Gastroenterology International

Primary adenocarcinoma of small intestine is a rare malignancy constitute <1% of whole abdominal malignancies.Adenocarcinoma of small intestine will rarely produce symptoms until the disease is advanced. Preoperative diagnosis is difficult due to inaccessibility for guided biopsies.Themost frequent presentations are abdominal pain, nausea, vomiting, and weight loss. They may also present with haemorrhage, obstructive symptoms or perforation peritonitis.The low incidence and lack of pathognomonic symptoms make an accurate diagnosis small bowel carcinoma a challenge to the surgeons. In this paper we are reporting a case of ileal adenocarcinoma in a patient who presented withacute abdomen and perforation peritonitis. We are presenting it because of the rarity of the condition.

Keywords: Adenocarcinoma; Carcinoid; Lymphoma; Sarcomas or Gastrointestinal Stromal Tumours (GIST); Laparotomy; Segmental Resection; Chemotherapy; Radiotherapy.

 Hiccups are self-limiting disorder caused due to involuntary spasms of the diaphragm and intercostal muscles leading to sudden inspiration and a characteristic sound. Hiccups are known to occur in patients with Chronic kidney disease but usually get corrected on dialysis and rectification of electrolyte imbalance. Here we describe a 60 year old male with Diabetic Nephropathy with intractable hiccups which persisted even after regular haemodialysis and electrolyte management. On Upper GI endoscopy, we found a gastric diverticulum in fundus with pus oozing from within which was confirmed to be Gastric diverticulitis. Hiccups got alleviated with antibiotic course. Incidence of Gastric Diverticulum is very rare (0.01-0.11%) on endoscopy. Presenting with hiccups is even more rare and has not been described till now. This case also highlights the importance of full inflation while performing an endoscopy.

Keywords: Hiccups; Chronic Kidney Disease; Diabetic Nephropathy; Endoscopy; Gastric Diverticulum.

 The stomach is normally positioned and fixed by ligamentous attachments to the spleen, liver, and diaphragm. Due to this rapid growth, new complications are sure to be noticed. Once SG has been performed, GV is no longer a valid term to be used when the remaining stomach, twists, folds, or turns, because the attachments have been disrupted and make the sleeve susceptible to this problem. Therefore, we believe that gastric torsion (GT) is a better term after SG or any gastric procedure that detaches the stomach from its natural points of fixation. GT after SG is a rare complication. To our knowledge, there are only 7 cases reported in the literature. Here, we expand on these reports by presenting a patient diagnosed with GT after SG and their subsequent management.

Keywords: Sleeve Gastrectomy Gastric Torsion.

 Intussusception in adults is highly uncommon and accounts for only 5% of all reported case. Small bowel intussusception is much less common than the ileocolic type, with jejunoileal intussusception being amongst the most rare. Benign tumors of the small bowel are rare clinical entities. These often remain asymptomatic throughout life. Despite comprising 75% of the length and 90% of the surface area of the gastrointestinal tract, the small bowel harbors relatively few primary neoplasms and fewerthan 2% of gastrointestinal malignancies. We report a case of 28 year old female with jejunal submucosal angiolipofibroma and lipoma that became symptomatic due to intermittent obstruction episodes and caused intestinal obstruction due to intussusception. Involved part of jejenum was resected and end-to-end anastomosis was done and the patient’s postoperative period was uneventful. In this case report, the diagnosis and management of intussusception due to benign tumour are discussed along with a literature review.

Keywords: Intussusception; Small intestines; Obstruction; Polyp; Neoplasm.