Perforación gástrica asociada al consumo de helado con nitrógeno líquido / Gastric perforation associated with the intake of ice cream with liquid nitrogen

La ingestión de nitrógeno líquido es una causa infrecuente de perforación gástrica, se conoce poco sobre como este compuesto afecta el tejido gastrointestinal, sus mecanismos de lesión y sus consecuencias clínicas. Cada vez es más frecuente el uso del nitrógeno líquido de forma comercial en productos de repostería y gastronomía, por lo que es importante reconocer sus potenciales efectos cuando la manipulación no es la adecuada. En este caso clínico describimos una perforación gástrica secundaria al consumo de helado preparado con nitrógeno líquido.

Liquid nitrogene ingestion is a frecuent cause of gastric perforation. It is unknown how this compound afects the gatrointestinal tissue, it mechanisisms of injury and the clinical consecuences. Nowadays, the use of liquid nitrogene in gastronomy is becoming a tendency, for this reason it is important to identify the potencial healt effects of this compound when is not correctly manipulated. The following article describes a secondary gastric perforation, as a consecuence of the consumption of ice cream prepared with liquid nitrogene.

Neumoperitoneo poscolonoscopia sin evidencia de perforación colónica / Post-Colonoscopy neumoperitoneum without evidence of colonic perforation

Objetivo: Reportar el caso de una complicación poscolonoscopia de tratamiento complejo. Caso clínico: Presentamos el caso de una mujer de 82 años, a quien se practicó una colonoscopia total por sangrado rectal, reportando úlcera anal. Dos días después presentó dolor abdominal y distensión abdominal. En las imágenes se encontró gran neumoperitoneo; se realizó laparotomía exploradora sin encontrar lesión en el colon. Presentó buena evolución postoperatoria. Se hace una revisión de la literatura respectiva.

Aim: To report a case of one of the most complex complication post-colonoscopy and is treatment. Case report: We report the case of a 82 years old woman, who was taken to complete colonoscopy for rectal bleeding, then reporting an anal ulcer. Two days later, she has abdominal pain and bloating. In images she has a great pneumoperitoneum. At laparotomy it was not found any injury to the colon. She has a good post-operative evolution. Respective literature review is done.

Neumoperitoneo asintomático asociado a neumatosis quística intestinal en paciente quirúrgico / Asymptomatic pneumoperitoneum associated to pneumatosis cystoides intestinalis in surgery patient

Abstract Introduction: Pneumatosis cystoides intestinalis (PCI) is a rare entity characterized by the presence of air in the intestinal wall. In most cases, it is secondary to a number of mainly intra-abdominal processesthat mostly require urgent surgery but, in a small percentage of cases, it is idiopathic and usually has a morebenign course, caused by, among other things, a series of mechanical factors causing mucosal damage andtherefore predisposing to the formation of cysts. Case report: Here we describe a case of a patient undergoingright hemicolectomy for colon cancer and subsequently treated with chemotherapy that developed PCI twoyears after treatment ended. At all times, the patient was asymptomatic, despite the evolution of PCI and thedevelopment of associated pneumoperitoneum.

Resumen Introducción: La neumatosis quística intestinal (NQI) es una entidad poco frecuente que se caracteriza por la presencia de aire en la pared intestinal. En la mayoría de las ocasiones es secundaria a una serie de procesos fundamentalmente intrabdominales y que en su mayoría requieren cirugía urgente, pero en un pequeño porcentaje de casos es idiopática y suele tener un curso más benigno, causada entre otras cosas por una serie de factores mecánicos que ocasionan el daño de la mucosa y por lo tanto predisponen a la formación de quistes. Caso clínico: Presentamos el caso de un paciente sometido a una hemicolectomía derecha por cáncer de colon y tratado posteriormente con quimioterapia que desarrolla una NQI a los dos años de finalizado el tratamiento. En todo momento el paciente se ha encontrado asintomático a pesar de la evolución de la NQI yel desarrollo de neumoperitoneo asociado.

Accuracy of sonographic diagnosis of pneumoperitoneum using the enhanced peritoneal stripe sign in beagle dogs

The objective of this study was to evaluate the feasibility and accuracy of estimating the smallest amount of abdominal free gas detectible in a large population of beagles by ultrasonography. Healthy dogs were randomly divided into three groups: group A that received 0.1 mL of air injected into the peritoneal cavity, group B that received 0.2 mL of air injected into the peritoneal cavity, and group C that received 0.5 mL of intraperitoneal air. Randomly, some dogs in each group did not receive air injection for the negative control. All ultrasonographic procedures were performed by individuals blinded to group assignments and the presence of intraperitoneal air. The minimum volume of consistently detectable air with good accuracy and reliability was 0.2 mL. Results of the study demonstrated that the enhanced peritoneal stripe sign (EPSS) can verify cases of pneumoperitoneum if more than 0.2 mL of intra-abdominal free gas is present The EPSS is a reliable and specific ultrasonographic characteristic for diagnosing pneumoperitoneum in dogs.

Mesocolon Laceration Following Colonoscopy / 대한소화기학회지

Colonoscopic examination is a safe procedure, however, unexpected complications can sometimes occur. Bleeding and perforation of the colon have been reported as the most common complications. Hemoperitoneum after colonoscopy is an unusual complication, but it may be catastrophic. We report on a 20-year-old man who experienced left low quadrant pain after undergoing colonoscopy. Hemoperitoneum was diagnosed using abdominal CT. A laparoscopic exploration was urgently performed, revealing a lacerated mesocolon of the descending colon. Bleeding of the injured site was controlled without complication. The patient recovered fully without signs of recurrent bleeding. This report implies that if the patient has persistent abdominal pain after undergoing colonoscopy, we should consider hemoperitoneum as one of the causes. To the best of our knowledge, no case of isolated laceration of the mesocolon of the descending colon after colonoscopy has been reported.

Frequency of duodenal ulcer perforation with radiological evidence of pneumoperitoneum

To determine the frequency of duodenal ulcer perforation with radiological evidence of gas under the diaphragm on X-ray chest. Descriptive. Department of Surgery Combined Military Hospital [CMH] and Military Hospital [MH], Rawalpindi, from Nov, 2005 to May 2006. Patients with acute abdomen presenting as emergency at CMH and MH Rawalpindi were evaluated. Preoperatively X-ray chest PA view, in standing posture, was done in all cases and presence or absence of pneumoperitoneum noted. The patients were then followed by laparotomy to confirm or otherwise a perforation of duodenum. Only 30 patients were included in the study where duodenal perforation was confirmed per-operatively. Pneumoperitoneum on X ray chest PA view was found in 25 [83.3%] out of 30 patients with duodenal ulcer perforation; The remaining 05 patients i.e. 16.67% did not show pneumoperitoneum. X-ray chest is a helpful tool in diagnosing majority of patients with a perforated duodenal ulcer. However there is a significant number of patients where the clinical acumen of the doctor would help in an early diagnosis and prompt treatment

Pneumothorax, pneumomediastinum, pneumoperitoneum and surgical emphysema in mechanically ventilated patients

A 29 year old male patient of Indian ancestry was admitted to an outside hospital with rapid deterioration of his level of consciousness. The patient required mechanical ventilation and transfer to MICU at Hamad Medical Corporation. The patient remained hypoxic. Chest X-ray, CT of chest, abdomen, pelvis and proximal areas of both lower limbs were performed. Pneumomediastinum, pneumoperitoneum, and extensive surgical emphysema were the diagnoses

Postsurgical pneumoperitoneum - comparison of abdominal ultrasound findings with plain radiography

To compare abdominal ultrasonography findings with plain radiography in the detection of postsurgical pneumoperitoneum. Cross-sectional, observational. Radiology Department, PNS Shifa Hospital, Karachi, from October, 2005 to April, 2006. Thirty patients of either gender who underwent laparotomies were included in the study. Patients were examined with plain radiography and abdominal ultrasound to detect postsurgical pneumoperitoneum within 24 hours of surgery. Upright chest radiography and left lateral decubitus views of abdomen were used to detect free air. McNemar test was applied to compute relationship between sonographic and radiographic findings. Among 30 patients, 22 [73.3%] were females and 8 [26.7%] were males [M: F = 1: 2.75]. Average age was 38.07 +/- 12.41 years. Out of 30 patients of postsurgical pneumoperitoneum, 27 [90%] were detected on ultrasonography while 3 [10%] were not detected. On plain X-rays, 4 patients were observed in group-I [no free air] and 26 in group-II [1-10 mm thickness]. Significant [p<0.001] relationship was observed between the two findings. Since both modalities can diagnose pneumoperitoneum reliably, ultrasonography can be a useful alternative imaging modality for the detection of pneumoperitoneum

Evaluation of the necessity of the three-film abdominal series in the diagnosis of abdominal pain.

The routine plain-film abdominal series, consisting of supine and upright abdominal radiographs and upright chest radiograph of 246 patients, who presented with abdominal pain from the emergency room of Bangkok Metropolitan Administration Medical College and Vajira Hospital from January 2000 to May 2001 were reviewed. Each radiograph was independently interpreted to detect any radiographic abnormality. Radiographic abnormalities were detected in 35 per cent on abdominal films and 13 per cent on chest films. The supine abdominal views could diagnose abnormalities in 84 per cent of these patients while the upright views diagnosed abnormalities in only 16 per cent of these cases. Most of the detectable abnormalities in the upright views were pneumoperitoneums that were clearly demonstrated on the upright chest radiographs. So elimination of the upright abdominal view from the routine plain-film abdominal series in the screening of surgical cases from medical cases could result in cost-saving and a decrease in radiation exposure without significant loss of diagnostic information.