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Penetrating ectopic peptic ulcer in the absence of Meckel's diverticulum ultimately presenting as small bowel obstruction

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World Journal of Gastroenterology 2007年第46期13卷 6281-6283页

作者： Hilary Hurley Ronan A Cahill Paul Ryan Ashraf I Morcos Henry P Redmond Helen M Kiely Department of Surgery Cork University HospitalCorkIreland Department of Pathology Cork University HospitalCorkIreland Department of Gastroenterology Mercy University HospitalCorkIreland

We report here how a heterotopic penetrating peptic ulcer progressed to cause small bowel obstruction in a pa- tient with multiple previous negative investigations. The clinical presentation, radiographic features and patho- logical findings of this case are described, along with the salient lessons learnt. The added value of wireless cap- sule endoscopy （WCE） in such circumstances is debated.

关键词： Non-Meckelean ectopic peptic ulcer bowel obstruction

Recurrent small bowel obstruction secondary to jejunal diverticular enterolith: A case report

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World Journal of Gastrointestinal Surgery 2022年第8期14卷 849-854页

作者： Chanyang Lee Geoffrey Menezes Department of General Surgery Geraldton Regional HospitalGeraldton 6530WAAustralia

BACKGROUND Small bowel diverticulosis is an uncommon condition which is usually asymptomatic and is discovered incidentally. One rare complication is enteroliths forming in the diverticula causing bowel obstruction. Only a few cases of such have been described in literature, and recurrence from this aetiology has not been reported previously. This case report outlines the management of a 68-year-old male who presented with recurrent small bowel obstruction secondary to jejunal diverticular enterolith impaction, seven months following a previous *** SUMMARY A 68-year-old male presented with symptoms of small bowel *** tomography(CT) of the abdomen demonstrated small bowel obstruction from an enterolith formed in one of his extensive jejunal diverticula. He required a laparotomy, an enterotomy proximal to the enterolith, removal of the enterolith, closure of the enterotomy, and resection of a segment of perforated ileum with stapled side-to-side anastomosis. Seven months later, he represented to emergency department with similar symptoms. Another CT scan of his abdomen revealed a recurrent small bowel obstruction secondary to enterolith impaction. He underwent another laparotomy in which it was evident that a large enterolith was impacted at the afferent limb of the previous small bowel anastomosis. A part of the anastomosis was excised to allow removal of the enterolith and the defect was closed with cutting linear stapler. In the following two years, the patient did not have a recurrent episode of enterolith-related bowel *** The pathophysiology underlying enterolith formation is unclear, so it is difficult to predict if or when enteroliths may form and cause bowel obstruction. More research could provide advice to prevent recurrent enterolith formation and its sequelae.

关键词： Small bowel diverticulosis Jejunal diverticulosis bowel obstruction Recurrent enterolith Acute care surgery Case report

Benefits of laparoscopy-assisted ileostomy in colorectal cancer patients with bowel obstruction

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世界临床病例杂志 2023年第24期11卷 5660-5665页

作者： Yi-Jie Wang Kuan-Hsun Lin Jung-Cheng Kang Je-Ming Hu Chao-Yang Chen Ta-Wei Pu Department of Surgery Tri Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgerySongshan branchTri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND Ileostomies are commonly performed after colon and rectal ***-assisted ileostomy with adhesion lysis may have potential benefits over conventional open *** To compare the outcomes of laparoscopy-assisted and conventional *** Data from 48 consecutive patients who underwent ileostomy at our institution between May 2021 and May 2022 were retrospectively *** groups comprised 26 and 22 patients who underwent laparoscopic ileostomy(laparoscopic group)and conventional ileostomy(conventional group),respectively,performed by a single *** demographics,operative characteristics,postoperative outcomes,and 30-d morbidities and mortality rates were *** The two groups had comparable mean ages,sex distributions,American Society of Anesthesiologists scores,and body mass ***,the laparoscopic group showed similar operative time,better visualization for adhesion lysis,and lower visual analog scale scores than the conventional *** Laparoscopy-assisted ileostomy is a safe and efficient method that produces lower visual analog scale scores,better intraoperative visualization for effective adhesion lysis,and similar operative time compared with conventional ileostomy.

关键词： Laparoscopy Ileostomy Colorectal cancer bowel obstruction Tissue adhesion Retrospective study

Application of stilamin on advanced gastrointestinal carcinoma patients complicated with malignant bowel obstruction

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The Chinese-German Journal of Clinical Oncology 2008年第4期7卷 233-236页

作者： Jundong Wu Yezhong Zhuang Wenhe Huang Miansheng Huang Weifeng Wang Muming Xu Department of Abdominal Surgery The Affiliated Cancer Hospital of Shantou University Medical College Shantou 515031 China

Objective： To investigate the effectiveness of stilamin in malignant bowel obstruction （MBO） due to advanced gastrointestinal carcinoma patients. Methods： 62 patients with MBO due to gastrointestinal carcinoma were randomly divided into two groups： routine therapy group （control group 30 patients） and stilamin group （32 patients）. Stilamin group received routine therapy combined with stilamin （6 rag/d） by 24 hours continuous infusion for three to twelve days. The curative effectiveness was observed and compared between the two groups. Results： After treatment, the clinical symptoms of abdominal distention and abdominal pain were relieved significantly in stilamin group compared with the control group （84.4% vs 57.6%; P 〈 0.05）. The exhaust of anus was more earlier （62.1% vs 25.6%; P 〈 0.05）, and the average volume of gastrointestinal decompression reduced more rapidly in stilamin group compared with the control group [（216 ± 158） mL/d vs （522 ± 184） mL/d; P 〈 0.001）, smaller and less fluid-air in the intestinal and in the colon at the 81.3% of patients plain abdominal radiography were observed in stilamin group. Quality of life, evaluated with Karnofsky score （57 ±7 vs 45 ±9; P 〈 0.01）, was improved significantly. Conclusion： The administration of stilamin, in combination with routine treatment can be very effective in the management of MBO. It can effectively relieve the symptoms of MBO and improve the quality of life in patients.

关键词： somatostatin gastrointestinal carcinoma bowel obstruction effect

Has the open surgical approach in colorectal cancer really become uncommon?

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1485-1492页

作者： Maria Cariati Giuseppe Brisinda Maria Michela Chiarello Department of Surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy Abdominal and Endocrine Metabolic Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy

Colorectal cancer is the third most common cancer in the *** is man-datory to treat patients with colorectal *** colorectal cancer be treated in laparoscopy?Scientific literature has validated the oncological quality of laparo-scopic approach for the treatment of patients with colorectal *** non-inferiority trials with good remote control have answered positively to this long-debated *** as 1994,first publications demonstrated technical feasibility and compliance with oncological imperatives and,as far as short-term outcomes are concerned,there is no difference in terms of mortality and post-operative morbidity between open and minimally invasive surgical approaches,but only longer operating times at the beginning of the ***,from 2007 onwards,long-term results were published that demonstrated the ab-sence of a significant difference regarding overall survival,disease-free survival,quality of life,local and distant recurrence rates between open and minimally in-vasive *** this editorial,we aim to summarize the clinical and technical aspects which,even today,make the use of open surgery relevant and necessary in the treatment of patients with colorectal cancer.

关键词： Colorectal cancer Laparoscopy Laparoscopic colorectal resection bowel obstruction bowel perforation Advanced colorectal cancer

Intestinal obstruction and bowel Ischemia due to a Rare Left Paraduodenal Hernia: Case Report

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Surgical Science 2022年第1期13卷 28-33页

作者： Rani Alsairafi General Surgery Department College of Medicine Umm Al-Qura University Makkah KSA

bowel obstruction is one of the most common problems found in outpatient departments (OPDs) and emergency rooms. The challenge for surgeons is to be suspicious and recognizing rare disease that could cause bowel obst... 详细信息

Bowel obstruction is one of the most common problems found in outpatient departments (OPDs) and emergency rooms. The challenge for surgeons is to be suspicious and recognizing rare disease that could cause bowel obstruction, such as paraduodenal hernia, without delaying the management as the risk of complications increase. This case study presents a patient with bowel obstruction secondary to a paraduodenal hernia.

关键词： Paraduodenal Hernia bowel obstruction bowel Ischemia

Endoscopic stenting-Where are we now and where can we go?

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World Journal of Gastroenterology 2008年第24期14卷 3798-3803页

作者： Mark Terence McLoughlin Michael Francis Byrne UBC Division of Gastroenterology

Self expanding metal stents (SEMS) play an important role in the management of malignant obstructing lesions in the gastrointestinal tract. Traditionally,they have been used for palliation in malignant gastric outlet and colonic obstruction and esophageal malignancy. The development of the polyflex stent,which is a removable self expanding plastic stent,allows temporary stent insertion for benign esophageal disease and possibly for patients undergoing neoadjuvant chemotherapy prior to esophagectomy. Potential complications of SEMS insertion include perforation,tumour overgrowth or ingrowth,and stent migration. Newer stents are being developed with the aim of increasing technical and clinical success rates,while reducing complication rates. Other areas of development include biodegradable stents for benign disease and radioactive or drug-eluting stents for malignant disease. It is hoped that,in the future,newer stents will improve our management of these diffi cult conditions and,possibly,provide prognostic as well as symptomatic benefi t in the setting of malignant obstruction.

关键词： Endoscopy Stent Palliation bowel obstruction Malignancy

Antegrade bowel intussusception after remote Whipple and Puestow procedures for treatment of pancreas divisum

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World Journal of Gastroenterology 2007年第44期13卷 5954-5956页

作者： Manuel Gigena Hugo V Villar Negar G Knowles John T Cunningham Erik K Outwater Luis R Leon Jr University of Arizona Health Science Center and Southern Arizona Veteran Affairs Health Care System Surgery Section Tucson AZ 85723 United States

To date, antegrade intussusception involving a Roux-en-Y reconstruction has been reported only once. We report a case of acute bowel obstruction due to an intussusception involving two Roux-en-Y limbs in a 40-year-old woman with a history of chronic pancreatitis due to pancreas divisum. Four years preceding this event, the patient had undergone a Whipple procedure, and three years prior to that, a Puestow operation. The patient was successfully treated with bowel resection and a side-to-side anastomosis between the most distal aspect of the bowel and the most distal Roux-en-Y reconstruction, which preserved both Roux-en-Y reconstructions.

关键词： Whipple procedure Puestow procedure Pancreas divisum Intussusception bowel obstruction

Intussusception of the bowel in adults:A review

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World Journal of Gastroenterology 2009年第4期15卷 407-411页

作者： Athanasios Marinis Anneza Yiallourou Lazaros Samanides Nikolaos Dafnios Georgios Anastasopoulos Ioannis Vassiliou Theodosios Theodosopoulos Second Department of Surgery Areteion University HospitalAthens Medical SchoolUniversity of Athens

Intussusception of the bowel is defined as the telescop-ing of a proximal segment of the gastrointestinal tract within the lumen of the adjacent *** condi-tion is frequent in children and presents with the classic triad of cramping abdominal pain,bloody diarrhea and a palpable tender ***,bowel intussusception in adults is considered a rare condition,accounting for 5% of all cases of intussusceptions and almost 1%-5%of bowel *** to twenty percent of cases are idiopathic,without a lead point *** intus-susception is caused by organic lesions,such as inflam-matory bowel disease,postoperative adhesions,Meckel's diverticulum,benign and malignant lesions,metastatic neoplasms or even iatrogenically,due to the presence of intestinal tubes,jejunostomy feeding tubes or after gas-tric *** tomography is the most sensitive diagnostic modality and can distinguish between intus-susceptions with and without a lead *** is the definitive treatment of adult *** bowel resection with oncological principles is followed for every case where a malignancy is *** of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid the short bowel syndrome in certain circumstances.

关键词： Intussusception Intestinal invagination Adult bowel obstruction Computed tomography Ultra-sonography Surgery