A case of intramural sparganosis of jejunum presenting as intestinal obstruction is described. Resected intestine from a 48 year old man with acute abdomen revealed a degenerated sparganum in the submucosa with typical tissue reaction and extensive edema. The tissue reaction was basically granulomatous, consisting of layers of inner palisading histiocytes and outer mononuclear cell infiltration. Many calcospherules were prominent within the degenerated worm. Eosinophil infiltration was scanty.
Granuloma/pathology ; Humans ; Intestinal Obstruction/*etiology ; Jejunal Diseases/etiology ; Male ; Middle Aged ; Sparganosis/*diagnosis

No abstract availble.
Colitis, Ulcerative/complications/*diagnosis/pathology ; Colonoscopy ; Female ; Humans ; Intestinal Obstruction/*diagnosis/etiology/pathology ; Middle Aged

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

Acute Disease ; Child, Preschool ; Diarrhea ; complications ; Female ; Humans ; Infant ; Intestinal Pseudo-Obstruction ; diagnosis ; etiology ; Male

Humans ; Intestinal Obstruction ; diagnosis ; etiology ; therapy ; Neoplasms ; complications ; Palliative Care ; methods ; Quality of Life

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

Small bowel capsule endoscopy has been now widely applied for patients who are highly suspected of small bowel disease with occult bleeding and unexplained abdominal pain. Capsule retention is a major complication, with an overall incidence of 1%-2%, commonly seen in the detection of Crohn's disease and small bowel tumors. Most cases run asymptomatically after retention, while intestinal obstruction or perforation can occur ralely. Conservative methods, endoscopic or surgical interventions are performed to deal with the retention. Patency capsule is currently used as a novel tool to reduce the risk of capsule retention.
Capsule Endoscopy ; adverse effects ; Capsules ; Crohn Disease ; diagnosis ; Endoscopy, Gastrointestinal ; adverse effects ; Foreign Bodies ; physiopathology ; Humans ; Incidence ; Intestinal Neoplasms ; diagnosis ; Intestinal Obstruction ; diagnosis ; etiology ; Intestine, Small

BACKGROUND/AIMS: Acute intestinal obstruction is an urgent disease to be diagnosed and treated promptly. In elderly, fecal impaction may be an important and preventable cause of colonic obstruction. We investigated the clinical features of patients presenting with denical features of intestinal obstruction transiently due to fecal impaction. METHODS: From February 2001 to March 2004, nineteen patients were diagnosed as transient intestinal obstruction due to fecal impaction. We evaluated clinical characteristics, radiologic findings, sigmoidoscopic or colonoscopic findings and managements. RESULTS: Male and female ratio was 1:1.1. Mean age was 79.3 years. All 19 patients had abdominal pain and distension. On digital rectal examination, the hard feces was palpable in only 8 patients (42%) while others showed empty rectum. The abnormal laboratory findings included leukocytosis in 5 patients (26%), anemia in 10 patients (53%) and electrolyte abnormalities in 7 patients (37%). Simple abdominal X-rays showed diffuse small and/or large bowel dilatations. In only 3 patients (16%) air-fluid levels were definite, but most patients showed abundant feces in the rectum and colon. During emergency sigmoidoscopy, abdominal pain and distension were relieved and there were Bristol type 1 hard stool in the recto-sigmoid junction in 7 patients (37%) and multiple rectal ulcers in 1 patient. On colonoscopy, there were no mass or pathologic obstruction in all patients. Patients were discharged after the adequate medication and toilet training. CONCLUSIONS: In elderly patients, fecal impaction is odd and preventable cause of intestinal obstruction. It is often significant to differentiate fecal impaction from other pathologic conditions in patients with chronic constipation.
Aged ; Aged, 80 and over ; Fecal Impaction/*complications/diagnosis/therapy ; Female ; Humans ; Intestinal Obstruction/diagnosis/*etiology/therapy ; Male

No abstract available.
Humans ; Intestinal Obstruction/*diagnosis/etiology/surgery ; Male ; Meckel Diverticulum/complications/*diagnosis ; Middle Aged ; Radiography, Abdominal ; Tomography, X-Ray Computed

OBJECTIVETo explore clinical features, diagnostic methods and treatment of gallstone ileus.

METHODSClinical data of 5 patients with gallstone ileus were analyzed retrospectively. Pertinent literature from China between 2000 and 2009 were reviewed. The disease onset, clinical manifestations, imaging characteristics, diagnosis and treatment of gallstone ileus were studied.

RESULTSFour out of 5 patients were female aged over 60, of whom 3 had a previous history of cholelithiasis, 2 had a history of cholangiojejunostomy internal drainage procedure. Four patients underwent enterotomy and gallstone extraction combined with hepatobiliary operation, while one underwent enterotomy alone. There was no postoperative recurrence. A review of the literature from China revealed 441 cases with intestinal obstruction caused by gallstone, consisting 1.15% of all the cases with bowel obstruction. 67.12% were female. 73.56% were elderly. 87.92% were from cystoenteral fistula. Site of bowel obstruction in ileum was 64.17% of the cases. 71.89% were misdiagnosed with other types of obstruction. Two hundred twenty-five patients underwent enterotomy and gallstone extraction combined with hepatobiliary operation, which carried a lower rate of postoperative recurrence and malignancy (P<0.05) than enterotomy alone. There were no statistical significant differences in the occurrence of postoperative cystoenteral fistula, wound infection, pulmonary infection, cure rate, and mortality(P>0.05).

CONCLUSIONSThe incidence of gallstone ileus is low and more common in female elderly. The gallstones often drain through cystoenteral fistula and lodge in the ileum. Enterotomy without hepatobiliary operation is associated with potential risk of recurrence and development of gallbladder malignancy. Combined hepatobiliary operation is recommended in patients without significant comorbidities.

Aged ; Female ; Gallstones ; complications ; diagnosis ; surgery ; Humans ; Intestinal Obstruction ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Retrospective Studies