Open Access Case Report

Recurrent Intestinal Necrosis Due to Polystyrene Sulphonate Use - A Case Report

Wai Tat Bernard Yung, Shun Yan Bryant Chan

Asian Journal of Case Reports in Surgery, Page 1-4

Sodium or calcium polystyrene sulfonate (Resonium) is commonly used in hospitals to treat hyperkalaemia. Intestinal necrosis and perforation have been scarcely reported as a serious and potentially life-threatening complication following the use of this drug.

We present a rare case of a 79 years old lady developing recurrent bowel ulceration, necrosis and perforation under the effects of polystyrene sulfonate, with a remarkable onset of the last episode of perforation taking place 60 days after her last use of polystyrene sulfonate. Small and large bowel perforations were present. The patient underwent three laparotomy operations for resection of perforated bowel segments. As demonstrated in this case, the need for further clinical and biochemical research on the properties and safety profile of polystyrene sulfonate is evident. We advocate clinicians to be vigilant when patients present with abdominal symptoms with the context of hyperkalaemic patients undergoing medical treatment even in a delayed stage.

Open Access Case Study

A Rare Case of Gall Stone Ileus with Obstruction of Small Bowel

H. M. Veeresh, Rajesh Patil

Asian Journal of Case Reports in Surgery, Page 1-5

Gallstone ileus is condition where small bowel is mechanically obstructed by gallstones. It’s a true mechanical obstruction. It is uncommon entity which accounts for one to three percent of all small bowel obstruction [1]. Elderly people are usually affected [2]. X-ray, USG, CT SCAN are usual modalities of diagnosis [2]. Mainstay of treatment is to relieve obstruction by surgery [3].

Open Access Case Study

Surgical Treatment of a Ruptured Pseudoaneurysm of the Descending Thoracic Aorta Associated with Takayasu’s Arteritis - A Case Report of a 9-year-old Boy

Tat Bang Ho, Van Phung Doan, Hoang Minh Pham, Van Nam Le, Thanh Khanh Van Le, Quyet Tien Tran

Asian Journal of Case Reports in Surgery, Page 1-7

Takayasu’s arteritis (TA) is a chronic inflammatory disease of the aorta and its major branches. Aortic aneurysm is a severe complication of TA, with an estimated mortality rate of 50% in patients that undergo surgery for a rupture [1]. We herein reviewed the clinical, paraclinical and operation characteristics of a 9-year-old male patient, who had a ruptured pseudoaneurysm of the thoracic aorta due to TA, and was successfully treated by open emergency surgery with cardiopulmonary bypass support.

Open Access Case Study

Accidental Ingestion of Spoon Presenting as Gastric Outlet Obstruction – An Unusual Case Report

Sumit Pathania, Ashish Vora, Rachan Kathpal, Dipankar Naskar, Nikhil Gupta, C. K. Durga

Asian Journal of Case Reports in Surgery, Page 1-4

We report a case of a 60 year old male, who presented to our emergency with history of accidental spoon ingestion causing gastric outlet obstruction. Patient had undergone endoscopic extraction which was unsuccessful. He underwent exploratory laparotomy to retrive the spoon and was discharged on 8th postoperative day.

Open Access Case Study

Diffuse Barium Associated Peritonitis as a Complication of Barium Enema Examination

Budhi Ida Bagus, Raharjo Suryo Wahyu, Metria Ida Bagus

Asian Journal of Case Reports in Surgery, Page 1-4

Introduction: Barium peritonitis is a rare but life threatening complication of contrast examination of the gastrointestinal tract. The chemical peritonitis due to barium contamination is characteristically severe and difficult to treat. Such a complication has a high morbidity and mortality rate.

Case Report: A 64 years old, male patient was referred immediately to our surgery department after extravasation was found during barium enema procedure. The patient underwent surgery after the diagnosis of acute abdomen was made. Exploratory laparotomy revealed perforation of the rectum with a diameter of 3 cm, located 12 cm above the anal verge and barium covering whole peritoneal cavity.  There were no post operative complications found on this patients and the patients tolerate well with oral intake early on the post operative day. The post opertaive period was uneventful and the patient was discharged from hospital on the 7th post operative day.  He was in good general health without any ileostomy related problems at 30 days after surgery and the closure of the ileostomy would be pending for the next 3 months.

Conclusion: Rectal perforation during barium enema examination with subsequent barium leakage into the peritoneal cavity, is a serious complication and an emergency condition. Barium-associated peritonitis associated with morbidity and with potential mortality. Early recognition and proper management are crucial for successful treatment.