Date: 18-06-18  Time: 08:43 AM

Author Topic: intestinal obstruction  (Read 1693 times)

mahmud_ul

  • Guest
intestinal obstruction
« on: June 26, 2012, 04:44:44 AM »
On May 18, 2012 indigestion and certain abdominal unrest created a state of emergency and I had to rush to the hospital for medical help. CT scan diagnosed multiple diverticulum in jejunum and stricture at 20cm from ileocecal junction in ileum and surgery was done on May 21, 2012 which restored the normal functioning of the affected parts.
Nature of Operation: Exp. Laprotomy and resection anastomosis and right inguinal hernia repair.
Histopathologist finds transmural chronic inflammation, fibrosis and focal interaction in ileum segment. However, no opinion is given about the basis cause of such condition. This may be due to crohn's disease or some other similar basis or causes. Detailed hispopathology report is given below for reference which may help in drawing the best possible inference .

Clinical History:
Small bowel obstruction

Gross Description:
Specimen received in formalin in one container coded as ileal segment with stricture. it consists of single loop of bowel measuring 5.5x4.5 cm. No stricture identified. Lumen show two suspicious eroded areas, one area is 0.2 cm from one resection margin, 3cm from other resection margin, lesion measuring approximately 0.6x0.5 cm each. Representative sections taken and embedded from both resection margins in 1. Representative sections taken and embedded from suspicious areas in 2 and 3. Representative sections taken and submitted other area in 4. Additional sections are submitted in R1, R2, R3.(ki)

Microscopic Examination:
Sections examined from the lesion show small bowel with focal ulceration, transmural chronic inflammation and fibrosis. No ischemic change or crypt distortion noted.
Section from resection margins examined which is intact and viable. No evidence of granuloma or maligancy seen in the sections examined.

Diagnosis:
Lieal segment:-
1. Transmural non specific chronic inflammation, fibrosis and focal ulceration.
2. Both resection margins are viable.

Please give your opinion about the possible basis cause and also suggest measures and precautions necessary to avoid such a condition in future.
With regards,
Mahmood-ul-hassan