MyMedR

Fulltext Bleeding small bowel cavernous haemangioma following blunt trauma to the abdomen presenting as subacute intestinal obstruction in a child

Abdul Aziz DA, Khandasamy Y, Tamba RP, Zaki FM

BMJ Case Rep, 2011;2011.

PMID: 22679168 DOI: 10.1136/bcr.08.2011.4672

The authors report a case of a 6-year-old girl who developed subacute intestinal obstruction after a trivial blunt trauma to her abdomen. Her normal vital signs masked the presence of intestinal bleeding. An incidental finding at surgery of a haematomatous polypoid vascular growth of the ileum was subsequently confirmed to be cavernous haemangioma of the small bowel. Surgical resection was curative in this patient.

Matched MeSH terms: Intestinal Obstruction/diagnosis; Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery

Fulltext Paravertebral Abscess Caused By Bukholderia Pseudomallei In

Ahmad, S., Azura, L., Duski, S., Aziz, M.Y.

Malays Orthop J, 2009;3(1):88-90.

MyJurnal

A 53-year-old Malay man was admitted with intestinal obstruction, fever and lower limb weakness. Initial clinical impression was myelitis causing paralytic ilues and paraperesis. Blood culture showed Burkholderia pseudomallei infection and subsequent MRI showed paravertebral abscess. This case highlights a rare manifestation of melioidosis involving the spine and difficulties in establishing the diagnosis.

Matched MeSH terms: Intestinal Obstruction

Primary extranodal diffuse large B-cell lymphoma of the uterine cervix

Akkour K, Alhulwah M, Alhalal H, Alqahtani N, Arafah M

Malays J Pathol, 2021 Aug;43(2):327-331.

PMID: 34448797

BACKGROUND: Small bowel volvulus is defined as the torsion of the small intestine, potentially leading to bowel obstruction, gangrene and perforation. It is a rare condition, especially in adults.

CASE PRESENTATION: A 30-year-old man was retrieved from the jungle with severe weight loss and abdominal symptoms. He succumbed to death despite 22 days of intensive medical treatment. An autopsy revealed a ruptured gangrenous ileal volvulus with peritonitis and subdiaphragmatic abscess. Further laboratory analysis detected systemic Candida tropicalis and intestinal gramnegative bacterial sepsis, systemic Zika virus viremia, leptospirosis complicating rhabdomyolysis and disseminated intravascular coagulopathy, Type I Herpes Simplex virus infection of the tongue and upper gastrointestinal tract. The cause of death was the ruptured ileal volvulus, complicated with upper gastrointestinal bleeding due to Herpes simplex virus esophagitis in a malnourished patient with resolving leptospirosis and underlying Zika virus co-infection.

CONCLUSION: Rare clinical scenarios of adult-onset intestinal volvulus with concomitant multiple infections precludes clinical diagnosis and early treatment, leading to devastating consequences of clinical outcome. The positive clinical and postmortem correlation is a good learning lesson in many disciplines of medicine and science.

Matched MeSH terms: Intestinal Obstruction*

Fulltext Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report

Ali AA, Gurung R, Fuad ZM, Moosa M, Ali I, Abdulla A, et al.

Ann Med Surg (Lond), 2020 Oct;58:76-79.

PMID: 32953103 DOI: 10.1016/j.amsu.2020.08.021

Background: Gastric trichobezoar happens when there is an indigestible substance or food found in the gastrointestinal tract. It is a rare presentation which is usually associated with trichotillomania and trichopagia. The presentation may not be specific and is usually related to dyspepsia-like symptoms. In the worst-case scenario, this may cause gastric outlet or intestinal obstruction which eventually requires surgery.

Case presentation: We present a 36-year-old lady with underlying end-stage renal failure (ESRF) and undiagnosed mental health issues who was treated for recurrent episodes of gastritis. Imaging modalities revealed intragastric foreign body ingestion which is consistent with gastric trichobezoar. She eventually underwent laparotomy and gastrotomy to remove the foreign body. Postoperatively, she was referred and followed-up by the psychiatric team.

Conclusion: Gastric trichobezoar has strong associations with psychiatric disorders. With the co-existence of an ESRF, uraemia might contribute to the aetiology of the trichotillomania and trichophagia. Open surgery is the choice of definitive management especially if bezoars are larger. Should the recurrence be remitted, a biopsychosocial modality and regular haemodialysis is the most sustainable approach to ensure the behaviour does not persist.

Matched MeSH terms: Intestinal Obstruction

Gallstone ileus

Ann WL

Med J Malaysia, 1977 Jun;31(4):316-21.

PMID: 927239

Matched MeSH terms: Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery

Fulltext Neonatal intestinal obstruction secondary to a floppy Meckel's diverticulum successfully treated by minimal access surgery

Aziz DA, Sehat SI, Osman M, Zaki FM

BMJ Case Rep, 2012;2012.

PMID: 23242081 DOI: 10.1136/bcr-2012-006956

Meckel's diverticulum has several known complications including diverticulitis and perforation. The presence of mesodiverticular band or a band from the diverticulum to the anterior abdominal wall is also described and can cause obstruction or rotation of the small bowel leading to volvulus. Meckel's diverticulum is also well known as the lead point for intussusception. It may be lined by ectopic gastric mucosa and can cause life-threatening gastrointestinal bleeding. We report a neonate who presented with acute intestinal obstruction secondary to a large, mobile Meckel's diverticulum which due to a direct compression effect on the adjacent small bowel caused mechanical intestinal obstruction. Diagnosis was confirmed at laparoscopy, and treated by curative surgical resection. This is the first report of a large mobile Meckel's diverticulum causing small bowel obstruction due to direct compression that was managed by minimally invasive surgical resection.

Matched MeSH terms: Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery

Case of spontaneous hernia through the transverse mesocolon

BALASEGARAM M

Med J Malaya, 1963 Mar;17:187-90.

PMID: 13969251

Matched MeSH terms: Intestinal Obstruction*

PRIMARY VOLVULUS OF THE SMALL INTESTINE

BALASEGARAM M

Med J Malaysia, 1963 Dec;18:122-4.

PMID: 14117280

Matched MeSH terms: Intestinal Obstruction*

Fulltext Recurrent gall-stone ileus: a case report

Baruah DR

Med J Malaysia, 1983 Sep;38(3):228-31.

PMID: 6672566

Gall stone is responsible for about 1% of total small bowel obstruction, 1.2 and recurrent gall stone ileus is even more unusual. 3 Gall stone ileus is caused by the impaction of the stone in bowel lumen. It was first described in a patient examined at autopsy by Bartholin in 1654. This paper based on unusual recurrent intestinal obstructions by a gall stone. The patient presented with large bowel obstruction and it was due to a large gall stone impacted in the pelvic colon. Four months later the same patient presented with small bowel obstruction due to large gall stone impacted in the terminal part of the ileum at 61 cms from the ileo-caecal valve. Gall stone obstruction of the colon is one of the rare complications. This rare complication usually occurs in elderly females' in whom there is frequently an underlying pathological condition at the site of obstruction in the colon. The calculus usually migrates through a cholecysto-colonic fistula in case of large bowel obstruction. In case of a small bowel obstruction the calculus usually migrates through a cholecysto-duodenal fistula. Diagnosis can be established by plain X-rays of the abdomen where there is gas shadow in the biliary system, sometimes the gall stone can be seen if it is radio opague (10-16% gall stone is radio opaque) at the site of obstruction. Otherwise diagnosis is always
made at laparotomy.

Matched MeSH terms: Intestinal Obstruction/etiology*

Phytobezoar: a case report

Chellappa M, Ahmad K

Med J Malaysia, 1978 Mar;32(3):245-6.

PMID: 683051

Matched MeSH terms: Intestinal Obstruction/surgery*

Fulltext Intestinal knot in acute Meckel's diverticulitis

Ezrien DE, Hayati F, Nik Lah NAS, Zakaria AD

BMJ Case Rep, 2019 Nov 24;12(11).

PMID: 31767613 DOI: 10.1136/bcr-2019-232611

Matched MeSH terms: Intestinal Obstruction/diagnosis*; Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery

Fulltext Wandering spleen as a cause of acute abdomen: a surgical conundrum from acute appendicitis to splenic torsion and ischemic small bowel volvulus

Fatimah Najid, Sanjeev Sandrasecra, Mohd Zuki Asyraf, Chang Haur Lee, Nornazirah Azizan, Andee Dzulkarnaen Zakaria, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):336-338.

MyJurnal

Wandering spleen is renowned as a surgical enigma due to its diverse presentations. Due to lack of its attaching ligaments which would usually place it at the left hypochondrium region, the spleen ‘wanders’ and may be located anywhere within the abdominal cavity. This condition has been associated with many complications such as splenic torsion, pancreatitis and portal hypertension. We report a case of a wandering spleen presenting as acute appen- dicitis in an 18-year-old young active sportsman. The patient developed post-operative ileus and later intestinal obstruction which necessitated exploratory laparatomy onto which the final diagnosis of splenic and small bowel infarct due to splenic torsion with small bowel volvulus was made. Splenectomy, small bowel resection and primary anastomosis were performed and the patient made a full recovery.

Matched MeSH terms: Intestinal Obstruction

Fulltext Obturator hernia: a rare condition with common surgical symptoms

Fitreena A.A., Shahidah C.A., Mohd. Nizam M.H., Wan Zainira W.Z., Wong, M.P.K.

Journal of Biomedical and Clinical Sciences, 2018;3(1):35-38.

MyJurnal

Hernia is a common surgical problem. However, worldwide
incidence of obturator hernia is

Matched MeSH terms: Intestinal Obstruction

Fulltext Obturator hernia: a case report

Goon HK, Mohd Bahari HM

Med J Malaysia, 1983 Sep;38(3):200-2.

PMID: 6672562

Obturator hernia is a rare clinical entity usually presenting with strangulation. Preoperative diagnosis is seldom made and this has contributed to a high. mortality. One should suspect a strangulated obturator hernia in an elderly thin female patient presenting with vague abdominal symptoms or intestinal obstruction associated with a positive Howship-Romberg sign. Urgent laparotomy is indicated to establish the diagnosis and for resection of bowel if indicated.

Matched MeSH terms: Intestinal Obstruction/diagnosis*

Mushroom Bezoar Causing Small Bowel Obstruction

Hamzah AA, Keow CK, Syazri A, Mallhi TH, Khan AH, Khan YH, et al.

J Coll Physicians Surg Pak, 2017 Mar;27(3):S13-S15.

PMID: 28302231 DOI: 238

A bezoar is a concretion of foreign or indigestible matter in the alimentary canal and is usual cause of gastric obstruction. Bezoars can become fragmented and migrate downward leading to intestinal obstruction. Diagnosis of phytobezoar has become challenging in clinical practice due to lack of patient history and inability of patient to correlate preceding events with the episode of bowel obstruction. Bezoar associated small bowel obstruction rarely occurs and is usually found in patients with history of gastrointestinal surgery. Very few cases are reported of small bowel obstruction due to bezoar in healthy population without prior illness or surgery. We present a case of small bowel obstruction due to mushroom bezoar in a 62-year patient with no past history of medical illness or gastric surgery. Enterotomy was performed and a whole piece of undigested mushroom measuring 5 x 3 cm was successfully removed.

Matched MeSH terms: Intestinal Obstruction/diagnosis; Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery

Fulltext Duodenal obstruction secondary to metastatic synovial sarcoma--a case report

Hashim S, Abdullah BJ, Rajasingam V, Moosa F

Med J Malaysia, 1999 Jun;54(2):267-9.

PMID: 10972041

A 17 year old Malay student who is a known case of synovial sarcoma of left elbow (treated with an above elbow amputation) presented with duodenal obstruction. We report an unusual case of gastrointestinal tract metastases from synovial sarcoma. To our knowledge, there is no previous such report in the literature. The computed tomography (CT) and magnetic resonance imaging (MRI) features are described.

Matched MeSH terms: Intestinal Obstruction/etiology*

Obstructed jejunal duplication cyst in an infant

Ho CK

Med J Malaysia, 2020 03;75(2):167-168.

PMID: 32281600

Intestinal obstruction in infancy due to duplication cyst is rare. This is a case of a three-month old boy presented to the hospital with symptoms and signs of intermittent intestinal obstruction for three-week duration. Investigation with ultrasound revealed a small bowel duplication cyst. Patient underwent successful segmental jejunal resection and made an uneventful recovery. He made significant weight gain at one-year follow-up. The diagnostic approach to infant with intestinal obstruction is described with special emphasis on ultrasonographic features of jejunal duplication cyst.

Matched MeSH terms: Intestinal Obstruction/surgery*

Fulltext Recurrent Intestinal Obstruction in a Patient with Selective IgA Deficiency

Hui CK

Malays J Med Sci, 2016 Nov;23(6):123-127.

PMID: 28090187 DOI: 10.21315/mjms2016.23.6.14

A 32 year old woman presented with acute onset of abdominal pain and fever. An urgent computerised tomography (CT) of the whole abdomen showed dilated loop at the terminal ileum in the right lower abdomen with thickening of the wall and oedema. The CT was suggestive of distal small bowel obstruction at the ileum with surrounding wall oedema. Multiple biopsies taken from the terminal ileum and colon on colonoscopy were all unremarkable. She represented one-year later with a recurrence of intestinal obstruction. CT enteroclysis showed collapse at the distal 3 cm segment of the terminal ileum. There was no associated wall thickening, active inflammatory changes or ileitis. This was suspicious of post-inflammatory change or fibrosis. She was subsequently found to have selective IgA deficiency with recurrent infection in the terminal ileum resulting in intestinal obstruction. In conclusion, selective IgA deficiency should be considered in patients with recurrent intestinal obstruction without anatomical obstructions.

Matched MeSH terms: Intestinal Obstruction

Intestinal obstruction due to rectal endometriosis: a surgical enigma

Jarmin R, Idris MA, Shaharuddin S, Nadeson S, Rashid LM, Mustaffa WM

Asian J Surg, 2006 Jul;29(3):149-52.

PMID: 16877213

Obstructed rectal endometriosis is an uncommon presentation. The clinical and intraoperative presentation may present as malignant obstruction. The difficulty in making the diagnosis may delay the definitive management of the patient. We report a unique case of rectal endometriosis mimicking malignant rectal mass causing intestinal obstruction and discuss the management of the case.

Matched MeSH terms: Intestinal Obstruction/diagnosis; Intestinal Obstruction/etiology*; Intestinal Obstruction/surgery*

Fulltext Intestinal obstruction: etiology, correlation between pre-operative and operative diagnosis

Kadhim Jawad Obaid

Int J Public Health Res, 2011;1(2):41-49.

MyJurnal

A prospective study done In al Zaafaranya General Hospital in Baghdad/Iraq In the period between April 2003 and February 2007. Ninety two patients admitted to the surgical wards diagnosed as Intestinal obstruction. The aim is to find out the possible common conditions resulting in causing this common surgical emergency. Also to compare the provisional clinical diagnosis about ischemic obstruction and the definitive post operative diagnosis. To encourage post graduate students to use their clinical abilities with the few laboratory and radiological facilities available needed to decide about the management of those patients.

Matched MeSH terms: Intestinal Obstruction

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