Mitochondrial neurogastrointestinal encephalomyopathy(MNGIE),a rare mitochondrial disorder caused by TYMP gene mutations,is characterized by severe gastrointestinal dysmotility,peripheral neuropathy,and leukodystrophy.This article summarizes the clinical data and intestinal ultrasound findings of a MNGIE case,aiming to provide insights for clinical diagnosis and treatment.
Humans ; Mitochondrial Encephalomyopathies/diagnostic imaging* ; Ultrasonography ; Intestines/diagnostic imaging* ; Male ; Female ; Intestinal Pseudo-Obstruction/diagnostic imaging* ; Ophthalmoplegia/congenital* ; Muscular Dystrophy, Oculopharyngeal

Objective To evaluate the diagnostic value of transrectal contrast-enhanced ultrasound (CEUS) for rectal cancer with intestinal stenosis caused by tumors. Methods Forty-nine patients with rectal cancer underwent transrectal CEUS and magnetic resonance imaging (MRI) before surgery.Intraoperative tumor localization and postoperative pathological results were taken as the gold standard for diagnosis.The differences in T stage,localization,and tumor length of rectal cancer were compared between the two methods. Results The total accuracy rates of transrectal CEUS and MRI in diagnosing T stage were 75.5% (36/49) and 67.3% (33/49),which had no significant difference (χ²=0.8,P=0.371).The total accuracy rates of transrectal CEUS and MRI in judging tumor localization were 79.5% (39/49) and 77.5% (38/49),which had no significant difference (χ²=0.061,P=0.806).The measurement results of tumor length in pathological examination had no significant difference from the transrectal CEUS results (t=1.42,P=0.162) but a significant difference from the MRI results (t=3.38,P=0.001).Furthermore,transrectal CEUS detected 8 (16.3%) cases of colonic polyps among the 49 patients,while MRI did not detect colon lesions. Conclusions Transrectal CEUS has good consistency with MRI in T staging and localization judgement of rectal cancer with intestinal stenosis,and this method can more accurately evaluate the tumor length and simultaneously evaluate whether there is a lesion in the entire colon at the proximal end of stenosis.It can be used as a supplementary examination before rectal cancer treatment in clinical practice.
Humans ; Rectal Neoplasms/complications* ; Male ; Middle Aged ; Female ; Aged ; Contrast Media ; Ultrasonography ; Adult ; Magnetic Resonance Imaging ; Constriction, Pathologic/diagnostic imaging* ; Aged, 80 and over ; Intestinal Obstruction/etiology*

Chilaiditi syndrome is an extremity rare disease that is typically asymptomatic, but can lead to fatal complications, such as volvulus, perforation, and bowel obstruction. This paper reports a case of an 80-year-old female patient who was admitted for right upper quadrant pain and nausea. She showed a positive Murphy sign with tenderness in the right upper quadrant area. Abdominal ultrasound showed that the gall bladder was normal, but abdominal computed tomography revealed multiple small bowel loops interposed among the liver and diaphragm, as well as an abrupt small transition in the bowel caliber with air fluid levels. Therefore, she was diagnosed with an acute small bowel obstruction by Chilaiditi syndrome. She was managed with surgical repair and was discharged without complications after 18 days of admission. Small bowel obstructions by Chilaiditi syndrome is one etiology of which every emergency physician should be aware.
Aged, 80 and over ; Chilaiditi Syndrome ; Diaphragm ; Emergencies ; Extremities ; Female ; Humans ; Intestinal Obstruction ; Intestinal Volvulus ; Intestine, Small ; Liver ; Nausea ; Rare Diseases ; Ultrasonography ; Urinary Bladder

PURPOSE: Intussusception is a common cause of intestinal obstruction in children. While most patients can be treated by enema reduction, about 20% require surgery. We investigated the usefulness and feasibility of laparoscopic surgery and the intraoperative risk of bowel resection. METHODS: We retrospectively reviewed pediatric patients who underwent surgery for intussusception from 2010 to 2017. We collected data for age, gender, body weight, associated symptoms, duration of symptoms, white blood cell count, operating time, and postoperative complications. RESULTS: Of 155 patients, 37 (23.8%) underwent surgery due to enema reduction failure in 29 (78.3%), recurrence in 6 (16.3%), a suspicious lead point in 1, and suspicious ischemic change observed on ultrasonography in 1. The mean age was 26.8±18.9 months (range, 3.5~76.7 months), and the mean body weight was 12.9±3.9 kg (range, 5.4~22.2 kg). Laparoscopic surgery was successful in 29 patients (78.4%), and 7 (18.9%) needed bowel resection and anastomosis. The mean operating time was 56.7±32.8 min. A lead point was found in 3 patients in the bowel resection group (p=0.005); in addition, the operating time and hospital stay were longer in this group. There were no intra- or postoperative complications. CONCLUSION: Laparoscopic surgery was successful in 78.4% of the patients with a short hospital stay and early oral intake. The only predictive factor for bowel resection was the presence of a lead point. Laparoscopic surgery may be an optimal treatment intervention for children with intussusception, except for those who show initial peritonitis.
Body Weight ; Child ; Enema ; Humans ; Intestinal Obstruction ; Intestine, Small ; Intussusception* ; Laparoscopy* ; Length of Stay ; Leukocyte Count ; Peritonitis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Ultrasonography

Neonatal gastrointestinal mucormycosis, a rare disease with a high mortality rate, shows a rapid progressive course in premature infants with an immature immune system. We report the case of a male neonate weighing 970 g, delivered via cesarean section at 27 weeks, as one of a pair of dizygotic twins. From the 7(th) day after birth, bile was seen to drain through the orogastric tube, and paralytic ileus was noted on performing an abdominal X-ray. Thus, oral feeding was discontinued because necrotizing enterocolitis (NEC) was highly suspected. On the 9(th) day after birth, a firm mass was palpable in left upper abdominal quadrant, but no pneumatosis intestinalis was observed on performing abdominal X-ray. Small bowel intussusception was suspected on performing abdominal ultrasonography. Based on these findings, an exploratory laparotomy was performed, and although no intussusception was found intraoperatively, we performed a partial gastrectomy and hemicolectomy due to the presence of necrotic changes and perforations of the stomach and colon. Postoperatively, he was observed to have hypotension with persistence of hemorrhage at the surgical site. He died on the 11(th) day after birth. Intraoperative histopathological examination of stomach and colon showed fungal aseptate hyphae with broad branching. Gastrointestinal mucormycosis was confirmed based on findings of vascular involvement in the form of fungal hyphae and thrombosis in the transmural blood vessels. We report a case of an extremely low birth weight infant with neonatal gastrointestinal mucormycosis with an initial clinical presentation suggestive of intussusception and atypical NEC.
Bile ; Blood Vessels ; Candida ; Cesarean Section ; Colon ; Enterocolitis, Necrotizing* ; Female ; Fungi ; Gastrectomy ; Hemorrhage ; Humans ; Hyphae ; Hypotension ; Immune System ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Premature ; Intestinal Pseudo-Obstruction ; Intussusception* ; Laparotomy ; Male ; Mortality ; Mucormycosis* ; Parturition ; Pregnancy ; Rare Diseases ; Stomach ; Thrombosis ; Twins, Dizygotic ; Ultrasonography

Superior mesenteric artery (SMA) syndrome is one of the rare causes of small bowel obstruction. It develops following a marked decrease in the angle between SMA and the abdominal aorta due to weight loss, anatomical anomalies, or following surgeries. Nutcracker syndrome in the left renal vein may also occur following a decrease in the aortomesenteric angle. Though SMA syndrome and renal nutcracker syndrome share the same pathogenesis, concurrent development has rarely been reported. Herein, we report a 23-year-old healthy male diagnosed with SMA syndrome and renal nutcracker syndrome due to severe weight reduction. The patient visited our outpatient clinic presenting bilious vomiting and indigested vomitus for 3 consecutive days. He had lost 20 kg during military service. We suspected SMA syndrome based on abnormal air-shadow in the stomach and small bowel on abdominal X-ray; we confirmed compression of the third portion of the duodenum with upper gastrointestinal series and abdominal computed tomography (CT). Concurrently, renal nutcracker syndrome was also detected via abdominal CT and Doppler ultrasound. Considering bilious vomiting and no urinary symptoms, SMA syndrome was corrected by laparoscopic duodenojejunostomy, and close observation for the renal nutcracker syndrome was recommended.
Ambulatory Care Facilities ; Aorta, Abdominal ; Duodenum ; Humans ; Intestinal Obstruction ; Laparoscopy ; Male* ; Mesenteric Artery, Superior* ; Military Personnel ; Renal Nutcracker Syndrome* ; Renal Veins ; Stomach ; Superior Mesenteric Artery Syndrome* ; Tomography, X-Ray Computed ; Ultrasonography ; Vomiting ; Weight Loss ; Young Adult

Aged ; Female ; Hernia, Obturator ; complications ; Humans ; Intestinal Obstruction ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: To evaluate ultrasonographic accuracy in the differentiation of a bezoar from feces in a small bowel obstruction showing feces-like material just proximal to the transitional zone in abdominal computed tomography (CT). METHODS: This study included 14 patients who showed feces-like material just proximal to the transitional zone, among 302 patients diagnosed with small bowel obstruction on abdominal CT. The diagnostic signs of a bezoar on ultrasonography included an arc-like surfaced intraluminal mass, posterior acoustic shadow and twinkling artifacts. The diagnostic performance of ultrasonography in each patient was compared with a final diagnosis that was surgically or clinically made. RESULTS: Among the 14 patients, seven were ultrasonographically diagnosed as having a bezoar, and five of the seven were surgically diagnosed as having a phytobezoar. The remaining two of the seven showed complete symptomatic improvement before surgery. The other seven patients were ultrasonographically diagnosed as not having a bezoar. Among them, six patients were conservatively treated with symptomatic improvement, suggesting the absence of a bezoar. The remaining one patient was confirmed not to have a bezoar during adhesiolysis. In all patients, the ultrasonographic diagnosis agreed with the clinically confirmed diagnosis. CONCLUSION: Ultrasonography might be an accurate method for the differential diagnosis of feces-like material just proximal to the transitional zone in abdominal CT. It can help radiologists to quickly and easily diagnose a bezoar.
Acoustics ; Artifacts ; Bezoars* ; Diagnosis ; Diagnosis, Differential ; Feces* ; Humans ; Intestinal Obstruction ; Intestine, Small ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVETo study the value of ultrasound, abdominal X-ray, and dual-source CT (DSCT) in the diagnosis of colon tumor obstruction.

METHODSA retrospective analysis was conducted among 45 patients who were admitted to our department between October 2010 and August 2011 for abdominal pain. All the patients underwent ultrasound, abdominal X-ray and DSCT examinations and subsequent surgical interventions, which confirmed the diagnosis of colon tumor obstruction.

RESULTSDSCT diagnosis was obviously more efficient than ultrasound and X-ray in detecting colon obstruction by neoplasms, and could better predict the position of the obstruction. Complete information of the vessels in the surgical field could be obtained by DSCT imaging three-dimensional reconstruction.

CONCLUSIONSCompared with ultrasound and X-ray, DSCT is more effective in the diagnosis of colon tumor obstruction by acquiring more thorough information by imaging reconstruction and should be considered for a rapid and accurate diagnosis.

Adult ; Aged ; Colonic Neoplasms ; complications ; Female ; Humans ; Intestinal Obstruction ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND/AIMS: Intussusception in adults is rarely seen and causes misdiagnosis due to its appearance with various clinical findings. The cause of intussusception in adults is frequently organic lesions. In this study, the underlying etiologic factors, diagnostic methods and alternative methods of treatment are discussed in the light of the literature. METHODS: In this study, a retrospective evaluation was performed on 47 cases with the diagnoses of intussusception, who were operated on for bowel obstruction between 1990-2011 in Department of Surgery of Necmettin Erbakan University Meram Medical Faculty. Data related to presentation, diagnosis, treatment and pathology were analyzed. RESULTS: Twenty-four of the patients (51%) were female, and 23 were male (49%). Mean age (year) was 49 (range: 23-78) in female group, and 50 (range: 17-72) in male group. All patients presented mechanical bowel obstruction findings and underwent operation. Intussusception was caused by benign and malignant tumors in 38 patients, and other reasons in 3 cases. No reason could be determined in the other 6 cases. Only small intestine resection was applied in 29 cases, and large intestine resection was also applied in 17 cases. Reduction and fixation surgery was performed in one patient. No postoperative mortality was observed. CONCLUSIONS: Adult intussusception remains a rare cause of abdominal pain. Diagnosis of intussusception in adults is still difficult. Main treatment was surgical in most cases.
Adolescent ; Adult ; Aged ; Colonoscopy ; Female ; Humans ; Intestinal Neoplasms/complications/diagnosis ; Intestinal Obstruction/*diagnosis/etiology/surgery ; Intussusception/*diagnosis/surgery/ultrasonography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult