Bowel Infarction Research Articles

Traumatic Abdominal Wall Hernia, often missed diagnosis in blunt trauma and delayed elective repair: A Case Report

Background: Traumatic Abdominal Wall Hernia (TAWH) is a rare type of hernia following blunt abdominal trauma that can easily missed. Always have high clinical suspicion following blunt trauma. Ultrasound scans and CT scans are particularly useful investigation to diagnose TAWH and associated abdominal injuries. Surgical repair is the definitive management of TAWH. Case description: This report presents a case of a 57-year-old male who presented abdominal wall hernia following blunt trauma to the abdomen and the diagnosis and management of TAWH. Conclusion: The timing of surgery depends on the concomitant injury. Delayed elective repair may be safe and cause less postoperative complications in stable patients. Delayed repair carries the risk of bowel incarceration and strangulation.

Congenital trans-mesentric internal hernia: a rare cause of acute intestinal obstruction in adult

Introduction and Importance: Internal hernia is responsible for 0.6–5.8% of all small intestinal obstructions. Only 8% of internal hernias are of the congenital trans mesenteric variant. Urgent surgical intervention should be considered in individuals who exhibit intestinal obstruction before the development of irreversible bowel ischemia and necrosis. Case Presentation: The authors report a 38-year-old male patient who presented to the emergency department with abdominal pain, distension, and vomiting for the last three days. After an explorative laparotomy, it was confirmed that there was a trans mesenteric hernia defect with strangulated distal ileal loops. End-to-end ileo-ileal anastomosis was done. Clinical Discussion: Early recognition and subsequent surgical treatment permit proper management and prevent complications. There should be a differential diagnosis. In this case, there is no prior history of abdominal surgery, and the patient presents with recurrent abdominal pain and intestinal obstruction. Conclusion: Early diagnosis and emergency laparotomy can save the intestine before gangrene, lowering morbidity and mortality, correcting the mesenteric defect to prevent recurrences, and enhancing clinical outcomes because many studies have shown that some cases are missed before radiological investigation. Laparotomy is still the method of choice for acute cases of incarceration with bowel obstruction, strangulation, and ischemia. The entire mesentery needs to be evaluated, and all mesenteric defects need to be sutured to prevent recurrence.

Hemoperitoneum Due to Dissection and Rupture of the Superior Mesenteric Artery in a Patient With COL3A1 Mutation.

Introduction: Vascular Ehlers-Danlos syndrome (vEDS) is an autosomal dominant disorder that results from mutations in the collagen type III gene. It is a risk factor for medium-sized artery aneurysms, dissections, and ruptures. We report a case of hemoperitoneum due to medial dissection and rupture of the superior mesenteric artery related to vEDS. Methods: A full body CT scan and full three cavity autopsy was performed in a 47-year-old man with a history of an intermittent abdominal cramping for one week rand complex past medical history that included a sigmoid bowel perforation at age 20, and previous popliteal artery pseudoaneurysm rupture. Histology and genetic testing were performed. Results: The postmortem computed tomography and autopsy showed a significant hemoperitoneum due to a ruptured dissection of the superior mesenteric artery and branches, and multiple splanchnic artery dissections with renal and small bowel infarctions. Genetic testing revealed a heterozygous COL3A1 gene variant associated with Ehlers-Danlos syndrome. Death was attributed to hemoperitoneum due to medial dissection and rupture of the superior mesenteric artery due to arteriopathy. Discussion: The relatively young age and medical history correlate with the autopsy findings and genetic testing towards the conclusion of an arteriopathy consistent with vEDS.

EP592 - A surgical case report of an epiploic hernia - A mobile right colon herniating through the foramen of Winslow

Abstract Introduction An Epiploic Hernia is an extremely rare type of abdominal hernia with <0.1 % incidence where the bowel or other intra-abdominal contents herniate through the Foramen of Winslow. A case of an Epiploic hernia in a middle-aged female is presented here. Presentation of case A woman in her 60s was admitted to a tertiary level hospital with severe right sided intermittent upper abdominal pain associated with nausea, bloating and constipation. The symptoms were thought to be due to biliary colic and managed conservatively. Since the symptoms persisted and a computed tomography scan of abdomen was organized. CT scan showed that the caecum was in the upper left quadrant. A laparoscopy was performed and demonstrated that her right colon was mobile herniating through the Foramen of Winslow into the lesser sac. The hernia was reduced, and the bowel was viable. The patient was discharged with no complications. Discussion There have been case reports of small bowel as the content of the hernia with lesser occurrences of caecum, ascending colon, transverse colon, gall bladder, omentum, or Meckel's diverticulum. A caecal herniation through the Foramen of Winslow is reported only with an incidence of 0.02 %. <10 % of these Epiploic hernias are diagnosed preoperatively making it a potentially life-threatening condition if not treated promptly due to high risk of bowel strangulation and mortality of up to 50 %. Conclusion A high index of suspicion is needed for the diagnosis of this internal hernia and radiological investigation is fundamental in making this diagnosis for allowing prompt surgical treatment.

Neuropsychiatric involvement in systemic lupus erythematosus contributes to organ damage beyond the nervous system: a post-hoc analysis of 5 phase III randomized clinical trials

ObjectiveTo investigate the association between neuropsychiatric systemic lupus erythematosus (NPSLE) and SLICC/ACR damage index (SDI) items, especially non-neuropsychiatric items.MethodsBaseline data from five phase III trials (BLISS-52, BLISS-76, BLISS-SC, BLISS-NEA, EMBRACE) were analysed. NPSLE involvement was defined as NP BILAG A/B/C/D (n = 272); NP BILAG E denoted non-neuropsychiatric SLE (n = 3273). We employed multivariable logistic regression analysis adjusting for age, sex, disease duration, and ethnicity.ResultsThe median (IQR) and mean ± SD SDI scores were 0 (0–1) and 0.62 ± 1.09. Compared with the non-neuropsychiatric SLE group, NPSLE patients were more likely to develop damage (adjusted (a)OR = 2.86; 95% CI = 2.28–3.59). This held true also after suppression of the NP SDI items (aOR = 1.70; 95% CI = 1.36–2.12). Beyond the neuropsychiatric domain, NPSLE was associated with damage in the cardiovascular (aOR = 2.63; 95% CI = 1.75–3.95), musculoskeletal (aOR = 1.90; 95% CI = 1.43–2.52), and skin (aOR = 1.54; 95% CI = 1.06–2.22) SDI domains. Dissecting domains into items, NPSLE was associated with coronary artery disease (aOR = 3.08; 95% CI = 1.44–6.58), myocardial infraction (aOR = 3.11; 95% CI = 1.54–6.27), muscle atrophy (aOR = 3.34; 2.16–5.16), scarring alopecia (aOR = 1.79; 95% CI = 1.19–2.70), bowel infarction (aOR = 1.98; 95% CI = 1.20–3.26), retinopathy (aOR = 2.23; 95% CI = 1.15–4.32), and premature gonadal failure (aOR = 2.10; 95% CI = 1.11–3.90).ConclusionThe intricate association between NPSLE and damage accrual extends beyond the nervous system to also comprise the musculoskeletal, skin, and cardiovascular organ systems.

Rectal Artery Embolization for Acute Uncontrollable Rectal Bleeding: Case Series and Systematic Literature Review

Purpose: The article aims to evaluate the possibilities of transcatheter arterial embolization (TAE) as a method of hemostasis in inoperable, life-threatening rectal cancer bleeding by embolizing rectal arteries related to the tumor. Materials and Methods: Using PubMed, Embase, Web of Science, and Cochrane Library, a systematic literature review following the PRISMA 2020 guidelines was performed on October 26, 2023. The search focused exclusively on patients with bleeding rectal cancer controlled by TAE. In addition, in alignment with the PROCESS 2016 guidelines, we describe three patients who underwent transcatheter embolization of the rectal arteries for rectal cancer bleeding from Surgery Department No.2, admitted to the Municipal Saint Trinity Hospital, in Moldova, Chisinau, over the period 2020-2023. Results: Out of 4,958 articles identified, 89 were included for analysis, and only nine were relevant to the topic addressed. In total, 33 cases of rectal cancer bleeding controlled by the rectal artery embolization (RAE) approach were found. Technical success was achieved in 32 out of 33 patients. Technical failure was encountered in one patient due to a practical shortfall in advancing the microcatheter to the source of bleeding. The most frequently embolized artery was the superior rectal artery (in 22 patients). Bleeding control was achieved in 24 patients from the first attempt. Recurrent bleeding was observed in nine patients who successfully responded to repeated RAE. There was no evidence of bowel infarction, and the procedure was well tolerated, in general. Conclusions: The present review and case presentation of patients who underwent endovascular approaches to treat rectal cancer bleeding showed that rectal artery embolization is a safe and feasible procedure, with a high technical success rate.

Effective Management of Ileocecal Hemorrhage with Super-Selective Arterial Embolization: A Case Study

Background: Acute colonic bleeding, including rectal bleeding and melena, affects approximately 36 per 100,000 people annually, with a higher incidence in the elderly. Effective management requires prompt diagnosis and intervention, especially for severe cases characterized by persistent bleeding and significant decreases in hemoglobin levels. Traditional therapeutic options include pharmacologic therapy, endoscopic coagulation, transcatheter therapy, and surgery. While percutaneous embolization is established for upper GI bleeding, its effectiveness for lower GI bleeding remains debated due to concerns over potential intestinal infarction. Methods: We present a case of a 31-year-old female with a history of severe mitral regurgitation and chronic atrial fibrillation who underwent mitral valve replacement. Post-operatively, she developed black tarry stools indicative of lower GI bleeding. Initial treatments, including proton pump inhibitors, tranexamic acid, and vitamin K, were ineffective. Gastroscopy and colonoscopy showed no active bleeding, but abdominal CT revealed contrast extravasation at the ileocecal junction, likely from the ileocolic artery. Super-selective arterial embolization was performed using a 6 Fr femoral sheath and microcatheter (2.7 Fr) with non-spherical polyvinyl alcohol (nsPVA) particles (355-500 μm) to target the bleeding source. Results: The embolization successfully halted hematochezia with no signs of peritonitis or mesenteric infarction. Post-procedure, the patient was discharged after 4 days with no abdominal pain or readmission for complications. Conclusion: Super-selective arterial embolization is a safe and effective method for managing lower GI bleeding, with no observed intestinal infarction in this case. This approach demonstrates the feasibility of embolization in controlling severe colonic hemorrhage, potentially offering a viable alternative to more invasive procedures while minimizing the risk of bowel ischemia.

Contemporary Bridge to Heart Transplantation With Venoarterial Extracorporeal Membrane Oxygenation.

Objective: In October 2018, the United Network for Organ Sharing changed their heart allocation criteria to prioritize patients on temporary mechanical circulatory support. This study assesses outcomes of patients bridged to orthotopic heart transplantation (OHT) with venoarterial extracorporeal membrane oxygenation (VA ECMO) since this change. Methods: We conducted a retrospective single-center study of adults (≥18 years) supported with VA ECMO at the time of OHT (October 1, 2018, to December 31, 2021). The primary outcome was midterm survival. Results: During the study period, 117 patients underwent OHT including 52 adults ≥18 years (44%) and 65 children <18 years (56%). Among adults, 8 (15%) were supported with VA ECMO at the time of OHT and are included in this study; 75% were male (n = 6), and the median age was 52.5 (interquartile range [IQR] = 23.5 to 57.25) years. Most patients were peripherally cannulated (75%, n = 6) and supported with an intra-aortic balloon pump during the pretransplant period (87.5%, n = 7). The median ECMO duration was 7 (IQR = 4.5 to 25.25) days. Three patients experienced complications on ECMO (37.5%), including thromboembolic bowel infarction (12.5%, n = 1) and bleeding requiring reintervention (25%, n = 2). All patients survived to discharge without posttransplantation complications and were alive at the latest follow-up. The median follow-up time was 24.8 (IQR = 19.5 to 28.2) months. Conclusions: Patients can be successfully bridged with VA ECMO directly to OHT with excellent midterm results. Key contributors to our outcomes include early extubation, use of bivalirudin over heparin, ambulation, and rehabilitation while on ECMO.

Don't be thrown for a loop: a review of internal hernias for the abdominal imager.

Internal hernias are herniations of abdominal viscera, usually small bowel, through congenital or acquired openings of the peritoneum or mesentery. Congenital hernias may involve anatomic fossae such as the epiploic foramen as well as those related to abnormal peritoneal or mesenteric defects; these include left and right paraduodenal, transomental, transmesenteric, pericecal and broad ligament hernias. Acquired hernias are due to defects in the mesentery or peritoneum, usually resulting from prior surgeries, and include those associated with Roux-en-Y surgery as well as colorectal cancer resections. Internal hernias account for 5.8% of small obstructions. Obstructed internal hernias are considered surgical emergencies due to the high risk of bowel strangulation. This review summarizes the various types of congenital and acquired internal hernias, their relevant anatomy, embryology, associated surgical history and imaging appearance. We will also discuss a location-based approach to identifying internal hernias on CT, as well as complications and relevant signs, of which abdominal imagers should be vigilant.

Recanalization of port-superior mesenteric vein thrombosis with long-term anticoagulant therapy after failed early anticoagulant therapy

BackgroundAnticoagulant therapy with heparin is the first-line treatment for acute mesenteric vein thrombosis and is effective in improving outcomes. Conversely, patients with failed early anticoagulant therapy occasionally develop bowel infarction requiring surgery. The efficacy of long-term anticoagulant therapy on recanalizing mesenteric vein thrombosis in patients with failed early anticoagulant therapy remains unclear. Herein, we report a patient who achieved recanalization of port-superior mesenteric vein thrombosis treated with anticoagulant therapy for 10 years after failed early anticoagulant therapy, followed by bowel resection.Case presentationA 38-year-old male patient visited an outpatient clinic due to acute exacerbation of abdominal pain that had persisted for a month. He was diagnosed with port-superior mesenteric vein thrombosis on contrast-enhanced computed tomography (CT) scan and was transferred to our institution. Although he presented with abdominal pain, his respiration and circulation were stable upon hospital arrival. Anticoagulant therapy with heparin was started, and the patient was admitted to the intensive care unit. However, the patient’s abdominal pain worsened, and he began to develop signs of peritonitis. Repeat CT scan revealed bowel infarction. Thus, the patient underwent bowel resection 6 h after admission. The initial surgery was completed with open abdomen management. Bowel anastomosis was performed on the second-look surgery on the first postoperative day. Finally, the abdomen was closed on the third postoperative day after confirming the absence of bowel ischemia progression. The patient had prolonged impaired bowel function with paralytic ileus, but was discharged on the 60th postoperative day. He was then diagnosed with protein C and S deficiency based on the tests performed. Anticoagulant therapy with warfarin was initiated. He also received anticoagulant therapy in the outpatient setting. The patient’s port-superior mesenteric vein thrombosis had improved gradually with warfarin during the follow-up period. At 10 years after surgery, total occlusion of the port-superior mesenteric vein was recanalized with improvement of the portal collateral vessels. In addition, no gastric or esophageal varices were observed.ConclusionsLong-term anticoagulation therapy could affect the recanalization of extensive thrombus in multiple segments in patients with mesenteric venous thrombosis.

Current concepts in the management of non-cirrhotic non-malignant portal vein thrombosis.

Non-cirrhotic non-malignant portal vein thrombosis (NCPVT) is an uncommon condition characterised by thrombosis of the portal vein, with or without extension into other mesenteric veins, in the absence of cirrhosis or intra-abdominal malignancy. Complications can include intestinal infarction, variceal bleeding and portal biliopathy. In this article, we address current concepts in the management of NCPVT including identification of risk factors, classification and treatment, and review the latest evidence on medical and interventional management options.

An unusual cause of adult transverse colonic intussusception with obstruction: Multiple large submucosal lipomas in a 50-year-old male

Intussusception is a gastrointestinal condition that predominantly affects the pediatric population. Although uncommon, it can occur in adults and is typically due to a pathological lead point that causes telescoping of the intestine during peristalsis. In this case, a 50-year-old male presents with abdominal pain, distension, diarrhea, and unintentional weight loss, which was revealed to be caused by intussusception that originated at a cluster of submucosal lipomas in the transverse colon. This patient had recently immigrated to the U.S. from Africa, and had missed his colorectal screening, which is recommended at age 45 for every person. It is crucial to accurately screen for, diagnose, and surgically treat this condition to prevent downstream complications such as bowel infarction or perforation.

Paraduodenal Hernia (PDH ): A Rare Cause of Abdominal Pain

An internal hernia is the protrusion of a viscus through a normal or abnormal opening within the confines of the abdominal cavity. Paraduodenal hernias result from incomplete rotation of the midgut, with part of the small intestine trapped posterior to the mesocolon. Right and left paraduodenal hernias are distinct and separate entities, varying not only in anatomic structure but also in embryological origin. Symptoms are often vague, and a high index of suspicion is required to make the diagnosis. This entity should be considered whenever atypical abdominal symptoms are present. A CT scan or barium upper gastrointestinal radiography provides the best preoperative evidence of this condition, although ultrasonography and plain films are also useful. Elective repair of such a hernia should always be performed to avoid bowel incarceration or strangulation. An understanding of the anatomy of these hernias facilitates the surgery and is necessary in decreasing the likelihood of complications. Careful reduction of the hernia and surgical repair will avoid injury to the major mesenteric vessels juxtaposed to the hernial orifice. The surgical management of the patient, who were diagnosed preoperatively with this condition, is described with a review of its pathogenesis and present surgical treatment.

Portal Vein Thrombosis: State-of-the-Art Review.

Background: Portal vein thrombosis (PVT) is a rare disease with an estimated incidence of 2 to 4 cases per 100,000 inhabitants. The most common predisposing conditions for PVT are chronic liver diseases (cirrhosis), primary or secondary hepatobiliary malignancy, major infectious or inflammatory abdominal disease, or myeloproliferative disorders. Methods: PVT can be classified on the basis of the anatomical site, the degree of venous occlusion, and the timing and type of presentation. The main differential diagnosis of PVT, both acute and chronic, is malignant portal vein invasion, most frequently by hepatocarcinoma, or constriction (typically by pancreatic cancer or cholangiocarcinoma). Results: The management of PVT is based on anticoagulation and the treatment of predisposing conditions. The aim of anticoagulation in acute thrombosis is to prevent the extension of the clot and enable the recanalization of the vein to avoid the development of complications, such as intestinal infarction and portal hypertension. Conclusions: The treatment with anticoagulant therapy favors the reduction of portal hypertension, and this allows for a decrease in the risk of bleeding, especially in patients with esophageal varices. The anticoagulant treatment is generally recommended for at least three to six months. Prosecution of anticoagulation is advised until recanalization or lifelong if the patient has an underlying permanent pro-coagulant condition that cannot be corrected or if there is thrombosis extending to the mesenteric veins.

Modern diagnostic methods for early assessment of the abdominal involvement in Schönlein-Henoch disease.

Schönlein-Henoch disease is a small vessel vasculitis resulting from IgA-mediated inflammation. It is the most common acute systemic vasculitis in childhood, mainly affecting the skin, gastrointestinal tract, joints, and kidneys. Although the prognosis of Schönlein-Henoch is generally good, gastrointestinal tract involvement is a potential complication, presenting as massive gastrointestinal bleeding, bowel infarction, perforation, as well as intussusception and peritonitis.

An inguinal surprise: strangulated femoral hernia

Femoral hernias account for 2% to 4% of groin hernias, are more common in women, and are more appropriate to present with strangulation and require emergency surgery. This condition may lead to symptoms of bowel obstruction or strangulation and possible bowel resection-anastomosis. There are few reports of strangulated femoral hernia. Femoral hernias, often, are usually delegated to a secondary differential or if even rarer not considered at all during dubious presentations as groin swellings which are irreducible without the classical features which have usually been described in our surgical literatures, Inguinal being forefront for diagnosis. We herein present a 45-year-old female had come to the outpatient department at MVJ MC and RH with the complaints of swelling in the left groin for 5 years and pain for 8 days sudden onset with irreducibility, with no features of small bowel obstruction. She was diagnosed as having a left side obstructed inguinal hernia after appropriate radiological investigations and underwent inguinal exploration. Intraoperative diagnosis of left sided strangulated femoral hernia with omentum as its content was made. Omentectomy with herniorrhaphy was done and post-operative period was uneventful, and patient was discharged with regular follow up. Femoral hernias are more common in women and lead to a substantial over risk for an emergency operation, and consequently, a higher rate of bowel resection and mortality. Femoral hernias should be operated with high priority to avoid incarceration and be repaired with a mesh.

Emergency transabdominal preperitoneal (TAPP) repair of a strangulated obturator hernia: A literature review and video vignette.

Obturator hernia (OH), a rare and potentially life-threatening condition, presents diagnostic and therapeutic challenges. This review article comprehensively delves into the clinical features, diagnosis, and management of OH, with a particular emphasis on the pivotal role of computed tomography (CT) in timely and accurate diagnosis. Delays, particularly in contrast-enhanced CT, dramatically increase mortality due to potential bowel strangulation. To illustrate the challenges and complexities surrounding OH, we present a video vignette of a 74-year-old female patient who presented with symptoms suggestive of bowel obstruction (BO) secondary to a strangulated left-sided OH. This patient case complements the theoretical framework established in the review, serving as a practical example for healthcare professionals. Her presentation included abdominal pain, absence of flatus and bowel movements, and abdominal distension. Laboratory tests demonstrated a mildly elevated white blood cell count and C-reactive protein. CT imaging confirmed the diagnosis of a strangulated OH with an ischemic small bowel. An emergency laparoscopy was undertaken, and the hernia was repaired using the transabdominal preperitoneal approach. A portion of the ischemic small bowel was resected through a 5-cm extension of the umbilical port, and an anastomosis was performed using a modified Barcelona technique. The surgery was successfully completed without immediate or long-term complications. This case highlights the crucial role of timely CT diagnosis and minimally invasive surgical management in achieving improved outcomes in acute BO secondary to OH, particularly when facilitated by pre-operative CT planning.

Asymptomatic Intestinal Ischemia Secondary to Thrombosis of the Spleno-Mesenteric Portal Axis: Usefulness of Laparoscopic Approach for Diagnosis and Therapeutical Decisions—Case Report and Review of the Literature

Mesenteric Venous Thrombosis (MVT) is a rare but often lethal form of ischemia. The diagnosis may be difficult for the clinician due to its mild symptoms with a great discrepancy between the pain suffered by the patients and the clinical observation. The non-specificity of the laboratory tests and the challenge in computed tomography (CT) scan in distinguishing when an ischemia is occurring lead to the risk of an unrecognized diagnosis, especially considering that an early onset of treatment is largely fundamental for better outcomes. Also, the choice between the surgical approach and the anticoagulation may be a pitfall for the clinicians. The treatment choice requires a multidisciplinary approach. Emergency exploration by laparoscopy allows clinicians to reach the correct diagnosis and the real-time assessment of the intestinal infarction extension, playing a double diagnostic and therapeutic role in those doubtful and tricky cases. Here, a 77-year-old male with a completely asymptomatic bowel ischemia secondary to a Mesenteric Venous Thrombosis was submitted to a laparoscopic approach.

Incisional hernias following robotic-assisted laparoscopic prostatectomy: does the extraction site matter?

The incidence of incisional hernia (IH) following robotic-assisted laparoscopic prostatectomy (RALP) varies widely within the literature (0.4-9.7%). Whilst small hernias may go unnoticed, the potential exists for bowel strangulation and subsequent emergency surgery. We suggest that the extraction site may influence the rate of IH. A retrospective chart review of a single surgeon RALP series was undertaken. One hundred charts were sampled, of which 69 had sufficient data to be analysed. Prior to July 2017, specimen extraction had been via the supra-umbilical port site. After this time, specimens were extracted via a Pfannenstiel incision. Of the 69 patients, 24 underwent RALP prior to July 2017. Three patients developed IH at the supra-umbilical port extended for extraction site in the pre-2017 group and three patients developed IH at the supra-umbilical port (not extraction) site in the post-2017 group. The rate of IH was almost double in the pre-July 2017 group (12.5% vs. 6.7%). No patient developed an incisional hernia at the Pfannenstiel site in the post-2017 group. In our series, no patient developed a hernia at the Pfannenstiel site. This is in keeping with the reported < 1% IH rate following Pfannenstiel specimen extraction. Given that incisional hernias are a known complication of robotic surgery, thought should be given to changing the site of specimen extraction site to lower the rate of incisional hernias and the morbidity associated with such.

​​The Frequency of Gangrenous Infarction of Intestine in Patients Undergoing Intestinal Resection at Tertiary Care Hospital, Rawalpindi

Gangrenous bowel or dead bowel most often occurs as a result of hernia, adhesions, and mesenteric insufficiency. Intestinal gangrene due to acute mesenteric vascular events requiring surgery is one of the most common surgical emergencies at tertiary care hospitals. Objective: To determine the frequency of gangrenous infarction in patients undergoing intestinal resection at a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in the Department of Surgery and Pathology, Rawalpindi, Pakistan. A total of 140 resected intestinal specimens were included in this study. Data were entered and analyzed using SPSS v. 23. o. Descriptive statistics were applied and a P-value &lt;0.05 was taken as statistically significant. Results: Out of 140 samples, clinical specimens from 30(21.4%) patients were found to be gangrenous. The frequency of gangrene was slightly higher in females 16 (53.3%) as compared to males 14 (46.7%) with a peak of 19 patients (63.3%) in the age group of 31 to 60 years and mostly affecting the small intestine 21 (70%). Among the total of 110 (78.6%) non-gangrenous specimens; mild inflammatory changes, perforation, ulceration, tumors, mucosal and mural infarction, infection, reactive hyperplasia, and autolytic changes were noted. Conclusions: The frequency of intestinal gangrene is much higher in our population than in most regions of the world, slightly more common in females as compared to males with a peak in the age group of 31 to 60 years and mostly involving the small intestine, indicating negligence towards this important problem.