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Intestinal perforation in a parastomal hernia by a migrated plastic biliary stent.

Organ perforation is a well-described complication of plastic biliary stent placement [1, 2, 3, 4, 5, 6, 7, 8, 9, 10][1-10]. Most commonly, a stent will cause duodenal perforation while still in the area of the biliary system. This often occurs in the setting of a periampullary diverticulum. Less frequently, a perforation occurs as a result of stent migration into the distal lumenal gastrointestinal tract. These cases have involved a migrated stent impacting at the level of the ileum or a sigmoid colon diverticulum. A plastic biliary stent causing perforation inside an incarcerated small bowel hernia sac has been reported [10]. We describe the first reported case of a plastic biliary stent causing perforation inside a parastomal hernia.

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Case report: intestinal perforation--an unusual complication of endoscopic biliary stenting.

The endoscopic placement of stents to decompress biliary obstruction is accepted practice in the management of malignant biliary strictures. In our patient, a 73-year-old man with a presumed malignant common hepatic duct stricture, palliation of his obstructive jaundice has been achieved. However, his clinical course was complicated by a colonic perforation--a previously unreported complication of distal stent migration.

Aged↗

Intestinal perforation in adults due to ingested opaque foreign bodies.

Accidental foreign body ingestion occasionally occurs in adults and is especially likely in those wearing dentures. While most foreign bodies pass readily through the gastrointestinal tract, complications such perforation, abscess, obstruction and hemorrhage occasionally occur. Radiography may be of help in detecting and localizing these foreign bodies and in determining complications caused by them.

Adult↗

[Multiple intestinal perforation in Crohn's disease].

Free perforation of the small bowel in Crohn's disease is a rare event. The reported incidence is between 1 to 2 per cent, and only in 25 per cent of the cases it appears as the first manifestation of the disease. A case is reported, which we consider is unique, due to the fact that within one year there had been three independent episodes of perforation as her first manifestation of the disease.

Combined Modality Therapy↗

E. coli meningitis as an indicator of intestinal perforation by V-P shunt tube.

Shunting systems widely used for the treatment of hydrocephalus have been connected with certain risks and potential complications which stem from implanting a non-biological material into the human body. Several complications have been reported to arise from the insertion of ventriculo-peritoneal shunts. This short report highlights the observation that when anaerobic meningitis together with gram negative E. Coli in the CSF of a V-P shunted patient is found, bowel perforation should be assumed. Four cases developed such a complication among 643 hydrocephalic patients of various etiology over a period of ten years.

Adult↗

A rare complication of miliary tuberculosis: intestinal perforation.

Small bowel perforation is a rare complication of miliary tuberculosis. We report the case of a 21-year old patient who developed a small bowel perforation 70 days after the initiation of adequate tuberculosis treatment. We also present a review of the literature.

Adult↗

Intestinal perforation from trauma to an inguinal hernia.

Inguinal hernias are most feared to result in incarceration and strangulation of intra-abdominal structures. Blunt abdominal blows have previously been reported to cause traumatic perforation of bowel that overlays the defect of any abdominal wall hernia. To my knowledge, this case report is the first to show that bowel perforation may be caused by direct trauma to an inguinal hernia that contains a loop of small bowel. It is proposed that the force of the blow first opposes the walls of the incoming and outgoing bowel, sealing the loop. Then, additional pressure that is applied will raise the loop's intraluminal pressure to the point that traumatic perforation occurs. A simple experiment on a necropsy specimen showed that the proposed mechanism is plausible. This case points out another risk of leaving an inguinal hernia unrepaired.

Abdominal Injuries↗

Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report.

Tension-free and sutureless hernioplasty by plug and mesh of nonreabsorbable material is one of the most common techniques for inguinal hernia repair. It's a simple and quick procedure with a low cost and allows for a short hospital stay. It shows a low reoccurrence rate, but it can result, in very few cases, in complications strictly related to prosthetic material. The literature describes some cases of plug migration from its proper position, for example, to the scrotum, preperitoneal adipose tissue, and abdominal cavity. We report on a case of sigmoid colon perforation due to a plug of Trabucco hernioplasty performed 2 years previously.

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Yersinia enterocolitica infection complicated by intestinal perforation.

Yersinia enterocolitica causes primarily ileocolitis in human beings, and is manifested by abdominal pain, diarrhea, and fever. Usually, it is a self-limiting disease. Local or systemic complications are rare. A 71-year-old man with Y enterocolitica colitis complicated by perforation and abscess formation is described. This complication is very rare, and the four other cases that have been reported in the literature are reviewed.

Aged↗

Intestinal perforation--a unique cause.

An illiterate, 65 years old, male attended surgery emergency with features of perforation peritonitis. Exploratory laparotomy revealed perforation in the terminal ileum and a sharp metallic object pointing at the perforation site. This, on removal, was found to be the sharp edge of a blister pack (with intact tablet within). The perforation was repaired. The abdomen was closed after leaving a drain. Postoperatively the patient had a morbid period and ultimately responded to management.

Aged↗

An unusual presentation of Behçet's disease: intestinal perforation.

Behçet's disease (BD), when first described in 1937, consisted of three symptoms: recurrent oral and genital ulcerations and iridocyclitis. Today, it is known that BD is a multisystemic chronic vasculitic disorder which may involve both arteries and veins of all sizes, as well as the central nervous and gastrointestinal systems. The rate of gastrointestinal involvement of BD varies in different populations, being more common in Japan (50%-60%) and less common in the Mediterranean basin, including Turkey (0%-5%). We present a 34-year-old Turkish woman with BD who had ileal and colonic ulcerations complicated by perforation and gastrointestinal bleeding. Special emphasis was placed on the differential diagnosis between Crohn's disease (CD) and BD with gastrointestinal involvement.

Adult↗