Adult ; Aged ; Female ; Humans ; Intestine, Small ; surgery ; Lymphangiectasis, Intestinal ; pathology ; surgery ; Male ; Middle Aged

OBJECTIVETo summarize the pathological classification, clinical symptom and experience in the diagnosis and treatment of primary tumor of small intestine.

METHODSData of 58 patients with primary tumor of small intestine pathologically confirmed from Oct. 1996 to Oct. 2006 were analyzed retrospectively.

RESULTSThirteen patient (22.4%) had primary benign tumors of small intestine and 45 patient (77.6%) had primary malignant tumors of small intestine. The major clinical signs of primary tumor of small intestine included hemorrhage(85%), abdomen pain(19%), abdomen mass and intestine obstruction(16%). Forty- eight patients (82.8%) were diagnosed by laparotomy of abdominal cavity and misdiagnosed preoperatively as other diseases.

CONCLUSIONSPrimary tumors of small intestine are difficult to be diagnosed preoperatively. CT scan, digital subtraction angiography and radionuclide imaging are helpful for the diagnosis. Laparotomy of abdominal cavity is the main choice for those patients with suspicious tumor of small intestine.

Adult ; Aged ; Female ; Humans ; Intestinal Neoplasms ; diagnosis ; surgery ; Intestine, Small ; pathology ; Male ; Middle Aged ; Retrospective Studies

To evaluate the ultrasound imaging characteristics and diagnostic criteria for acute abdominal Meckel's di- verticulum disease (MD), we retrospectively analyzed the ultrasonic characteristics, clinical data of 58 cases of pathologically proved MD from January 2009 to May 2012. We found that among all the 58 patients, 21 patients were diagnosed with the preoperative clinical diagnosis of MD. Fourteen cases of MD inflammation with acute appendicitis were evaluated by pathological examinations after the surgery. We also found 4 cases of MD with perforation, 15 cases of MD with intussusceptions, 14 cases MD with intestinal obstruction, 5 cases of MD secondary to intestinal obstructionor intestinal necrosis, and 5 cases of MD without any obvious complications. Emergency ultrasound examinations revealed 8 cases of simple MD, 1 case of MD with intussusceptions, 9 cases of MD with acute appendicitis, 12 cases of MD with intestinal obstruction, 2 cases of MD with intussusceptions and intestinal obstruction, 1 case of MD with omphalocele and 1 case of MD with abdominal abscess. The emergency sonographic findings suggested that MD was relatively fixed bowel or thick-walled cystic mass, with one end connected to small intestine, and the other end connected to the blind side, at the periumbilicus region or at the lower right abdomen. A conclusion could be drawn that MD is difficult to be detected by ultrasound (detection rate was about 15. 5%), and MD with complications such as intussusceptions, intestinal obstruction, acute appendicitis can usually be more easily detected (detection rates were 24.1%, 24.1% and 15.5%, respectively). Sonography is a simple, effective way to make diagnosis and differential diagnosis of MD with different acute abdomen symptoms from other disease.
Acute Disease ; Appendicitis ; pathology ; Diagnosis, Differential ; Humans ; Inflammation ; Intestine, Small ; pathology ; surgery ; Meckel Diverticulum ; diagnostic imaging ; surgery ; Retrospective Studies ; Ultrasonography

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

A jejunal ectopic pancreas, where pancreatic tissue is found outside of the usual anatomical location, is a rare submucosal tumor that may cause obscure gastrointestinal (GI) bleeding. After initial negative endoscopic evaluation of the obscure GI bleeding, including colonoscopy and/or upper endoscopy, it is reasonable to proceed with further evaluation of the small bowel. Diagnostic options for the evaluation of the small bowel may include capsule endoscopy, push enteroscopy, or barium contrast small bowel studies. Here, we report a case of obscure GI bleeding caused by a jejunal ectopic pancreas, diagnosed through capsule endoscopy and barium contrast small bowel studies, which was treated successfully with single incision access laparoscopy.
Aged ; Capsule Endoscopy ; Diagnosis, Differential ; Female ; Gastrointestinal Hemorrhage/*diagnosis/surgery ; Humans ; Intestine, Small/radiography ; Jejunum/pathology ; Pancreas/pathology

Lymphangioma is a benign vascular lesion with characteristics of subepithelial tumor which can proliferate in the lymphatic system. Lymphangioma of the small-bowel mesentery is rare, having been reported in less than 2% of all lymphangiomas. Lymphangioma does not require any specific treatment because it is absolutely a benign tumor. However, surgical exploration is rarely required for cases with disease-related symptoms or complications, or for those misdiagnosed as a malignant lesion. We recently experienced a case of mesenteric cavernous lymphangomas in a 53-year-old female who was misdiagnosed as having a liposarcoma. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via laparoscopic exploration. Herein, we report a very rare case of mesenteric cavernous lymphangioma along with a brief review of relevant literature.
Female ; Humans ; Intestine, Small/pathology ; Laparoscopy ; Lymphangioma/*diagnosis/pathology/surgery ; Mesentery/pathology ; Middle Aged ; Peritoneal Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

No abstract available.
Abscess/*diagnosis ; Fibrosis ; Humans ; Intestine, Small/pathology/surgery ; Male ; Peritonitis/diagnosis ; Tomography, X-Ray Computed ; Urachus/*abnormalities ; Young Adult

Adenocarcinoma ; metabolism ; pathology ; surgery ; Aged ; Humans ; Intestinal Neoplasms ; metabolism ; pathology ; surgery ; Intestine, Small ; Ki-1 Antigen ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; surgery ; Male ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Rectal Neoplasms ; metabolism ; pathology ; surgery

Intestinal obstruction is a common surgical emergency. Transmesenteric hernia is an unusual cause of bowel obstruction that may result in irreversible damage of the bowel and a fatal outcome. Once incarceration of the bowel occurs, strangulation and gangrene follow immediately. The mortality rate associated with this condition is about 15%, but in the presence of gangrene of the bowel, the mortality rate is more than 50%. An accurate preoperative diagnosis of a transmesenteric hernia is very difficult and rarely made. Therefore, in patients with small bowel obstruction, in the absence of a history of previous surgery to suggest adhesions or an external hernia, the possibility of a transmesenteric hernia must be considered. We describe a case with gangrene of a long segment of the small bowel caused by a transmesenteric hernia through a large defect of small bowel mesentery in a child.
Child ; Diagnosis, Differential ; Female ; Gangrene ; Hernia/complications/*diagnosis/radiography ; Humans ; Ileal Diseases/*diagnosis/radiography/surgery ; Intestinal Obstruction/etiology/radiography ; Intestine, Small/*pathology/surgery ; Mesentery ; Tomography, X-Ray Computed

OBJECTIVETo study the clinical and pathologic features of ischemic intestinal disease due to mesenteric phlebitis.

METHODThe clinical and pathologic features of the mesenteric venous lesions in 3 patients of ischemic intestinal disease admitted during the period from 2003 to 2004 were studied.

RESULTSAll 3 patients had a clinical history of acute abdominal pain accompanying with a diffuse peritonitis. During operation, an infarcted intestinal segment was identified and was resected respectively in each patient. Histologic examination showed a lymphocytic infiltration and fibrinoid necrosis of the small to medium-sized veins, associated with mural thrombosis and infarction of the corresponding intestinal wall and mesentery. The mesenteric arteries were spared. Two-year follow up of one case showed no evidence of local recurrence or systemic vasculitis.

CONCLUSIONSIschemic intestinal disease due to mesenteric phlebitis is a rare entity with a pathological feature of inflammation of venous wall accompanying with the development of mural thrombosis and subsequent haemorrhagic infarction of intestine. The etiology is unknown and surgical resection of the involved intestinal segment is usually recommended.

Adult ; Aged ; Colitis, Ischemic ; etiology ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Intestinal Diseases ; etiology ; pathology ; surgery ; Intestine, Small ; blood supply ; pathology ; surgery ; Ischemia ; complications ; Male ; Mesenteric Vascular Occlusion ; complications ; Mesenteric Veins ; pathology ; Middle Aged ; Phlebitis ; complications