Case Of Acute Bowel Obstruction Research Articles

INVAGINATION INTESTINALE AIGUË DE L’ADULTE : ASPECTS DIAGNOSTIQUES, THERAPEUTIQUES A PROPOS DE SEPT CAS DIAGNOSTIQUES AU CHU DE L’AMITIE SINO-CENTRAFRICAINE DE BANGUI, RCA

Objective: To report the diagnostic and therapeutic difficulties of acute intussusception in adults in Bangui, Central African Republic. Patients and method: It was a retrospective descriptive study carried out in the general surgery department of Friendship Sino Centrafricaine University Hospital in Bangui. The reported data run from January 2019 to June 2023. It focuses on the records of adult patients of both sexes who underwent exploratory laparotomy for a bowel obstruction in which intussusception was diagnosed. Results: Intussusception accounted for 1.03% (N:7) of the 674 cases of acute bowel obstruction operated during the period. The mean age of patients was 32.8 years ± 9.7. Male subjects accounted for 57.14% (sex ratio = 1.33). At admission, five patients had occlusive syndrome and the other two had prolapse of a mass through the anus. Laparotomy was used to diagnose intussusception in all cases. These were ileo ileal intussusception (57.1%), ileocecal (14.3%), colo-colic profunated by the anus (14.3%) and ileo-caeco-colic profunted by the anus (14.3%). Surgical procedures consisted of hail resection followed by termino-terminal anastomosis (42.8%), hail resection followed by ileocolic anastomosis (28.6%) and colonic resection, colostomy and restoration of delayed digestive continuity (28.6%).The histopathological study of the operating rooms had found chronic inflammation of the colonic mucosa (28.6%), colonic adenocarcinoma (14.3%), and adenomatous polyp (14.3%). In 3 patients aged 18, 22, and 29 years respectively no cause was found (42.8%). The postoperative follow-up was simple in all operated patients. Conclusion: Intussusception is a rare condition in adults. The diagnosis is often difficult and made on laparotomy. Practitioners' attention should be drawn to prolapsed masses in the anus in adults.

Colo-Colic Invagination on Lipoma

Intussusception in adults is rare and accounts for 1% to 5% of cases of acute bowel obstruction. Moreso, colic intussusception remains exceptional in adults and is usually secondary to an endoluminal lesion. Abdominal intestinal lipomas are rarely responsible for colonic invagination. They are often located on the caecum or the ascending colon and rarely on the left colon. We report the case of colo-colic invagination on a descending colon lipoma in a 50-year-old woman.

TEXTILOME ENDOLUMINALE : UNE CAUSE RARE D’OCCLUSION INTESTINALE AIGUË

Acute bowel obstruction by transmural migration of retained surgical sponge is rare. Diagnosis is difficult. It most often gives a presentation of bowel obstruction or intestinal fistula. We report a case of acute bowel obstruction by transmural migration of retained surgical sponge consecutive to caesarean section. It was a 26 years old-women, IIGIIP, with a history of two caesarean sections. It was received 3 months after cesarean for bowel obstruction. In biology, there was leukocytosis 20,000/mm3. Surgical exploration by laparotomy showed intestinal obstruction by endoluminal glossipoboma at the ileum. Bowel esection and end-to-end anastomosis was performed. The postoperative course was uneventful.

Abdominal actinomycosis: A report on two cases of acute bowel obstruction in males

Abdominal actinomycosis: A report on two cases of acute bowel obstruction in males

Acute Bowel Obstruction Due to Endometriosis Treated With Colonic Stent

Introduction: Endometriosis is defined as the presence of extrauterine endometrium. It affects up to 8% of premenopausal women. Intestinal involvement is the most common extrapelvic site, affecting 5.4% of women with endometriosis, and out of which rectosigmoid endometriosis comprises 90%. Endometriosis is an extremely rare cause of large bowel obstruction. Urgent surgical intervention carries high morbidity and mortality, and operative intervention can be more difficult in extensive pelvic endometriosis. Less invasive alternatives can be considered in this situation. Case Report: A 35-year-old female presented with 2 weeks of progressive abdominal pain, nausea, and constipation. She denied hematochezia and reported no other gastrointestinal problem. She was afebrile, hemodynamically stable, and in moderate distress due to abdominal pain. Abdomen was diffusely tender, distended, and bowel sounds were present. Rectal exam revealed no abnormality. WBC count was 15 K. CT abdomen showed distended large bowel and colonic obstruction due to distal sigmoid colon stricture. A discrete mass was not seen. Colonoscopy showed tight colonic stricture with sharp angle at 18 cm above dentate line, unable to pass endoscope. The edge of the stricture was biopsied. A guide wire was advanced into the dilated colon proximal to stricture. Contrast injection revealed a 2.5-cm-long stricture. A 2.5-cm x 8-cm uncovered stent was deployed after consulting with the surgical team. Pathology showed benign edematous colonic mucosa. She did well for 2 days with scant semi-formed stools, but her symptoms got worse, and she ultimately underwent surgery. Upon initial inspection of bowel during surgery, the cecum and sigmoid colon were very dilated. The cecum was ischemic in appearance with splitting of the serosa in several areas. There was a hard, obstructing lesion in the proximal rectum, just distal to the confluence of tenia. The proximal sigmoid was resected. The initial surgical impression was diverticular disease, but pathology revealed extensive sigmoid colon endometriosis. Discussion: It is very rare to have endometriosis leading to bowel obstruction without any prior symptoms or history of endometriosis. This is the second reported case of acute bowel obstruction treated initially with colonic stent. Colonic stenting is currently widely used in malignant obstruction. The use of self expanding metallic stents to treat benign conditions is controversial; however, due to associated long-term complications. This case demonstrates that stenting can provide a bridge to major surgery in the rare event of acute endometriotic colonic obstruction. The initial treatment with stent can provide time to prepare and medically optimize the patient for surgery.

Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

Colo-colonic intussusception in an adult: an unusual presentation of perforated diverticulitis

We describe an unusual case of acute bowel obstruction caused by a colo-colonic intussusception associated with perforated sigmoid diverticulitis in an adult. Radiographic and pathologic features of the colo-colonic intussusception are presented. A review of the recent literature with regard to the clinical symptoms, signs, diagnosis, etiology, and treatment of colo-colonic intussusception is provided. Colo-colonic intussusception is a rare cause of acute intestinal obstruction in the adult and is usually associated with a malignancy. Treatment should include primary resection without attempts at reduction of the intussusception.

Spinal anaesthesia in a child with Job's syndrome, pneumatoceles and empyema

We present a case of acute bowel obstruction in an immunocompromised child, who also had lobar pneumonia and a giant unilateral pneumatocele. She was successfully managed with subarachnoid anaesthesia for exploratory laparotomy to relieve a colonic obstruction. This proved to be a safe alternative to general anaesthesia with tracheal intubation in this patient and should be considered in infants and children in selected cases whenever a contraindication to general anaesthesia exists.