101
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Abstract
Small bowel obstructions (SBOs) are primarily caused by adhesions, hernias, neoplasms, or inflammatory strictures. Intraluminal strictures are an uncommon cause of SBO. This report describes our findings in a unique case of sequential, stenotic intraluminal strictures of the small intestine, discusses the differential diagnosis of intraluminal intestinal strictures, and reviews the literature regarding intraluminal pathology.
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Affiliation(s)
- George Van Buren
- The University of Texas Health Science Center Houston, Department of Surgery, 6431 Fannin Street, MSB 4.169, Houston, Texas 77030, United States.
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102
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Liang HH, Chai CY, Lin YH, Lee CH, Wu CH, Chang CC. Jejunal and multiple mesenteric calcifying fibrous pseudotumor induced jejunojejunal intussusception. J Formos Med Assoc 2007; 106:485-9. [PMID: 17588842 DOI: 10.1016/s0929-6646(09)60298-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We describe here a patient with an unusual presentation--mesenteric calcifying fibrous pseudotumor in association with jejunojejunal intussusception. This 25-year-old woman came to our emergency department with severe abdominal distension and intermittent epigastric cramping pain. She was found to have rebound tenderness and an ill-defined mass palpable in her lower abdomen. Abdominal computed tomography revealed an inhomogeneous soft tissue mass with target sign and intussusception of small intestine was suspected. Emergency laparotomy showed jejunojejunal intussusception involving ~30cm of jejunum with multiple tumors on the mesentery surface extending over the whole bowel mesenteric and peritoneal surfaces. One of the mesenteric tumors formed the leading point of the intussusception. Segmental resection of jejunum with primary anastomosis was done. Some larger tumors were resected but most of the other tumors were left in place because they were small and numerous and total resection was impossible. Pathology confirmed that the lesions were benign mesenteric calcifying fibrous pseudotumors. In such patients, surgery might be curative. If a large segment of the bowel is affected by calcifying fibrous pseudotumor, smaller pseudotumors might be left in place because these tend to be asymptomatic. But they might become the leading points of recurrent intussusception.
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Affiliation(s)
- Hung-Hua Liang
- Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan
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103
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Patuto N, Acklin Y, Oertli D, Langer I. Gastric necrosis complicating lately a Nissen fundoplication. Report of a case. Langenbecks Arch Surg 2007; 393:45-7. [PMID: 17690904 DOI: 10.1007/s00423-007-0216-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Accepted: 07/16/2007] [Indexed: 02/06/2023]
Abstract
BACKGROUND Gastric necrosis after Nissen fundoplication is a rare and life-threatening complication described in paediatric surgery and in some experimental models. Prompt diagnosis and appropriate therapy of acute gastric dilatation is mandatory to avoid potentially fatal gastric necrosis. CASE REPORT This case report is the first one to describe a gastric necrosis in an adult as a late and very severe complication after Nissen fundoplication. Gastric dilatation and subsequent necrosis occurred 14 years after Nissen fundoplication because of small bowel obstruction based on adhesions. CONCLUSION Early diagnosis and treatment of gastric dilatation after Nissen fundoplication are essential to prevent from severe secondary complications but can be difficult to establish because of atypical symptoms.
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Affiliation(s)
- Nicola Patuto
- Department of Surgery, University Hospital Basel, Basel, Switzerland
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104
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Milanchi S, McVay C, Fermelia DE. Jejunal Enterolith Causing Small-Bowel Obstruction. J Am Coll Surg 2007; 205:377. [PMID: 17660086 DOI: 10.1016/j.jamcollsurg.2006.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2006] [Revised: 09/13/2006] [Accepted: 09/13/2006] [Indexed: 11/30/2022]
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105
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Sai Prasad TR, Lim KH, Lim KH, Yap TL. Bleeding Jejunal Dieulafoy Pseudopolyp: Capsule Endoscopic Detection and Laparoscopic-Assisted Resection. J Laparoendosc Adv Surg Tech A 2007; 17:509-12. [PMID: 17705738 DOI: 10.1089/lap.2006.0063] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this paper, we report a case of bleeding solitary jejunal Dieulafoy pseudopolyp that was detected on capsule endoscopy and treated with a laparoscopic-assisted transumbilical polypectomy procedure. This case illustrates an innovative, tailored application of minimal invasive techniques in the management of a relatively uncommon lesion. To our knowledge, this is the first case report of the combination of capsule endoscopy and laparoscopic-assisted transumbilical resection for a bleeding jejunal Dieulafoy pseudopolyp in children.
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Affiliation(s)
- T R Sai Prasad
- Department of Pediatric Surgery, KK Women's and Children's Hospital, Singapore.
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106
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Affiliation(s)
- S-P Cheng
- Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan
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107
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Hernández Piñero Y, Martín Malagón AI, Díaz Romero F, López-Tomassetti Fernández EM, Arteaga González IJ. [Localization of gastrointestinal bleeding from jejunal diverticuli by methylene blue dye]. Cir Esp 2007; 81:351-3. [PMID: 17553410 DOI: 10.1016/s0009-739x(07)71337-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Localization of digestive hemorrhage is essential for the management of this entity. However, management is difficult in the small bowel, where emergency situations are rare but may require surgery without precise location of the lesion. We present a case of hemorrhage caused by jejunal diverticulum diagnosed by angiography. A highly selective microcatheter was placed in the bleeding site to achieve staining of the lesion with intraoperative methylene blue.
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Affiliation(s)
- Yaiza Hernández Piñero
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España.
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108
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Mousa D, Altayeb A. A chronic HCV positive hemodialysis patient with an unusual treatment complication. Saudi J Kidney Dis Transpl 2007; 18:282-6. [PMID: 17612040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Affiliation(s)
- Dujanah Mousa
- Renal Department, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
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109
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Abstract
Heterotopic pancreas causing small bowel intussusception is rare. We report the case of a 24-year-old woman who presented with intermittent episodes of abdominal cramping and pain that had persisted for 10 days. A target-shaped lesion consisting of multiple concentric rings was found on the left side on contrast-enhanced computed tomography. Surgical intervention demonstrated jejunal intussusception caused by a jejunal heterotopic pancreas. Microscopically, several nesidioblastoses of pancreas were identified. Although very rare, small intestinal pancreatic rests may cause subacute bowel obstruction.
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Affiliation(s)
- Va-Kei Kok
- Department of Emergency Medicine, Taipei County Hospital, Taipei, Taiwan.
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110
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Assenza M, Ricci G, Antoniozzi A, Clementi I, Simonelli L, Modini C. Perforated jejuneal diverticulosis. Case report and review of literature. Ann Ital Chir 2007; 78:247-50. [PMID: 17722502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Acquired (non-Meckel's) jejunoileal diverticulosis is an uncommon disease, generally characterised by vague and unspecific symptoms. This rare condition is mainly expressed as acute complications: gastrointestinal haemorrhage, mechanic obstruction of the small intestine or perforated diverticulum, requiring urgent surgical intervention. The authors report a case of this unusual clinical occurrence characterized by a picture of abdominal pain due to perforation of jejuneal diverticulum. The final etiological diagnosis was possible only during surgery.
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Affiliation(s)
- Marco Assenza
- Università degli Studi La Sapienza di Roma, Policlinico Umberto I, Dipartimento di Emergenza Accettazione, Roma.
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111
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Abstract
While jejunoileal diverticula are rare and often asymptomatic, they may lead to chronic non-specific or acute symptoms. The large majority of complications present with an acute abdomen similar to appendicitis, cholecystitis or colonic diverticulitis but they also may appear with atypical symptoms. As a result, diagnosis of complicated jejunoileal diverticulosis can be quite difficult, and may solely depend on the result of surgical exploration. In the absence of contra-indications, diagnostic laparoscopy has the benefit of thorough examination of the abdominal contents and helps to reach an absolute diagnosis. Surgical resection of the involved small-bowel segment with primary anastomosis is the preferred treatment in patients with symptomatic complicated jejunoileal diverticular disease. An atypical presentation of complicated jejunal diverticulitis in conjunction with sigmoid diverticulitis diagnosed with laparoscopy and treated with surgical resection is presented.
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Affiliation(s)
- Woubet T Kassahun
- University of Leipzig, Faculty of Medicine, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, OKL, Liebig Strasse 20a, 04103 Leipzig, Germany.
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112
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Omotosho PA, Varnholt H, Tirabassi MV, Prasad R, Moriarty KP. Giant Polypoid Gastric Heterotopia of the Jejunum Presenting with Intermittent Intussusception. J Laparoendosc Adv Surg Tech A 2007; 17:249-51. [PMID: 17484660 DOI: 10.1089/lap.2006.0071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
We report the case of a 17-year-old female with symptoms of intermittent small bowel obstruction. Computed tomography scan of the abdomen revealed an intussusception. The patient underwent a laparoscopic-assisted resection of the mass, which proved to be gastric heterotopia of the jejunum. We report on the case, discuss the surgical approach, and review the pertinent literature.
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Affiliation(s)
- Philip A Omotosho
- Baystate Children's Hospital, Tufts University School of Medicine, Springfield, MA 01199, USA.
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113
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Affiliation(s)
- Tadao Kubota
- Department of Surgery Chibanishi General Hospital Chiba, 107-1 Kanegasaku Matsudo, Chiba, 270-2251 Japan.
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114
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Oktar SO, Erbaş G, Yücel C, Aslan E, Ozdemir H. Closed perforation of the small bowel secondary to a phytobezoar: imaging findings. Diagn Interv Radiol 2007; 13:19-22. [PMID: 17354189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Small bowel perforation secondary to phytobezoars is a rare clinical entity, which is not well-documented in the radiological literature. Sonographic and computed tomography (CT) findings of a case of closed small bowel perforation secondary to phytobezoars in a patient with previous gastric surgery are presented. Both abdominal ultrasound and CT examinations revealed a collection containing air at the left lower quadrant as well as neighboring intraluminal masses suggestive of bezoars. We propose that appropriate CT examination is a very useful imaging modality for evaluating this kind of bowel perforation.
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Affiliation(s)
- Suna Ozhan Oktar
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.
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115
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Macari M, Faust M, Liang H, Pachter HL. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management. Clin Radiol 2007; 62:73-7. [PMID: 17145267 DOI: 10.1016/j.crad.2006.09.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Revised: 09/07/2006] [Accepted: 09/19/2006] [Indexed: 10/23/2022]
Abstract
AIM To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. MATERIALS AND METHODS CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. RESULTS Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. CONCLUSION The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient.
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Affiliation(s)
- M Macari
- Department of Radiology, Abdominal Imaging, NYU School of Medicine, New York, USA.
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116
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Jeon SJ, Yoon SE, Lee YH, Yoon KH, Kim EA, Juhng SK. Acute pancreatitis secondary to duodenojejunal intussusception in Peutz-Jegher syndrome. Clin Radiol 2007; 62:88-91. [PMID: 17145271 DOI: 10.1016/j.crad.2006.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Revised: 08/12/2006] [Accepted: 08/15/2006] [Indexed: 11/27/2022]
Affiliation(s)
- S J Jeon
- Department of Radiology, Wonkwang University School of Medicine, Iksan, Jeonbuk, Korea
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117
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Abstract
We describe a 55-year-old man with isolated duodenal and jejunal amyloidosis producing rare endoscopic and histologic findings. The patient had no specific gastrointestinal complaints but underwent esophagogastroduodenoscopy and colonoscopy because of progressive microcytic anemia. Endoscopy revealed multiple polyps, some filiform and measuring up to 3 cm in length, in the duodenum and proximal jejunum. Microscopically, the polyps resulted from amyloid deposition, predominantly within the submucosa, but also focally involving muscularis mucosae and lamina propria. The amyloid formed multiple globular submucosal deposits with a lamellated appearance reminiscent of corpora amylacea; linear amyloid deposition was also present in a perivascular distribution and within the overlying mucosa. Immunophenotyping confirmed AL amyloidosis with lambda immunoglobulin light chain restriction. There was no clinical evidence of visceral amyloidosis. The source of lambda light chain production was unclear as bone marrow biopsy and multiple gastrointestinal biopsies revealed normal numbers of polyclonal plasma cells. Further, immunoglobulin-free light chain assay was normal, as were serum and urine protein electrophoreses with immunofixation. This endoscopic presentation of isolated small bowel polyposis is an uncommon association with AL amyloidosis and to our knowledge this represents the first case of globular gastrointestinal amyloidosis resulting from AL amyloid.
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Affiliation(s)
- Patrick R Hemmer
- Division of Anatomic Pathology, Department of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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118
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Stephant E, Rimbot A, Juglard R, Meusnier F, Talarmin B, Paoletti H, Arteaga C. Pneumatose du grand omentum révélé par une invagination sur métastase de mélanome. ACTA ACUST UNITED AC 2007; 88:285-8. [PMID: 17372559 DOI: 10.1016/s0221-0363(07)89818-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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119
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Efremidou EI, Liratzopoulos N, Papageorgiou MS, Kouklakis G, Minopoulos GJ, Manolas KJ. Enterolith small-bowel obstruction caused by jejunal diverticulosis: Report of a case. Surg Today 2007; 36:1003-6. [PMID: 17072724 DOI: 10.1007/s00595-006-3283-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2005] [Accepted: 05/16/2006] [Indexed: 11/25/2022]
Abstract
We report the successful surgical treatment of intestinal obstruction caused by enteroliths formed in jejunal diverticula. A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. Thus, we performed a laparotomy, which revealed multiple diverticula in the jejunum, with one enterolith inside a diverticulum and one enterolith in the terminal ileum. There was no abnormal communication between the gallbladder and the intestinal tract, excluding the possibility of a gallstone ileus. The stone in the terminal ileum could not be broken manually, so we performed an enterotomy to remove the stones. Intestinal obstruction caused by enteroliths in small-bowel diverticula is a rare event, which is difficult to diagnose and manage. To our knowledge, only 35 such cases have ever been reported.
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Affiliation(s)
- Eleni I Efremidou
- First Department of Surgery, University General Hospital of Alexandroupolis, Medical School of Democritus, University of Thrace, Dragana, 68100, Alexandroupolis, Greece
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120
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Mönkemüller K, Fry LC, Ebert M, Bellutti M, Venerito M, Knippig C, Rickes S, Muschke P, Röcken C, Malfertheiner P. Feasibility of double-balloon enteroscopy-assisted chromoendoscopy of the small bowel in patients with familial adenomatous polyposis. Endoscopy 2007; 39:52-7. [PMID: 17252461 DOI: 10.1055/s-2006-945116] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Patients with familial adenomatous polyposis (FAP) are at increased risk of developing duodenal and jejunal adenocarcinomas. The aim of this study was to assess the usefulness of double-balloon enteroscopy- (DBE-) assisted chromoendoscopy for the detection and characterization of small-bowel polyps in patients with FAP. PATIENTS AND METHODS We performed a prospective evaluation of patients with clinically and genetically proved FAP who were enrolled in an endoscopic surveillance program. DBE was performed using a Fujinon intestinoscope (FN 450P 5/20; Fujinon Corp., Omiya, Japan), and chromoendoscopy was performed using indigo carmine. The severity of small bowel polyposis was based on the Spigelman-Saurin classification. RESULTS Nine patients underwent DBE-assisted chromoendoscopy. Small-bowel polyps (including papillary adenomas) were detected in seven patients (88 %). The mean depth of small-bowel insertion was 180 cm (range 120-320 cm). The mean Spigelman-Saurin score was 4.6 (range 0-8). Jejunal polyps were detected in six patients (67 %). Chromoendoscopy aided in the detection of additional polyps in two patients. In one patient the polyps were flat and only visible with chromoendoscopy (biopsy confirmed these to be adenomas). Jejunal polyps and advanced neoplasms were more frequent in patients with APC gene mutations in exon 15. The following endoscopic therapies were performed: polypectomy (n = 1), duodenal mucosectomy (n = 1), and ablation therapy with argon plasma coagulation (n = 2). CONCLUSIONS DBE was found to be a helpful method for the evaluation of small-bowel polyps in patients with FAP. DBE-assisted chromoendoscopy was of further assistance for the detection of jejunal polyps.
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Affiliation(s)
- K Mönkemüller
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.
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121
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122
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Abstract
BACKGROUND Acute pelvic pain in women is a common diagnostic dilemma encountered by the gynecologist. We describe a case of acute pelvic pain with an unusual etiology. CASE A 40-year-old multipara presented within hours of the onset of acute pelvic pain. She was treated conservatively with analgesics after computed tomography of the abdomen and pelvis revealed a ruptured ovarian cyst. Upon return to the emergency room, she was admitted to a gynecologic service for pain control. The etiology of her acute pelvic pain eventually declared itself. CONCLUSION The differential diagnosis of acute pelvic pain represents a variety of organ systems.
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Affiliation(s)
- Jamie N Bakkum
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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123
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Zingales F, Pivetta E, Vittadello F, Franchi F, Da Re C, Corsini A. [Intestinal hemorrhage from diverticulosis of the jejunum: a case report]. Chir Ital 2006; 58:803-6. [PMID: 17190287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The diagnosis of intestinal diverticulosis is difficult to achieve preoperatively because the clinical symptoms are usually non-specific. Intestinal bleeding is a rare complication of jejunal diverticulosis. Its diagnosis and treatment can be difficult and an emergency laparotomy is often needed. We report a case of massive intestinal bleeding from jejunal diverticulosis. The correct diagnosis was first suggested by CT and then confirmed at laparotomy. The treatment was a segmental jejunal resection with primary anastomosis.
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124
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Munteanu M, Pîrşcoveanu M, Mănescu P, Biciuşci V, Petrescu F, Munteanu MC, Munteanu AC, Tudoraşcu C, Fulger S, Gugilă I. Intussusception of efferent intragastric loop after gastrojejunostomy--an exceptional cause of high occlusion and hematemesis. Chirurgia (Bucur) 2006; 101:525-8. [PMID: 17278647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Jejunogastric intussusception (GI) is an extremely rare complication of gastrojejunostomy (GJS) that may appear any time after surgical intervention. Less than 200 cases have been reported so far, on very small series. Young female, 32, who 12 years ago was operated for a gastroduodenal disease that she doesn't know many details about. She presented severe pain in the superior abdominal segment posteriorly irradiated, incoercible biliary nausea followed by hematemesis. The endoscopic, imaging and biological explorations suggested a huge gastric tumor that occupied the whole stomach and was bleeding diffusely. The rapid acute evolution asked for the urgent laparotomy that emphasized: soft tumour mass, intragastrically mobile without any scar at the stomach or duodenum level; adherent to the posterior of the stomach we discovered a ball of jejunal loops that couldn't be undone. The anterior gastrotomy sets the diagnosis: JGI of the efferent loops of a GJS. We hardly managed to reduce the intussusception, without resection, the loop being absolutely viable. In order to prevent a relapse, and because the anastomosis was not justified it was taken down. JGI in a patient presenting GJS must be taken into consideration in the presence of epigastric pain that would not cease, biliary nausea followed by hematemesis and rapid deterioration of general health status.
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Affiliation(s)
- M Munteanu
- 3rd General Surgery Clinic, University of Medicine and Pharmacy Craiova, Romania.
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125
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Affiliation(s)
- Stacy A Kahn
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Chicago, IL, USA.
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126
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Shanmugam RP, Shivakumar P. A rare complication of jejunal diverticulosis. Trop Gastroenterol 2006; 27:134-5. [PMID: 17310558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Jejunal diverticulae are rare and usually asymptomatic, Jejunoileal diverticulae are generally thought to be acquired and are estimated to occur in 1-5% of the population of which only 10% developed complications which include diverticulitis, perforation, hemorrhage, enterolith formation and obstruction. We present a case of jejunal diverticulosis associated with stricture formation resulting in obstruction of the jejunum, the first reported case of this kind so far.
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Affiliation(s)
- R P Shanmugam
- Department of Surgical Gastroenterology, Kumaran Hospital, Chennai
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127
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Yamaner S, Akyüz M, Buğra D. Massive lower gastro-intestinal bleeding due to small bowel diverticula. A report of two cases. Acta Chir Belg 2006; 106:427-9. [PMID: 17017699 DOI: 10.1080/00015458.2006.11679922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Gastro-intestinal bleeding from the small bowel is a rare entity. It is difficult to determine the source of bleeding because of the unavailability of routine small bowel endoscopy. The most common reasons for bleeding from the small bowel are tumours, arteriovenous malformations and inflammatory bowel diseases. Diverticula of the small bowel are very uncommon. We present two cases of gastro-intestinal bleeding due to small bowel diverticula. Both of them were diagnosed on laparotomy. One had a short segment of small bowel, with six diverticula, which was resected. The second case had a long segment of small bowel with multiple diverticula. This patient was treated by isolating and excising the bleeding diverticulum. Haemodynamically unstable lower gastro-intestinal bleeding mandates exploratory laparotomy. Mesenteric angiography and Tc 99 labelled erythrocyte scintigraphy can detect the bleeding site. Intra-operative endoscopy can be performed safely via an enterotomy and can localize the bleeding site.
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Affiliation(s)
- S Yamaner
- Istanbul University, Faculty of Medicine, Department of General Surgery, Millet caddesi, Capa, Istanbul, Turkey
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128
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Rivera Irigoín R, García Fernández G, Medina Cano FJ, Ubiña Aznar E, Méndez Sánchez IM, Vera Rivero F. [Severe lower gastrointestinal hemorrhage due to jejunal diverticulosis. Preoperative diagnosis by enteroscopy]. Cir Esp 2006; 80:53-4. [PMID: 16796957 DOI: 10.1016/s0009-739x(06)70919-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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129
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Nielsen C, Sutton DA, Matise I, Kirchhof N, Libal MC. Isolation of Cokeromyces recurvatus, initially misidentified as Coccidioides immitis, from peritoneal fluid in a cat with jejunal perforation. J Vet Diagn Invest 2006; 17:372-8. [PMID: 16130998 DOI: 10.1177/104063870501700413] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cokeromyces recurvatus, a zygomycete, was isolated by fungal culture from the peritoneal fluid of a cat with jejunal perforation secondary to intestinal lymphosarcoma. This organism has not been recovered previously from a veterinary patient. The tissue form of C. recurvatus is morphologically similar to those of Coccidioides immitis and Paracoccidioides brasiliensis and may be misdiagnosed as 1 of these organisms on the basis of cytologic or histopathologic specimens, particularly in geographic regions where these organisms are not endemic.
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Affiliation(s)
- Cheri Nielsen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA
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130
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Nishida M, Hamaoka K. An unexpected cause of abdominal pain in a peritoneal dialysis patient. Pediatr Nephrol 2006; 21:600. [PMID: 16520950 DOI: 10.1007/s00467-006-0035-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 11/05/2005] [Indexed: 10/24/2022]
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131
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Abstract
Non-Meckelian jejunoileal diverticula are more frequently diagnosed in men aged more than 50 years old. They are a rare cause of acute abdomen. They are usually asymptomatic and are estimated to cause complications in 10-20% of cases. We present the recently diagnosed case of an 82-year-old man admitted to our hospital.
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Affiliation(s)
- Luis J García
- Servicio de Cirugía General y Aparato Digestivo, Hospital Carmen y Severo Ochoa, Asturias, España.
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132
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Chen YY, Su WW, Soon MS, Yen HH, Chen ML. Eosinophilic jejunitis presenting with acute abdomen: the usefulness of double-balloon enteroscopy. Gastrointest Endosc 2006; 63:532-4. [PMID: 16500420 DOI: 10.1016/j.gie.2005.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2005] [Accepted: 10/03/2005] [Indexed: 02/08/2023]
Affiliation(s)
- Yang-Yuan Chen
- Department of Gastroenterology, Changhua Christian Medical Center, Taiwan, ROC
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133
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Crankson SJ, Oda O, Al-Zaben AA, Al Suwairi W, Makanjoula D. Intestinal ischamemia in a child due to polyarteritis nodosa: a case report. Trop Gastroenterol 2006; 27:41-3. [PMID: 16910060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Polyarteritis nodosa (PAN) is a rare type of childhood vasculitis. We report the case of a 10-year-old boy who was referred to our hospital following an appendicectomy with fever, abdominal pain, vomiting, diarrhoea, weight loss, joint pains and skin rash. Shortly after admission, he developed peritonitis, and an emergency laparotomy revealed ischaemia of the jejunum which required partial resection. Histologic examination of the resected bowel showed features consistent with PAN. He was treated with steroids and cyclophosphamide. Nineteen months later, he is asymptomatic and thriving. PAN should be included in the differential diagnosis if a child with constitutional symptoms also has gastrointestinal complaints or develops an acute abdomen.
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Affiliation(s)
- Stanley J Crankson
- Department of Surgery, King Abdulaziz Medical City-Riyadh, King Fahad National Guard Hospital, Kingdom of Saudi Arabia.
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134
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Bazaev AV, Petrov SV, Galanin IA, Zakharov AG. [Treatment of a patient with multiple intestinal fistulas complicated with migration of obturation device]. Khirurgiia (Mosk) 2006:61-2. [PMID: 16715989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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135
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Singh RB, Pavithran NM, Parameswaran RM, Sangwan K. Chronic jejuno-uterine fistula: an unusual cause for recurrent second trimester abortions. Aust N Z J Obstet Gynaecol 2005; 45:533-4. [PMID: 16401224 DOI: 10.1111/j.1479-828x.2005.00493.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Raghubir B Singh
- Department of Plastic Surgery, Pt. B.D. Sharma PGMIS, Haryana, India.
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136
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Stukavec J, Duchác V, Jirásek T. [Diverticulosis of the small intestine--the authors study group and a case review]. Rozhl Chir 2005; 84:589-91. [PMID: 16447576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Our case review describes an unusual case of an acute GIT haemorrhaging, caused by multiple diverticulosis of the proximal jejunum. The disorder is rare, rarely reported in literature worldwide. The typical course of the disease is asymptomatic, manifesting itself late as acute complications, most commonly urgent abdominal disorders. Chronic symptoms are less frequent, e.g. unspecific abdominal pain or occult haemmorhage. Inspired by literature data, the authors set up their own group of patients, who had been operated by the team for diverticles located in the small intestine, in the last 9 years.
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Affiliation(s)
- J Stukavec
- Chirurgická klinika Fakultní nemocnice Kráflovské Vinohrady a 3. LF UK, Praha
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137
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Mutoh M, Orii F, Okada Y, Yoshida A, Amizuka H, Matsumoto A, Taruishi M, Nenohi M, Kanda M, Saitoh Y. [A case of multiple jejunal diverticula causing massive bleeding]. Nihon Shokakibyo Gakkai Zasshi 2005; 102:1429-33. [PMID: 16318384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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138
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Hafen GM, Taylor AC, Oliver MR, Stokes KB, Rao P, Robertson CF, Ranganathan SC. Intussusceptions arising from two different sites in a child with cystic fibrosis. Pediatr Pulmonol 2005; 40:358-61. [PMID: 16015664 DOI: 10.1002/ppul.20246] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abdominal pain is common in individuals with cystic fibrosis (CF). We report on a 17-year old boy with CF and two recognized intussusceptions: the first colonic intussusception was presumed due to distal intestinal obstruction syndrome, and the second enteric one due to polypoid lesions containing heterotopic gastric mucosa. The presentation, pathology, management, and a literature review of intussusception in CF are discussed.
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Affiliation(s)
- Gaudenz M Hafen
- Department of Respiratory Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
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139
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Abstract
A 4-year-old Latino boy with a history of malrotation, nonobstructing annular pancreas, and a Ladd procedure during infancy presented with recurrent severe gastrointestinal tract bleeding. Investigations revealed a large mass in the proximal small bowel. At laparotomy, the proximal jejunal segment containing the mass was resected. Pathological examinations revealed a large intraluminal polyp composed of ectopic gastric mucosa. The patient presented 10 months later with recurrent bleeding, and subsequent laparotomy demonstrated a newly acquired segment of jejunal polyposis not present at the first operation. The case is presented, along with a plan of patient surveillance and a review of the pertinent literature.
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Affiliation(s)
- Juan Carlos Jimenez
- Division of Pediatric Surgery, University of California, Irvine, Orange, CA 92868, USA
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140
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Terryn F, Mabrut JY, Olagne E, Gignoux B, Garbit V, de La Roche E, Adham M, Gerard M, Souquet JC, Ducerf C, Baulieux J. [Gastrojejunocolic fistula, report of two recent cases with original management]. ACTA ACUST UNITED AC 2005; 130:491-4. [PMID: 16084484 DOI: 10.1016/j.anchir.2005.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2004] [Accepted: 04/27/2005] [Indexed: 11/26/2022]
Abstract
Gastrojejunocolic fistulae, ultimate complication of anastomotic peptic ulceration, are presently uncommon. We report two recent cases of postoperative gastrojejunocolic fistulas (after duodenal ulcer surgery and total duodenopancreatectomy), which were complicated at time of diagnosis (acute peritonitis and liver cirrhosis) and required a two-stage treatment.
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Affiliation(s)
- F Terryn
- Service de chirurgie générale digestive et de la transplantation hépatique, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
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141
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Orts JA, Morell L, Camps J, Traba ML, Belenguer A, Guerrero A. [Multiple enterolithiasis, coexisting with bladder and gallbladder lithiasis, associated with colon adenocarcinoma]. ACTA ACUST UNITED AC 2005; 22:227-30. [PMID: 16001938 DOI: 10.4321/s0212-71992005000500006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Enteroliths are calculi primarily formed in the intestine. Enterolithiasis is a rare condition frequently associated with intestinal stasis. Usually it causes no symptoms in most cases, but it can be an important diagnostic clue in patients presenting intestinal occlusive symptoms. We report a case of multiple enterolithiasis, very infrequent pathology, coexisting with bladder and gall bladder lithiasis in a patient with colon adenocarcinoma. Diagnosis was made by X-rays and CT images. Calculi were analysed by several methods: chemical, infrared spectroscopy, stereoscopic microscopy and atomic emission spectroscopy; they showed that caluli are made up of organic material and whilokita (calcium and magnesium ortophosphate). No risk factors for lithogenesis were found in this patient excluding the intestinal stasis caused by intestinal narrowing as a result of adenocarcinoma. Genetic factors are suggested as main contributors to hyperlithogenesis observed in this patient. The physiopathological conditions were studied in depth and literature about this subject reviewed.
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Affiliation(s)
- J A Orts
- Area de Diagnóstico Biológico, Hospital de la Ribera, Alzira, Valencia.
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142
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Brasoveanu V, David L, Buga I, Popescu I. [A rare cause of lower digestive hemorrhage--jejunal diverticulosis]. Chirurgia (Bucur) 2005; 100:369-72. [PMID: 16238201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Small bowel diverticula are usually asymptomatic and rare. Digestive bleeding is a rare complication of jejunal diverticulum whose diagnosis and treatment are difficult. We report a rare case of hematochezia whose origin was a proximal jejunal diverticulum and not determined by endoscopic investigations. Bowel resection with primary anastomosis was the chosen surgical procedure. There was no complication until discharge nor was any recurrent bleeding or functional disorder of the bowel reported during follow-up. The clinical presentation, the different value of diagnostic tools and the therapy are discussed.
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Affiliation(s)
- V Brasoveanu
- Centrul de Chirurgie Digestivă şi Transplant Hepatic, Institutul Clinic Fundeni
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143
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Costa G, Mancini R, Di Castro A, Capaldi M, Sciacca P, Ialongo P. [Perforated jejunal diverticulum: a rare cause of acute abdomen]. Chir Ital 2005; 57:521-5. [PMID: 16060194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Jejunal diverticulum is an uncommon, acquired condition, and the majority of patients are usually asymptomatic. Jejunal diverticula become clinically relevant when complications, such as diverticulitis, intestinal bleeding, obstruction, or perforation occur. A rare case of acute abdomen due to a perforated jejunal diverticulum is presented. The diagnosis was initially suggested by CT and confirmed intraoperatively when a 74-year-old male patient underwent a segmental jejunal resection with primary anastomosis. A review of the literature indicates the rarity of this condition, and therefore the aetiology, pathogenesis, diagnosis, and management are briefly discussed. An early diagnosis, based on ultrasonography and CT, and consequently prompt resection of the jejunum affected are the keys to a successful outcome. Because a longer duration of symptoms before operation correlates with a worse prognosis, the possibility of a clinical diagnosis of perforated jejunal diverticulum should be entertained as part of any evaluation of acute abdomen, especially in the elderly.
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Affiliation(s)
- Gianluca Costa
- UOC Chirurgia Generale, Urgenza e Pronto Soccorso, DEA, Azienda Ospedaliera San Camillo-Forlanini, Roma
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144
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Kornprat P, Langner C, Mischinger HJ. Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report. Wien Klin Wochenschr 2005; 117:297-9. [PMID: 15926622 DOI: 10.1007/s00508-004-0277-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. Intestinal obstruction due to enterolithiasis is uncommon. We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. On physical examination, there was discomfort on palpation of the upper abdomen. Laboratory tests revealed mild elevation of leucocytes and C-reactive protein. CT scan demonstrated dilatated loops of proximal jejunum with thickening of the wall, suggesting ingestion of a foreign body. Clinical and radiological findings did not indicate conservative therapy; our patient underwent minilaparotomy, and pronounced jejunal diverticulosis was identified. An enterotomy was performed and a cylindrical enterolith, 10cm long and 3cm in diameter, was removed. The operative and postoperative course was uneventful. Enterolithiasis must be considered as a potential source of intestinal obstruction. The differential diagnosis should take gallstone ileus and ingestion of a foreign body into consideration. Initial therapy is nonoperative; if this management fails, surgery is indicated.
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Affiliation(s)
- Peter Kornprat
- Division of General Surgery, Department of Surgery, University Medical Center, Graz, Austria.
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145
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Affiliation(s)
- Sophie Aalaei
- Department of Pathology, Rush University Medical Center, Chicago, Ill 60612, USA.
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146
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Higgins PDR, Umar RK, Parker JR, DiMagno MJ. Massive lower gastrointestinal bleeding after rejection of pancreatic transplants. ACTA ACUST UNITED AC 2005; 2:240-4; quiz 1 p following 244. [PMID: 16265207 DOI: 10.1038/ncpgasthep0175] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 04/06/2005] [Indexed: 11/08/2022]
Abstract
BACKGROUND This article highlights two cases of massive lower gastrointestinal bleeding in patients on dialysis after rejection of kidney-pancreas transplants. Patient 1 was a 34-year-old female with 27 years of type I diabetes, who had a kidney-pancreas transplant in 1996, which was complicated by rejection of the kidney and pancreas in 2000 and 2002, respectively. Later in 2002, she presented in shock after experiencing cramping abdominal pain and passage of large bloody stools. Patient 2 was a 38-year-old male with 26 years of type I diabetes, who had a pancreas-kidney transplant in 1998, which was complicated by rejection of the kidney and pancreas in early 2003. He presented in late 2003 with a single episode of coffee-ground emesis and two episodes of brisk hematochezia. INVESTIGATION Arterial angiography. DIAGNOSIS Pseudoaneurysm and small-bowel fistula from the arterial supply to the transplanted pancreas. MANAGEMENT Angiographic embolization of the aneurysmal vessel and fistula achieved hemostasis. Patient 1 did not have her transplanted organ surgically removed and suffered a recurrent massive lower gastrointestinal bleed that proved fatal. In Patient 2, subsequent surgery and removal of the rejected pancreas was performed and the patient continues to do well.
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Affiliation(s)
- Peter D R Higgins
- Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
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147
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Mathew AT, Zacharias P, Ponnambathayil S, Kumar A, Madhavan L, Harris M, Ramakrishnan KG, Bhagyanathan PV. Massive gastrointestinal bleeding in a patient with AIDS. Natl Med J India 2005; 18:76-7. [PMID: 15981442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Cytomegalovirus enteritis can lead to gastrointestinal bleeding in patients with the acquired immune deficiency syndrome. The commonest site of involvement is the colon, followed by the stomach and terminal ileum. Most of these lesions can be diagnosed by colonoscopy or gastroscopy. We present our experience of a patient with cytomegalovirus infection involving only the proximal jejunum causing massive lower gastrointestinal bleeding. Conventional endoscopy and imaging had failed to locate the source of bleeding. Enteroscopy performed at the time of laparotomy showed an ulcerated lesion in the jejunum. Resection followed by histological examination of the resected area confirmed the diagnosis of cytomegalovirus infection. In addition to highly active antiretroviral therapy, ganciclovir was given for 14 days in a dose of 5 mg/kg twice a day and tapered over a period of 3 months. There has been no further episode of gastrointestinal bleeding over a follow up of 9 months.
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Affiliation(s)
- A T Mathew
- Malabar Institute of Medical Sciences, Mini Bypass Road, Govinthapuram, Calicut 673016, Kerala, India.
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148
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Abstract
A recently dead adult female European brown hare (Lepus europaeus Pallas) was found in the wild with no evidence of trauma or external injury. Necropsy revealed symptoms consistent with endotoxic shock and a haemorrhagic jejuno-jejunal intussusception with a necrotic intussusceptum. Small, unattached nodules were present extensively in the jejunal lumen and within the intussuscipiens. These nodules proved to be masses of unsporulated Eimeria leporis oocysts. Review of the literature reveals E. leporis to be a common parasite of wild hares, with protracted pathogenic potential under some circumstances. This is the first report of intussusception in this species and the most severe lesion seen associated with E. leporis. This case suggests that E. leporis may be more harmful to the wild European brown hare population than previously supposed.
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Affiliation(s)
- C R McCulloch
- Department of Pathobiology, Institute of Parasitology and Zoology, University of Veterinary Medicine Vienna, Veterinärplatz 1, A-1210 Vienna, Austria.
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149
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Vijayaraghavan R, Sujatha Y, Santosh KV, Belagavi CS. Inflammatory fibroid polyp of jejunum causing jejuno-jejunal intussusception. Indian J Gastroenterol 2005; 23:190-2. [PMID: 15599009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Intussusceptions originating in the jejunum are rare. We report a 20-year-old woman who had a chronic jejuno-jejunal intussusception due to an inflammatory fibroid polyp manifesting in the post-partum period as peritonitis. Resection-anastomosis of the intussuscepted segment was done. She is well one year later.
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Affiliation(s)
- R Vijayaraghavan
- Departments of Laparoscopic Surgery, Raj Mahal Vilas Hospital, Sanjaynagar, Bangalore-560 094, India.
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150
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