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Surg Endosc 2021 May 14. Epub 2021 May 14.

Section of Minimally Invasive and Bariatric Surgery, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr. EH 122, Indianapolis, IN, 46202, USA.

Background: Chylous ascites is often reported in cases with lymphatic obstruction or after lymphatic injuries such as intraabdominal malignancies or lymphadenectomies. However, chylous ascites is also frequently encountered in operations for internal hernias. We sought to characterize the frequency and conditions when chylous ascites is encountered in general surgery patients. Read More

BMJ Case Rep 2021 May 13;14(5). Epub 2021 May 13.

Department of Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA.

Visceral myopathy is a rare, often misdiagnosed disease characterised by abnormalities in the gastrointestinal smooth muscle layer. Its clinical presentation includes pseudo-obstruction, intestinal dysmotility and spontaneous perforation. We report an atypical case of a 51-year-old man with a history of recurrent small bowel perforations who presented with an acute abdomen. Read More

Gastrointest Tumors 2021 Apr 18;8(2):58-62. Epub 2021 Feb 18.

Department of General Surgery, AIIMS, Bhopal, Madhya Pradesh, India.

Hepatic EHE (epithelioid hemangioendothelioma) is an uncommon entity of vascular origin and a low-grade malignant tumor. Primary hepatic EHE is rare. These tumors can be multifocal at presentation like in the soft tissues, bones, brain, liver, and small intestine. Read More

Adv Clin Exp Med 2021 May 11. Epub 2021 May 11.

Department of Hematology, Transplantation and Internal Medicine, University Clinical Center of the Medical University of Warsaw, Poland.

Amyloidosis is a heterogeneous group of diseases in which the extracellular deposition of abnormal fibrillar proteins disrupts tissue structure and function. Intestinal involvement is a very rare manifestation of amyloidosis compared to the most affected organs, the heart and kidneys. Damage of the gastrointestinal tract may be the only manifestation of amyloidosis, or - more often - is a component of the involvement of several organs in systemic amyloidosis. Read More

Colorectal Dis 2021 May 11. Epub 2021 May 11.

Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Background: Clinical trials suggest that hyaluronate carboxymethycellulose (HA/CMC) prevents adhesion-related complications after intra-abdominal surgery, but at a high upfront cost. This study evaluated the cost-effectiveness of HA/CMC for patients undergoing curative-intent open colorectal cancer surgery.

Methods: Using a Markov Monte Carlo microsimulation model, we conducted a cost-utility analysis comparing the cost-effectiveness of HA/CMC at curative-intent open colorectal cancer surgery versus standard management. Read More

Cureus 2021 Apr 7;13(4):e14351. Epub 2021 Apr 7.

First Department of Surgery, Saint George General Hospital of Chania, Chania, GRC.

Abdominal cocoon syndrome or encapsulating peritoneal sclerosis is a rare condition causing small bowel obstruction. It is called cocoon syndrome because of the existence of an abnormal membrane that contains part or the entire small intestine. We present a case of a 49-year-old male, presenting to our department with recurrent episodes of obstructive ileus that did not respond to conservative treatment. Read More

World J Clin Cases 2021 May;9(13):3114-3119

Endoscopy Center, Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China.

Background: Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract. Gastric ulcer, gastrointestinal perforation, and intestinal obstruction are the main complications. Acute pancreatitis secondary to bezoar is rare. Read More

Autops Case Rep 2021 Apr 20;11:e2021279. Epub 2021 Apr 20.

Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Departamento de Patologia, Botucatu, SP, Brasil.

Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant polyposis entity that often remains undiagnosed. The major problems associated with PJS are acute complications due to (i) polyp-related intestinal obstruction, (ii) intussusception, and (iii) the risk of cancer in the long-term. We report the case of a 32-year-old female who presented at the emergency room with signs of acute abdomen and died during the clinical workup. Read More

Cureus 2021 Apr 6;13(4):e14330. Epub 2021 Apr 6.

Internal Medicine, Northwestern Medicine McHenry Hospital, Rosalind Franklin University of Medicine and Science, McHenry, USA.

Small bowel obstruction can occur due to multiple etiologies, including intra-abdominal adhesions, hernias, strictures, Crohn's disease, and malignancies. An infrequent cause of small bowel obstruction can be seed bezoars. We present a case of a 72-year-old male who presented to the emergency department with a clinical picture of small bowel obstruction without any apparent risk factors for this condition. Read More

F1000Res 2019 14;8:55. Epub 2019 Jan 14.

Faculty of Medicine, Institute of Social and Preventive Medicine (ISPM), Bern, 3012, Switzerland.

A 38-year-old woman presented at Orotta National Referral Hospital emergency department in May 2017 with pain in the epigastric region and vomiting. Physical examination revealed no pertinent findings. Blood and urine tests were normal, and erect abdominal x-ray revealed a distended small intestine with multiple layers of "air-fluid levels". Read More

Surg Obes Relat Dis 2021 Mar 8. Epub 2021 Mar 8.

Section of Minimally Invasive and Bariatric Surgery, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, California; Center for Obesity and Metabolic Health, University of California, Los Angeles, California; Center for Advanced Surgical & Interventional Technology, University of California, Los Angeles, California. Electronic address:

Background: Small bowel obstruction (SBO) following laparoscopic Roux-en-Y gastric bypass (LRYGB) is associated with significant morbidity.

Objectives: To evaluate the rate of and risk factors for readmission for SBO within 30 days of LRYGB.

Setting: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)-accredited centers. Read More

Am J Surg 2021 Apr 30. Epub 2021 Apr 30.

Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA. Electronic address:

Background: Small bowel obstructions (SBO) are one of the most common surgical emergencies, but they remain a major cause of high morbidity and mortality in patients with previous history of abdominal and pelvic surgery. Socioeconomic factors have not been extensively studied in surgical management of SBO.

Methods: We queried the 2016 NRD database for all surgically managed admissions ≥18 years of age with a primary diagnosis of SBO. Read More

Int J Surg Case Rep 2021 Apr 27;82:105905. Epub 2021 Apr 27.

Department of General Surgery, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia.

Introduction And Importance: Heterotopic mesenteric ossification is a benign bony tissue growth in the mesentery that mostly follows repetitive or severe abdominal injuries leading to reactive bone formation in the mesentery. There are only 73 cases (51 publications) identified in the literature up to the beginning of 2020.

Case Presentation: 45-year-old Saudi male underwent multiple laparotomies to manage complicated appendicitis which ended with a diverting ileostomy and a colostomy as a mucus fistula. Read More

Scand J Gastroenterol 2021 May 7:1-7. Epub 2021 May 7.

Digestive Surgery Unit, Fondazione Policlinico Agostino Gemelli IRCCS di Roma, Rome, Italy.

Introduction: The incidence of adhesive bowel obstruction (ASBO) progressively increases with age. Strong evidences on the influencing role of age on ASBO clinical course and management are still lacking. Aim of this study is to retrospectively analyze the clinical outcomes of patients older than 65 years of age admitted to a tertiary referral Emergency Department with a diagnosis of ASBO. Read More

Urologiia 2021 May(2):14-20

Department of Urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia.

Aim: To present the technical features and results of intestinal and appendicular ureteral replacement.

Material And Methods: From 1998 to 2020, a total of 196 patients aged 18 to 77 years (mean age 49.5 +/- 1. Read More

Surg Endosc 2021 May 6. Epub 2021 May 6.

Department of Surgery, McGill University Health Centre, Glen Campus-DS1.3310, 1001 Decarie Boulevard, Montreal, QC, H3G 1A4, Canada.

Introduction: Emergency department (ED) visits after surgery represent a significant cost burden on the healthcare system. Furthermore, many ED visits are related to issues of healthcare delivery services and may be avoidable. Few studies have assessed the reasons for ED visits after colorectal surgery. Read More

J Surg Case Rep 2021 Apr 30;2021(4):rjab024. Epub 2021 Apr 30.

Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.

Gallstone ileus (GSI) is an uncommon entity that causes obstruction of the intestinal lumen due to gallstones. It affects mainly the elderly with multiple comorbidities, leading to a high mortality rate. In this case, an 81-year-old woman was admitted due to GSI. Read More

BMJ Case Rep 2021 May 6;14(5). Epub 2021 May 6.

Department of General Surgery, Ayr Hospital, Ayr, UK.

An 85-year-old man with no previous laparotomies and no herniae presented with a small bowel obstruction. CT imaging did not suggest any obvious cause; however, a transition point at the terminal ileum was noted. At laparotomy, the small bowel was unexpectedly found to be obstructed through a tight anterior hiatal defect. Read More

AJR Am J Roentgenol 2021 May 6:1-7. Epub 2021 May 6.

Department of Radiology, NorthShore University HealthSystem, Evanston, IL.

The purpose of this study was to reassess the outcome and potential consequences of intraperitoneal barium leakage during radiologic evaluation of the gastrointestinal tract. This retrospective study included 18 patients who had significant intraperitoneal leakage of barium from gastrointestinal perforations that were not suspected or diagnosed before the radiologic procedures. This complication occurred during a barium enema examination in nine patients, an upper gastrointestinal study in seven, and a small bowel series in two patients. Read More

J Gastrointest Surg 2021 May 4. Epub 2021 May 4.

Gastrointestinal Associates, PC, 1311 Dowell Springs Blvd, Suite 300, Knoxville, TN, 37909, USA.

J Med Case Rep 2021 May 4;15(1):239. Epub 2021 May 4.

Department of Pediatric, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey.

Background: Intrauterine midgut volvulus is a very rare, life-threatening condition, and prenatal diagnosis is difficult. In this article, we present a case of midgut volvulus followed by a pre-diagnosis of antenatal jejunal atresia.

Case Presentation: A 1-day-old Turkish male baby, who was followed with a diagnosis of antenatal jejunal atresia, with a birth weight of 3600 g, delivered by cesarean section at 38 weeks of gestation from a 19-year-old mother in her fourth pregnancy, was taken to the newborn intensive care unit. Read More

Ann Card Anaesth 2021 Jan-Mar;24(1):92-94

Department of General Medicine, Apollo Multi.Speciality Hospital, Sheshadripuram, Bangalore, Karnataka, India.

Gastrointestinal mucormycosis involving ileum is a very rare phenomenon. We present a case of 52-year-old male, known case of diabetes mellitus requiring extracorporeal membrane oxygenation (ECMO) for H1N1 pneumonia with severe acute respiratory distress syndrome (ARDS). The patient had small bowel obstruction with impending perforation requiring emergency bowel resection and ileostomy. Read More

J Anus Rectum Colon 2021 28;5(2):197-201. Epub 2021 Apr 28.

Department of Gastroenterological Surgery, Yokohama City University Graduate School Medicine, Yokohama, Japan.

Here, we report our experience with a 5-mm trocar site hernia (TSH) near a stoma. This is the first report describing the relationship between TSH and extraperitoneal colostomy. A 72-year-old man underwent laparoscopic abdominoperineal resection with extraperitoneal sigmoid colostomy and partial hepatectomy for rectal cancer accompanied by synchronous liver metastasis (pT3N1aM1a Stage IVA Union for International Cancer Control [UICC] 8th edition). Read More

Radiol Case Rep 2021 Jun 14;16(6):1469-1472. Epub 2021 Apr 14.

Radiology Department, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla sn 39008, Santander, Spain.

We present a case of cecal bascule in a 60-year-old woman with abdominal pain and vomiting. Imaging tests revealed a cecal bascule causing mechanic obstruction of the stomach. Besides a small bowel dilatation was not seen, the distended cecum was extrinsically obstructing the antrum and therefore, the gastric outlet. Read More

BMC Surg 2021 May 1;21(1):227. Epub 2021 May 1.

Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, No. 5 Jingyuan Road, Shijingshan District, Beijing, 100043, China.

Background: Preperitoneal herniation is a rare complication after transabdominal preperitoneal patch plasty (TAPP) and may be caused by inadequate peritoneal closure. We herein report two cases of postoperative small bowel obstruction due to preperitoneal herniation through a disrupted peritoneum.

Case Presentation: Two men in their 70s were admitted to our center because of small bowel obstruction after TAPP. Read More

Cureus 2021 Mar 27;13(3):e14142. Epub 2021 Mar 27.

General Surgery, All India Institute of Medical Sciences, Rishikesh, IND.

Intestinal obstruction is one of the most important cause of acute abdomen. An internal herniation is an uncommon yet relevant clinical entity causing an acute intestinal obstruction that can occur after major bowel surgery. Here, we describe a case of acute intestinal obstruction caused by internal herniation in a patient with muscle-invasive urinary bladder carcinoma who underwent robot-assisted radical cystectomy with an ileal conduit. Read More

J Surg Case Rep 2021 Apr 24;2021(4):rjab148. Epub 2021 Apr 24.

General Surgery Department, Hospital del Mar, Barcelona, Spain.

Caecal volvulus represent the 20-40% of colonic volvulus, being the second most frequent localization. It causes intestinal occlusion symptomatology (nausea, vomiting, abdominal distension). We present a case of 45-year-old women with feeding jejunostomy tube due to connatal anoxia. Read More

J Surg Case Rep 2021 Apr 19;2021(4):rjab118. Epub 2021 Apr 19.

Department of Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Hospital Rd, Concord, New South Wales, Australia.

Bouveret syndrome is a rare complication of cholecystitis, in which impaction of a gallstone creates a cholecystoduodenal fistula leading to gastric outlet obstruction. We report a case of a 90-year-old female who presented with nausea and vomiting on a background of previous necrotic cholecystitis managed conservatively. Computed tomography of the abdomen demonstrated a large gallstone impacted in the third part of the duodenum leading to gastric outlet obstruction. Read More

Ann Med Surg (Lond) 2021 May 10;65:102284. Epub 2021 Apr 10.

Department of Radiology, Kabul University of Medical Sciences, Kabul, Afghanistan.

Introduction: Superior mesenteric artery syndrome is a rare entity, caused by compression of the duodenum between the superior mesenteric artery and the aorta.

Case Presentation: A 16-year-old male in the inpatient service of our hospital complained of vomiting for two weeks. The patient had a long hospital stay in our center for the management of trauma-related complications, which resulted in significant weight loss despite the parenteral nutrition as he was unable for taking the enteral nutrition due to severe facial traumatic injury. Read More

BMJ Case Rep 2021 Apr 28;14(4). Epub 2021 Apr 28.

Department of Anatomy, Makunda Christian Leprosy and General Hospital, Karimganj, India.

We report a case of right paraduodenal hernia with strangulation of almost the entire small bowel at presentation. Since resection of all bowel of doubtful viability would have resulted in too little residual length to sustain life, a Bogota bag was fashioned using transparent plastic material from an urine drainage bag and the patient monitored intensively for 18 hours. At re-laparotomy, clear demarcation lines had formed with adequate length of viable bowel (100 cm) and resection with anastomosis was done with a good outcome on follow-up, 9 months after surgery. Read More