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Midgut malrotation is a congenital anomaly seen usually in childhood. Its presentation as an acute intestinal obstruction is extremely rare in adults usually identified intra operatively. A high index of suspicion is always required when dealing with any case of acute intestinal obstruction. We report a case of young adult who presented with symptoms of acute intestinal obstruction and was diagnosed intra-operatively as cecal volvulus with impending perforation caused by midgut malrotation. Malrotation of the intestinal tract is seen due to aberrant embryology. The presentation of intestinal malrotation in adults is very rare. Contrast enhanced Computed tomography (CT) can show the abnormal anatomy clearly. Anomalies like midgut malrotation can present as an operative dilemma and awareness regarding these conditions can help surgeons deal with these conditions.
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Gastrointestinal stromal tumours (GIST) as such is a rare disease, but according to some study it may end up to malignant type in approximately 10-30%. Herein we present a 2 cases of GIST who presented with acute intestinal obstruction in emergency department. In imaging studies (X-ray erect abdomen, ultrasonography abdomen), it showed a features of intestinal obstruction but could not rule out the exact mechanism or pathology behind the obstruction. As commonly adhesions is a main culprit behind the cause of acute intestinal obstruction in case of any post-operative patient. So, we try to highlight that in case of any old aged individual and in virgin abdomen GIST should be keep in mind as a cause of intestinal obstruction.
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Intestinal obstruction is one of the common diseases in abdominal surgery. Various causes may result the incidence of intestinal obstruction. Over the past decades, due to changes in human living and dietary habits, changes in disease spectrum, and advances in surgical techniques, the risk factors of intestinal obstruction have also changed significantly. At present, the most common causes of intestinal obstruction are intestinal adhesion, tumor and hernia. In addition, acute intestinal obstruction caused by inflammatory bowel disease has also increased in recent years.Comprehensive understanding the etiology and trend of intestinal obstruction contribute to the early diagnosis and timely treatment of it, and can also improve the prognosis of patients.
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Background: Stoma is a surgically made intestinal opening on the anterior abdominal wall. Its common forms include colostomy and ileostomy. Shock, marked blood loss, significant fecal contamination, associated injuries, time till presentation and multiplicity of injury are widely accepted factors favoring stoma formation than primary repair which leads to significant mortality and morbidity owing to friable tissue that cannot hold a suture. Aims and objectives: To study the various etiologies for stomas in emergency laparotomies, to assess the postoperative morbidity and mortality and its relation to cause and type of stoma done. Materials and methods: This observational study was done in Madras medical college and Rajiv Gandhi Government Hospital from 2013-2016. Method of sampling was non-random, purposive. Those patients who had undergone emergency stomas were included in this study. Informed written consent was taken from the patients or their guardian willing to participate in the study. A detailed history was taken from the study group to establish a proper diagnosis. Thorough physical examination was done in each case. Data collection sheets were filled in by the investigator himself. The operation procedure and related preoperative factors were observed directly and recorded in the data collection sheet instantly. After completing the collection of data it was compiled in a systematic way and analyzed. Results: The common procedures performed included primary closure of a perforation in case of small isolated perforations with not much contamination. Resection followed by either anastomosis or stomas was done in most of the patients with malignant obstruction or nonviable or ischemic bowel. Even in those patients who had anastomosis, a covering stoma was placed as the healing process in these patients may be impaired.
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Objective To evaluate the emergency treatment strategy of acute intestinal obstruction induced by left colorectal cancer.Methods 50 patients with acute intestinal obstruction caused by left colorectal cancer were selected as the research subjects .The clinical data were retrospectively analyzed .Results Of 50 patients,6 cases of postoperative incision infection occurred in phase I excision anastomosis surgery ,no anastomotic fistula.21 cases received ileus tube decompression and phase I excision anastomosis of incision ,there were no postoperative complica-tions.50 patients recovered after surgery , no patients died in the follow-up.Conclusion For acute intestinal obstruction caused by left half colon cancer ,the method ofⅠ resection and heal surgery is the most safe ,and can be used as the preferred way to make a diagnosis and treatment ,but for patients can't tolerance emergency surgery,need the help of colonoscopy,through anal insertion catheter colon decompression and lavage and clean the dirt .
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Background: Intestinal obstruction is one of the most frequently encountered problems in surgical emergency. Intestinal obstruction is one of the major causes of morbidity and mortality Aim: Acute intestinal obstruction is one of the most common surgical emergencies. The objective of this paper was to identify various causes of intestinal obstruction, mode of presentation, hemodynamic status, importance of early intervention and importance of viral markers in emergency procedures. Influence of factors like age, sex, previous surgeries in the pathogenesis of intestinal obstruction and complications in acute intestinal obstruction were also discussed. Materials and methods: The materials for our retrospective study of acute intestinal obstruction were collected from the medical record department of various surgical units in department of general surgery, Stanley medical college. Totally 50 cases were taken for this study with exclusion of age less than 12 years (Pediatric age group). The study was divided into clinical presentation, investigation, management and complications. The results were analyzed based on the following factors like age, sex, symptoms, signs, investigation, probable causative factor, operative findings, procedure and complications. Results: The study group consists of 50 cases of acute intestinal obstruction in adult age group from 12 years. The common age group was 31-40, common sex was female, commonest cause of acute intestinal obstruction in this study was post operative adhesions (48%) followed by obstructed hernia (18%). The other causes are malignancy (10%), ileo-caecal tuberculosis (8%), intussuception(6%), volvulous (4%), mesenteric ischemia (4%), meckel’s band obstruction (2%). Conclusion: Our study observed still post operative adhesions is the most common cause of acute intestinal obstruction followed by obstructed hernia. The success in the treatment of intestinal S. Thirumuruganand, S. Chelladurai, S. Mathan Sankar. A retrospective study of acute intestinal obstruction and its management in our institution. IAIM, 2016; 3(7): 302-309. Page 303 obstruction depends upon early diagnosis and early intervention as well as the patients’ hemodynamic status. Lastly this study highlights the importance of using universal precaution in the emergency setting because of the ever increasing number of HIV and HBsAg in our country.
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Acute intestinal obstruction is a frequently encountered surgical emergency but cases arising from internal herniation through the broad ligament are very rare. We report a case of a middle aged lady with intestinal obstruction due to internal herniation of small bowel through the right side of broad ligament and managing her successfully by timely and immediate surgical intervention.
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Neurofibromatosis type-1 (NF1), also known as von Recklinghausen disease, is a common autosomal dominant condition. It is a multisystem disorder. Abdominal involvement in patients with NF1 has been described in the form of neurofibromas within the liver, mesentery, retroperitoneum and gastrointestinal (GI) tract. Involvement of bowel is rarely seen. Malignant peripheral nerve sheath tumour of small intestine is a rare entity with very few cases reported in literature. Surgery remains the only curative option. Chemotherapy may be used as an adjuvant for advanced diseases. We report a case of malignant peripheral nerve sheath tumour of small intestine which presented as acute intestinal obstruction.
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Objective To study the relationship between operative procedures and complication of colorectal carcinoma with acute colonic obstruction in the elderly patients. Methods 65 elderly patients undergoing emergency operation for acute colonic obstruction were analyzed retrospectively. One stage tumor resection and anastomosis was performed in 25 cases with right-side colonic lesion and in 26 cases with left-side colonic lesion, Hartmann operation in 8 cases, Dixon operation in 4 cases and proximal colostomy in 2 cases. Results In 65 cases, 13 cases of postopera-tive complications,the rate was 20.0% (13/65) ,which infected with toxic shock two cases,four cases of pulmonary infection,anastomotic leakage two cases, wound infection, split 2 cases, death three cases, the mortality rate was 4.6%. The rates of postoperative complications in right-side colonic lesion, left-side colonic lesion, Hartmann opera-tion and Dixon operation were 69.2% ,0,30.7% and 0 respectively(P < 0.05 ～ 0.01). Conclusion Acute obstruc-tion of colon cancer,the right-side colonic lesion were safe,feasible and few complications in colorectal carcinoma with acute colonic obstruction.