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Laparoscopically Treated Small Bowel Obstruction Due to Internal Herniation Through the Broad Ligament

100%

Vyrdal C. D., El-Hussuna A.

vol. 86

issue 8

377-379

The authors reported a case of small bowel obstruction secondary to internal herniation through a defect of the broad ligament. This is a rare cause of small bowel obstruction. A 42 year-old woman without previous abdominal surgery presented with episodes of abdominal pain, nausea and vomiting. Due to rather unspecific and changing symptoms and the fact that objective findings were normal the patient was discharged and admitted a couple of times before a computed tomography-scan showed small bowel obstruction. Acute diagnostic laparoscopy showed internal herniation of a loop of small bowel trapped in a 2 cm defect in the right side of the broad ligament. The defect was gently expanded bluntly and it was then possible to retract the strangulated part of the small bowel which afterwards was vital. The defect was sutured laparoscopically. The postoperative recovery was uneventful. This case demonstrates that a preoperative diagnosis is difficult and a high index of suspicion is necessary to prevent diagnostic delay. Internal herniation through a defect in the broad ligament should be considered as a differential diagnosis in female patients presenting with symptoms of small bowel obstruction without a history of prior abdominal surgery, especially in parous women.

Ileus and Intestinal Obstruction - Comparison Between Children and Adults

84%

Peyvasteh M., Askarpour S., Javaherizadeh H., Taghizadeh S.

Bowel obstruction is the interference with movement of bowel content. Large and small in testing from duodenum to anal region can be obstructed mechanical or non-mechanical and complete or partial. Mechanical obstruction can presented because of obstructive causes in intestinal lumen, intestinal wall or pressure from other tissue on intestine.The aim of the study was to evaluate etiology, laboratory findings of intestinal obstruction and ileus among children and adults who discharged with good condition.Material and methods. This retrospective study was carried out from 2001 to 2006 in Imam Khomeini Hospital (Ahvaz-Iran). Cases of bowel obstruction were included in this study. For each case, a questionnaire was filled. There are 752 cases with suspected bowel obstruction. From 752 cases, 403 patients that agreed and treated and discharged with good condition were studied. Cases were divided into two groups: children (age < 15 yrs) and adults (age> 15 yrs). Data were analyzed by SPSS Ver 16.0 (Chicago, IL, USA) and Epi-info Ver 6.00.Results. In our study, 221 adults and 192 children were included. Mortality rate was 12.2%. Forty-eight percent of 403 cases were children (m - 61%, f - 38%, ambigus genitalia - 1%) and 52% were adults (m - 67%, f - 33%). Etiology of bowel obstruction in children were as follows: ileus (26%); adhesion band (17.7%), partial obstruction (16.1%), and Hirschsprung's disease (12%). Causes of bowel obstruction in adults are: partial obstruction (29.9%); ileus (19%); adhesion band (18.5%); colonic pseudo obstruction(8.5%); GI cancer (5.2%); hernia (4.7%); Crohn (2.8%); fecal impaction (3.3%); bezoar (2.4%), and 4.7% for other causes. Fifty-one percent of children and 36% of adults were operated. Of all children, 91.7% had upright abdominal X-ray, 51.6% had supine X-ray, and 80.7% had sonography. Hundred percents of adults had upright & supine plain abdominal X-ray and 75.4% had sonography. Most change in children's CBC was 10000

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2 Polish Journal of Surgery

1 2014

1 2011

1 Askarpour S.

1 El-Hussuna A.

1 Javaherizadeh H.

1 Peyvasteh M.

1 Taghizadeh S.

1 Vyrdal C. D.

Search results

Laparoscopically Treated Small Bowel Obstruction Due to Internal Herniation Through the Broad Ligament

Ileus and Intestinal Obstruction - Comparison Between Children and Adults