Obstruccion intestinal por Íleo biliar: reporte de un caso / Biliary Ileus intestinal obstruction. a case report

El ileo biliar es una rara complicación de la colelitiasis no tratada. Presentamos el cuadro clínico y el manejo de un paciente masculino de 72 años (AU)

The biliary or Gallstone ileus is a rare complication of the non-treated Cholelithiasis. We present the clinical features and the treatment of a 72 years old patient

Terminal ileum duplication: an unusual case of small bowel obstruction / Duplicación del ileon terminal: un caso inusual de obstrucción del intestino delgado

Duplications of the alimentary tract are uncommon congenital anomalies that usually present during infancy and early childhood. The case of an adolescent presenting with small bowel obstruction secondary to a duplication cyst is presented and the challenges in the management described.

Las duplicaciones del aparato digestivo constituyen anomalías congénitas poco frecuentes que suelen presentarse durante la infancia y niñez temprana. Se presenta el caso de un adolescente con obstrucción del intestino delgado secundaria a un quiste de duplicación, y se describen los desafíos del tratamiento.

Multiple enteric duplication cysts in a twin fetus

Enteric duplication cysts are rare congenital anomalies of the gastrointestinal tract. These can be suspected if cystic lesions are noted in the fetal abdomen during an antenatal ultrasonogram. The differential diagnoses of fetal intra-abdominal cystic lesions include fetal omental cysts, fetal mesenteric cysts, meconium pseudocysts and fetal ovarian cysts. We report an antenatally diagnosed enteric duplication cyst in one of a set of twin fetuses which was managed successfully

Incomplete small bowel obstruction caused by idiopathic diaphragm disease of the proximal ileum

Diaphragm disease is a rare pathology and describes the phenomenon of circumferential, concentric mucosal lesions of the bowel which can cause progressive narrowing of the bowel lumen and bowel obstruction. The etiology in significant majority of cases is previous or concurrent ingestion of non-steroidal anti-inflammatory drugs [NSAID]. A 55-year-old Caucasian man with no history of prior ingestion of NSAID presented with a three week history of progressive abdominal pain, distension and subsequent absolute constipation. He failed a trial of conservative management and subsequently underwent a laparotomy and small bowel resection for small bowel obstruction. Histopathological analysis revealed diaphragm disease of the small bowel. This case emphasizes the complexities in the management of patients with incomplete small bowel obstruction and highlights the possibility of diaphragm disease of the bowel in the absence of known risk factors

Duplication cyst in a new born

Intestinal duplication is a rare congenital anomaly. Duplications found in proximity of small intestine are the most common enteric duplications encountered and majority of these occurs in the ileum. They may be either cystic or tubular and most of them are located in the mesentery of intestine. We are here presenting a case of a neonate who got delivered by lower segment caesarean section [LSCS] with a huge abdominal mass. At surgery there was huge small gut duplication at ileum

Adenocarcinoma en duplicación intestinal del íleon: Caso clínico / Adenocarcinoma and intestinal duplication of the ileum: Report of one case

Gastrointestinal duplications are uncommon developmental abnormalities that occur anywhere along the gastrointestinal tract. We report a 36 year-old female admitted to the emergency room due to abdominal pain. Computed abdominal tomography demonstrated small bowel ¡oops surrounding a tubular cystic structure and peritoneal free fluid. The surgical exploration revealed multiple malignant implants covering the visceral and parietal peritoneum and infiltrating completely the omentum. At the Heal mesentery we found a tubular cystic whitish tumor measuring 12 cm of diameter and 15 cm on length. A complete resection of the tumor was not considered an option due to the extensive peritoneal dissemination. Thirty-four days after the operation the patient died. The histopathology of the cystic wall was compatible with the architecture of intestinal wall extensively infiltrated by a moderately differentiated mucinous adenocarcinoma; a mucosal lining in parts atrophic and in parts infiltrated or replaced by adenocarcinoma was observed. A well structured muscular layer was recognized, and the myenteric plexus was identified.

Duplicación intestinal: diagnóstico y tratamiento de una condición inusual / Intestinal duplieation: diagnosis and treatment of an unusual condition

We report a 2.5 years old male presenting with abdominal pain, nausea and vomiting lasting 30 days. A CAT scan showed an intestinal duplication cyst. The patient was operated and a cystic lesion of 6 cm diameter was fond and excised along with five cm of terminal ileum. Intestinal transit was reconstituted with a terminal anastomosis between ileum and colon.

Reportamos el caso clínico de un paciente de 2 años y 6 meses de edad que fue intervenido quirúrgicamente por una duplicación intestinal del ileon terminal. Discutimos la presentación clínica, estudio radiológico, procedimiento quirúrgico y resultados del tratamiento. Revisamos la literatura actual pertinente haciendo énfasis en el diagnóstico y tratamiento de estas malformaciones por el potencial de malignidad que presentan en la vida adulta.

Congenital hernia of the cord.

Several embryopathies involve umbilicus including midgut herniation, omphaloceles, urachal and vascular anomalies. Although described earlier, hernia into umbilical cord has not found enough mention in the literature. Poor understanding of its clinical characteristics has made to miscategorization of this entity as "omphalocele minor" by many. Some of these undergo spontaneous reduction or epithelialisation if left alone. The present study describes a series of four consecutive cases of this entity and describe their clinical characteristics, associated GI anomalies and possible embryogenesis.

Jejunal Diverticulitis

Although uncommon, jejunoileal diverticula are associated with significant morbidity and mortality. Both acute and chronic symptoms can be varied and non-specific, making jejunoileal diverticular disease a diagnostic and therapeutic challenge. We report a case of jejunal diverticular disease, complicated by acute diverticulitis, in a 75-year-old male who was successfully treated with conservative approach. The non-surgical approach was enabled by early assessment with multislice CT and active close observation

Association of biliary atresia with jejuno-ileal atresia

Jejuno-ileal atresia [JIA] is a congenital anomaly characterized clinically by bilious vomiting and abdominal distension. The incidence of JIA is between 1: 330 to 1: 3000 live births in different parts of the world. It has been associated with various congenital anomalies but the association of JIA with biliary atresia is extremely rare [0-3.2%]. We herein present a case of jejunal atresia with meconium peritonitis associated with biliary atresia. The patient was a boy who was born at 39 weeks of gestation with polyhydramnious detected on Prenatal Ultra Sonography done at 8th month of gestation. It is important to explore gallbladder in cases of JIA especially when associated with meconium peritonitis

A Case of Ileal Duplication Cyst Lined by Ciliated Columnar and Squamous Epithelium / 대한소화기학회지

Duplication is a rare congenital abnormality and may occur in any region of the gastrointestinal tract. A 19-year-old woman was admitted due to lower abdominal pain. Abdomino-pelvic CT scan showed a cystic mass interpreted as mesenteric cyst or duplication cyst. On the operation finding, it seemed to be arised from mesentery but attached to the ileum. Microscopically, the cystic wall was lined by non-keratinizing squamous, ciliated pseudostratified columnar epithelium, and ectopic gastric mucosa with two distinct muscular layers and a serosa. We report the first case of ileal duplication cyst lined by squamous and ciliated columnar epithelium in Korea.

Atresia of the jejunum and ileum: what is the difference?

BACKGROUND: Atresia of the jejunum and ileum is one of the major causes of neonatal intestinal obstruction. Most affected newborn infants present with bilious emesis and abdominal distention. Traditionally, jejunal and ileal atresia have been grouped together as jejunoileal atresia. OBJECTIVE: To elucidate the difference between jejunal and ileal atresia. MATERIAL AND METHOD: A retrospective analysis of patients diagnosed with jejunal or ileal atresia, who were treated at the Department of Surgery, Queen Sirikit National Institute of Child Health during January 1988 to December 2007, was carried out. RESULTS: There were 74 patients with jejunal atresia and 68 patients with ileal atresia. The mean birth weight and gestational age of patients with jejunal atresia were significantly lower than those with ileal atresia. Antenatal perforation occurred more frequently in ileal atresia. Postoperative course was more prolonged and mortality was higher injejunal atresia. Prolonged ileus and anastomotic dysfunction requiring long-term parenteral nutrition were the major causes of complications leading to death. CONCLUSION: There were many differences between patients with jejunal atresia and those with ileal atresia. The more compliant jejunal wall allows massive dilatation upon obstruction with subsequent loss of peristaltic activity, thus poorer outcome in comparison with ileal obstruction. We suggest that atresia of the jejunum and ileum be considered differently.

Adenocarcinoma in an ileal duplication.

Alimentary tract duplications are a rare congenital anomalies that usually present in childhood and occasionally in adults. To our knowledge, since 1884, there have been only 14 reported cases of ileal duplications in adults of which 3 patients had developed malignancy in the duplicated ileum. We report here such an extremely rare case of isolated ileal duplication in an elderly male in whom malignancy occurred and perforated.

Recurrent Lower Gastrointestinal Bleeding from Congenital Arteriovenous Malformation in the Terminal Ileum Mimicking Intestinal Varicosis: A Case Report

We report on an exceptional vascular cause of gastrointestinal hemorrhage. A 30-yr-old man was admitted because of recurrent hematochezia. Colonoscopy showed circumferential, erythematous, and nodular vascular distensions with hematocystic spots in the terminal ileum resembling varicosis and subsequent computed tomography with 3-dimensional angiographic reconstruction revealed a vascular architecture around the terminal ileum. No other potential source of bleeding was identified. The patient was treated by ileocecectomy and the final diagnosis was of an arteriovenous malformation confined to the terminal ileum. He has been followedup without a further hemorrhagic episode.

Ileo biliar / Biliary ileus

El íleo biliar es una entidad clínica difícil de diagnosticar que se produce como resultado de una comunicación anormal entre la vía biliar y el tubo digestivo, con la consiguiente evaluación del cálculo e impactación del mismo distalmente hasta que se presenta como un cuadro de obstrucción intestinal. Reportamos el caso de un paciente de 47 años de edad, sin antecedentes médicos ni quirúrgicos de importancia, que ingresó al servicio de emergencias quirúrgicas con un abdomen agudo, caracterizado por dolor en epigastrio e hipocondrio derecho de cinco días de evolución, fiebre y vómitos. El ultrasonido de abdomen reveló una colecistitis aguda. La radiografía simple de abdomen mostró niveles hidroaéreos y una asa fija en el hipocondrio derecho. La laprotomía exploratoria reveló una fístula colecistogástrica asociada a obstrucción intestinal secundaria a un lito biliar enclavado en el íleon terminal. Se le practicó una colecistectomía, enterolitotomía, enterorrafia y reparación de la fístula en un solo tiempo quirúrgico. Se realiza una revisión bibliográfica de este tema de difícil diagnóstico, con el fin de exponer la controversia que aún existe sobre el manejo quirúrgico del íleo biliar y establecer los diversos criterios de resolución quirúrgica, tanto en uno como en 2 tiempos quirúrgicos. Descriptores: Ileo biliar, obstrucción intestinal, fístula colecistogástrica, gallstone ileus, intestinal obstruction, cholecystogastric fistula