The Role of Laparoscopy in the Management of a Diagnostic Dilemma: Jejunal Ectopic Pancreas Developing into Jejunojejunal Intussusception

Giordano, Alessio; Alemanno, Giovanni; Bergamini, Carlo; Prosperi, Paolo; Bruscino, Alessandro; Valeri, Andrea

doi:10.1155/2017/8452947

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Moreover, with laparoscopy it is possible to locate a source of disease precisely and to perform a minimal incision that is optimally located under visual monitoring – the laparoscopic assisted open approach. And finally, laparoscopy may be used as a definitive therapeutic method with all its commonly known advantages [ 3 , 4 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopy in small bowel obstruction - current status - review.

Szeliga

Jackowski

2017

Videosurgery and Other Miniinvasive Techniques

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IntroductionAcute small bowel obstruction (SBO) is an urgent medical condition. Its diagnosis is based mainly on a clinical examination followed by confirmatory simple routine radiological examinations such as plain X-ray of the abdominal cavity or computed tomography (CT). However, a real surgical challenge is not a decision whether to perform a surgery, but a decision when and how to perform it.AimTo determine the place of laparoscopy in contemporary management of acute SBO based on the current literature.Material and methodsA review of the literature based on the Medline database and including mainly the period of 2013–2017 was performed.ConclusionsWith regard to SBO, laparoscopy is a technique showing its advantages resulting from a minimally invasive approach. However, SBO is still a condition where the use of laparoscopy is limited mainly to selected cases such as SBO caused by single adhesions or foreign bodies. A basic limitation of using this technique is advanced and complicated SBO and lack of sufficient technical skills of the surgeon.

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Section: Resultsmentioning

confidence: 99%

Laparoscopy in small bowel obstruction - current status - review.

Szeliga

Jackowski

2017

Videosurgery and Other Miniinvasive Techniques

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“…disease accurately and, if required, perform a mini-laparotomy in the afflicted abdominal quadrant under the vision and complete the surgery. Lastly, laparoscopy, with all its well-known advantages, may be used as the definitive therapeutic modality [14][15][16]. Conventional open surgery for ASBO is associated with high morbidity and prolonged hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Role of Laparoscopy in the Surgical Management of Acute Small Bowel Obstruction: Fact or Fiction?

Harvitkar¹,

Kumar²,

Joshi³

2021

Cureus

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Background: Laparotomy (open surgery) is considered the standard approach for acute small bowel obstruction (ASBO). However, with the advent of minimally invasive surgery, the laparoscopic approach is gaining popularity. There is no consensus on the appropriate setting for laparoscopic therapy for small bowel obstruction (SBO).Aim and objectives: The purpose of this study is to evaluate the outcomes of laparoscopic surgery for ASBO.Patients and methods: We retrospectively evaluated the prospectively collected data of all the 38 patients who had undergone laparoscopy for ASBO, performed by a single surgeon at our institution, due to adhesions (30 patients), internal hernias (five patients), midgut malrotation (one patient), ileo-ileal intussusception (one patient), and superior mesenteric artery (SMA) syndrome (one patient) from 2012 to 2020. Data were extracted from the hospital electronic medical records (EMR) for the following parameters of each individual patient: age, sex, clinical presentation, preoperative investigation findings, final diagnosis, surgical details, operating time, time to postoperative oral feeds, length of hospital stay, complications, recurrences, and time taken to resume normal activity. A preoperative abdominal contrastenhanced computed tomography (CECT) was performed in all the cases. Patients with peritonitis and septic shock were excluded from the study.Results: The mean age of the 38 patients was 58 years (ranged between 33 and 83 years) with a standard deviation (SD) of 16.5. The mean age of the female patients in the study was 60.5 years with an SD of 16.6, while the mean age of the male patients was 54.9 years (SD = 16.2). The age difference between male and female patients in the study was not statistically significant (p = 0.36). The mean operating time was 74.4 minutes (range: 60-90 minutes, with an SD of 7.2). The mean time to oral liquid/soft diet was 2.5 days. The mean postoperative stay was 5.7 days. Three patients (8%) underwent conversion to open surgery, out of which two patients had multiple complex bowel-to-bowel and bowel-to-parietes adhesions, and in one patient, massive distension of small bowel caused technical difficulties.Conclusion: Laparoscopic management of ASBO is feasible, effective, and safe. Optimum surgical techniques, the surgeon's experience with the procedure, and stringent patient selection criteria enable a high probability of success.

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“…Most of EP lesions do not cause symptoms and are incidentally detected during abdominal surgeries for other indications [ 3 ]. The frequent complications associated with EP include gastrointestinal bleeding, development of intussusception, bowel obstruction and bowel perforation [ 1 , 5 ]. Rarely, malignancy such as adenocarcinoma, intraductal papillary mucinous neoplasm and solid pseudopapillary tumor can develop in the EP [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Ectopic pancreas (EP) is a rare entity characterized by the development of pancreatic tissue in areas other than the pancreas and without any ductal or vascular continuity [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Ectopic pancreas: A rare cause of occult gastrointestinal bleeding

Ammar

Said

Mizouni

et al. 2020

Annals of Medicine and Surgery

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Ectopic pancreas (EP) is a rare entity characterized by the development of pancreatic tissue in areas other than the pancreas. We present the case of a 16-year-old female with a heterotopic pancreas in the jejunum revealed by occult gastrointestinal bleeding. Contrast-enhanced computed tomography (CT) of the abdomen revealed a 2 × 3 cm enhancing nodular jejunal mass suspicious of a neuroendocrine or gastrointestinal stromal tumor. Octreoscan was planned but the patient presented in the emergency department with fever and sudden onset severe abdominal pain. The patient underwent emergency laparotomy. On abdominal exploration, appendicular perforation was present for which appendectomy and peritoneal lavage were performed. The small jejunal lesion seen on CT was identified during surgery and segmental jejunal resection with end-to-end anastomosis was performed. The histopathological examination of the jejunal mass revealed the presence of pancreatic acini and ductal structures without islets of Langerhans in the submucosa of the small intestine covered by normal mucosa. At the last follow-up of eight months after surgery, the patient is symptom-free and the abdominal CT is normal. Preoperative diagnosis of EP requires high clinical suspicion and should be included in the differential diagnosis while treating patients with gastrointestinal bleeding or gastrointestinal mass on CT.

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The Role of Laparoscopy in the Management of a Diagnostic Dilemma: Jejunal Ectopic Pancreas Developing into Jejunojejunal Intussusception

Cited by 6 publications

References 27 publications

Laparoscopy in small bowel obstruction - current status - review.

Laparoscopy in small bowel obstruction - current status - review.

Role of Laparoscopy in the Surgical Management of Acute Small Bowel Obstruction: Fact or Fiction?

Ectopic pancreas: A rare cause of occult gastrointestinal bleeding

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