A renal transplant patient presented with ileal perforation due to histoplasmosis 3 years after transplantation. Mesenteric lymph nodes and lungs were also affected by the disease. She was successfully treated with amphotericin B followed by ketoconazole.
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J Surg Case Rep
January 2025
Department of Colorectal Surgery, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, New South Wales 2076, Australia.
An 84-year-old lady presented with 1 day history of sudden onset generalized abdominal pain, fevers, and peritonism. Computed tomography was suggestive of a mid-small bowel perforation associated with a distal ovoid soft tissue density structure without pneumobilia. An urgent laparotomy demonstrated two areas of jejunal diverticula necrosis and perforation associated with a 3 cm luminal mass in the proximal ileum, and proximal small bowel dilatation.
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December 2024
Department of General Surgery, Uttar Pradesh University of Medical Sciences, Saifai, IND.
Enteroenteric fistula in the pediatric age group is an unusual presentation. It can create a diagnostic dilemma for the physician, particularly in the absence of any previous surgery, prolonged abdominal symptoms, or inflammatory bowel disease. The patient is a 10-year-old girl who presented with mild-grade fever, abdominal distension, scanty stool passage, and foul-smelling vomiting for the past 10 days.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
We report a case of small bowel perforation from ileo-ileal intussusception with necrotising enterocolitis (NEC) after indomethacin exposure mimicking spontaneous intestinal perforation in an extremely preterm neonate. Indomethacin exposure can cause mesenteric hypoperfusion, resulting in an ischaemic lead point for intussusception and NEC. We advocate that intussusception should be considered as one of the differentials for neonates with recurrent feeding intolerance postindomethacin exposure.
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December 2024
Upper Gastrointestinal Surgery, North Manchester General Hospital, Manchester, GBR.
Non-Meckel small bowel diverticula, particularly ileal diverticula, are rare, especially when incarcerated within an inguinal hernia sac. This case involves an 80-year-old man who presented with a newly noticed tender, irreducible lump in his left groin, accompanied by symptoms of bowel obstruction such as inability to pass flatus and vomiting. His medical history included a previous right inguinal hernia repair.
View Article and Find Full Text PDFAnn Gastroenterol
December 2024
Department of Gastroenterology, Center for Advanced Therapeutic Endoscopy at Porter Adventist Hospital (Douglas G. Adler).
Background: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a common surgical procedure for ulcerative colitis and familial adenomatous polyposis. IPAA strictures are a known complication, often requiring surgical intervention. Endoscopic interventions offer a less invasive alternative, but their safety and efficacy remain uncertain.
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