Anastomosis, Surgical ; Humans ; Ileostomy ; Infant ; Intestinal Obstruction ; etiology ; surgery ; Male ; Mesenteric Cyst ; complications ; congenital ; pathology ; surgery

Paraduodenal hernias are a rare congenital malformation, but they are the most common internal hernias. They develop secondary to a failure in midgut rotation, which may lead to small bowel obstruction or other clinical manifestations. The authors recently experienced a case of a left paraduodenal hernia presenting with unusual symptoms of left flank pain and vomiting.
Adult ; Hernia/*complications/*diagnosis/pathology/surgery ; Humans ; Intestinal Obstruction/*etiology/surgery ; Male

Colonic hamartomas are rare polypoid lesions. We report an unusual case of multiple colonic hamartomatous polyps, including a giant hamartoma, unrelated to hereditary or familial polyposis syndromes, in a 48-year-old man. The diameter of the largest polyp was 9.5 cm, and endoscopy revealed that the lesion caused colonic obstruction. The clinical, endoscopic and histological aspects of this case are discussed.
Middle Aged ; Male ; Intestinal Obstruction/*pathology/surgery ; Humans ; Hamartoma/*pathology/surgery ; Colonoscopy ; Colonic Polyps/*pathology/surgery ; Colonic Diseases/*pathology/surgery ; Colectomy

Sclerosing encapsulating peritonitis (SEP) is a poorly understood and rarely documented cause of small bowel obstruction. Although recurrent peritonitis has been reported as the main contributory factor leading to secondary SEP, the pathogenesis of primary (idiopathic) SEP is still uncertain. A 40-year-old woman with a history of total abdominal hysterectomy due to gestational trophoblastic disease presented with progressive lower abdominal pain and abdominal distension. Ultrasonography and contrast-enhanced abdomen-pelvis computed tomography of the abdomen revealed encapsulation of the entire small bowel with a sclerotic capsule. At laparotomy, a fibrous thick capsule encasing small bowel loops was revealed. Extensive adhesiolysis and removal of the capsule from the bowel loops were performed. The patient recovered uneventfully; she was discharged without complications. SEP is a rare cause of small bowel obstruction. We treated a case of abdominal cocoon with intestinal partial obstruction in a woman with a history of abdominal hysterectomy due to gestational trophoblastic disease. Surgical treatment was effective and the patient recovered without complication.
Adult ; Female ; Humans ; Hysterectomy/*adverse effects ; Intestinal Obstruction/diagnosis/*etiology ; Intestine, Small/*pathology ; Peritonitis/diagnosis/*etiology/surgery ; Sclerosis/*pathology

OBJECTIVETo evaluate the clinical significance of microlaparoscopic treatment for adhesive intestinal obstruction in children.

METHODSAdhesion -lysis operation was performed in 18 patients with adhesive intestinal obstruct ion by microlaparoscope from March 2001 to January 2004. The clinical data were analyzed retrospectively.

RESULTSMicrolaparoscope assisted accretion-lysis operation was successfully performed in all patients. The operative time ranged from 15 min to 45 min (averaged 30 min), the aerofluxus time ranged from 12 hours to 28 hours (averaged 22 hours) after operation. All patients can take general activity at the first day and take in food at the second day after operation respectively. The hospital stay ranged from 3 to 5 days (averaged 4 days) without complications. All patients were followed-up from 3 months to 18 months (average d 6 months). All patients recovered well without occurrence of adhesive intestinal obstruction.

CONCLUSIONSMicro-laparoscope assisted adhesion-lysis operation is a simple,safe,and feasible approach for adhesive intestinal obstruction in children.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Intestinal Obstruction ; pathology ; surgery ; Laparoscopy ; Male ; Retrospective Studies ; Tissue Adhesions

A 46-year-old Chinese woman with a history of cholecystectomy and appendicectomy presented to the emergency department with symptoms of intestinal obstruction. Physical examination revealed central abdominal tenderness but no clinical features of peritonism. Plain radiography of the abdomen revealed a grossly distended large bowel loop with the long axis extending from the right lower abdomen toward the epigastrium, and an intraluminal air-fluid level. These findings were suspicious for an acute caecal volvulus, which was confirmed on subsequent contrast-enhanced computed tomography (CT) of the abdomen and pelvis. CT demonstrated an abnormal positional relationship between the superior mesenteric vein and artery, indicative of an underlying intestinal malrotation. This case highlights the utility of preoperative imaging in establishing the diagnosis of an uncommon cause of bowel obstruction. It also shows the importance of recognising the characteristic imaging features early, so as to ensure appropriate and expedient management, thus reducing patient morbidity arising from complications.
Abdominal Pain ; Appendectomy ; China ; Cholecystectomy ; Contrast Media ; Emergency Medicine ; Female ; Humans ; Intestinal Obstruction ; diagnostic imaging ; surgery ; Intestinal Volvulus ; diagnosis ; pathology ; Middle Aged ; Tomography, X-Ray Computed

Meckel's diverticulum is the most common anomaly of the intestine. It is usually asymptomatic but approximately 4% are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation. Gastrointestinal bleeding is the most common presenting symptoms of Meckel's diverticulum in children, however, intestinal obstruction is the most common complications in adult patients. Reported mechanism of intestinal obstruction in Meckel's diverticulum include intussusception, adhesion, and volvulus. Recently, we experienced a case with Meckel's diverticulum associated with ileal stricture causing recurrent partial intestinal obstruction in a 48-year-old man. In contrast to other published cases of small bowel obstruction in Meckel's diverticulum, this case was caused by ileal stricture associated with Meckel's diverticulum.
Endoscopy, Gastrointestinal ; Humans ; Ileal Diseases/*diagnosis/*etiology/surgery ; Intestinal Obstruction/*diagnosis/etiology/surgery ; Male ; Meckel Diverticulum/*complications/pathology/surgery ; Middle Aged ; Recurrence

Peutz-Jeghers syndrome is an autosomal dominant inherited disorder characterized by multiple gastrointestinal hamartomatous polyps and mucocutaneous pigmentation. Peutz-Jeghers syndrome has an incidence of approximately 1 in 25,000 to 300,000 births. Crohn's disease is a chronic inflammatory bowel disease that typically manifests as regional enteritis with its incidence ranging from 3.1 to 14.6 cases per 100,000 person-years in North America. Herein, we report a case of a 30-year-old male patient who had both Peutz-Jeghers syndrome and Crohn's disease. We believe that this is the first case in Korea and the second report in the English literatures on Peutz-Jeghers syndrome coincidentally accompanied by Crohn's disease.
Adult ; Crohn Disease/complications/*diagnosis/pathology ; Endoscopy, Gastrointestinal ; Humans ; Intestinal Obstruction/etiology ; Intestinal Perforation/etiology ; Intestinal Polyps/pathology/surgery ; Male ; Peutz-Jeghers Syndrome/complications/*diagnosis/genetics ; Protein-Serine-Threonine Kinases/genetics

Intestinal obstruction involves a partial or complete blockage of the bowel which results in the failure of intestinal contents to pass through. The mechanical causes of obstruction may include the followings: hernias, postoperative adhesions or scar tissue, impacted feces, gallstones, tumors, granulomatous processes, intussusception, volvulus, foreign bodies, and etc. Hernias are the third leading cause of intestinal obstruction by 10% approximately. However, most hernias are the cases with abdominal wall, inguinal or internal hernia. Femoral, obturator, lumbar, or sciatic hernia as the cause of obsturction is rare. Furthermore, the cases accompanying soft tissue necrosis are seldomly reported. Herein, we report a case of intestinal obstruction caused by strangulated femoral hernia accompanying soft tissue necrosis in a 78-years-old female patient.
Aged ; Diagnosis, Differential ; Female ; Hernia, Femoral/*complications/diagnosis/surgery ; Humans ; Intestinal Obstruction/diagnosis/*etiology/surgery ; Necrosis ; Skin/*pathology ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the safety and efficacy of transanal drainage tube followed by laparoscopic surgery in management of malignant colorectal obstruction.

METHODSFrom March 2007 to October 2010, 37 patients with colorectal cancer manifesting acute complete mechanical obstruction were treated by ileus tube drainage. After irrigation and drainage ranging from 4 to 10 days, the radical operations and anastomosis were performed by laparoscopy.

RESULTSThe drainage tubes were successfully implanted in 34 patients. The decompression time of patients was (5.8 ± 1.6) d, ranging from 4 to 10 d. The abdominal pain and bloating symptoms were faded away after (3.8 ± 1.3) d (1 to 7 d) drainage. And comparing to that of patients when admission, abdominal circumference significantly reduced from (92 ± 7) cm to (84 ± 6) cm (P = 0.013) before surgery. Thirty-one cases were performed radical resection and anastomosis by laparoscopy after decompression. Postoperative recovery was smooth, and there was no serious complication.

CONCLUSIONSLaparoscopic surgery followed decompression by transanal ileus tube is effective and safe for acute lower colorectal obstruction. Emergency surgery may be converted to limit surgery by this method. After appropriate bowel preparation, laparoscopic radical surgery and anastomosis is feasible.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; surgery ; Drainage ; methods ; Female ; Humans ; Intestinal Obstruction ; etiology ; surgery ; Laparoscopy ; Male ; Middle Aged