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Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...
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Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
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Wilkie's syndrome causing persistent vomiting post-colectomy.

N M Fearon1, H M Mohan, D C Winter

  • 1Department of Surgery, St Vincents Hospital, Dublin 4, Ireland.

International Journal of Surgery Case Reports
|November 19, 2013
PubMed
Summary
This summary is machine-generated.

Wilkie's syndrome, or superior mesenteric artery (SMA) syndrome, causes small bowel obstruction due to duodenal compression. This case highlights its presentation and conservative management after colorectal surgery.

Keywords:
DuodenumPost operative complicationSMA syndromeWilkie syndrome

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Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Vascular Compression Syndromes

Background:

  • Wilkie's syndrome involves superior mesenteric artery (SMA) compression of the duodenum.
  • It results from loss of the protective retroperitoneal fat pad, often linked to significant weight loss.

Purpose of the Study:

  • To present a case of Wilkie's syndrome in a post-operative colorectal surgery patient.
  • To discuss the diagnostic and management strategies for this rare condition.

Main Methods:

  • A 79-year-old male with anemia and weight loss underwent right hemicolectomy for ascending colon malignancy.
  • Post-operatively, he developed nausea and vomiting, diagnosed as SMA duodenal compression via CT imaging.
  • Management included initial parenteral nutrition followed by nasojejunal tube enteral feeding.

Main Results:

  • The patient's symptoms resolved with nutritional support and weight gain.
  • CT imaging confirmed duodenal compression by the SMA.

Conclusions:

  • Wilkie's syndrome can present insidiously or acutely, particularly in surgical patients.
  • Diagnosis relies on characteristic CT findings, with conservative management often successful, though surgery is an option.
  • A high index of suspicion is crucial for timely diagnosis and treatment of SMA syndrome.