A 26-year-old female patient was admitted to our hospital, complaining of obstipation, nausea, and vomiting for the past 3 days. She had no significant medical and clinical history. The patient had no history of previous abdominal operations or medication use....

Background: The aim of this study was to analyze the etiology, symptom frequency, management, and surgical outcome of gastrointestinal obstruction in the first month of life. Methods: A total of 72 neonates with gastrointestinal obstruction were reviewed over a period of 16 months. Results: The male to female ratio was 2. 4: 1. In this study, 75% of the neonates were presented in the first 7 days of life. The mean gestational age was 39. 25 weeks. In addition, 68 of the neonates were term babies. The most common cause of admission was anorectal malformation (22%); furthermore, small bowel atresia was observed in 15% of the cases. Vomiting was the most common symptom of gastrointestinal obstruction reported in 31% of the cases, followed by abdominal distension. In this study, the overall mortality after surgery was 17%. The significant determining cause of mortality was sepsis reported in 33% of the cases. Conclusion: Early referral, diagnosis, and treatment of gastrointestinal obstruction in neonates are needed to improve the survival outcome. The most common cause of neonatal gastrointestinal obstruction was found to be imperforate anus.

Postpolypectomy bleeding and perforation are the major complications of colonoscopy. This report presents a rare case of colon obstruction immediately after colonoscopy. A 56-year-old man underwent colonoscopy because of 6 months lower abdominal pain. Colonoscopy revealed diverticulosis and multiple small sessile polyps in sigmoid colon. Biopsy samples were taken from the polyps and the procedure was continued up to cecum. Soon after the procedure, the patient complained of colicky abdominal pain accompanied by diaphoresis. In physical examination, the abdomen seemed distended and bowel sounds were high-pitched. There was no abdominal tenderness or guarding. Plain and upright abdominal radiography showed multiple colonic air-fluid levels. Immediately, the patient underwent second colonoscopy, but passage of scope through sigmoid colon (at the site of biopsies) was somewhat hard because of edema and spasm. The colonoscope proceeded gently up to cecum and decompressed the entire colon by suctioning the air that was entrapped in proximal parts. By second colonoscopy and further conservative treatments, the patient’s condition improved without any surgical procedure and was discharged after 24 hours.

Background: The term phytobezoar refers to a trapped mass in the gastrointestinal tract caused by the agglomeration of indigestible ingested plant materials, including fibers, skins, and seeds. A persimmon phytobezoar is formed after the frequent consumption of persimmons. The clinical manifestations of persimmon phytobezoars are similar to other phytobezoars and depend on the localization and size of the trapped mass. Case Presentation: Here, we presented a 57-year-old male with persimmon phytobezoars, which finally led to small bowel obstruction. The patient was referred to the emergency room with complaints of severe abdominal pain and frequent vomiting. The patient underwent laparotomy surgery that led to the removal of a portion of his ileum. Conclusion: Overindulgence in taking persimmon can lead to formation of phytobezoar and subsequent obstruction of small intestinal. Persimmon phytobezoars are difficult to break up into pieces because of containing tannins, cellulose, hemicellulose, and lignin.

Background: Early diagnosis of intestinal obstruction is critical for preventing subsequent complications. In this study, we compare the accuracy of plain abdominal X-ray and ultrasound imaging among children with intestinal obstruction, in terms of the diagnosis of obstruction and its underlying causes. Methods: This analytical cross-sectional study was performed at Akbar Children’, s Hospital of Mashhad, Iran, in 2019-2021. Children with clinical manifestations of bowel obstruction underwent abdominal ultrasound examination and plain abdominal X-ray imaging, and the diagnostic findings were compared with the final definite diagnosis. Radiologic signs of obstruction were bubble signs in obstructions until the jejunum, and sausage-shaped air-filled bowel in obstructions of the rest of the bowel. The ultrasound signs were fluid-filled dilated loops, tubular or sausage-shaped dilated bowels, parallel valvulae conniventes (stack of coins), the to-and-fro motion, and the cause of the obstruction. Results: Overall, 60 children with a mean age of 3. 05 ±,0. 87 years were studied. Post-operative adhesion was the most common cause of obstruction (28%). Plain radiography revealed a normal pattern in 15% of cases, bubble sign and/or decreased abdominal gas pattern in 15% of patients (highlevel obstruction), and sausage-shaped pattern of low-level obstruction in 70% of cases, with 72% accuracy. The sonographic signs of bowel obstruction were seen in all patients, with 96. 6% accuracy. The cause of obstruction could be determined in 91% of patients, with 91. 6% accuracy. Conclusion: Plain abdominal X-ray had a normal pattern in 15% of bowel obstructions while sonography revealed all obstructions with 91. 6% accuracy. Therefore, ultrasound imaging can be used as the preferred imaging modality to diagnose gastrointestinal tract obstructions.

Peritoneal tuberculosis (PTB) is a rare subset of extrapulmonary tuberculosis which account for only 0. 5-1% of all cases. PTB diagnosis can be challenging due to nonspecific clinical manifestations. We present a known case of pulmonary tuberculosis that admitted to the surgery ward due to the major complaint of abdominal pain since ten days before admission. In imaging studies, positive findings favoring mechanical obstruction were detected. There were also several hypodense lesions in the liver suggestive of visceral tuberculosis. An adhesion was noted during exploratory laparotomy prior to the ileocecal valve responsible for intestinal obstruction, which was released. Pathology reports of excised tissues were consonant with the PTB diagnosis. PTB diagnosis can be challenging because of its presentation. This can delay the treatment of patients and thus increase morbidity and mortality. As a result, physicians should always be aware of the PTB diagnosis in patients with nonspecific abdominal involvement.

Dear Editor Adhesive small bowel obstruction (ASBO) is one of the most frequently encountered disorders in Emergency Surgery Departments worldwide without negligible hospital admission rates and social costs (1, 2). Notwithstanding significant improvements in techniques and materials, intra-abdominal adhesions following abdominal surgery still represent a major unsolved and debated issue harbouring challenges regarding diagnosis, pathogenesis, management and prevention. In this setting, the cornerstone lies on a proper nosological classification with a subsequent diagnostic dilemma in distinguishing ASBO from other causes of obstruction and in an early identification of emergency surgery cases. Moreover, conflicting results raise more questions...

1. Case presentation A 30-year-old married woman with a history of infertility was referred to the general surgery department with complaints of occasional and intermittent left lower abdominal and left inguinal pain. Abdominal examination was normal and there was no obvious bulging in the left inguinal region. Routine laboratory tests were normal. Abdominal and pelvic ultrasonography revealed a left inguinal hernia with a defect of 15 millimeters (mm) and did not report any other pathological points. The patient was a candidate for laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. . .