Can fruit seeds and undigested plant residuals cause acute appendicitis

<p><b>OBJECTIVE</b>To investigate the relation between fruit seeds, plants residuals and appendicitis.</p><p><b>METHODS</b>Among cases that underwent appendectomy, the appendicitis cases having fruit seeds and undigested plant residuals in their etiology were examined retrospectively. Also, histopathological features, age, sex, and parameters of morbidity and mortality were used.</p><p><b>RESULTS</b>Fruit seed was found in one case (0.05%) with presence of pus in appendix lumen, undigested plant residuals in 7 cases (0.35%). It was determined that there were appendix inflammation in 2 of the plant residuals cases, while there were obstruction and lymphoid hyperplasia in the appendix lumen of 5 cases. No mortality was observed.</p><p><b>CONCLUSIONS</b>The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.</p>

Adult intussusception at the line of Braun anastomosis causing small bowel obstruction: report of a case

Intussusception is a rare disease in adulthood. Its clinical findings are indistinct and therefore it is hard to diagnose. It is also a rare complication after gastric surgery. Intussusception into Braun anastomosis is seen due to peristaltic movement of small bowel loop into the enlarged jejunojejunostomy section. It may be fetal due to intestinal necrosis unless diagnosed early. It may be seen soon after gastric surgery or it may be seen years later. We report a rare case of intussusception into the Braun anastomosis in a patient with a history of gastric surgery twenty years ago and review the relevant literature

Small bowel tumors: insidious and important abdominal problems for surgeons

To evaluate the major clinical symptoms, etiology and presentation of small bowel tumors so that they can be diagnosed. Retrospective study. Izmir Bozyaka Teaching and Research Hospital, Turkey. Forty-five patients with 46 small bowel tumors over a 15-year period were included in the study. Biopsy or small bowel resection. The data obtained from the medical records including clinical features, diagnostic workup, operative procedures and pathologic diagnosis. The male to female ratio was 1.4:1 with a median age at presentation of 53 years [range, 30 - 83 years]. Thirty [66.7%] patients presented with abdominal emergencies such as bowel obstruction [40%], bowel perforation [24.4%] and intestinal bleeding [2.3%]. Non-urgent presentations were found in 15 [33.3%] patients. The preoperative diagnosis of small bowel tumor was positive in nine [20%] of the elective cases. The tumors were located in the ileum in 68.8%, the jejunum in 26% and the duodenum in 6.6% of patients. Thirty-eight [82.6%] malignant and eight [17.4%] benign tumors were identified. In addition, patients with malignant tumors more commonly presented with bowel obstruction and perforation. Segmental resection was done in 41[91%] patients. These observations suggest that small bowel tumors are difficult to diagnose because of delayed presentations and vague symptoms. Clinicians must have a high degree of suspicion and should perform early laparotomy without hesitation