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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Intestinal obstruction secondary to the use of fortified milk is a rare cause in pre-term patients. Case report. We present the case of a female pre-term newborn admitted as a result of abdominal distension and rectal bleeding, which mimicked necrotizing enterocolitis. On abdominal X-ray, she had an obstruction pattern, and on ultrasonography, echogenic masses at the distal ileum were observed. Given the lack of improvement with conservative management, urgent exploratory laparotomy was decided upon. At surgery, compact milk masses at the level of the distal ileum were identified as the cause of intestinal obstruction. Appendicostomy and lavage with saline solution through the ileocecal valve were performed. This allowed milk masses to come out towards the colon, and a great amount of acholic stools to be expelled. Conclusion. The increase in “milk curd syndrome” cases should lead us to consider this cause in the differential diagnosis of intestinal obstruction in pre-term newborns fed with fortified milk. [ABSTRACT FROM AUTHOR]

Introduction. Superior mesenteric artery syndrome, also known as Wilkie syndrome, is a rare entity in which a reduction in the aorto-mesenteric angle or space determines extrinsic compression with obstruction of the distal third of the duodenum, demonstrating characteristic symptoms and signs of intestinal obstruction. The mainstay of treatment is conservative medical management with nutritional repletion, with the aim of increasing the thickness of the retroperitoneal fat and thereby resolving duodenal compression. Clinical case. A 16-year-old patient, with a chronic course marked by abdominal pain, constipation, bloating, heartburn and weight loss. Initially was treated as an acid-peptic disease, with poor improvement. Imaging studies were performed, which documented a decrease in the aorto-mesenteric angle. Conclusion. Based on the symptoms and findings on diagnostic images, the diagnosis of superior mesenteric artery syndrome was made, which is a cause of intestinal obstruction with a very low incidence. Its clinical presentation includes a wide variety of symptoms, among which abdominal pain and weight loss stand out. Confusion with other more common diseases is common, such as acid-peptic disease, gastrointestinal reflux and malabsorption. Its diagnosis requires a high index of suspicion, so it is important to know this entity and consider it in the study of patients with the aforementioned symptoms. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Angiología is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mechanical small bowel obstruction is a significant surgical problem in terms of prevalence, morbimortality, and associated economic costs. In recent years, advances have been made in: detection of physio pathological mechanisms of adhesion genesis, improvement in diagnosis of patients suitable for conservative treatment, assessment the efficacy of intraoperative tools that define the need for intestinal resection, and development of preventive therapies. The objective of this narrative review is to synthesize the updated scientific evidence published, regarding the diagnosis and treatment of mechanical small bowel obstruction. [ABSTRACT FROM AUTHOR]

Introduction. The primitive intestine rotates during embryonic life. When it occurs inappropriately, intestinal malrotation appears, which can lead to obstruction or midgut volvulus. The incidence decreases when age increases. Intestinal malrotation is one of the main causes of complications of the gastrointestinal tract in pediatric age. Method. Retrospective, observational, cross-sectional and analytical study of the experience over 10 years in patients under 15 years of age with a diagnosis of intestinal malrotation, treated at Hospital Infantil of San Vicente Fundación, in Medellín, Colombia. The association between demographic, clinical and imaging variables with the outcomes was sought. Results. There were 58 patients with intestinal malrotation, 65% under one year of age. In 29.3% of patients, intestinal malrotation was diagnosed clinically. The predominant symptoms were abdominal distension and emesis. In 24.1% the diagnosis was confirmed with imaging. The variables with a statistically significant difference in favor of finding a complicated malrotation were septic shock (OR=11.7), systemic inflammatory response syndrome (OR-8.4), and dehydration (OR=5.18). Conclusions. Malrotation has complications such as perforation, peritonitis, volvulus, and short bowel. Volvulus is accompanied by shock and sepsis, with mortality of up to 50%. Diagnostic images are helpful, but medical conduct cannot be based on them because no image guarantees a definitive diagnosis. The warning signs are not very specific. In children under one year of age with emesis, distension and abdominal pain, intestinal malrotation should be suspected. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica de Rosario is the property of Circulo Medico de Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: La intususcepción intestinal es la enfermedad donde un segmento de intestino proximal y su mesenterio se invaginan en el lumen del segmento adyacente distal. Se han descrito varias etiologías tanto benignas como malignas, su presentación en la población adulta es poco común, con síntomas inespecíficos y tardíos. Objetivo: Presentar el caso clínico de un paciente con obstrucción intestinal, secundaria a una intususcepción ileo-ileal, causada por presencia de tejido ectópico pancreático en un divertículo de Meckel. Caso clínico: Paciente masculino de 37 años de edad, con antecedentes de consumo de marihuana y cocaína, que presentó dolor abdominal de inicio súbito y se le diagnostica una obstrucción intestinal. La tomografía contrastada reveló intususcepción íleo-ileal causada por un divertículo de Meckel. Se realizó laparotomía exploratoria con resección segmentaria y anastomosis íleo-ileal. La histopatología confirmó la presencia de tejido pancreático ectópico. El paciente se recuperó sin complicaciones, tras la cirugía. Conclusiones: En este caso, se destaca la importancia de considerar la intususcepción íleo-ileal como una posible causa de obstrucción intestinal en adultos, especialmente cuando se asocia con un divertículo de Meckel que contiene tejido pancreático ectópico.

El dolor abdominal en los adultos mayores (AM) es un desafío por los cambios fisiológicos del envejecimiento, manifestaciones clínicas atípicas y multimorbilidad. El objetivo es presentar un paciente AM con dolor abdominal de una etiología poco común de dolor abdominal y de obstrucción intestinal, como lo es el vólvulo intestinal. Se presenta un paciente de 82 años con múltiples condiciones geriátricas, quien ingresó por dolor abdominal subagudo, y clínica sugestiva de obstrucción intestinal. La tomografía axial computarizada (TAC) de abdomen muestra el signo del remolino compatible, con diagnóstico de vólvulo de íleon distal.

Introduction. Hematomas are a rare cause of intestinal obstruction. Subcutaneous heparin can bring about direct punctures on small bowel loops, potentially leading to traumatic hematoma and intestinal obstruction. Case reports. We present three cases of pediatric patients with clinical signs of intestinal obstruction treated with subcutaneous heparin. Two cases had increased acute-phase reactants and radiological signs of intestinal suffering, so surgical treatment was decided upon, with intramural hematoma emerging as an intraoperative finding. The third case was conservatively managed with anticoagulant discontinuation and gut rest, since the patient had an adequate general condition and no findings compatible with ischemia or necrosis were noted in the complementary tests. Discussion. The administration of subcutaneous heparin may cause intestinal wall hematomas due to its anticoagulating effect and to the risk of inadvertent punctures on small bowel loops. [ABSTRACT FROM AUTHOR]

Una paciente femenina de 50 años es referida al servicio de emergencias por signos, síntomas y un ultrasonido de abdomen que sugieren obstrucción intestinal. Las radiografías simples de abdomen documentan un cuerpo extraño en la fosa iliaca derecha asociado a neumobilia, se realiza diagnóstico clínico y ultrasonográfico de íleo biliar. Se lleva a sala de operaciones y se realiza un abordaje laparoscópico con resolución de su cuadro de oclusión intestinal. La paciente se recupera exitosamente y se egresa en el postoperatorio cinco días.

The article titled "Multiple colonic phytobezoar as a cause of cecal volvulus in the critically ill adult" describes a clinical case of a 33-year-old exclusive vegan patient who was admitted to the Intensive Care Unit due to an acute cerebral hemorrhagic event. The patient presented symptoms of partial intestinal obstruction and a tomography was performed, revealing severe dilation of the cecum. An exploratory laparotomy was carried out, in which multiple phytobezoars were found in the transverse and left colon, resulting in a right hemicolectomy. The article highlights the importance of tomography as the study of choice and intraoperative maneuvers in the definitive treatment of this condition. [Extracted from the article]

Introduction: Intestinal obstruction is the alteration of the flow of the luminal contents of the gastrointestinal tract due to mechanical factors. Severe cases may progress to refractory septic shock with high mortality. Innovative therapies have been proposed for this condition that may change the prognosis. Report: A 62-year-old male patient presents with intestinal obstruction accompanied by sepsis. Exploratory laparotomy reveals a tumor in the descending colon and extensive colon necrosis, requiring colonic resection and ileostomy. Despite the intervention, the patient develops refractory septic shock and multiorgan failure, with a severe prognosis. Cytokine hemoadsorption therapy and immunoglobulin G enriched with immunoglobulin M were implemented within the first 32 hours. Progressive recovery of clinical and laboratory parameters is subsequently presented, as well as general condition. Conclusions: Hemoadsorption therapy can reduce the dose of vasopressors, improve hemodynamics and reduce inflammatory markers in patients with sepsis. Pentaglobin can reduce the risk of mortality, decrease the duration of mechanical ventilation and improve renal function in patients with sepsis. [ABSTRACT FROM AUTHOR]

Introducción: Dentro de las causas poco frecuentes de oclusión intestinal se encuentra el vólvulo de intestino delgado, el cual consiste en una torsión anormal del intestino alrededor del su propio eje de mesenterio, que provoca una obstrucción mecánica del intestino. Objetivo: Describir la semiografía del vólvulo de intestino delgado en un paciente de edad avanzada. Caso clínico: Paciente masculino de 62 años de edad, que ingresa en el cuerpo de guardia de cirugía, por dolor abdominal, tipo cólico intermitente, con una evolución de 72 horas; además, presenta distensión abdominal, náuseas y vómitos. Con el cuadro clínico, más los exámenes complementarios, se constata oclusión intestinal mecánica, causada por un vólvulo del intestino delgado. A los 5 días de ser intervenido quirúrgicamente se complicó por una perforación intestinal debido a necrosis del asa. Conclusiones: Debido a su presentación atípica y sus graves complicaciones, se precisa un diagnóstico certero y tratamiento urgente al paciente con vólvulo del intestino delgado, ya que pone en riesgo la vida.

The article in the ANACEM Magazine presents a pediatric case of intestinal malrotation with atypical presentation in a 14-year-old patient. The importance of a multidisciplinary approach and continuous monitoring in the diagnosis of this condition in pediatric patients is highlighted. The relevance of imaging studies to rule out complications such as intestinal volvulus is emphasized. Ladd's surgery is considered the primary treatment to address this congenital anomaly. [Extracted from the article]

Introduction: Intestinal obstruction accounts for 20% of emergency department visits for abdominal pain and up to 75% are due to adhesions from previous surgery. Despite high resolution rates with conservative treatment, it is often recurrent and requires surgical management. Objective: To determine the surgical epidemiology of intestinal obstruction due to adhesions in the general surgery service of the Complejo Hospitalario Dr. Arnulfo Arias Madrid in the period 2015-2020. Methodology: A descriptive, retrospective, cross-sectional, retrospective, observational study was carried out by reviewing the records of patients with a diagnosis of intestinal obstruction due to adhesions. Results: 54% of the patients were women and 46% men. With a higher frequency in >65 years and a mean age of 72.5 years. Most patients had at least one previous abdominal surgical history (89%). The time elapsed since the last surgery was more than 10 years (53%). The response to conservative treatment was 75%. Of the operated patients, 77% underwent adhesiolysis, 13% underwent intestinal resection and anastomosis, 3% underwent ostomies and 7% underwent other procedures. The mode of hospitalization time was <5 days for conservative management and 5-10 days for surgical management. Conclusions: This study marks the beginning of a series of projects, aimed at evaluating the risks and results of treatment, and deciding the optimal time for surgical intervention, with the primary objective of decreasing morbi-mortality and improving the quality of life of the population. [ABSTRACT FROM AUTHOR]

Gallstone ileus-induced intestinal obstruction is a rare but significant condition that occurs when a gallstone becomes lodged in the gastrointestinal tract. Major risk factors for gallstone ileus-induced intestinal obstruction include older age, female sex, diabetes, history of gallbladder disease such as gallstones, as well as previous gallbladder-related surgical procedures such as cholecystectomy. Pregnancy is also a known risk factor for gallstone disease. We present the case of a 38-year-old patient with a history of three cesarean sections and no apparent comorbidities. Prior to her visit to the emergency department, the patient experienced moderate colicky abdominal pain in the lower abdomen for two days. The physical examination revealed diffuse abdominal tenderness, predominantly in the right iliac fossa, along with signs of irritation of the peritoneum. Laboratory tests showed a leukocyte count of 11,490 cells/µl and neutrophilia of 85.6 %. Following an exploratory laparotomy, the suspected diagnosis of gallstone ileus was confirmed. An enterolithotomy was performed, and the patient experienced good post-surgical progress. In conclusion, it is important to consider gallstone ileus-induced intestinal obstruction among patients with relevant symptoms and medical history. This case report highlights the importance of considering gallstone ileus-induced intestinal obstruction among patients with gastrointestinal symptoms and a history of pregnancy. Early diagnosis and intervention are crucial to prevent serious complications. [ABSTRACT FROM AUTHOR]

Copyright of Alerta (San Salvador) - Revista Cientifica del Instituto Nacional de Salud is the property of Instituto Nacional de Salud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Tesla Revista Científica is the property of Puerto Madero Editorial Academica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute Mesenteric Ischemia is associated with a mortality rate between 50% and 100%; the rarest cause of this is venous thrombosis of the mesenteric (5%) and portal (1%) vessels. The clinical manifestations are diverse, with abdominal pain being the main symptom. Computed tomography with intravenous contrast in the portal phase is the most accurate image for diagnosis. Treatment in the acute phase is based on anticoagulation, intravenous fluids, prophylactic antibiotics, intestinal rest, and decompression. Damage control laparotomy, including bowel resection and open abdomen, may ultimately be warranted for patients with bowel necrosis and sepsis. Clinical case: 35-year-old man, with no significant history, only smoking for 15 years. For 5 days before, he reported crampy epigastric pain of moderate intensity. He subsequently reported that the pain became generalized and increased in intensity, accompanied by nausea, vomiting, oral intolerance, and temperature rise. The physical examination showed signs of a systemic inflammatory response, conscious and oriented, abdomen painful on superficial and deep palpation at a generalized level but accentuated on the right flank, positive rebound with resistance, generalized tympanism, absent peristalsis. The operating room was entered for exploratory laparotomy, finding an ischemic-necrotic intestinal lesion at 190 - 240 cm from the angle of Treitz, and 400cc of blood fluid. Resection of the affected intestinal part is performed, with entire manual terminal end anastomosis. The specimen was sent to pathology, reporting an acute inflammatory process with transmural necrosis and vascular congestion. Given these findings, abdominal CT angiography was performed, which reported a filling defect in the superior mesenteric vein, secondary to thrombosis that extended to the confluence and the portal vein. Conclusion: Mesenteric and portal venous thrombosis is a very rare pathology in young patients without risk factors in whom abdominal pain occurs. The diagnosis is complex because the clinical and laboratory data are not very specific. However, we must take it into account in the differential diagnosis of abdominal pain etiologies. [ABSTRACT FROM AUTHOR]

La intususcepción intestinal es la invaginación intraluminal de un segmento proximal de intestino y su mesenterio dentro de otro adyacente o distal. Su presentación en la edad adulta es infrecuente1. Representa el 5 % de todos los casos de invaginación, que corresponde de dos a tres casos por 1.000.000 personas al año, con un pico de incidencia entre los 30 y 50 años, sin predominio de sexo 2.

Introduction. Intestinal malrotation is a congenital pathology with potentially catastrophic complications, such as volvulus, whose treatment has barely not changed in nearly 100 years (Ladd's procedure). Dr. Abu-Elmagd recently described a new technique that was applied in one of our patients. Clinical case. 12-year-old boy who had undergone Ladd's procedure as a result of intestinal volvulus secondary to malrotation when he was 2 days old. He had subocclusion and eventually obstruction, with intestinal volvulus compatible imaging. Intraoperative findings: duodenal subocclusion, volvulus and lymphangiectasias. Kareem's procedure: bowel positioning in normal rotation, duodenopexy (duodenal C posterior to the mesenteric vessels), formation of neo-Treitz, and fixation of the cecum, the ascending colon, and the mesenteric root. The patient was discharged on postoperative day 6 and remains asymptomatic after 1 year of follow-up. Discussion. Kareem's procedure is a safe and effective malrotation repair technique. It can replace Ladd's procedure as it reduces the risk of re-volvulation and improves digestive symptoms. [ABSTRACT FROM AUTHOR]

Obturator hernia has an incidence of less than 1% of all abdominal wall hernias, it is predominantly observed in elder women and it is characterized by protrusion of intra-abdominal viscera into the shutter hole. The preoperative diagnosis is difficult due to the lack of external manifestations, nonspecific symptoms and lack of clinical suspicion. Delaying diagnosis and treatment is associated with high mortality. We report the case of a female patient with a complicated obturator hernia with concomitant bilateral inguinal hernias that underwent minimally invasive surgery with no complications and a seven day stay in hospital. [ABSTRACT FROM AUTHOR]

Copyright of Duazary. Revista de la Facultad de Ciencias de la Salud is the property of Universidad del Magdalena and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Gallstone ileus manifests as intestinal obstruction. It occurs due to the passage of a stone and its subsequent lodging in the lumen of the digestive tract. The diagnosis is confirmed by imaging; the gold standard is abdominal tomography. Management is based on the extraction of the intraluminal calculus in one or more surgical times, depending on the patient's condition. We present the case of a patient with multiple comorbidities who showed a picture of cholangitis complicated by gallstone ileus and successfully treated with enterolithotomy. Surgical management is controversial since the optimal approach for these patients has not been established. [ABSTRACT FROM AUTHOR]

Background: Melanoma is one of the main neoplasms with metastasis to the digestive system and needs a high index of diagnostic suspicion. Case report: A 64-year-old male patient with abdominal pain, vomiting and liquid stools. The admission diagnosis was gastrointestinal bleeding, ruled out by endoscopy and colonoscopy. Fifteen days after hospitalization, he presented symptoms of intestinal obstruction, confirmed by tomography, and incidentally, a tumor in the right hemithorax. The surgery finding was a polypoid mass in the ileum. Extended anamnesis reveals a history of cutaneous melanoma on the face. The immunohistochemistry demonstrated the melanocytic lineage of the lesion. The final diagnosis was intestinal obstruction due to intestinal polypoid metastatic melanoma. Conclusion: Intestinal obstruction due to melanoma metastasis is a diagnostic challenge due to the nonspecific clinical and radiologic presentation. The suspicion of the etiology should start from the anamnesis and confirm the tumor cellular lineage trough histopatology. [ABSTRACT FROM AUTHOR]

Background: Rapunzel syndrome is a rare presentation of trichobezoar, secondary to the ingestion of hair known as trichophagia. This bezoar has been found mainly in women, it invades the stomach and extends to the small intestine. Clinically, patients present weight loss and chronic obstructive symptoms at the intestinal level. A case of Rapunzel syndrome is presented. Clinical case: A 13-year-old female presented with a weight loss of 10kg in two months, chronic constipation, predominantly nocturnal vomiting, and abdominal pain of seven days’ duration. Physical examination revealed decreased peristalsis and a palpable mass in the epigastrium. Laboratories taken on admission: normal blood count, kidney function tests, and liver function tests. The abdominal X-ray showed opacity in the fundus, body and gastric antrum, the abdominal ultrasound showed non-specific findings in the epigastrium, later an abdominal tomography was performed with a swallow of water-soluble contrast medium and showed occupation in the gastric lumen. She underwent exploratory laparotomy and the finding was a trichobezoar in the stomach with extension to the duodenum and part of the jejunum, which was removed without complications. The evolution of the patient was favorable. Conclusions: For the diagnosis of Rapunzel Syndrome, the use of contrast imaging studies is necessary, and the treatment of choice is surgical. [ABSTRACT FROM AUTHOR]

La hernia obturadora se define como un defecto del piso pélvico, de origen congénito o adquirido, en el que existe protrusión de una víscera intraabdominal o parte de esta a través del canal obturador. Es una afección rara, con una incidencia del 0,07 % al 1 % de todas las hernias abdominales y del 0,2 % al 1,6 % de los casos de obstrucción intestinal, por eso, el diagnóstico es complejo, precisando la realización de estudios imagenológicos. El tratamiento es quirúrgico, mediante laparotomía o abordaje laparoscópico.

Copyright of Revista Colombiana de Cirugía is the property of Asociacion Colombiana de Cirugia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La intususcepción como causa de obstrucción intestinal en el adulto es una entidad muy rara, la mayoría es secundario a una neoplasia de intestino delgado benigna o maligna. Los lipomas son tumores benignos raros, considerados neoplasias del tejido adiposo maduro sin pleomorfismo que se hallan en el tubo digestivo como tumores bien delimitados de la submucosa, y se encuentran con mayor frecuencia dentro de la pared del intestino delgado. Presentamos el caso de un varón de 72 años que es intervenido quirúrgicamente por obstrucción intestinal, y un diagnóstico intraoperatorio de intususcepción de intestino delgado secundario a un angiolipoma submucoso según anatomía patológica. La intususcepción en adultos es rara, y que la misma se deba a otra entidad benigna inusual, es aún más raro. El estudio tomográfico es útil, pero la mayoría se diagnostican en la etapa intraoperatoria. La resección “en bloque” es lo más recomendado debido a la sospecha de malignidad.

El síndrome de Bouveret es una causa infrecuente de íleo biliar, posee una elevada morbimortalidad. Se produce por la migración de un cálculo, generalmente de gran tamaño, hacia el tracto gastrointestinal a través de una fistula colecistoduodenal. El objetivo de esta carta científica es presentar un paciente con un estadio previo de la enfermedad donde la fistula se encuentra constituida, pero sin migración del cálculo, por lo que el diagnóstico oportuno tendría un impacto favorable en el tratamiento y pronóstico debido a que no se encuentra instaurado el cuadro obstructivo intestinal.

Introducción. El íleo biliar es una complicación rara de la colelitiasis y su incidencia varía del 1 al 4 %. Consiste en la migración de un cálculo de la vesicular biliar al tracto gastrointestinal, generando obstrucción intestinal. Presenta síntomas inespecíficos dependiendo del nivel de la obstrucción, lo que hace que su diagnóstico no suela ser precoz, repercutiendo en el deterioro clínico del paciente. Es especialmente grave en pacientes de edad avanzada y con comorbilidades. Casos clínicos. Se reportan los casos de dos pacientes con dolor abdominal difuso, en quienes se diagnosticó íleo biliar por tomografía. Se realizó manejo quirúrgico, el primero mediante técnica abierta y estrategia de 2 pasos, y el otro mediante técnica laparoscópica. Discusión. El íleo biliar es una etiología rara de obstrucción intestinal. El cálculo migra debido a una fistula colecistoentérica y el nivel de obstrucción es con mayor frecuencia la válvula ileocecal. Los síntomas son inespecíficos y dependen del nivel de obstrucción: dolor abdominal difuso mal caracterizado, náuseas, vómito, ausencia de flatos. El diagnóstico se hace mediante tomografía abdominal, en la cual se evidencia la tríada de Rigler. El manejo es quirúrgico, con enterotomía para extraer el cálculo y resolver la obstrucción. Conclusión. El íleo biliar es una patología que debe ser considerada en el abordaje de la obstrucción intestinal, aunque sea poco frecuente. El manejo quirúrgico es clave para resolver el cuadro de obstrucción intestinal; aún así genera importante morbimortalidad en especial en pacientes de avanzada edad.

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Obturator hernias are those in which the hernia sac and its contents are introduced into the obturator orifice and protrude through the canal of the same name. They are the most frequent hernias of those that affect the pelvic floor, but overall, they are a very rare variety since they account for less than 1 % of all hernias of the abdominal wall. Clinically, they usually present as a picture of mechanical intestinal obstruction, although they are a very infrequent cause of it (0.2-1.6 % of cases). Material and methods: Review of 10 cases of obturator hernia operated in our Service between november 2010 and march 2021. Results: All of our patients were women with a mean age of 85.2 years (range, 77-92). In all cases, the presentation was a small bowel occlusion. Two patients (20 %) had a history of significant weight loss. Computerized Tomography was performed in all of our patients, which was diagnostic of incarcerated obturator hernia in 80 % of the cases. In the remaining 20 % the diagnosis was femoral hernia. The laterality of the hernia was distributed 50 % on the right and left. All of the cases were operated on urgently through an infraumbilical median laparotomy. In 4 patients (40 %) an initial intestinal resection was necessary and, in another case, it was performed after 48 h. of the first laparotomy. Hernia repair was performed by simple suture in 8 cases (80 %) and with the placement of a mesh plug in two (20 %). The average hospital stay was 6.5 days (range, 3-12). Practically all of our cases presented postoperative morbidity of greater or lesser severity associated with pre-existing pathology. Mortality was 40 %. Conclusion: Obturator hernia is an infrequent cause of intestinal occlusion, but it must be suspected as a cause of it, especially when it occurs in elderly female patients. The diagnostic and therefore therapeutic delay make these hernias present a high morbidity and mortality. [ABSTRACT FROM AUTHOR]

Los tumores neuroendocrinos bien diferenciados son raros, de cre-cimiento lento, pueden originarse en múltiples órganos como pán-creas, timo, tiroides, ovarios, piel, etc., aunque son más frecuentes en el sistema bronquial y tracto gastrointestinal. Su presencia puede pasar imperceptible por años, sin síntomas ni signos detectables. Constituyen solo 0,5 % de los tumores malignos y 2 % de los tumores del tracto gastrointestinal, son diagnosticados con relativa frecuen-cia en apéndice y recto, pero su presencia en íleon se considera es-porádica. Se presenta el caso de un paciente masculino de 31 años de edad, que durante dos años presentó dolor abdominal, náuseas y vómitos, interpretado y tratado como cólico nefrítico. Por la persis-tencia del dolor y anemia, se realizó drenaje biliar con diagnóstico de Necátor americano, imponiéndose tratamiento con mejoría clínica. Al presentar dolor abdominal agudo, distención abdominal acentuada en posición de pie, es valorado por Gastroenterología, se indicó Rx de abdomen simple observándose signos de oclusión intestinal baja. Se decidió intervención quirúrgica de urgencia, hallándose tumor en región distal del íleon, no detectado en estudios de imágenes reali-zados; el diagnóstico anatomopatológico fue tumor neuroendocrino bien diferenciado. La obstrucción intestinal por este tipo de tumor ha sido escasamente reportada, y su diagnóstico es habitualmente incidental, lo que nos motivó a presentar este caso.

Meckel's diverticulum is diagnosed by a complication. There are three most common complications: hemorrhage, inflammation, and occlusion. The last one occurs more frequently in children. It has a higher incidence in males, however, in recent years in the Baracoa municipality (Guantánamo, Cuba) there have been several cases, five in 2019 and one in 2020; four of them were women. The clinical case of a 62-years-old patient is presented, with a history of abdominal surgery due to perforated duodenal ulcer, which required medical attention in the Surgery on-call service, of the Baracoa municipal hospital, due to colic-type abdominal pain, vomiting and difficulty in expelling stool and gas. She was hospitalized with a presumptive diagnosis of mechanical intestinal occlusion due to post-surgical bands and an exploratory laparotomy was performed, with a diagnostic finding of an inflamed Meckel's diverticulum. It was concluded with intestinal resection of the ileum segment. The patient evolved satisfactorily and was discharged on the eighth day after the intervention, without complications.

La obstrucción intestinal es una entidad relativa-mente frecuente, que ocasiona entre el 1,4 % y el 12 % de los ingresos a urgencias por dolor abdo-minal 1. En los adultos las causas más frecuentes de obstrucción son las adherencias, las hernias y las neoplasias, sin embargo, existen otras etiologías menos comunes, como el íleo biliar 2,3. Debido a la falta de una presentación típica, su diagnóstico generalmente es tardío

We present the case of a 94-year-old female patient with a surgical history of exploratory laparotomy + ventral herniorrhaphy. She presented with a history of abdominal pain and distension of 4 days of evolution, associated with nausea, vomiting and constipation. Acute abdominal series showed hydro-aerial levels with staircase pattern and absence of air in the distal colon. A contrasted CT scan of the abdomen and pelvis showed mild dilatation of the middle and distal ileum secondary to small bowel obstruction at the level of a right obturator hernia. The patient was taken to the operating room where an exploratory laparotomy with hernia reduction was performed. [ABSTRACT FROM AUTHOR]

Gallstone ileus is a rare pathology and it arises more frequently in the elderly as a complication of cholelithiasis. It is a disease in which a stone from the biliary tree conditions mechanical obstruction with dilatation and subsequent inflammation of intestinal loops. Its clinical presentation is usually non-specific, resulting in a diagnostic challenge it is accompanied by pain and abdominal distension, nausea, vomiting and alteration of the evacuatory rhythm. Treatment generally requires a surgical approach in order to prevent the development of other complications. We present the clinical case of a male patient, elderly, who attends the Japanese Bolivian Gastroenterology Institute of Cochabamba, Bolivia, with a nonspecific presentation of the clinical picture after a previous hospitalization that did not resolve the initial picture and whose diagnosis required performance of extended imaging studies, such as contrastenhanced computed tomography, for subsequent surgical resolution. [ABSTRACT FROM AUTHOR]

The case report of a 67 years patient with several comorbidities is described, among them polycythemia vera, who went to the emergency room of Ambrosio Grillo Portuondo University Clinical Surgical Hospital in Santiago de Cuba due to symptoms and signs of a syndrome of occlusive acute abdomen. An emergency surgical intervention was indicated, that confirmed the presumptive diagnosis of mesenteric vascular thrombosis. The immediacy of the surgical treatment, the reversibility of the vascular damage without necessity of intestinal resection procedure and the effective use of anticoagulants allowed a favorable clinical course without complications. [ABSTRACT FROM AUTHOR]

Copyright of Revista Salud UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)