Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 260
Filter
2.
Rev. cir. (Impr.) ; 72(5): 468-471, oct. 2020. tab
Article in Spanish | LILACS | ID: biblio-1138741

ABSTRACT

Resumen Introducción: El íleo biliar es una causa poco frecuente de obstrucción intestinal mecánica, siendo más frecuente en pacientes mayores de 65 años y sexo femenino. Casos Clínicos: Se exponen cuatro casos clínicos diagnosticados de íleo biliar, intervenidos en nuestro centro. Discusión: El íleo biliar es una enfermedad que se produce a consecuencia del paso de un cálculo al lumen intestinal. Esto se produce por la presencia de una fístula entre la vesícula y el intestino, localizada mayormente a nivel duodenal. Se manifiesta con una clínica muy inespecífica, lo que condiciona un retraso en su diagnóstico. La tomografía computarizada es actualmente el examen de elección. El tratamiento consiste en la enterotomía con extracción del cálculo, realizándose la reparación de la fístula en un primer o segundo tiempo. Tiene un mal pronóstico debido a comorbilidad de los pacientes y la demora diagnóstica y terapéutica.


Introduction: Gallstone ileus is a rare cause of mechanical intestinal obstruction, being more frequent in patients over 65 years and females. Clinical Cases: Four clinical cases diagnosed with gallstone ileus, operated on in our center, are reported. Discussion: Gallstone ileus frequently occurs as a result of a fistula that communicates the digestive tract with the gallbladder. Their clinic is very unspecific, which determines a delay in its diagnosis. Computed tomography is currently the gold standard. The treatment is enterolithotomy and fistula repair in a first or second stage. Prognosis is poor due to patient comorbidities and diagnostic and therapeutic delay.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Gallstones/diagnostic imaging , Ileal Diseases/diagnostic imaging , Intestinal Obstruction/diagnostic imaging , Tomography, X-Ray Computed , Ultrasonography , Biliary Fistula
3.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1369-1374, July-Aug. 2020. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1131499

ABSTRACT

This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery.(AU)


Este relato de caso descreve um equino com compactação de íleo corrigida por laparotomia em estação pelo flanco direito. A decisão dessa abordagem foi influenciada por vários fatores: o paciente exibiu um temperamento calmo e demonstrou responsividade ao tratamento analgésico para controle da dor; a afecção intestinal em questão foi passível de correção pela abordagem pelo flanco direito em estação; e o proprietário relatou limitações financeiras. A desobstrução ileal foi realizada com sucesso e o cavalo apresentou recuperação satisfatória. Este caso destaca que, em casos específicos da síndrome de cólica, o uso de um procedimento em estação pode ser uma abordagem viável e promover uma rápida recuperação.(AU)


Subject(s)
Animals , Horses/surgery , Ileal Diseases/veterinary , Ileum/surgery , Intestinal Obstruction/urine , Laparotomy/veterinary
4.
Rev. bras. ginecol. obstet ; 41(2): 129-132, Feb. 2019. graf
Article in English | LILACS | ID: biblio-1003528

ABSTRACT

Abstract Ectopic pregnancy is the leading cause of pregnancy-related death during the first trimester, and it occurs in 1 to 2% of pregnancies. Over 90% of ectopic pregnancies are located in the fallopian tube. Abdominal pregnancy refers to an ectopic pregnancy that has implanted in the peritoneal cavity, external to the uterine cavity and fallopian tubes. The estimated incidence is 1 per 10,000 births and 1.4%of ectopic pregnancies. Lithopedion is a rare type of ectopic pregnancy, and it occurs when the fetus from an unrecognized abdominal pregnancymay die and calcify. The resulting "stone baby" may not be detected for decades andmay cause a variety of complications. Lithopedion is a very rare event that occurs in 0.0054% of all gestations. About 1.5 to 1.8% of the abdominal babies develop into lithopedion. There are only ~ 330 known cases of lithopedion in the world. We describe a lithopedion that complicated as intestinal obstruction in a 71-year-old woman.


Resumo A gravidez ectópica é a principal causa de morte materna no primeiro trimestre, e ocorre em 1 a 2% das gestações. Mais de 90% ocorrem nas tubas uterinas. Gravidez abdominal refere-se à gravidez ectópica implantada na cavidade peritoneal, externamente ao útero e às tubas uterinas.Aincidência estimada éde 1 por 10mil nascimentos e 1,4%das gravidezes ectópicas. A litopedia é um tipo raro de gravidez ectópica, e ocorre quando o feto de uma gravidez abdominal não reconhecida morre e se calcifica. O "bebê de pedra" resultante pode não ser detectado por décadas, e pode causar complicações futuras. A litopedia é um evento muito raro que ocorre em 0,0054% de todas as gestações. Cerca de 1,5 a 1,8% dos bebês abdominais se tornam litopédios. Existem somente cerca de 330 casos conhecidos de litopedia no mundo. Descrevemos uma litopedia que se agravou, tornando-se uma obstrução intestinal, em uma idosa de 71 anos.


Subject(s)
Humans , Female , Pregnancy , Aged , Pregnancy, Abdominal , Fetus , Ileal Diseases/etiology , Intestinal Obstruction/etiology , Calcinosis/complications , Tissue Adhesions/etiology , Pelvic Pain/etiology , Lithiasis/complications , Intestinal Obstruction/surgery
5.
Pediátr. Panamá ; 47(3): 24-28, diciembre 2018.
Article in Spanish | LILACS | ID: biblio-980130

ABSTRACT

La invaginación intestinal se presenta con mayor frecuencia en el lactante menor de 2 años, con un pico entre los 5 y 9 meses de edad. En la gran mayoría de los casos es idiopática o de causa desconocida, probablemente secundaria a una infección viral que provoca un crecimiento del tejido linfático intestinal. Sólo en un 2-8% de los pacientes se demuestra una alteración anatómica como causa de la intususcepción (divertículo de Meckel, pólipo). Es la llamada invaginación intestinal secundaria, que suele presentarse en los menores de 3 meses o mayores de 3 años. El síndrome de Peutz-Jeguers (SPJ) es una condición rara y su frecuencia es probablemente inferior a 1/50,000. Se caracteriza por la presencia de pólipos hamartomatosos potencialmente malignos en el tracto digestivo asociada a pigmentaciones mucocutáneas características. Los datos actuales sugieren la existencia de al menos 2 genes implicados: STK11 (19p13.3), identi cado recientemente, es el responsable de la enfermedad en el 70% de las familias. Se describe el caso de dos adolescentes con cuadro de Intususcepción intestinal con diagnóstico de poliposis familiar de Peutz-Jeghers, requiriendo ambas procedimiento quirúrgico


Intestinal intussusception occurs more frequently in the infant younger than 2 years, with a peak between 5 and 9 months of age. In the vast majority of cases it is idiopathic or of unknown cause, probably secondary to a viral infection that causes a growth of the intestinal lymphatic tissue. Only in 2-8% of the patients an anatomical alteration as cause of the intussusception is demonstrated (Meckel's diverticulum, polyp). It is called secondary intestinal invagination, which usually occurs in children under 3 months or older than 3 years. Peutz-Jeguers syndrome (SPJ) is a rare condition and its frequency is probably less than 1 / 50,000. It is characterized by the presence of potentially malignant hamartomatous polyps throughout the digestive tract associated with characteristic mucocutaneous pigmentations. Current data suggest the existence of at least 2 genes involved: STK11 (19p13.3), recently identi ed, is responsible for the disease in 70% of families. We describe the case of two adolescents with intestinal intussusception with a diagnosis of familial polyposis of Peutz Jeghers, requiring both surgical procedures


Subject(s)
Adolescent , Peutz-Jeghers Syndrome , Intestinal Polyposis , Ileal Diseases , Intestinal Diseases , Intussusception
6.
J. coloproctol. (Rio J., Impr.) ; 37(4): 290-294, Oct.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-894009

ABSTRACT

ABSTRACT Introduction: Ileocolic resection (ICR) is the most common surgical procedure performed for Crohn's disease (CD). Similarly, right-sided Colorectal cancer (CRC) is treated by the same operation. The primary aim of this study was to analyze and compare the frequency and profile of early postoperative complications of ICR between patients with CD and CRC. Methods: Retrospective and observational study with patients submitted to ICR from two Brazilian tertiary referral units in colorectal surgery. We included patients with diagnosis of CD or CRC, treated with ICR, at any stage of follow-up. Variables analyzed: age at surgery, gender, diagnosis, surgical approach (open or laparoscopy), type of anastomosis (hand-sewn/stapled; end-to-end/side-to-side), presence and type of early postoperative complications (30 days) and mortality, among others. Results: 109 patients were included, 73 with CD (67%) and 36 with CRC (33%). CD patients were younger (42.44 ± 12.73 years vs. 66.14 ± 11.02 years in the CRC groups, p < 0.0001) and had more previous resections (20 ± 27.4 in CD and 0 in CCR, p = 0.001). There were no significant differences between the groups in terms of overall early postoperative complications [17/73 (23.3%) in the CD and 5/36 (13.9%) in the CRC groups (p = 0.250)]. There was no significant difference between the groups in relation to anastomotic leakage (p = 0.185), surgical site infections (p = 0.883), other complications (0.829) and deaths (p = 0.069). Conclusions: There was no significant difference in early postoperative complications in patients with CD or CRC submitted to ICR.


RESUMO Introdução: A ileocolectomia direita (ICD) é a operação mais realizada no manejo cirúrgico da doença de Crohn (DC). Da mesma forma, é o procedimento de escolha no tratamento do câncer colorretal (CCR) quando localizado à direita. O objetivo deste estudo foi analisar e comparar as complicações cirúrgicas em pacientes submetidos a ICD por DC e CCR em uma coorte de pacientes. Método: Estudo longitudinal, retrospectivo e observacional, de uma coorte de pacientes submetidos a ICD provenientes de 2 centros de referência em coloproctologia. Os critérios de inclusão foram pacientes com DC ou CCR, submetidos a ICD, em qualquer estágio de acompanhamento. As variáveis analisadas foram: idade à cirurgia, gênero, diagnóstico, abordagem (aberta ou laparoscópica), tipo de anastomose, presença e tipo de complicações pós-operatórias precoces (até 30 dias) e óbito. Resultados: Foram incluidos 109 pacientes, 73 com DC (67%) e 36 com CCR (33%). Os grupos foram homogêneos em todas as variáveis, à exceção da idade (42,44 ± 12,73 na DC e 66,14 ± 11,02 no CCR, p < 0,0001). Não houve diferença entre os grupos em relação às complicações precoces, com 17/67 (23,3%) na DC e 5/36 (13,9%) no CCR, p = 0,250. Da mesma forma, não houve diferença entre os grupos em relação a deiscência de anastomose (p = 0,185), infecções do sítio cirúrgico (p = 0,883), outras complicações (0,829) e óbitos (p = 0,069). Conclusões: Não houve diferença nas complicações pós-operatórias em pacientes submetidos a ICD entre portadores de DC e CCR.


Subject(s)
Humans , Male , Female , Colorectal Neoplasms/surgery , Crohn Disease/surgery , Ileal Diseases , Intussusception , Postoperative Complications
9.
Cambios rev. méd ; 16(1): 73-77, ene. - 2017. ilus
Article in Spanish | LILACS | ID: biblio-1000024

ABSTRACT

Introducción: Los tumores gastrointestinales son las neoplasias mesenquimáticas más frecuentes del sistema gastrointestinal. Se originan de las células de Cajal encargadas de regular la motilidad intestinal. Afecta a individuos de mediana edad. Histopatológicamente estos tumores se expresan por inmunohistoquímica a los marcadores KIT (CD117) y DOG1. Caso: Paciente masculino de 63 años de edad, antecedentes de resección quirúrgica de un tumor en el ileon, seis años antes del ingreso. Acude por dolor abdominal y el examen tomográfico muestra múltiples lesiones tumorales en hígado, colon, vejiga. Se extrae la lesión supravesical y recibe imatinib. Discusión: El diagnóstico es inmunohistoquímico, se hace con el receptor de tirocincinasa CD 117 en 86% a 95%. Otros marcadores a menudo positivos son CD 34 y Actina de músculo liso. Luego de la cirugía el paciente recibe imatinib y permanece asintomático.


Introduction: Gastrointestinal tumors are among the most common mesenchymal neoplasms of the gastrointestinal system. They belong to the cells of Cajal that regulate bowel motility. It affects middle age and older from both sexes. Histologically, these tumors express positivity in immunohistochemistry tests (KIT CD117 and DPG1). Case: This is a sixty-three year-old male patient with a past history of tumor resection from the ileum, six years before. Admitted for abdominal pain. The CT scan showed several lesions in liver, colon and bladder. After resection of the lesion located in the upper part of the bladder. Discusion: Diagnosis is done by immunohistochemistry to identify tirosin-kinase receptor CD-117 in 86% to 95% of patients. Other markers like CD34 are often also positive. After surgery, patient received imatininb and remained asymptomatic.


Subject(s)
Humans , Middle Aged , Gastrointestinal Stromal Tumors , Ileal Diseases , Abdominal Neoplasms , Immunohistochemistry , Mortality , Mesenchymal Stem Cells
10.
Rev. Nac. (Itauguá) ; 9(2): 91-102, 2017.
Article in Spanish | LILACS, BDNPAR | ID: biblio-884666

ABSTRACT

El íleo biliar es una rara complicación de la colelitiasis, que se caracteriza por presentar clínicamente una obstrucción intestinal mecánica intraluminal, secundaria a la impactación de un cálculo biliar en el tubo digestivo, debido a la existencia de una fístula bilio-entérica. El diagnóstico preoperatorio es difícil, ya que presenta síntomas y signos de obstrucción intestinal, los cuales son muy inespecíficos para sospechar un íleo biliar. El tratamiento de elección en el manejo del íleo biliar es el quirúrgico. Habitualmente se realiza una cirugía en dos tiempos, enterolitotomía como único gesto, sin embargo no hay una técnica quirúrgica definitiva estandarizada. Presentamos el caso de una paciente de 70 años que acude al Departamento de Urgencias con el diagnóstico clínico de obstrucción intestinal mecánica baja, de cuatro días de evolución, como consecuencia de un cálculo impactado en colon sigmoides.


Gallstone ileus is a rare complication of cholelithiasis, which is characterized by clinically presenting as an intraluminal mechanical intestinal obstruction secondary to the impaction of a gallstone in the digestive tract, due to the existence of a biliary-enteric fistula. The preoperative diagnosis is difficult, since it presents symptoms and signs of intestinal obstruction, which are very unspecific to suspect a Biliary Ileus. The treatment of choice in the management of gallstone ileus is surgery; usually is performed in two stages, whole lithotomy as the only gesture, however there is no standardized definitive surgical technique. We present the case of a 70-year-old patient, who attended the emergency department with the clinical diagnosis of low mechanical bowel obstruction, four days of evolution, as a result of a stone impacted in the sigmoid colon.


Subject(s)
Humans , Female , Aged , Sigmoid Diseases/etiology , Gallstones/complications , Ileal Diseases/complications , Intestinal Obstruction/etiology , Sigmoid Diseases/surgery , Sigmoid Diseases/diagnostic imaging , Gallstones/surgery , Gallstones/diagnostic imaging , Ileal Diseases/surgery , Ileal Diseases/diagnostic imaging , Intestinal Obstruction/surgery , Intestinal Obstruction/diagnostic imaging
11.
Rev. cuba. cir ; 55(3): 248-253, jul.-set. 2016. ilus
Article in Spanish | LILACS | ID: biblio-830459

ABSTRACT

La intususcepción intestinal, definida como la penetración de un segmento intestinal en otro adyacente, es una causa infrecuente de obstrucción intestinal en el adulto. El objetivo de este trabajo es presentar el caso de un paciente adulto con intususcepción ileocólica como presentación de un linfoma no Hodgkin de intestino delgado. Este paciente presenta una causa poco frecuente de intususcepción intestinal. Dada lo inespecífico de la clínica, el diagnóstico etiológico suele ser intraoperatorio, precisando resección de la lesión causante y, en el caso de nuestro paciente, quimioterapia adyuvante(AU)


Intestinal intussusception, defined as penetration of an intestinal segment into an adjacent, is a rare cause of intestinal obstruction in adults. The aim of this paper is to present the case of an adult patient with ileocolic intussusception as presenting a non-Hodgkin lymphoma of the small intestine. This patient has a rare cause of intestinal intussusception. Because of its non-specific clinical, etiologic diagnosis is usually intraoperative, requiring resection of the culprit lesion and, in the case of our patient, adjuvant chemotherapy(AU)


Subject(s)
Humans , Male , Adolescent , Chemotherapy, Adjuvant/statistics & numerical data , Ileal Diseases/diagnostic imaging , Intestinal Obstruction/surgery , Lymphoma, Non-Hodgkin/etiology
12.
Pakistan Journal of Pharmaceutical Sciences. 2016; 29 (1 Supp.): 331-334
in English | IMEMR | ID: emr-177613

ABSTRACT

To investigate the clinical applications of robot-assisted radical cystectomy with orthotopic ileal neobladder [RARC-INB] and make a preliminary summary. Retrospective analysis the clinical data of 12 patients underwent robotic bladder cancer [da vinci surgical system] assisted laparoscopic cystectomy with ileal orthotopic neobladder from March 2015 to April 2015. 12 cases were successful, with no surgical intervention, and organ damage occurred. The operation time was 330470 min, which average [390.0 +/- 61.5] min; blood loss was 90870 ml, which average [185.0 +/- 88.3] ml. One case of intraoperative blood transfusion was 400 ml. The enjoin eating time of postoperative intestinal ventilation was 36 d, and the average time was [4.0 +/- 1.5] d. Removal of ureteral stents time was 1428 d and the average time was [21 +/- 7] d. Removal of the catheter time was 1828 d and the average time was [23 +/- 5] d. Postoperative hospital stay 1929 d and the average time was [24 +/- 5] dRARC-INB make the surgical tends to simplify, which was conducive to surgeon intraoperative control and assurance. RARC-INB make the surgical tends to use less trauma, less bleeding, complete lymphadenectomy, quick recovery, etc. It is a safe, effective and reliablethe method in the treatment of invasive bladder cancer. So the method should be widely applied


Subject(s)
Humans , Male , Middle Aged , Aged , Adult , Ileal Diseases , Preoperative Care , Retrospective Studies , Urinary Bladder Neoplasms , Robotic Surgical Procedures , Laparoscopy
13.
Gastroenterol. latinoam ; 27(1): 31-36, 2016. ilus
Article in Spanish | LILACS | ID: biblio-868979

ABSTRACT

Tuberculosis (TB) remains a major public health challenge. The true incidence of intestinal TB is unknown, as it can be asymptomatic, and by its nature, often diverts its diagnosis to neoplastic diseases or inflammatory bowel disease. Therefore, we must have a high index of suspicion, not only in high risk populations and immunocompromised patients. Diagnostic tests that certify the pathology, don’t always achieve excellent performance. Endoscopic findings are not always clear in differentiating malignancy, and in some cases, a therapeutic trial may be needed to confirm the disease. We present the case of a patient with chronic diarrhea, consumptive syndrome and without respiratory symptoms at its onset.


La tuberculosis (TBC) sigue siendo un reto importante de salud pública. La verdadera incidencia de TBC intestinal es desconocida, ya que puede ser asintomática, y por su naturaleza a menudo desvía su diagnóstico a patologías neoplásicas o de enfermedad inflamatoria intestinal. Por lo tanto, se debe tener un alto índice de sospecha, no sólo en poblaciones de alto riesgo y en pacientes inmunocomprometidos. Las pruebas diagnósticas que certifiquen la patología no siempre se logran ni tienen un excelente rendimiento. Los hallazgos endoscópicos no siempre son claros para diferenciarla de una neoplasia, y en algunos casos una prueba terapéutica puede ser la confirmación de la enfermedad. Presentamos el caso de un paciente con diarrea crónica, cuadro consuntivo y sin síntomas respiratorios al inicio de su cuadro.


Subject(s)
Humans , Male , Middle Aged , Cecal Diseases/diagnosis , Cecal Diseases/therapy , Ileal Diseases/diagnosis , Ileal Diseases/therapy , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Gastrointestinal/therapy , Diarrhea/etiology
14.
Rev. cuba. cir ; 54(3): 0-0, jul.-set. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-765757

ABSTRACT

La oclusión intestinal es una causa frecuente de abdomen agudo quirúrgico. Dentro de sus múltiples casusas se encuentra el nudo ileosigmoideo, entidad rara en el mundo, pero puede verse con relativa frecuencia en algunas latitudes geográficas como Asia, Medio Oriente y otros países del continente africano. El objetivo de este trabajo es presentar cuatro casos de pacientes con oclusión intestinal por nudo ileosigmoideo en los hospitales Souro Sanu de Bobo Diulaso, Burkina Faso y Wa Regional Hospital, de Gana. Se intervinieron quirúrgicamente, se hizo resección en bloque de los segmentos ileales y sigmoideos gangrenados con anastomosis íleo-ascendente y colostomía de tipo Hartman. Los pacientes evolucionaron satisfactoriamente y luego de tres meses se restableció definitivamente el tránsito intestinal. Se realizó una revisión de la literatura(AU)


Intestinal occlusion is a frequent cause of surgical acute abdomen. Among its multiple causes are the ileosigmoid knot, a rare entity worldwide, which is relatively frequent in some geographic areas such as Asia, Middle East and Africa. The objective of this paper was to present four patients with intestinal occlusion due to ileosigmoid knot in Souro Sanu of Bobo Diulaso hospitals in Burkina Faso and Wa Regional Hospital in Ghana. They were operated on through block resection of gangrenous ileal and sigmoid segments with ascending ileoanastomosis and Hartrman-type colostomy. The patients recovered satisfactorily and three months later, the intestinal transfer was finally re-established. A literature review on the topic was made(AU)


Subject(s)
Humans , Male , Middle Aged , Abdomen, Acute/diagnostic imaging , Ileal Diseases/surgery , Intestinal Obstruction/surgery , Sigmoid Diseases/surgery , Africa , Review Literature as Topic
15.
Int. braz. j. urol ; 41(4): 796-803, July-Aug. 2015. graf
Article in English | LILACS | ID: lil-763063

ABSTRACT

ABSTRACTBackground:Uretero-ileal anastomotic stricture (UIAS) is a urological complication after ileal neobladder, the initial management being endourological intervention. If this fails or stricture recurs, surgical intervention will be indicated.Design and Participants:From 1994 to 2013, 129 patients were treated for UIAS after unsuccessful endourological intervention. Unilateral UIAS was present in 101 patients, and bilateral in 28 patients; total procedures were 157. The previous ileal neobladder techniques were Hautmann neobladder, detubularized U shape, or spherical shape neobladder.Surgical procedures:Dipping technique was performed in 74 UIAS. Detour technique was done in 60 renal units. Ileal Bladder flap was indicated in 23 renal units. Each procedure ended with insertion of double J, abdominal drain, and indwelling catheter.Results:Follow-up was done for 12 to 36 months. Patency of the anastomosis was found in 91.7 % of cases. Thirteen patients (8.3%) underwent antegrade dilatation and insertion of double J.Conclusion:After endourological treatment for uretero-ileal anastomotic failure, basically three techniques may be indicated: dipping technique, detour technique, and ileal bladder flap. The indications are dependent on the length of the stenotic/dilated ureteral segment. Better results for long length of stenotic ureter are obtained with detour technique; for short length stenotic ureter dipping technique; when the stenotic segment is 5 cm or more with a short ureter, the ileal tube flap is indicated. The use of double J stent is mandatory in the majority of cases. Early intervention is the rule for protecting renal units from progressive loss of function.


Subject(s)
Female , Humans , Male , Ileal Diseases/surgery , Ureteral Obstruction/surgery , Ureterostomy/methods , Urologic Surgical Procedures/methods , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Constriction, Pathologic/surgery , Cystectomy/adverse effects , Dilatation , Follow-Up Studies , Ileal Diseases/etiology , Postoperative Care , Surgical Flaps/surgery , Ureteral Obstruction/etiology , Urinary Bladder/surgery
16.
Rev. paul. pediatr ; 33(2): 241-245, Apr-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-750805

ABSTRACT

OBJECTIVE: To report a case of a preterm infant with complex meconium ileus at birth and cystic fibrosis. CASE DESCRIPTION: A male infant was born by vaginal delivery at 33 weeks and 5 days of gestational age with respiratory distress and severe abdominal distension. The exploratory laparotomy in the first day of life identified meconium ileus and secondary peritonitis. Ileal resection and ileostomy were performed, followed by reconstruction of the bowel transit at 20 days of life. At 11 days of life, the first immunoreactive trypsinogen (IRT) was 154 ng/mL (reference value = 70), and oral pancreatic enzymes replacement therapy was started. After 23 days, the second IRT was 172ng/mL (reference value = 70). At 35 days of age he was discharged with referrals to primary care and to a special clinic for CF for the determination of sweat chloride. He was received in the outpatient clinic for neonatal screening for CF at 65 days of life presenting malnutrition and respiratory distress. The sweat chloride test was performed, with a positive result (126mEq/L). COMMENTS: This case illustrates the rapid evolution of CF in a premature patient with complex meconium ileus as the first clinical manifestation.


OBJETIVO: Relatar o caso de um recém-nascido prematuro com íleo meconial complexo e fibrose cística. DESCRIÇÃO DO CASO: Recém-nascido do sexo masculino nasceu de parto vaginal com 33 semanas e cinco dias de idade gestacional e apresentou desconforto respiratório e distensão abdominal grave. Foi submetido à laparotomia exploratória no primeiro dia de vida e identificado íleo meconial com peritonite secundária. Foram feitas ressecção ileal e ileostomia, com reconstrução do trânsito intestinal aos 20 dias de vida. Com 11 dias de idade, a primeira dosagem sérica de tripsina imunorreativa (TIR) foi 154ng/mL (valor de referência = 70) e optou-se pelo início da terapia de reposição oral de enzimas pancreáticas. Após 23 dias, a segunda TIR foi 172ng/mL (valor de referência = 70). Recebeu alta com 35 dias de vida com encaminhamentos à rede básica de saúde e ao serviço de referência para a detecção de fibrose cística. Foi atendido no ambulatório de triagem neonatal para fibrose cística aos 65 dias de vida e apresentava desnutrição e desconforto respiratório. O resultado do teste do cloro no suor foi positivo (126 mEq/L). COMENTÁRIOS: O caso ilustra a rápida evolução da fibrose cística em um paciente prematuro com íleo meconial complexo como primeira manifestação clínica.


Subject(s)
Humans , Male , Infant, Newborn , Ileal Diseases/complications , Cystic Fibrosis/complications , Infant, Premature
17.
Article in English | IMSEAR | ID: sea-159383

ABSTRACT

Ileosigmoid knotting also known as compound volvulus or double volvulus is a rare cause of intestinal obstruction. Here, we present a case of acute intestinal obstruction in shock. The patient was resuscitated taken up for an emergency exploratory laparotomy, which revealed a large volume of hemorrhagic fluid and dilated gangrenous loops of ileum and sigmoid. A loop of ileum had encircled the base of sigmoid to form a knot resulting in gangrene of both the ileum and the sigmoid colon. Resection of gangrenous ileum and sigmoid colon with ileo-ileal and colorectal anastomosis with a temporary diversion colostomy was done.


Subject(s)
Adult , Humans , Ileal Diseases/diagnosis , Ileal Diseases/epidemiology , Ileal Diseases/surgery , Intestinal Obstruction/diagnosis , Intestinal Obstruction/epidemiology , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestinal Volvulus/diagnosis , Intestinal Volvulus/epidemiology , Intestinal Volvulus/surgery , Male , Sigmoid Diseases/diagnosis , Sigmoid Diseases/epidemiology , Sigmoid Diseases/surgery
18.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2015; 25 (1): 76-77
in English | IMEMR | ID: emr-167501

ABSTRACT

Intussusception is a rare entity in neonates. It may present with non-specific signs including abdominal distension, feeding intolerance, vomiting and bloody stools. Symptomatology is similar to Necrotizing Entero-Colitis [NEC]. Ultrasound can help to establish early diagnosis in neonate. A 27-week preterm newborn was initially suspected as NEC based on abdominal distention, bilious vomiting, worsening clinical condition and dilated loops of bowel on X-ray, which turned out to be ileo-ileal intussusception. Diagnosis was made by ultrasound obtained for a palpable mass to rule out intra abdominal abscess and lack of improvement in clinical condition despite 5 days of conservative treatment. Surgery was performed consisting of removal of the necrotic intussusception area and end-to-end anastomosis and patient was discharged from hospital on day 60 of life. As a conclusion, pathological abdominal findings in preterm newborns can also be due to conditions other than NEC and ultrasound may be a useful tool for timely and accurate diagnosis


Subject(s)
Humans , Female , Ileal Diseases , Infant, Premature , Infant, Newborn , Enterocolitis, Necrotizing/etiology
19.
Gut and Liver ; : 756-760, 2015.
Article in English | WPRIM | ID: wpr-67329

ABSTRACT

BACKGROUND/AIMS: Pediatric inflammatory bowel disease (IBD) has been increasing worldwide. The characteristics of pediatric-onset IBD have mainly been reported in Western countries. We investigated the clinical characteristics of pediatric IBD in Korea and compared these with the data from the 5-year European multicenter study of children with new-onset IBD (EUROKIDS registry). METHODS: Children who were diagnosed with IBD between July 1987 and January 2012 were investigated at five Korean university hospitals. Their clinical characteristics were retrospectively evaluated by medical record review. The results were compared with the EUROKIDS data. RESULTS: A total of 30 children with Crohn's disease (CD) and 33 children with ulcerative colitis (UC) were enrolled. In comparison with the EUROKIDS group, Korean pediatric IBD patients showed a male predominance (86.7% vs 59.2%, p=0.002 in CD; 75.8% vs 50%, p=0.003 in UC). Korean pediatric CD patients had a higher prevalence of terminal ileal disease (36.7% vs 16.3%, p=0.004) and perianal disease (33.3% vs 8.2%, p<0.001) than patients in the EUROKIDS group. Korean pediatric UC patients had a higher prevalence of proctitis than patients in the EUROKIDS group. CONCLUSIONS: Our results suggest that the characteristics of Korean pediatric IBD patients and European pediatric IBD patients may be different.


Subject(s)
Adolescent , Anus Diseases/complications , Child , Colitis, Ulcerative/complications , Crohn Disease/complications , Europe/epidemiology , Female , Humans , Ileal Diseases/complications , Male , Prevalence , Proctitis/epidemiology , Registries , Republic of Korea/epidemiology , Retrospective Studies , Sex Factors
20.
Professional Medical Journal-Quarterly [The]. 2014; 21 (5): 864-868
in English | IMEMR | ID: emr-153913

ABSTRACT

To evaluate the success rate of hydrostatic reduction of intussusception and incidence of complications in late presenting cases. Prospective study. Study was carried out in Armed Forces Institute of Radiology and Imaging Rawalpindi and different Combine Military Hospitals during last 5 years. All the children up to 2 years age with diagnosis of ileo-colic intussusception and 3 days or less history of onset of symptoms were included in the study. Patients with signs of perforation, suspicion of lead point or long intussusceptum protruding through rectum were excluded. After plain film evaluation, thin barium was instilled through Foleys catheter under fluoroscopic guidance. Rule of 3 was followed and reduction was considered successful when contrast refluxed into terminal ileal segment. Follow up plain x-ray and ultrasound was done after 48 hours to rule out recurrence. Hydrostatic reduction was successful in 18 out of 21 patients collected during last five years. Reduction was incomplete in one case while perforation was observed in 2 cases. These complications were observed in the largest group [52%] of patients reporting on 3rd day of onset of symptoms. A significant number [38%] of patients reached the hospital within 48 hours. Only 2 [10%] patients presented in first 24 hrs but uneventful reduction was possible in later two groups. Careful hydrostatic reduction in cases of ileo-colic intussusception reporting within 72 hrs will reduce hospital stay and patient morbidity in most of the cases


Subject(s)
Humans , Male , Female , Intussusception/surgery , Intussusception/pathology , Ileal Diseases , Intussusception/therapy , Enema
SELECTION OF CITATIONS
SEARCH DETAIL