Jejunal Lipomatosis with Diverticulosis: Report of a Case

(Received for publication on Nov. 25, 1996; accepted on July 8, 1997)     

A Rare Case of Jejunal Diverticulosis Causing Mesenteric Volvulus

Jejunal diverticulosis is a rare asymptomatic entity [1]. In literature, there are only few cases of jejunal diverticulosis where small gut volvulus is reported. The disease entity is important as it may masquerade as hemorrhage, obstruction, or perforation which are life threatening. We report a rare case of small bowel volvulus secondary to jejunal diverticulosis.     

Intestinal Duplication Cyst Associated with Intestinal Malrotation Anomaly: Report of a Case

Duplications of the alimentary tract are rare congenital malformations and may occur anywhere in the intestinal tract. Intestinal duplication cysts have been rarely found with intestinal malrotation anomaly. We present a 2-year old boy who had intestinal duplication cyst, associated with intestinal malrotation anomaly.     

Jejunal Diverticulosis - Rare Cause of Gastrointestinal Bleed

Jejunal diverticulosis was first described by Somerling in 1794 and by Sir Astley Cooper in 1807. Jejunal diverticula are rare. Hemorrhage from jejunal diverticula usually presents as gastrointestinal bleeding. Here, we present a case of severe gastrointestinal bleeding presenting as malena due to jejunal diverticulosis.     

Giant Bladder Diverticulum as a Rare Cause of Intestinal Obstruction: Report of a Case

We report a case of intestinal obstruction as an unusual manifestation of bladder diverticulum. To our knowledge, this is the first report of a giant bladder diverticulum causing acute abdomen as a result of mechanical bowel obstruction.     

Segmental Intestinal Preservation and Enteral Nutrition Help to Maintain the Intestinal Function After a Massive Intestinal Resection: Report of a Case

We report a case in which both segmental intestinal preservation and enteral nutrition helped to maintain the intestinal function after a massive bowel resection for superior mesenteric artery (SMA) thrombosis. A 53-year-old Japanese man was admitted to our hospital with acute abdomen. Extensive necrosis of the small intestine was found during the operation; however, a loop of the ileum appeared to be viable. A massive resection of the small intestine which preserved a 50-cm length of the viable ileum loop was thus performed. However, diffuse stenosis of the remaining ileum was found after surgery. An end-to-end anastomosis of the distal end of the preserved ileum loop and the terminal ileum was made in the second operation, and enteral nutrition was infused to improve the remnant intestinal function. A jejunoileostomy was performed in the final operation. An X-ray study after the final operation showed the stenosis of the remaining ileum to have improved. The patient therefore did not need any nutritional support after being discharged. Received: December 5, 2000 / Accepted: May 15, 2001     

Multiple Jejunal Diverticulitis with Perforation in a Patient with Systemic Lupus Erythematosus: Report of a Case

A 70-year-old man with systemic lupus erythematosus (SLE) was brought to our Emergency Department after the sudden onset of acute and severe abdominal pain. Physical examination revealed a tender and distended abdomen with guarding and rebound tenderness in the periumbilical region and the left upper quadrant. A plain abdominal X-ray taken with the patient upright showed air fluid levels with dilatation of several loops in the small bowel. As the examination could not rule out bowel ischemia, perforation, or obstruction, an emergency laparotomy was performed, which revealed multiple jejunal diverticulosis, one of which had perforated and adhered to the right colon, causing rotation. The diverticulosis segment was resected and an end-to-end anastomosis was done. The patient had an uneventful postoperative recovery without any complications. This is an unusual cause of peritonitis in a patient with SLE, and we could not find any evidence to suggest involvement of the underlying SLE in the jejunal diverticulosis and diverticulitis in this patient. Nevertheless, the involvement of SLE might be possible and further investigation is warranted.     

Enterolith Small-Bowel Obstruction Caused by Jejunal Diverticulosis: Report of a Case

We report the successful surgical treatment of intestinal obstruction caused by enteroliths formed in jejunal diverticula. A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. Thus, we performed a laparotomy, which revealed multiple diverticula in the jejunum, with one enterolith inside a diverticulum and one enterolith in the terminal ileum. There was no abnormal communication between the gallbladder and the intestinal tract, excluding the possibility of a gallstone ileus. The stone in the terminal ileum could not be broken manually, so we performed an enterotomy to remove the stones. Intestinal obstruction caused by enteroliths in small-bowel diverticula is a rare event, which is difficult to diagnose and manage. To our knowledge, only 35 such cases have ever been reported.     

Antegrade Jejunojejunal Intussusception After Roux-en-Y Esophagojejunostomy as an Unusual Cause of Postoperative Intestinal Obstruction: Report of a Case

Postoperative intestinal obstruction in adults is rarely caused by intussusception. A case of antegrade jejunojejunal intussusception that occurred after Roux-en-Y esophagojejunostomy is described, followed by a discussion of the literature on this unusual entity. Received: January 7, 2000 / Accepted: September 26, 2000     

Small Bowel Obstruction Caused by a Congenital Intestinal Web with an Enteric Bezoar in an Adult: Report of a Case

An intestinal web is a rare congenital anomaly, typically reported in childhood, but often remaining asymptomatic throughout the entire life span of the individual. We report the case of a symptomatic intestinal web associated with an enteric bezoar in an adult, which to the best of our knowledge has never been documented before. A 25-year-old man presented with acute small bowel obstruction, and laparotomy revealed a stenotic area of the ileum as well as impaction of an enteric bezoar. We resected this segment of ileum and an intestinal web was subsequently found in the stenotic area. The patient recovered well and has remained asymptomatic for 3 years. Although rare, a congenital intestinal web may be a cause of adult small bowel obstruction requiring surgical resection.     

Complicated jejunal diverticulosis: Report of a case

The authors report a case of complicated multiple jejunal diverticulosis and review the data from the literature on this pathology. A 74-year-old man was admitted to our unit presenting with symptoms of intestinal obstruction. He had previously experienced three episodes of the same symptomatology with melena. Endoscopy excluded gastroduodenal or colonic bleeding; an X-ray of the small bowel detected multiple large jejunal diverticula. The patient underwent surgery: a jejunal resection was performed just below the Treitz angle extending about 60–70 cm. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. At present, the patient is doing well and has not since demonstrated any symptoms of either intestinal obstruction or melena.     

Intestinal malrotation associated with colon cancer in an adult: Report of a case

Intestinal malrotation is a congenital anomaly of intestinal rotation and fixation that generally becomes symptomatic during the neonatal period. However, it rarely occurs in adulthood, and synchronous colon cancer is even rarer. This report presents the case of a 45-year old man who suffered from intestinal malrotation associated with colon cancer.     

Diffuse Cavernous Hemangioma of the Rectum: Report of a Case

Cavernous hemangioma of the rectum (CHR) is an uncommon benign vascular lesion, which mainly affects young adults. The rectosigmoid area is the most common site of cavernous hemangioma in the gastrointestinal tract. CHR is often misdiagnosed due to a lack of knowledge of the clinical features. We report a case of CHR, focusing on the clinical features, diagnostic procedures used, and treatments given. This patient was finally treated effectively with abdominoperineal resection. Thorough preoperative imaging is necessary to confirm the diagnosis and evaluate both the site and extent of the hemangioma. Magnetic resonance imaging (MRI) provides information about the dimensions of the tumor and involvement of the adjacent structures with its high resolution and multiplanar capability, without the use of contrast medium. Moreover, endorectal surface coil MRI depicts the five separate layers of the bowel wall and internal and external sphincter more clearly than the conventional body coil MRI. Received: December 26, 2001 / Accepted: May 7, 2002 Reprint requests to: M. Watanabe     

Intestinal Obstruction in the Terminal Ileum Caused by an Anomalous Congenital Vascular Band Between the Mesoappendix and the Mesentery: Report of a Case

We report a case of intestinal obstruction caused by a congenital abnormal vascular band in a 17-year-old boy. The patient was admitted with acute colicky abdominal pain, and an emergency laparotomy revealed that the ileum was strangulated by a fibrous band with vessels about 2mm in diameter and 7cm in length, extending from the antemesenterium of the terminal ileum to the mesoappendix. The affected intestine was resected with the band and the appendix. Histologically, the fibrous band was composed of loose connective tissue containing arteries, veins, and nerve fibers, suggesting that it was congenital and originated from a remnant of the ventral mesentery in the embryonic period. There have been few reports of intestinal obstruction being caused by a congenital vascular band, especially in patients beyond the pediatric age group.     

Portomesenteric Gas due to Intestinal Obstruction: a Case Report

A case of mesenteric vein gas as a nonfatal complication of intestinal obstruction is reported. A 48-year old woman presented postoperatively signs and symptoms of acute abdomen on the eighth day following a gastric pull-up surgery due to an oesophageal carcinoma. The abdominal tomography findings revealed dilated jejunal segments and free gas in the superior mesenteric vein and end branches of the portal vein in the left hepatic lobe. The patient underwent a second laparotomy with a provisional diagnosis of intestinal ischaemia. Intraoperative gross appearance of the intestines revealed no ischaemic finding, the pathology was the dense adhesions between the jejunal segments and previous incision site. On the basis of these findings, the operation was ended with adhesiolysis. One month after the operation, the patient was well, there were no complications. As the authors, we think that the main reason for por-tomesenteric gas is mucosal destruction and that these cases may be followed conservatively as long as intestinal ischaemia is excluded.     

Intestinal Perforation Due to Phytobezoar Obstruction: a Case Report

Phytobezoars are uncommon causes of acute abdomen. We report a patient who presented with acute abdomen and who was intra-operatively diagnosed as having a small intestinal perforation due to an intestinal phyto-bezoar.     

A Small Bowel Volvulus Caused by a Mesenteric Lipoma: Report of a Case

A 31-year-old man underwent a laparotomy for acute intestinal obstruction symptoms, which he had intermittently experienced for 14 years. The cause of the obstruction was due to a volvulus of the small bowel caused by a mesenteric lipoma. This is a rare finding, which is ideally diagnosed by computed tomography, with surgery the best and most highly recommended treatment. This particular presentation, to the best of our knowledge, has not yet been previously reported in the English language.     

A Left Paraduodenal Hernia Causing Acute Bowel Obstruction: a Case Report

We present the case of a 54-year old woman who presented twice at our emergency department with progressive abdominal pain. Over the last few years, multiple short periods of abdominal pain had occurred: the pain always resolved spontaneously after a few hours. She had no past medical history. CT scan revealed a sac-like mass of small bowel loops to the left of the ligament of Treitz, consistent with the diagnosis of a left paraduodenal hernia. On laparotomy, a left paraduodenal hernia with incarceration of small bowel loops was found; the herniated loops were reduced and the hernia orifice closed. The anatomy, treatment and importance of considering this uncommon diagnosis when examining a patient with acute small bowel obstruction are discussed.     

Lipomatosis of the ileum with volvulus: Report of a case

(Received for publication on Jan. 8, 1997; accepted on July 8, 1997)