Cases reported "Pulmonary Atelectasis"

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11/71. Strangulated internal hernia through the lesser omentum with intestinal necrosis: a case report.

    CONTEXT: Internal hernias account for only 0.2 to 0.9% of the cases of intestinal obstruction. They do not have specific clinical manifestations, and are usually diagnosed during laparotomy for acute intestinal obstruction. Internal hernias through the lesser omentum are extremely rare. CASE REPORT: We report here the case of a 36-year-old patient who underwent exploratory laparotomy for acute intestinal obstruction. An internal hernia through the lesser omentum was found, with a strangulated ileal segment passing through the perforation into an abscess within the lesser sac. The surgical procedures included ileal resection, primary anastomosis, abscess removal, and placement of a drain in the lesser sac. The patient was reoperated 6 days later for abdominal sepsis; a lesser sac abscess was removed and the abdominal incision was left open. The patient stayed in the intensive care Unit for 15 days, and eventually left the hospital on the 28th post-admission day, with complete recovery thereafter. CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative complications, as illustrated by the present case.
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ranking = 1
keywords = obstruction
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12/71. Portal venous air in an adult patient with obstructive small bowel volvulus.

    BACKGROUND: Diagnosis of small bowel volvulus is frequently delayed often resulting in bowel ischaemia and infarction and impairing clinical outcome. Instant and correct diagnosis and subsequent adequate surgery may improve the outcome. methods: We describe a 19-year-old female with small bowel obstruction due to volvulus in whom the diagnosis was suspected based on the finding of air in the bowel wall and in the portal vein on a plain abdominal radiograph. CONCLUSIONS: air, present in the portal vein and bowel wall on a plain abdominal X-ray, suggests bowel ischaemia or necrosis and that the need for laparotomy is urgent.
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ranking = 0.25
keywords = obstruction
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13/71. diaphragm disease of the small bowel--a case report and literature review.

    A 75-year-old man who had an emergency laparotomy for small bowel obstruction was found at operation to have multiple mid-ileal strictures. histology of the resected specimen confirmed diaphragm disease of the bowel. The pathogenesis of this disease remains unclear but it is associated with long-term use of NSAID. Diagnosis is often difficult as many clinicians are unaware of this condition. The relevant literature has been reviewed.
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ranking = 0.25
keywords = obstruction
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14/71. Cutaneous squamous carcinoma leading to acute abdomen after renal transplantation.

    skin carcinoma is the commonest malignant complication of renal transplantation. We report the first case of a renal transplant recipient who presented with ileal obstruction as a consequence of squamous cell carcinoma metastases to the small intestine. This complication highlights the unusual presentation of malignancies associated with prolonged exposure to immunosuppression and the need for extra vigilance in such cases.
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keywords = obstruction
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15/71. Double omental hernia--case report on a very rare cause of intestinal obstruction.

    INTRODUCTION: We report a case of transomental herniation of the ileum through a defect in the gastrocolic ligament with re-emergence through a defect in the gastrohepatic ligament. This type of herniation is extremely rare and a review of the literature is presented. CLINICAL PRESENTATION: A 41-year-old Chinese male presented with signs and symptoms of intestinal obstruction. TREATMENT: An urgent laparotomy was undertaken and he was found to have a rare form of intra-abdominal hernia. The hernia was reduced and the defects were closed. OUTCOME: Postoperative recovery was unremarkable. CONCLUSION: Urgent operation should not be delayed because of the high mortality associated with strangulation.
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ranking = 1.25
keywords = obstruction
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16/71. wandering spleen presenting as a right hypochondrial mass and intestinal obstruction.

    This is a case report of a 23 year old multiparous woman who presented with intestinal obstruction and a right hypochondrial mass. Laparatomy revealed an infarcted 1.4 Kg spleen in the right lumbar region compressing the ascending colon. There was also ileal volvulus around the splenic pedicle. This is probably the first documented case of wandering spleen in the right hypochondrium, presenting as right large bowel obstruction, to be reported in our region. wandering spleen is a rare condition, often asymptomatic, but may present as an acute abdomen. Pre-operative diagnosis is difficult and rarely made. Laboratory tests are seldom useful, but imaging studies do assist. Up to 1971 only 350 cases had been reported in the western literature. review of English literature from 1900 to 1991 reported only 51 cases in children. In our region 11 cases were reported in uganda between 1968 and 1971. No other literature is available from our region. Clinical presentation, aetiology, investigation, and management of wandering spleen is discussed.
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ranking = 1.5
keywords = obstruction
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17/71. A rare cause of intestinal obstruction in the adult: Morgagni's hernia.

    Morgagni's hernia is a rare congenital diaphragmatic herniation and is usually diagnosed in childhood. It is quite rare in adults, and intestinal obstruction as a complication due to intrathoracic intestinal herniation rarely occurs. We present the plain radiography and computed tomography findings of an adult patient with acute abdomen symptoms due to Morgagni's hernia.
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ranking = 1.25
keywords = obstruction
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18/71. Midgut volvulus in an adult patient.

    The authors report on a case of midgut volvulus in a 27-year-old man who presented with bilious vomiting and acute abdominal pain. US demonstrated a reversal of the normal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV). A clockwise whirlpool sign, diagnostic for midgut volvulus, was not visualised. In a further assessment, upper gastrointestinal series demonstrated obstruction in the second part of the duodenum highly suspicious of Ladd's bands. Malpositioning of bowel structures, as already suggested by the reversal of the SMA and SMV on ultrasound, and a distinctive whirl pattern due to the bowel wrapping around the SMA was demonstrated on CT. Furthermore angiography revealed focal twisting of the SMA. US is the first imaging modality to perform in suspicion of midgut volvulus. When inconclusive, CT is in our opinion the next stage in the diagnostic work-up.
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ranking = 0.25
keywords = obstruction
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19/71. Duodenal complications of gynecological malignancies.

    Isolated para-aortic lymph node metastasis leading to intestinal complications is uncommon and diagnosis may therefore be delayed. In the present report duodenal bleeding, obstruction and perforation due to isolated para-aortic lymph node metastasis from stage I uterine malignancies are described. knowledge of these potential problems may lead to early recognition and planning of treatment.
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ranking = 0.25
keywords = obstruction
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20/71. Case report: CT diagnosis of nonobstructive left paraduodenal hernia.

    The preoperative diagnosis of paraduodenal hernias (PH) can only be made radiologically. PH are seldom diagnosed preoperatively unless they cause bowel obstruction. We report an unusual case of a nonobstructive left PH diagnosed preoperatively by computed tomography (CT). The CT findings of internal hernias are discussed.
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ranking = 0.25
keywords = obstruction
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