Gossypiboma as a Rare Cause of Small Bowel Obstruction: A Case Report.

Unintentionally retained textile foreign bodies in the abdomen after laparotomy is a serious medical error, with unknown incidence which can lead to severe complications. We present the case of a 24-year-old woman with a retained surgical sponge migrated into the jejunal lumen and causing an intestinal obstruction. Removal of the foreign body required repeated laparotomy and segmental resection of the affected intestinal loop. The article provides the analysis of the imaging diagnostic results, as well as possible reasons that led to the foreign body being left unintentionally. Reliable reduction of incidence and severity of consequences after retention of textile surgical objects in the abdomen can only be achieved through improved standards of patient safety, including careful sponge counting and the routine use of materials with radiopaque markers.

Duplication of Inferior Vena Cava, Possible Cause of Internal Hernia? Literature Review and Rare Case Presentation.

Duplication of inferior vena cava (DIVC) is a rare congenital malformation of extreme importance for vascular and urology surgeons, interventional radiologists. Oftentimes it goes unnoticed and is diagnosed incidentally at a routine or emergency CT-scan when complications occur due to associated congenital malformations. We present a case of a 70-year-old male patient who was admitted into the emergency room (ER) accusing abdominal pain. He was diagnosed with an intestinal obstruction due to a left paraduodenal hernia (LPDH), associated with a DIVC. The reviewing the literature led to concluding that DIVC is not the cause of LPDH.

Surgical Management of Malignant Intestinal Obstruction: Outcome and Prognostic Factors.

Background: Malignant intestinal obstruction is a frequent complication in advanced stages cancer patients. The prognosis is poor, with mean survival rate beneath 3 months. Clinical treatment, endoscopic or surgical procedures are options for malignant intestinal obstruction management. There is no generally accepted management strategy. Objectives: To evaluate prognostic factors of patients with malignant intestinal obstruction who underwent surgical treatment. Methods: A retrospective analysis was performed including patients of a single institution with diagnosis of malignant intestinal obstruction. Demographic data, in-hospital stay, postoperative complications, and overall survival were assessed. Logistic regression was used to evaluate associated prognostic factors. Results: Two hundred thirty-three surgeries were performed due to suspicion for malignant intestinal obstruction over a seven-year period. This diagnosis was confirmed in 210 operations (90.1%). The main causes of malignant obstruction were colorectal (49.5%) and gynecological cancer (21.9%). The rate of severe complications was 11.42%. In-hospital mortality rate was 40.95% (CI 95%: 34.16-47.74%). Functional status impairment,high serum urea, and low albumin levels were associated to higher mortality rate. Conclusion: Malignant intestinal obstruction implies poor prognosis, with high in-hospital mortality rate and severe postoperative complications. The decision regarding management of malignant intestinal obstruction must be multimodal and individualized, according to individual prognostic factors.

A Rare Case of Intestinal Obstruction in an Elderly Woman.

Among intestinal obstruction, intussusception is one of the rare mechanical causes in the adult period. When it is met it present with abdominal pain, vomiting and other symptoms compatible with intestinal obstruction varying on the segments being involved. Compared to pediatric invagination which it is mostly idiopathic the adult form has an organic etiology causing a blurred symptomatology and needing advanced imaging diagnosis like computerized tomography. We present the case of a 70 year old woman with multiple Emergency Department presentations with abdominal pain and vomiting which received a clear diagnosis only the third time she came to hospital. Ultrasonography and plain abdominal x-ray were no specific and only the CT scan revealed the real cause of obstruction. Also conservative measures were useless the definitive treatment being surgery, the lesion necessitating enteral resection and end to end anastomosis. The pathology report revealed a benign tumor of proximal jejunum. In conclusion, adult intestinal invagination, although it is a rare condition, can present with symptomatology varying with segment of bowel involved into the intussusception. Unlike pediatric invagination, the adult one needs standard surgical revision unless there are certain contraindications.

Oclusión intestinal por duplicación intestinal: diagnóstico y tratamiento en urgencias / Intestinal occlusion by intestinal duplication: diagnosis and treatment in the emergency

Las duplicaciones intestinales son anomalías congénitas; se han descrito a lo largo de todo el tracto digestivo con una presentación clínica inespecífica. Reportamos el caso clínico de un paciente de 83 años intervenido quirúrgicamente por una oclusión intestinal por duplicación intestinal del íleon terminal. Discutimos la presentación clínica, estudios de imagen, procedimiento quirúrgico y resultados del tratamiento. Revisamos la literatura actual pertinente por ser un hallazgo etiológico de oclusión intestinal poco frecuente.

The intestinal duplication are congenital abnormalities; have been described throughout the digestive tract with a nonspecific clinical presentation. We report the clinical case of a patient of 83 years underwent surgery for an intestinal occlusion by intestinal duplication of the terminal ileum. We discuss the clinical presentation, image studies, surgical procedure and results of treatment. We review the current literature relevant to be a finding etiological diagnosis of intestinal occlusion rare.

The diagnostic value of multi-slice spiral CT to carcinomatous intestinal obstruction of colon / 中国医师进修杂志

Objective To explore the clinical value ofmulti-slice spiral CT (MSCT) to carcinomatous intestinal obstruction of colon.Methods The clinical and MSCT data of 40 patients with carcinomatous intestinal obstruction of colon diagnosed by MSCT were analyzed.Results In the 40 cases,complete intestinal obstruction were in 17 cases,incomplete intestinal obstruction in 23 cases,39 cases were carcinomatous intestinal obstruction of colon confirmed by surgery and pathology,and 1 case was intussusception intestinal obstruction by multiple polyps.The MSCT qualitative analysis of obstruction reason was 97.5％ (39/40),the MSCT diagnostic accuracy of intestinal obstruction was 100.0％ (40/40).The obstruction site was at ascending colon showed in 14 cases,transverse colon in 4 cases,splenic flexure of colon in 2 cases,descending colon in 6 cases,sigmoid colon in 12 cases,both ascending colon and transverse colon in 1 case,colon and small intestine in 1 case.The obstruction site accuracy rate of MSCT was 100.0％ (40/40).Conclusion MSCT has obvious advantages in obstruction existing,obstruction site,obstruction reason to carcinomatous intestinal obstruction of colon,it can offer reliable examination data to clinic.