Intestinal Obstruction Research Articles

S4770 Tuberculosis Ileitis Presenting as Small Bowel Obstruction

S4770 Tuberculosis Ileitis Presenting as Small Bowel Obstruction

S3055 Swirling Strangulated Cecal Volvulus Masked as Small Bowel Obstruction

S3055 Swirling Strangulated Cecal Volvulus Masked as Small Bowel Obstruction

Deep Infiltrating Endometriosis Presenting as Large Bowel Obstruction

Deep Infiltrating Endometriosis Presenting as Large Bowel Obstruction

S2352 Between a Stone and a Hard Place: A Case of Cholecystocolonic Fistula and Large Bowel Obstruction

S2352 Between a Stone and a Hard Place: A Case of Cholecystocolonic Fistula and Large Bowel Obstruction

Effectiveness of Early Feeding versus Conventional Protocol after Stoma Reversal in Adult Surgical Practices.

To compare the effectiveness of early feeding and conventional feeding protocol after stoma reversal in adult surgical practices. Randomised controlled trial. Place and Duration of the Study: Department of General Surgery, District Headquarters Hospital Mardan, Pakistan, from January 2020 to July 2022. A total of 72 patients enrolled in the surgical unit for stoma reversal were included in this study. After applying the exclusion criteria, 68 patients were randomised in two equal groups of 34 patients each. In Group A, patients were allowed oral liquid feed within 24 hours after surgery while in Group B oral liquid feed was allowed after 72 to 96 hours when the nasogastric tube was removed and bowel functions were returned. Efficacy, safety, and tolerability were evaluated from outcomes such as postoperative ileus, anastomosis leakage, infection of the wound, and length of hospital stay. The age range in this study was from 18 to 43 years with mean ± SD of 31.602 ± 6.75 years. There were 41 (60.29%) males while 27 (39.71%) females in this study and the male population was dominant in both groups. The results were significantly in favour of Group A, where 28 (82.35%) patients did not have postoperative ileus compared to 17 (50%) patients in Group B (p = 0.004). Wound healing was also significantly better in Group A compared to Group B, where 30 (88.23%) patients had no wound infection compared to 21 (61.76%), respectively (p = 0.001). There was no difference between both groups regarding anastomotic leakage. Length of hospital stay was significantly shorter in Group A (3.117 ± 0.87 days) compared to Group B (5.617 ± 1.43 days) (p = 0.001). Early feeding after stoma reversal is effective, minimises the postoperative complications, and leads to shortening of hospital stay in adult surgical practices. Anastomosis leakage, Early feeding, Length of hospital stay, Stoma reversal.

Evaluation of Postoperative Adhesions in a Subsequent Cesarean Section Following the Use of Dextrin Hydrogel Spray as Adhesion Barrier for Laparoscopic Myomectomy

Objectives: Laparoscopic myomectomy (LM) is a procedure with a high rate of postoperative adhesions, which can lead to complications such as bowel obstruction and subsequent surgical problems, making anti-adhesion measures important. Various anti-adhesion materials are already on the market and have shown efficacy, but dextrin hydrogel spray (AdSpray™), an anti-adhesion material launched in 2017, has not yet been reported in the field of gynecology, although there are papers showing its usefulness in the surgical field such as repeat hepatectomy and ileostomy closure. Thereby, we investigated the postoperative status of AdSpray™ in LM. Materials and Methods: We report 24 cases in which AdSpray™ was used at Teine Keijinkai Hospital from 2018 to 2021 for LM, followed by cesarean section (CS) from 2019 to 2022. Adverse effects related to AdSpray™ and the presence of uterine adhesions in CS were examined. Results: Adhesions were observed in 4 (16.7%) cases, none of which resulted in significant adverse effects of AdSpray™. Conclusion: AdSpray™ was effective in preventing adhesion and may be an option as an anti-adhesion material in LM.

Mid-jejunal diverticulitis with closed-loop bowel obstruction, strangulation, and contained perforation.

Closed-loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is rare and should be included in the differential diagnosis of acute abdomen. The association between polymyalgia rheumatica and diverticular disease requires further research but may prompt clinicians to consider appropriate therapies in patients with both diseases. Jejunal diverticulosis is a sac-like outpouching of the intestinal wall that can cause complications such as diverticulitis, obstruction, abscess, perforation, or fistula formation. Complicated jejunal diverticulosis may present with acute abdomen and nonspecific symptoms which can lead to misdiagnosis and delayed treatment. A 76-year-old male with a remote history of polymyalgia rheumatica (PMR) presented with sudden onset abdominal pain, fever, nausea, vomiting, and inability to pass flatus. Physical exam revealed a distended and diffusely tender abdomen with signs of peritonitis. Laboratory test results were significant for neutrophil-dominant leukocytosis and elevated inflammatory markers. CT scan of the abdomen with IV contrast revealed a contained perforation and a closed-loop small bowel obstruction in the mid-abdomen. The patient underwent emergent exploratory laparotomy and resection of 100 cm of mid-jejunum which was found to have numerous diverticula surrounding the closed-loop obstruction and contained perforation. Pathology findings showed evidence of acute on chronic jejunal diverticulitis. Jejunal diverticulosis with complications may present with an acute abdomen and peritonitis. Closed-loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is uncommonly thought of and should be considered in the differential diagnosis. Additionally, the association between PMR and diverticular disease is notable. While the patient had a remote history but no active PMR on presentation, studies suggest a possible association between gut inflammation and rheumatologic disease. This association should prompt clinicians to consider appropriate therapies and bear in mind the potential risk for diverticular perforation if glucocorticoids are given to treat PMR. Jejunal diverticulosis with multiple complications such as closed-loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is rare and may present with an acute abdomen and nonspecific symptoms. Including rare pathologies as such in the differential diagnosis may prevent misdiagnosis and delayed treatment. While further investigation is needed, the association between diverticulosis and PMR is noteworthy as patients who present with both diseases would require mindful management due to the potential risk of diverticular perforation after treatment with steroids.

Presentation and management of post-esophagectomy or Gastrectomy Hiatal Hernia.

Hiatal hernia may development after esophagectomy or Gastrectomy. Post- esophago-gastric hiatal hernia is a rare but challenging condition. Nearly half of reported cases involve emergent situations, underscoring the urgency of addressing this condition. However, there is currently no consensus on the optimal treatment approach for this type of hernia. All consecutive patients who underwent repair for Post- esophago-gastric hiatal hernia over the past five years were retrospectively reviewed. Patient characteristics and perioperative data were collected. The primary outcomes, repair methods, and surgical results following post-esophago-gastric hiatal repair were analyzed. A total of eight patients with post-esophago-gastric hiatal hernia were included in this study. All patients presented with emergent conditions, specifically bowel obstruction. Laparoscopic repair was successful in four cases, with a conversion rate to open surgery of 50% (4 out of 8). Primary suture was performed in three cases, while biological mesh repair was carried out in four cases, and one case was left unrepaired. Bowel gangrene and perforation occurred in one case. The most notable postoperative complications included wound infection and pleural fluid collection. Importantly, there were no instances of hernia recurrence during the follow-up period, which ranged from 2 to 55 months, with a 100% follow-up rate observed. Post-esophago-gastric hiatal hernia is a rare yet significant condition, often presenting emergently and linked to higher morbidity and mortality rates. Therefore, symptomatic patients warrant surgical repair, and immediate intervention should be provided to those with acute-onset symptoms and clinical signs of bowel obstruction. Primary suture repair, with or without biological mesh, appears to be a durable method of repair.

Coexistence of Cecal duplication cyst and Meckel’s diverticulum presenting as intestinal obstruction: a rare case report: Retraction

Coexistence of Cecal duplication cyst and Meckel’s diverticulum presenting as intestinal obstruction: a rare case report: Retraction

Complicated small-bowel diverticulosis and the role of Acute Care for the Elderly Unit

Small-bowel diverticulosis is a rare condition that occurs in older adults. Patients are usually asymptomatic, and some will develop complications such as gastrointestinal (GI) bleeding, intestinal obstruction, diverticulitis, and perforation. This is the case of a 95-year-old male patient with a previous history of heart failure with a preserved ejection fraction of 55%–60% and aortic stenosis since October 2019, atrial fibrillation managed with a permanent pacemaker, oral anticoagulation treatment (which was discontinued due to GI bleeding), hypertension, hypothyroidism, and chronic kidney disease. The patient presented with melena and was diagnosed with upper GI bleeding. The GI, general surgery, interventional radiology, geriatric, and palliative care teams were involved in his care. The patient received multiple blood transfusions, and upper and lower GI endoscopic and interventional radiological procedures were performed. However, owing to the patient’s functional status and age, surgery was not an option. The patient was referred to a palliative care team.

S4758 A Rare Case of Ileocecal Valve Adenocarcinoma Presenting as Intestinal Pseudo Obstruction

S4758 A Rare Case of Ileocecal Valve Adenocarcinoma Presenting as Intestinal Pseudo Obstruction

Visceral to subcutaneous fat area ratio predicts early postoperative small bowel obstruction after total gastrectomy for cardia cancer.

We aimed to investigate the relationship between the visceral to subcutaneous fat area ratio (V/S ratio) and incidence of early postoperative small bowel obstruction (EPSBO) following total gastrectomy for cardia cancer. We conducted a retrospective analysis among patients with cardia cancer who underwent elective total gastrectomy with esophagojejunostomy Roux-en-Y anastomosis at Nanjing Yimin Hospital between November 2019 and April 2024. Preoperative, intraoperative, and postoperative factors were meticulously monitored. The V/S ratio was calculated using computed tomography scans at the umbilical level with Slice-O-Matic software (Tomovision, Montreal, Canada). Statistical analyses included logistic regression and receiver operating characteristic (ROC) curve analysis. Among 175 patients, 27 (15.4%) developed EPSBO. The V/S ratio was significantly higher in the EPSBO group (1.76 ± 1.05 vs. 1.01 ± 0.54). Logistic regression identified the V/S ratio as a significant predictor of EPSBO (odds ratio [OR] = 1.612, 95% [CI]: 1.102-1.605). ROC curve analysis demonstrated high sensitivity (92%) and specificity (100%) for the V/S ratio in predicting EPSBO, with a 0.83 AUC. Our findings indicated a higher V/S ratio was a significant predictor of EPSBO following total gastrectomy for cardia cancer. Preoperative assessment of the V/S ratio can inform risk stratification and guide targeted interventions to improve postoperative outcomes.

S4910 Gastroenterologist's Recognition of Rare Adverse Drug Effect Prevents Further Harm in a Patient with Small Bowel Obstruction Due to Lisinopril: A Case Report and Literature Review

S4910 Gastroenterologist's Recognition of Rare Adverse Drug Effect Prevents Further Harm in a Patient with Small Bowel Obstruction Due to Lisinopril: A Case Report and Literature Review

S4001 Colonic Stenting and EUS-Guided EnteroColostomy in Malignant Small Bowel Obstruction: A Case Report

S4001 Colonic Stenting and EUS-Guided EnteroColostomy in Malignant Small Bowel Obstruction: A Case Report

31 Clinical and Imaging Predictors of Need for Emergent Surgical Intervention for Small Bowel Obstruction

31 Clinical and Imaging Predictors of Need for Emergent Surgical Intervention for Small Bowel Obstruction

S2956 Large Bowel Obstruction From a Gallstone in Cholecystocolonic Fistula

S2956 Large Bowel Obstruction From a Gallstone in Cholecystocolonic Fistula

S2758 Large Bowel Obstruction Induced by Pancreatic Tumor: Clinical Insights

S2758 Large Bowel Obstruction Induced by Pancreatic Tumor: Clinical Insights

S2757 Large Bowel Obstruction Induced by Lung Carcinoma: Clinical Insights

S2757 Large Bowel Obstruction Induced by Lung Carcinoma: Clinical Insights

S2999 True or False? A Case of Large Bowel Obstruction Secondary to Right-Sided Colonic Malignancy Initially Presenting as Ogilvie Syndrome

S2999 True or False? A Case of Large Bowel Obstruction Secondary to Right-Sided Colonic Malignancy Initially Presenting as Ogilvie Syndrome

S2864 The Womb Wanders to the Bowel: An Uncommon Case of Large Bowel Obstruction Secondary to Intestinal Endometriosis

S2864 The Womb Wanders to the Bowel: An Uncommon Case of Large Bowel Obstruction Secondary to Intestinal Endometriosis