ABSTRACT
We report the successful surgical treatment of intestinal obstruction caused by enteroliths formed in jejunal diverticula. A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. Thus, we performed a laparotomy, which revealed multiple diverticula in the jejunum, with one enterolith inside a diverticulum and one enterolith in the terminal ileum. There was no abnormal communication between the gallbladder and the intestinal tract, excluding the possibility of a gallstone ileus. The stone in the terminal ileum could not be broken manually, so we performed an enterotomy to remove the stones. Intestinal obstruction caused by enteroliths in small-bowel diverticula is a rare event, which is difficult to diagnose and manage. To our knowledge, only 35 such cases have ever been reported.
Subject(s)
Calculi/complications , Diverticulum/complications , Intestinal Obstruction/etiology , Jejunal Diseases/complications , Aged , Calculi/diagnosis , Calculi/surgery , Diagnosis, Differential , Diverticulum/diagnosis , Diverticulum/surgery , Humans , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Jejunal Diseases/diagnosis , Jejunal Diseases/surgery , Laparotomy , Male , Tomography, X-Ray ComputedABSTRACT
A case of perforated gastrointestinal stromal tumor (GIST) of small intestine causing acute abdomen is described, with a brief review of the literature. A male patient presented with symptoms of acute abdomen. After evaluation, a laparotomy was performed, where perforation of a tumor in the ileum was found. The perforated part along with the tumor was resected and the cytopathological examination showed that the tumor was GIST. Postoperatively, the patient received treatment, using imatinib. Gastrointestinal stromal tumors are relatively rare and often present with vague symptoms. Their first clinical manifestation as acute abdomen due to their perforation is extremely rare. In emergency laparotomy, a R0 resection is required and adjuvant therapy with imatinib must be considered.
Subject(s)
Abdomen, Acute/etiology , Abdomen, Acute/therapy , Gastrointestinal Stromal Tumors/pathology , Gastrointestinal Stromal Tumors/therapy , Ileal Neoplasms/pathology , Ileal Neoplasms/therapy , Aged , Humans , MaleABSTRACT
A 53-year old male, with a history of squamous cell lung carcinoma, was presenting with jaundice. Examinations showed a pancreatic tumor infiltrating the common bile duct and a percutaneous biopsy proved that the lesion was metastatic from the lung carcinoma. The decision was taken to perform a laparotomy. During laparotomy, a palliative operation was performed to relieve the jaundice. According to the literature, symptomatic metastatic lesions of the pancreas from squamous cell carcinoma of the lung are infrequent.
