Unspecific abdominal symptoms and pneumobilia: a rare case of gastrointestinal obstruction.
Ontology highlight
ABSTRACT:
SUBMITTER: Keller M
PROVIDER: S-EPMC4105949 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:IntroductionSclerosing encapsulating peritonitis (SEP), or abdominal cocoon, is a remarkably rare entity. It consists of a fibrous layer or cocoon-like sac encasing, in most cases, the small bowel. The lack of specific symptoms makes preoperative diagnosis challenging.Case presentationA 50-year-old patient, with no history of abdominal surgery or medical diseases, was admitted for symptoms of small bowel obstruction. On examination, the patient was underweight with a BMI of 18 kg/m2. Vital signs were stable. His abdomen was mildly distended and soft. Abdominal CT scan showed signs in favor of a left paraduodenal hernia with incarcerated small bowel loops. Intraoperatively, the small bowels were encapsulated in a cocoon-like structure formed by thick fibrous tissue associated with multiple adhesions. Careful adhesiolysis with complete resection of the membrane was performed. The postoperative course was uneventful. One year later, the patient was symptom-free.DiscussionSEP is thought to be a persistent inflammatory disorder due to a cause that remains unidentified. It is divided into two categories based on its etiology: primary and secondary. The most common mode of SEP revelation is bowel obstruction. Because there is no clear consensus on SEP management, the therapeutic approach typically follows the management strategy of bowel obstruction.ConclusionSEP is an uncommon cause of bowel obstruction. Preoperative detection can be challenging in the absence of pathognomonic signs. Treatment is based on surgery, specifically entailing complete excision of the cocoon and adhesiolysis.
| S-EPMC10551648 | biostudies-literature
Project description:Graphical abstract Highlights • Postoperative anatomical changes can cause unique disease presentations.• Tamponade physiology can occur secondary to GI obstruction in esophagectomy patients.• Point-of-care ultrasound imaging leads to expedited diagnosis and disposition.
| S-EPMC9270669 | biostudies-literature
Project description:Introduction and importanceIntestinal tuberculosis (TB) comprises of about 5 % of all cases of tuberculosis in susceptible communities. Intestinal tuberculosis establishes itself in the lymphoid follicles of the Peyer's patches and spreads to the submucosal and subserosal planes. A gastroduodenal location for TB is very rare even in patients with pulmonary TB and gastroduodenal TB lesions are usually secondary.Case presentationA 48 year old Ethiopian patient presented with non-bilious, non-projectile vomiting of ingested matter which progressively worsens over time. Associated with this he had burning type of epigastric pain for which he had been treated with antiulcer drugs on multiple occasion, but he had no improvement. The vomiting worsened over the past year and he had unquantified but significant weight loss. Subsequently the patient was diagnosed with duodenal TB and was treated with antituberculous drugs according to the national protocol for six months and the above symptoms subsided. The patient had significant weight gain after starting treatment.Clinical discussionThe commonest site for gastro-intestinal tuberculosis (TB) is the ileocecal region and duodenal tuberculosis constitutes around 2 % of cases of abdominal tuberculosis. A high index of suspicion for tuberculosis is required in any patient with gastrointestinal symptoms living in endemic areas.ConclusionWe suggest that a diagnosis of duodenal tuberculosis should always be considered in young patients presenting with gastric outlet obstruction (GOO) or unresponsive or relapsing dyspepsia, in areas where tuberculosis is endemic.
| S-EPMC10070631 | biostudies-literature
Project description:Introduction Small bowel obstruction is a common surgical emergency abdominal condition in clinical practice. Fecalith is one of the rare causative factors, especially phytobezoars. Case Report We report the case of a 66-year-old man admitted with “abdominal pain with vomiting for 1 day.” Enhanced CT of the abdomen suggested incomplete small bowel obstruction. The symptomatic treatment with fasting, fluid replacement, gastrointestinal decompression, and antibiotics was conducted after the patient was admitted to the hospital. After 2 days of treatment, the patient's abdominal pain was not significantly relieved, so a decision was made to perform laparoscopic examination surgery. During surgery, a columnar foreign body was found embedded in the lumen of the small intestine about 10 cm away from the ileocecal region. Combined with the patient's preoperative history of consuming a large number of persimmons, the primary diagnosis of small intestinal fecalith obstruction was considered. We performed an enterotomy to remove the foreign body, and the procedure was uneventful. On postoperative day 7, the patient was successfully discharged. Conclusion When we encounter a patient with intestinal obstruction without a history of surgery in our clinical work, we should take a careful history, especially about the consumption of foods that can cause phytoliths. When a patient has consumed a large amount of food that can cause phytobezoars before the abdominal pain, we should diagnostically consider it as phytobezoars intestinal obstruction, which helps to reduce the incidence of misdiagnosis and allows the patient to receive treatment timely and effectively.
| S-EPMC9086506 | biostudies-literature
Project description:We present an extremely rare report on gastric inlet obstruction due to giant abdominal aortic aneurysm. Despite the rare occurrence of this manifestation, it should be considered in the differential diagnosis of gastric inlet obstructions.
| S-EPMC8142391 | biostudies-literature
Project description:Abdomen cocoon is a rare disease in which a thick peritoneal membrane wraps the intestine causing the bowel loops to adhere to each other. It may be either primary(idiopathic) or secondary to other causes like previous abdominal surgery. Most patients present with abdominal pain and intestinal obstruction. The condition is usually diagnosed intraoperatively.Case 1A 30-year-old male patient presented with abdominal pain and bilious vomiting. The patient had similar previous attacks. Examination showed distension abdominal distension with central tenderness. Plain abdominal X-ray showed multiple air fluid levels. During surgery most of ileum was enclosed by thin membrane with dilated proximal jejunum. Release of the bowel loops was done. The patient was well after surgery and was discharged with no post-operative complications.Case 2A 35-year old male presented with chronic right lower quadrant abdominal pain, the past medical and surgical histories were non-relevant. Abdominal examination showed tenderness on deep palpation at the right iliac fossa, abdominal ultrasound and abdominal X-ray were normal. During diagnostic laparoscopy the terminal ileum was enclosed with a thick whitish membrane with dilated proximal ileum. Release of the adhesions was done. The patient was well in the post-operative period and he was discharged home with no post-operative complications.In both cases the biopsy from the membranes showed features of chronic inflammatory process.Abdomen cocoon is one of the rare causes of small bowel obstruction. The bowel adhesions should be opened and nonviable segments resected. Most patients have good long term outcome.
| S-EPMC6806387 | biostudies-literature
Project description:Renal cell carcinoma (RCC) accounts for about 3% of adult cancers. RCC is the third most common cancer among the urogenital cancers, clear-cell RCC being the most common histological subtype. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and are derived from interstitial Cajal cells (ICCs). The ICCs in the urinary system were first shown in 2003 in a study by Solari et al. However, there is no publication of a GIST of renal origin yet. Here we report a case of renal GIST that has not previously been published in the literature.
| S-EPMC6562833 | biostudies-literature
Project description:Introduction and Importance: Meckel's diverticulum band is an uncommon cause of intestinal obstruction in adults. Case presentation We report the case of a 57-year-old diabetic and hypertensive male who presented with sudden onset of vomiting and abdominal pain. Initial laboratory and imaging investigations, including an abdominal X-ray and computed tomography scan, were suggestive of an intestinal obstruction; however, these were not helpful in assigning a presumptive cause. A laparoscopic exploration was offered after a repeated abdominal X-ray showed an air-fluid level. Intraoperative findings revealed an ischemic closed loop obstructed by a fibrous band of Meckel's diverticulum. Resection and anastomosis of the bowel was performed, and the patient was discharged on day 3 post-operative with no complications. Clinical discussion Surgical resection performed by open or laparoscopic approach is the recommended treatment for patients with symptomatic Meckel's diverticulum. Generally, a wedge resection of the Meckel's diverticulum is performed, and occasionally part of the ileum is resected by end-to-end anastomosis, as was the case in our patient. Conclusion We believe early surgical intervention is crucial for a favorable outcome. Thus, surgeons should consider complicated Meckel's diverticulum in patients presenting with signs and symptoms of small bowel obstruction. Highlights • Intestinal Obstruction Caused by Meckel's Diverticulum Band are extremely rare in adult.• Obstruction Caused by Meckel's Diverticulum Band may present a challenging clinical diagnosis.• Surgical resection remains the treatment of choice and plays a potentially curative role.
| S-EPMC9207010 | biostudies-literature
Project description:Malignant gastrointestinal neuroectodermal tumors (GNETs) are rare malignant mesenchymal neoplasms. To our knowledge, only 99 cases have been reported worldwide. The tumor has an aggressive malignancy, with a rapid progression. The histological features of GNET overlap with those of clear cell sarcoma, which contain Ewing sarcoma breakpoint region 1 mutation. GNETs lack melanocyte-specific markers, while clear cell sarcoma exhibits melanocytic differentiation. Various symptoms have been reported previously, and the most reported lesion is in the small bowel. The patient was a 69-year-old man who presented with abdominal pain and vomiting. Computed tomography revealed a nodule in the small bowel, which induced small intestinal obstruction. Enteroscopic images revealed a submucosal tumor. Surgery was performed, and the patient was diagnosed with GNET. Only two patients whose primary lesions were in the small intestine, including the patient in this report, have undergone enteroscopy before surgery. This is a rare case of GNET in which a patient underwent enteroscopy before surgical treatment.
| S-EPMC9302053 | biostudies-literature
Project description:IntroductionSystemic mastocytosis is a rare disease resulting from infiltration of atypical mast cells in multiple organ systems and present with variety of symptoms. Primary appendiceal and cecal mass with isolated abdominal pain as a presenting feature in systemic mastocytosis have not been reported in literature up to now.Case reportWe described a 69- years-old female with systemic mastocytosis who presented with chronic abdominal pain and recent progression. On imaging of the abdomen and pelvis showed a mass in cecum. The patient underwent surgery and histopathologic evaluation of cecal and appendiceal masses revealed uniform small round cell tumor with eosinophilic cytoplasm admixed with many eosinophils distorting normal colonic mucosal architecture. The neoplastic cells showed positive expression of CD117 and Mast cell tryptase. According to all these considerations systemic mastocytosis was confirmed as the diagnosis.ConclusionIsolated abdominal pain and primary large intestinal mass are uncommon features of systemic mastocytosis. This case report informed physicians and pathologists to consider it as one of differential diagnosis.
| S-EPMC9422182 | biostudies-literature