rare in childhood. The diagnosis was established at laparotomy in the first case while the second case was diagnosed because of heightened awareness. The clinical features of the disease are essentially as in adults.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
7/29. Primary repair of the cholecyst-enteric fistula in gallstone ileus.Gallstone ileus is a rare cause of mechanical bowel obstruction. The attendant lack of awareness by the clinician will not only result in the diagnosis being made intraoperatively but will also affect the adequacy of the preoperative preparation of these ill patients. These patients are often elderly, septic and have significant concomitant medical illnesses. Recently two patients with gallstones ileus were managed with enterolithotomy and primary repair of the cholecyst-duodenal fistula at the University Hospital of the west indies, jamaica. Their clinical presentations and progress are described along with a review of the classical clinical course, radiological features, and operative choices available.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
8/29. Abdominal cocoon. An unusual cause of intestinal obstruction.We report a case of abdominal cocoon in a young male patient, presenting with acute intestinal obstruction and abdominal mass. This is a rare acquired condition of the peritoneum in which the small bowel is encased either partially or totally by a dense fibrous membrane. Operative findings, perioperative imaging and treatment guidelines are discussed. A better awareness of this condition may facilitate preoperative diagnosis; prevent inadvertent bowel damage at laparoscopy and unnecessary bowel resection at laparotomy.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
9/29. Dramatic development of severe SLE in a patient with an incomplete disease.This case report describes the previously-unreported clinical course of a patient with a so-called incomplete systemic lupus erythematosus (SLE), i.e. symptoms related to one organ system only, together with the presence of ANA. He had an indolent course initially and developed, 6 months after the first symptoms, a severe disease with rapid appearance of major and unusual manifestations. The possibility of fast progression and a grave course of an incomplete SLE should be kept in mind. This report is meant to heighten awareness of such an atypical presentation so that prompt and aggressive immunosuppressive therapy may be instituted.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
10/29. diaphragm disease: complete small bowel obstruction after long-term nonsteroidal anti-inflammatory drugs use.diaphragm-like stricture of the small bowel is an infrequent complication of the treatment of patients with nonsteroidal anti-inflammatory drugs (NSAIDs) and is part of the spectrum of diseases associated with NSAIDs injury. We report a patient with this condition who had used various forms of NSAIDs for over 20 years. Patient presented with abdominal pain and indigestion. Plain abdominal film revealed small bowel obstruction. Surgical resection of jejunum and proximal part of ileum identified dilated thickened hyperemic mucosa alternating with areas of small bowel fibrotic constriction. The mucosal surface showed multiple pink-tan mucosal folds (circumferential ridges) with focal hemorrhage and edema. Our findings support the local stimulation and damage and reparative process seen with NSAIDs use. A high degree of suspicion and awareness of diaphragm disease is necessary in those patients.- - - - - - - - - - ranking = 1keywords = awareness (Clic here for more details about this article) |
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