Obstruction of the small intestine caused by a hairball in 2 young beef calves.
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Two beef calves, with a history of anorexia and absence of feces, were dehydrated and bloated on presentation. Intestinal obstruction was suspected based on clinical and laboratory findings. Hairballs obstructing the small intestine were removed surgically and the calves recovered. Intestinal obstruction due to hairballs has not been described before. (+info)
Gastrointestinal bezoars: a retrospective analysis of 34 cases.
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AIM: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, they frequently cause small bowel obstruction (SBO). We aimed to present our experience by reviewing literature. METHODS: Thirty-four patients with gastrointestinal BZ were presented. The data were collected from hospital records and analyzed retrospectively. Morbidity and mortality rates were statistically analyzed between the subgroups according to SBO and endoscopic or surgical treatment modalities. RESULTS: The 34 patients had phytobezoars (PBZ). Two patients with mental retardation and trichotillomania had trichobezoars (TBZ). More than half of them (55.88%) had previous gastric surgery. Also most of them had small bowel bezoars resulting in obstruction. Surgical and endoscopic morbidity rates were 32.14% and 14.28% respectively. The total morbidity rate of this study was 29.41%. Four patients in surgically treated group died. There was no death in endoscopically treated group. The total and surgical mortality rates were 11.76% and 14.28% respectively. The differences in morbidity and mortality rates between the subgroups were not statistically significant. CONCLUSION: BZ are commonly seen in stomach and small intestine. SBO is the most common complication. When uncomplicated, endoscopic or surgical removal can be applied easily. (+info)
Clinics in diagnostic imaging (104): Gastric trichobezoar (or hairball).
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A 56-year-old man underwent triphasic computed tomography (CT) of the abdomen as part of his work-up for liver transplantation. A mottled, rounded lesion with a dense rim was noted in the gastric lumen, which remained unchanged in appearance in the arterial, portal venous, and delayed phases of the CT. Gastroscopy performed three days later confirmed the presence of trichobezoar. The foreign body was broken down into smaller pieces by an endoscopic snare and was passed out spontaneously. The clinical presentation, radiological findings, and management of trichobezoars are discussed. (+info)
Calcified reticulate rind sign: a characteristic feature of gossypiboma on computed tomography.
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We herein report a gossypiboma resulting from a retained surgical swab, which had been left in peritoneum for 20 years after appendectomy. CT revealed a cystic mass with a calcified reticulate rind. Subsequent surgery and pathological examination showed a gossypiboma. A simple experiment, using a barium-soaked surgical swab demonstrating similar CT appearance, supported our postulation that calcium deposition on the reticulated fibers of a surgical swab could generate such a characteristic "calcified reticulate rind" sign. We believe that identification of this CT sign facilitates the diagnosis of gossypibomas. (+info)
Development of bile duct bezoars following cholecystectomy caused by choledochoduodenal fistula formation: a case report.
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BACKGROUND: The formation of bile duct bezoars is a rare event. Its occurrence when there is no history of choledochoenteric anastomosis or duodenal diverticulum constitutes an extremely scarce finding. CASE PRESENTATION: We present a case of obstructive jaundice, caused by the concretion of enteric material (bezoars) in the common bile duct following choledochoduodenal fistula development. Six years after cholecystectomy, a 60-year-old female presented with abdominal pain and jaundice. Endoscopic retrograde cholangiopancreatography demonstrated multiple filling defects in her biliary tract. The size of the obstructing objects necessitated surgical retrieval of the stones. A histological assessment of the objects revealed fibrinoid materials with some cellular debris. Post-operative T-tube cholangiography (9 days after the operation) illustrated an open bile duct without any filling defects. Surprisingly, a relatively long choledochoduodenal fistula was detected. The fistula formation was assumed to have led to the development of the bile duct bezoar. CONCLUSION: Bezoar formation within the bile duct should be taken into consideration as a differential diagnosis, which can alter treatment modalities from surgery to less invasive methods such as more intra-ERCP efforts. Suspicions of the presence of bezoars are strengthened by the detection of a biliary enteric fistula through endoscopic retrograde cholangiopancreatography. Furthermore, patients at a higher risk of fistula formation should undergo a thorough ERCP in case there is a biliodigestive fistula having developed spontaneously. (+info)
Gastrointestinal obstruction due to plaster ingestion: a case-report.
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BACKGROUND: Plaster ingestion forming gastric bezoar is a strange way to attempt suicide and this method has not yet been reported. It may lead to a mechanical obstruction of the gut, especially the pyloric region, and could manifest with abdominal pain, epigastric distress, nausea, vomiting, and fullness. CASE PRESENTATION: Herein we report a case of a 37 year-old woman presenting with plaster ingestion and gastric outlet obstruction, who underwent surgery. At six months follow-up the patient was fully recovered. CONCLUSION: Plaster has no toxic or erosive effects. Endoscopic or surgical removing of such material is recommended. Moreover, psychiatric intervention and management is imperative to prevent recurrence in such cases. (+info)
An unexpected finding in an eight-year-old child with cerebral palsy and weight loss.
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Poor weight gain is frequently seen in children with cerebral palsy. This is most commonly due to poor oral-motor coordination, resulting in inadequate caloric intake. We present the case of an eight-year-old girl with Aicardi syndrome who had been an exclusively oral feeder and who was noted to have had a 10-lb weight loss over the previous months when she was admitted to the hospital with seizures. Due to ongoing diminished oral intake, a barium swallow was performed, which revealed a filling defect. The mass that was removed at surgery proved to be a lactobezoar, a very uncommon finding in a child of this age. (+info)
A case of Glanzmann's thrombasthenia successfully treated with recombinant factor viia during a surgical procedure: observations on the monitoring and the mechanism of action of this drug.
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Recombinant factor VIIa (rFVIIa) has been shown to be efficient for the treatment of haemorrhages in patients with Glanzmann's thrombasthenia presenting anti-glycoprotein IIb-IIIa antibodies, but the mechanism of action is not well established and there is no routine laboratory test for the monitoring of rFVIIa. In this study, thrombin generation (TG) test was used to assess the efficacy of rFVIIa ex vivo in a Glanzmann patient with inhibitor, who had a surgery for cholesteatoma. The day before surgery, TG capacity in platelet rich plasma was significantly diminished (Endogenous thrombin potential = 637nM x min) in comparison with the normal control group (1338+/-353 nM x min). Thirty minutes after the first infusion of 90 microg/kg of rFVIIa, TG was increased by 59% (1010 nM x min). rFVIIa was administered as intravenous bolus injection of 90 microg/kg q x 2h during the first 24h, than 66microg/kg q x 2h during 24h and 53 microg/kg q x 2h on the post-operative day 3. Residual TG capacity measured before rFVIIa administration mostly remained above 1000nM x min and the coagulation capacity was not significantly modified after a new injection of rFVIIa. The fibrin network was studied with 3D confocal microscopy using clots obtained with TG test. After rFVIIa infusion, the fibrin network was tighter in comparison with the sample before rFVIIa injection. These results provide further ex vivo evidence on haemostatic efficacy of rFVIIa in Glanzmann's patients. (+info)