A rare case of neonatal intestinal obstruction

Omphalocele minor is often associated with the presence of other anomalies compared to that of omphalocele major. The occurrence of intestinal atresia is seldom associated with omphalocele minor. Prompt diagnosis and intervention can prevent morbidity and mortality. Following is a rare case report of combination of omphalocele minor and intestinal atresia with strangulation of the proximal bowel.

Predictive factors with intestinal strangulation and operative intervention for recurrence in adhesive small bowel obstruction / 中国实用外科杂志

OBJECTIVE: To analyze the predictive factors for intestinal strangulation and to identify the surgical intervention for recurrence of adhesive small bowel obstruction(aSBO).METHODS: A retrospective study was conducted according the database in Department of Gastric and Colorectal Surgery, the First Hospital of Jilin University. Patients with aSBO from January 2013 to April 2016 were included in the study and were subject to follow-up. The clinical factors associated with strangulating obstruction and recurrences after treatment were analyzed by using univariate and multivariate logistic regression model.RESULTS: Total of 288 aSBO patients were included. Thirty-seven(12.9%)patients hadoccurredstrangulatingobstructions,and 251(87.1%)patients had simple obstructions.Increasing heart rate[>100/min;OR(95%CI):4.14(1.31-13.07),P=0.015],increasing WBC count[>15×10~9∕L;OR(95%CI):4.31(1.31-14.16),P=0.016],CT findings of thickening or swelling of the mesentery[OR(95%CI):11.04(2.18-55.92),P=0.004],and CT showing seroperitoneum [OR(95%CI):28.36(9.85-81.66),P<0.01] were detected as independent predictive factors for intestinal strangulation. During the follow-up,84 cases(29.2%)experienced recurrence of obstruction. The recurrence rates were reduced in the operation groups compared with non-operative groups[21.3%(26/122)vs.34.9%(58/166),P =0.01].CONCLUSION: Tachycardia,leukocytosis,CT findings of thickening or swelling of the mesentery,and CT showing seroperitoneum are considered as the predictive factors with intestinal strangulation in aSBO. Meanwhile,surgical treatments can reduce recurrence rate of aSBO patients significantly.

Corrección quirúrgica de infartode intestino delgado en un equinomediante yeyunocecostomíacon grapadora quirúrgica mecánica / Surgical management of small intestine infarction by stapled jejunocecostomy in a horse

Un equino macho, entero, criollo colombiano de siete años de edad, fue remitido a la clínica de grandes animales del centro de veterinaria y zootecnia CES debido a síndrome abdominal agudo. Al ser evaluado clínicamente presentó depresión, ruidos abdominales disminuidos, deshidratación (6%), frecuencia cardiaca y respiratoria en 40 lpm y 28 rpm, respectivamente, temperatura en 37.1 °C y distensión marcada de intestino delgado evidente mediante palpación rectal y ultrasonografía transabdominal. No hubo respuesta a los analgésicos por parte del equino; los parámetros en líquido peritoneal estuvieron alterados. Se sospechó lesión estrangulante en intestino delgado. La laparotomía exploratoria reveló infarto idiopático de siete metros de yeyuno y la porción proximal del íleon. Fue practicada una yeyunocecostomía latero lateral con grapadora quirúrgica mecánica (GIA 80). El animal permaneció hospitalizado 10 días y la recuperación postquirúrgica fue exitosa. Este caso es el primer reporte en el país de esta cirugía.

A 7- years-old criollo colombiano stallion was referred to the Large Animal Hospital Centro de Veterinaria y Zootecnia CES (Envigado, Colombia) because of an acute abdominal syndrome that had persisted for seven hours despite medical treatment. On physical examination the stallion was depressed, dehydrated (6%), borborygmi were diminished, rectal temperature was � 37.1 °C,hearth and respiration rates were 40 beats/min and 28 breaths/min, respectively. On rectal examination and abdominal ultrasonography small intestine was distended. Peritoneal fluid analysis was altered. Signs of pain were nonresponsive to analgesics. The diagnosis by exploratory � laparotomywas infarctionof small intestine (seven meters of the jejunum and proximal portion of the ileum) of unknown etiology. A jejunocecostomy was done using a GIA 80 surgical stapler (United Surgical). Postsurgical recuperation was successful. This case becomes the first report of a jejunocecostomy in a horse in Colombia.

Meckel's Diverticulum with Mesodiverticular Band (A Rare Cause of Intestinal Strangulation In Elderly ).

We present a 60 year old male who had 3 days history of intestinal obstruction. At the time of presentation there were sings of peritonitis. The patient was operated after proper resuscitation. Per- operative findings were that of distended small bowel with a band (mesodiverticular band ) extending from mesentery across the ileum to Meckel's diverticulum beneath which the herniated loops of ileum were strangulated. Division of the mesodiverticular band, resection of involved gut along with Meckel's diverticulum and end to end anastomosis was done. The patient made an uneventful recovery in the post-operative period.