Congenital intestinal flange as a cause of intestinal obstruction. A case report

DOI: 10.17605/OSF.IO/GRSA2

Perzabal-Aviléz CT, Lopez-Jaime CA, Zapata-Arredondo TG, Soto-Posada AK, Acosta-Garcia AG, Ruiz-Cereceres SJ. Congenital intestinal flange as a cause of intestinal obstruction. A case report. Am J Med Surg. 2021; 5(2). 15-19

BACKGROUND. An intestinal obstruction occurs when there is an interruption in the forward flow of the luminal content in the gastrointestinal system. This entity was first diagnosed and treated by Hippocrates.

An 18-year-old patient with no significant history, went to the emergency room after presenting a picture of sudden moderate abdominal pain of the colic type predominantly in the upper hemiabdomen accompanied by nausea and vomiting, on physical examination, slightly distended abdomen in the upper hemiabdomen with percussion bloat in the upper hemiabdomen and hypoactive peristalsis, slightly painful on diffuse palpation.

Medical management was started without presenting improvement at 78 hours, for which it was decided to perform exploratory laparotomy, identifying the flange at 120 cm of the Treitz angle, the flange is resected and secondary stenosis is identified, an end-to-end anastomosis of the small intestine is performed.

Bowel obstruction is an important cause of morbidity and mortality reporting for nearly 30,000 deaths; it is responsible for approximately 15% of hospital admissions for acute abdominal pain in the US and 20% of cases needing acute surgical care.

Patients presenting with intestinal obstruction are often frail and elderly. Small bowel obstruction with strangulation and large bowel obstruction can lead to mortality rates of 20% to 30%.  They can also present septicemia, respiratory tract infections, anastomosis leak, short bowel syndrome which must be treated with parental nutrition support, enterocutaneous fistula and wound infection.

 

KEY WORDS

Intestinal obstruction; small bowel obstruction; laparoscopic adhesiolysis; resection and end to end anastomosis.