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A neural network was developed to detect and characterize bowel obstruction, a common cause of acute abdominal pain. In this retrospective study, 202 CT scans of 165 patients with bowel obstruction from March to June 2022 were included and partitioned into training and test data sets. A multi-channel neural network was trained to segment the gastrointestinal tract, and to predict the diameter and the longitudinal position (longitude) along the gastrointestinal tract using a novel embedding. Its performance was compared to manual segmentations using the Dice score, and to manual measurements of the diameter and longitude using intraclass correlation coefficients (ICC). ROC curves as well as sensitivity and specificity were calculated for diameters above a clinical threshold for obstruction, and for longitudes corresponding to small bowel. In the test data set, Dice score for segmentation of the gastrointestinal tract was 78 ± 8%. ICC between measured and predicted diameters was 0.72, indicating moderate agreement. ICC between measured and predicted longitude was 0.85, indicating good agreement. AUROC was 0.90 for detection of dilated bowel, and was 0.95 and 0.90 for differentiation of the proximal and distal gastrointestinal tract respectively. Overall sensitivity and specificity for dilated small bowel were 0.83 and 0.90. Since obstruction is diagnosed based on the diameter and longitude of the bowel, this neural network and embedding may enable detection and characterization of this important disease on CT.

IntroductionSmall bowel obstruction (SBO) is one of the most common causes for hospital admission in Ethiopia. The use of water-soluble contrast agents (WSCAs) such as Gastrografin to manage adhesive SBO can predict nonoperative resolution of SBO and reduce decision time to surgery and length of hospital stay. However, nothing is known about practice patterns and Gastrografin use in low-income settings. We sought to characterize current management practices, including use of WSCAs, as well as outcomes for patients with SBO in Addis Ababa, Ethiopia.MethodsWe conducted a mixed-methods study consisting of a survey of surgeons throughout Ethiopia and a retrospective record review at five public, tertiary care-level teaching hospitals in Addis Ababa.ResultsOf the 76 surgeons who completed the survey, 63% had heard of the use of WSCAs for SBO and only 11% used oral agents for its management. Chart review of 149 patients admitted with SBO showed the most common etiology was adhesion (39.6% of admissions), followed by small bowel volvulus (20.8%). Most patients (83.2%) underwent surgery during their admission. The most common diagnosis in patients who did not require surgery was also adhesion (68.0%), as well as for those who had surgery (33.9%), followed by small bowel volvulus (24.2%).ConclusionsThe etiology of SBO in Ethiopia may be changing, with postoperative adhesions becoming more common than other historically more prevalent causes. Although a Gastrografin protocol as a diagnostic and potentially therapeutic aid for SBO is feasible in this population and setting, challenges can be anticipated, and future studies of protocol implementation and effectiveness are needed to further inform its utility in Ethiopia and other low-income and middle-income countries.

Objective: Rare disease. Background: Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of peritoneal dialysis (PD). It is characterized by a fibrous membrane partially or totally encasing the small bowel and is a rare cause of small bowel obstruction (SBO). Here we present a case of a young woman with a history of PD presenting with SBO due to EPS. Case Report: A 37-year-old woman with end-stage renal disease secondary to uncontrolled hypertension previously on PD presented to the emergency department for evaluation of 1 week of intractable nausea and vomiting associated with diffuse abdominal pain. Computed tomography of the abdomen showed findings consistent with a fibrous membrane encapsulating the small bowel and a small bowel follow-through revealed an SBO. She was diagnosed with secondary stage 3 EPS due to PD. She was started on prednisone and tamoxifen with quick resolution of her symptoms. Unfortunately, due to numerous recurrent SBOs, she is now being evaluated for surgical treatment options. Conclusions: This report has presented a case of EPS, a rare complication of PD, which requires early diagnosis and management to prevent potentially fatal consequences. Management should focus on treating the underlying condition, optimizing nutrition, and using corticosteroids or tamoxifen (alone or in combination) depending on disease state and contraindications, with the aim of reducing recurrent SBOs. Failure of conservative management may require surgical evaluation. [ABSTRACT FROM AUTHOR]

Introduction: Intestinal obstruction is a common complication in patients with advanced malignancies, often attributed to the disease itself or as a side effect of opioid analgesics used for pain management. However, the occurrence of intestinal obstruction following antituberculosis therapy is rare. Case presentation: We report a unique case of a 58-year-old Asian male diagnosed with stage IV pancreatic carcinoma and pulmonary tuberculosis. The patient was initiated on a regimen of ethambutol hydrochloride, pyrazinamide, rifampicin, and isoniazid tablets (II) for tuberculosis, alongside morphine for the management of severe cancer-related pain. Subsequently, he developed symptoms indicative of intestinal obstruction. Despite discontinuation of morphine, the patient's symptoms persisted until he autonomously ceased all medications, leading to a rapid improvement in his condition. This unexpected resolution highlighted the antituberculosis drugs as the probable cause of his intestinal obstruction. Conclusions: This case underscores the importance of considering antituberculosis drugs as a potential cause of intestinal obstruction, especially in patients who do not respond to conventional management strategies for drug-induced gastrointestinal side effects. It also emphasizes the need for heightened vigilance and monitoring when prescribing these medications to patients with advanced malignancies, to promptly identify and address rare but significant side effects. [ABSTRACT FROM AUTHOR]

Gallstone ileus is an uncommon pathology that often requires surgery in the acute setting to address the bowel obstruction, followed by definitive biliary management. Sparse literature cites the use of robotic technique in this setting. We present the case of an 86-year-old female with an independent functional status and a history of medically-managed cholecystitis, who previously declined cholecystectomy. Years later, she presented acutely with a small bowel obstruction secondary to gallstone ileus. At that time, she underwent a diagnostic laparoscopy, small laparotomy, and enterotomy for extraction of her gallstone. She returned 7 months later for an interval elective robotic-assisted cholecystectomy and repair of a cholecystoduodenal fistula. The duodenotomy was repaired in two layers with absorbable suture. Postoperatively, an upper gastrointestinal study showed normal passage of contrast without leakage. She recovered well, and shortly after returned to her baseline functional status. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Closed‐loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is rare and should be included in the differential diagnosis of acute abdomen. The association between polymyalgia rheumatica and diverticular disease requires further research but may prompt clinicians to consider appropriate therapies in patients with both diseases. Jejunal diverticulosis is a sac‐like outpouching of the intestinal wall that can cause complications such as diverticulitis, obstruction, abscess, perforation, or fistula formation. Complicated jejunal diverticulosis may present with acute abdomen and nonspecific symptoms which can lead to misdiagnosis and delayed treatment. A 76‐year‐old male with a remote history of polymyalgia rheumatica (PMR) presented with sudden onset abdominal pain, fever, nausea, vomiting, and inability to pass flatus. Physical exam revealed a distended and diffusely tender abdomen with signs of peritonitis. Laboratory test results were significant for neutrophil‐dominant leukocytosis and elevated inflammatory markers. CT scan of the abdomen with IV contrast revealed a contained perforation and a closed‐loop small bowel obstruction in the mid‐abdomen. The patient underwent emergent exploratory laparotomy and resection of 100 cm of mid‐jejunum which was found to have numerous diverticula surrounding the closed‐loop obstruction and contained perforation. Pathology findings showed evidence of acute on chronic jejunal diverticulitis. Jejunal diverticulosis with complications may present with an acute abdomen and peritonitis. Closed‐loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is uncommonly thought of and should be considered in the differential diagnosis. Additionally, the association between PMR and diverticular disease is notable. While the patient had a remote history but no active PMR on presentation, studies suggest a possible association between gut inflammation and rheumatologic disease. This association should prompt clinicians to consider appropriate therapies and bear in mind the potential risk for diverticular perforation if glucocorticoids are given to treat PMR. Jejunal diverticulosis with multiple complications such as closed‐loop bowel obstruction and contained perforation secondary to acute on chronic jejunal diverticulitis is rare and may present with an acute abdomen and nonspecific symptoms. Including rare pathologies as such in the differential diagnosis may prevent misdiagnosis and delayed treatment. While further investigation is needed, the association between diverticulosis and PMR is noteworthy as patients who present with both diseases would require mindful management due to the potential risk of diverticular perforation after treatment with steroids. [ABSTRACT FROM AUTHOR]

We report a case of incomplete intestinal obstruction in a 29-year-old adult male with Down syndrome in The First Affiliated Hospital, Hebei Medical University from January 2023 to July 2023 the patient had been experiencing intermittent abdominal distension and reduced bowel movements and gas for a period of two years. Physical examination revealed tenderness in the left lower abdomen. Abdominal CT and gastrointestinal imaging showed intestinal and colonic distension, while colonoscopy did not show any abnormalities. During laparoscopic exploration, adhesions were observed between the greater omentum and the left lower abdominal wall, resulting in dilation of the proximal colon. After the adhesions were released, intestinal contents were able to pass through the distal segment, relieving the obstruction. The patient had no history of trauma or surgery. This case highlights a potential association between Down syndrome and congenital abdominal adhesions that can lead to intestinal obstruction. Due to the communication difficulties in patients with Down syndrome, there is a potential for misdiagnosis, emphasizing the importance of awareness. Laparoscopic examination not only aids in the diagnosis but also offers therapeutic benefits in such cases. [ABSTRACT FROM AUTHOR]

After emergency surgery for intestinal obstruction caused by colorectal cancer, postoperative ileus (POI) is more likely to occur in the early-stage oral intake. POI incited the occurrence of postoperative complications and prolongs hospital stay. Reducing the occurrence of POI will Enhance Recovery After Surgery (ERAS). Aim: The aim of this study is to observe and evaluate the preventive effect of postoperative oral administration of 76% Meglumine Diatrizoate in reducing the incidence of POI and promoting intestinal absorption during the recovery of intestinal peristalsis in patients after intestinal obstruction surgery. Methods: From October 2018 to December 2021, 94 patients (47 vs 47) with intestinalobstruction were rolled. Patients with an ASA score of 4 or higher and gastrointestinal perforation with peritonitis were excluded. After 24 hours of surgery, the patients were divided into experimental group and control group disposed of with an opaque airtight envelope method, patient-side single blind. After intestinal peristalsis recovery (2.45 ± 0.62 d vs 2.60 ± 0.68 d, P > 0.05), the experimental group was given 76% Meglumine Diatrizoate 20 ml orally 9am and the control group was given 10% glucose 20 ml for three consecutive days. POI cases, the time taken to achieve full daily oral calorie and discharge days were counted. Results: The time required to achieve full daily oral calorie (11.04 ± 2.70 d vs 14.09 ± 3.74 d, p < 0.05), POI cases (10/47 vs 20/47, p < 0.05) and discharge days (14.00 ± 4.89 d vs 16.77 ± 5.94 d, p < 0.05) are significantly different between the two groups. Conclusions: Oral 76% Meglumine Diatrizoate is safe and effective, which can reduce the occurrence of POI, promote the recovery of intestinal absorption and shorten the length of hospital stay effectively. [ABSTRACT FROM AUTHOR]

Background: Acute intestinal obstruction is a blockage of the intestine which causes a range of clinical symptoms such as acute and severe abdominal pain, nausea, and obstipation. Intestinal obstruction is a medical emergency and can be life‐threatening when left untreated. In cases where treatment involves emergency abdominal surgery, a multimodal perioperative care pathway (enhanced recovery after surgery ERAS) has shown to accelerate patient recovery after surgery, reduce hospital length of stay, and improve overall outcomes. The objective of this scoping review was to identify and synthesize the existing evidence regarding the implementation of ERAS components with a focus on postoperative components in patients undergoing surgery for acute intestinal obstruction. Methods: This scoping review followed the preferred reporting items for systematic reviews and meta‐analysis extension for scoping reviews framework. PubMed‐Medline and Embase database were searched. Results: The search identified 1860 studies of which 16 were included in the final analysis. All the studies were quantitative. Eleven studies used 10 or more ERAS interventions (range 10–28). The most common interventions were multimodal systemic analgesia, and the least common were the management of blood glucose and screening tools. Conclusion: This scoping review found that 56% (n = 9/16) of the identified studies used 10 or more ERAS interventions out of a possible 35. This review highlighted the need for studies on the ERAS emergency laparotomy guidelines. [ABSTRACT FROM AUTHOR]

Gallstone ileus is a relatively rare complication of cholelithiasis, and an uncommon cause of small bowel obstruction most commonly seen in elderly and debilitated people with associated comorbidities. Symptoms of gallstone ileus are insidious and may be vague while the delay in diagnosis results in a high mortality rate. Herein we report two cases of gallstone ileus in elderly patients with complex medical history who presented at the emergency department with abdominal pain and distension, vomiting and fluid/electrolyte disorders due to cholecysto-enteric fistula and bowel obstruction. [ABSTRACT FROM AUTHOR]

The authors report a case of sclerosing mesenteritis managed successfully at Hospital Estadual Alberto Torres in a 50-year-old male patient with three previous laparotomy. He was discharged from hospital after 75 days of hospitalization in wich he was submitted seven abdominal procedures and prednisone and tamoxifen therapy. [ABSTRACT FROM AUTHOR]

Introduction: Intestinal obstruction is the impairment or arrest of the passage of contents through the intestine. Tubercular aetiology is the commonest cause of small intestinal obstruction in developing countries, while postoperative adhesions are common in developed countries. Neoplastic aetiology is more common in Large Bowel Obstruction (LBO). Clinical and radiological findings are non specific, and histopathology is required for a definitive diagnosis of the aetiology. Aim: To study histopathological examination of obstructive lesions of the small and large intestine. Materials and Methods: The present cross-sectional study was conducted from January 2020 to September 2021, including a total of 77 cases of intestinal obstruction due to mechanical causes. Detailed gross and microscopic examinations were performed, along with routine and special stains (wherever required), in the Department of Pathology at Government Medical College, Haldwani, Nainital, Uttarakhand. Data were presented in numbers and percentages. Results: The present study showed a male predominance 46 (59.8%) with a male to female ratio of 1.5:1. The most commonly affected age group was 31-40 years 20 (25.9%). Constipation (76; 98.7%) was the most common clinical symptom, followed by abdominal pain 72 (93.5%). The small intestine was more commonly involved 35 (45.5%). Among cases of large intestine obstruction, the caecum was the most common site 10 (14.2%). Perforation was the most common gross finding 25 (32.9%). Non specific inflammatory pathology was the most common cause of obstruction (23.5%), followed by adenocarcinoma (20.8%). Tubercular pathology was the third most common cause (11.9%). Conclusion: The present study highlights the important pathologies in the aetiology of obstruction. Prevention and early intervention can help control some of the infective diseases and avoid such emergencies. Early diagnosis and treatment of neoplastic pathology, which is a leading cause of LBO, are beneficial for the better management of patients. A detailed histopathological study of small and large intestinal specimens should be conducted in constant correlation with clinical and radiological findings for an accurate diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Complications of ascariasis are a significant cause of abdominal pain in pediatric emergencies, especially where it is endemic. A literature review was conducted with the aim of improving diagnostic and therapeutic approaches for these patients. Data sources: A PubMed search was conducted using the key terms “ascariasis complications” and “hepatobiliary ascariasis”. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, case reports, and reviews published up to December 2023. Summary of findings: Obstruction of the small bowel is the most common complication. Others that are, rarer and more difficult to properly identify and treat, such as biliary, hepatic, and pancreatic complications, acute appendicitis, Meckel’s diverticulitis, or peritoneal granulomas. Hepatic and pancreatic complications are rarer and more serious in children than in adults. While plain radiography is usually the only option in cases of intestinal obstruction, ultrasonography is the examination of choice in cases of hepatobiliary, pancreatic, and appendicular ascariasis complications in childhood. The treatment is clinical and conservative in most patients. Surgical treatment is indicated if conservative therapy fails, or if there are signs of complications. Laparoscopy has been used as an excellent technical alternative in adults with hepatobiliary complications of ascariasis, but further studies on its use in children are still needed. Conclusion: The creation of protocols and greater debate on this subject should be encouraged for a better understanding of the disease and to establish an early diagnosis and adequate treatment for children with complications resulting from massive infestation by Ascaris lumbricoides. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Introduction Intestinal obstruction is a common complication in patients with advanced malignancies, often attributed to the disease itself or as a side effect of opioid analgesics used for pain management. However, the occurrence of intestinal obstruction following antituberculosis therapy is rare. Case presentation We report a unique case of a 58-year-old Asian male diagnosed with stage IV pancreatic carcinoma and pulmonary tuberculosis. The patient was initiated on a regimen of ethambutol hydrochloride, pyrazinamide, rifampicin, and isoniazid tablets (II) for tuberculosis, alongside morphine for the management of severe cancer-related pain. Subsequently, he developed symptoms indicative of intestinal obstruction. Despite discontinuation of morphine, the patient’s symptoms persisted until he autonomously ceased all medications, leading to a rapid improvement in his condition. This unexpected resolution highlighted the antituberculosis drugs as the probable cause of his intestinal obstruction. Conclusions This case underscores the importance of considering antituberculosis drugs as a potential cause of intestinal obstruction, especially in patients who do not respond to conventional management strategies for drug-induced gastrointestinal side effects. It also emphasizes the need for heightened vigilance and monitoring when prescribing these medications to patients with advanced malignancies, to promptly identify and address rare but significant side effects.

Purpose : Intussusception is a common pediatric surgical emergency and non-operative reduction is its first line of management. We aimed to compare 3 contemporary techniques of intussusception reduction. Methods : A retrospective study was performed in 3 tertiary care centers in India from January 2017 through December 2019. In the 3 centers, the primary reduction techniques were ultrasound-guided saline reduction (USR), fluoroscopy-guided pneumatic reduction (FPR), and fluoroscopy-guided barium reduction (FBR), respectively. As per these techniques used, we compared clinical characteristics, such as the successful reduction. Results : A total of 255 patients underwent one of the 3 reduction techniques in the study period. Reduction was successful in 90.3%, 85.1%, and 87.7% in the USR, FPR, and FBR groups, respectively (P = 0.961). Mean time to reduction was shorter in the FPR group (30.8 ± 8.9 seconds), compared with the USR (575.0 ± 242.3 seconds) and FBR groups (495.0 ± 118.4 seconds; P < 0.001). Recurrence rates were 11.8%, 20.3%, and 15.8% in the USR, FPR, and FBR groups, respectively (P = 0.522). No association was found between the patients’ age or symptom duration and the successful reduction. One patient in the USR group, 3 in the FPR group, and 4 in the FBR group reported second recurrences. Perforation occurred in 1 patient in the FPR group while no complications occurred in the other groups. There was no in-hospital mortality. Conclusion : All 3 techniques are equally effective, with FPR requiring a shorter time than the other 2 techniques. The reduction technique should be chosen based on the strengths and weaknesses of each technique, as well as local availability.

Introduction: Ultrasonography (USG) serves as a crucial diagnostic tool in emergency settings, extending beyond the assessment of the acute abdomen to encompass a wide range of acute conditions involving both superficial and deep soft tissue components of the body. Aim: To analyse the demographic profile and diagnostic findings associated with emergency USG requisitions at a tertiary care centre. Materials and Methods: A retrospective observational descriptive study was conducted in the Department of Radiodiagnosis at Tomo Riba Institute of Health and Medical Sciences (TRIHMS), Naharlagun, Arunachal Pradesh, India. Data from all emergency on-call ultrasound cases performed at TRIHMS from June 18, 2022, to June 17, 2023, were collected from the ultrasound room. A total of 258 cases of emergency ultrasounds were conducted. The age, sex and findings of emergency USG were analysed. Results were expressed in terms of frequency and percentages. Results: Among a total of 258 cases, 175 (67.8%) were females and 83 (32.2%) were males. The mean age of the participants was 29.02±11.03 years. The distribution pattern by age revealed that the most common age group was 21 to 30 years, encompassing a total of 106 patients (41.1%), with 84 females and 22 males. A total of 71 cases were registered for obstetrics and gynaecology conditions, constituting 27.5% of the total. Conclusion: Although USG is requested for many emergency conditions in the hospital, the acute abdomen remains the foremost indication for an emergency USG call.

Objective To investigate the predictive value of preoperative HALP score for postoperative intestinal obstruction in elderly patients undergoing radical resection of colorectal cancer. Methods A total of 162 elderly patients with colorectal cancer who underwent radical resection in the 904th Hospital of the PLA Joint Logistic Support Force from 2020 to 2022 were selected for retrospective analysis. The patients were divided into an intestinal obstruction group (30 cases) and a control group (132 cases) according to whether intestinal obstruction occurred 4 d after operation. The clinical data of the two groups were compared, logistic regression was used to analyze the influencing factors of intestinal obstruction after colorectal cancer surgery, and ROC curve was used to analyze the predictive value of preoperative HALP score for intestinal obstruction after colorectal cancer surgery. Results The preoperative HALP score and preoperative globulin (Glb) level in the intestinal obstruction group were lower than those in the control group (P < 0.05) . Multivariate logistic regression analysis showed that the preoperative HALP score and preoperative Glb level were independent risk factors of intestinal obstruction after colorectal cancer surgery (P < 0.05) . ROC curve analysis showed that, the AUC of preoperative HALP score for the prediction of intestinal obstruction after colorectal cancer surgery was 0.901 (95% CI: 0.842 - 0.976), the optimal cut-off value was 35.5 scores, the sensitivity was 92.2% , and the specificity was 87.6% . Conclusion Preoperative HALP score is a risk factor of postoperative intestinal obstruction in elderly patients with colorectal cancer, and has a high predictive value for postoperative intestinal obstruction.

Introduction: Intestinal obstruction is the impairment or arrest of the passage of contents through the intestine. Tubercular aetiology is the commonest cause of small intestinal obstruction in developing countries, while postoperative adhesions are common in developed countries. Neoplastic aetiology is more common in Large Bowel Obstruction (LBO). Clinical and radiological findings are non specific, and histopathology is required for a definitive diagnosis of the aetiology. Aim: To study histopathological examination of obstructive lesions of the small and large intestine. Materials and Methods: The present cross-sectional study was conducted from January 2020 to September 2021, including a total of 77 cases of intestinal obstruction due to mechanical causes. Detailed gross and microscopic examinations were performed, along with routine and special stains (wherever required), in the Department of Pathology at Government Medical College, Haldwani, Nainital, Uttarakhand. Data were presented in numbers and percentages. Results: The present study showed a male predominance 46 (59.8%) with a male to female ratio of 1.5:1. The most commonly affected age group was 31-40 years 20 (25.9%). Constipation (76; 98.7%) was the most common clinical symptom, followed by abdominal pain 72 (93.5%). The small intestine was more commonly involved 35 (45.5%), with the ileum being the most commonly affected site 40 (53.2%). Among cases of large intestine obstruction, the caecum was the most common site 10 (14.2%). Perforation was the most common gross finding 25 (32.9%). Non specific inflammatory pathology was the most common cause of obstruction (23.5%), followed by adenocarcinoma (20.8%). Tubercular pathology was the third most common cause (11.9%). Conclusion: The present study highlights the important pathologies in the aetiology of obstruction. Prevention and early intervention can help control some of the infective diseases and avoid such emergencies. Early diagnosis and treatment of neoplastic pathology, which is a leading cause of LBO, are beneficial for the better management of patients. A detailed histopathological study of small intestinal specimens should be conducted in constant correlation with clinical and radiological findings for an accurate diagnosis.

Objective: Complications of ascariasis are a significant cause of abdominal pain in pediatric emergencies, especially where it is endemic. A literature review was conducted with the aim of improving diagnostic and therapeutic approaches for these patients. Data sources: A PubMed search was conducted using the key terms “ascariasis complications” and “hepatobiliary ascariasis”. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, case reports, and reviews published up to December 2023. Summary of findings: Obstruction of the small bowel is the most common complication. Others that are, rarer and more difficult to properly identify and treat, such as biliary, hepatic, and pancreatic complications, acute appendicitis, Meckel's diverticulitis, or peritoneal granulomas. Hepatic and pancreatic complications are rarer and more serious in children than in adults. While plain radiography is usually the only option in cases of intestinal obstruction, ultrasonography is the examination of choice in cases of hepatobiliary, pancreatic, and appendicular ascariasis complications in childhood. The treatment is clinical and conservative in most patients. Surgical treatment is indicated if conservative therapy fails, or if there are signs of complications. Laparoscopy has been used as an excellent technical alternative in adults with hepatobiliary complications of ascariasis, but further studies on its use in children are still needed. Conclusion: The creation of protocols and greater debate on this subject should be encouraged for a better understanding of the disease and to establish an early diagnosis and adequate treatment for children with complications resulting from massive infestation by Ascaris lumbricoides.

Intestinal obstruction is a surgical emergency frequently encountered in routine practice, usually caused by abdominal adhesions. Although extra nodal lymphoma is most often localized in the gastrointestinal tract and may be responsible for intestinal obstruction, Burkitt's lymphoma is a very rare cause in adults.We report a case of Burkitt's lymphoma mimicking an intestinal obstruction in a 48-year-old adult who presented with an obstructive syndrome and altered general condition.Imaging and anatomopathological examination after immunohistochemical analysis concluded to a multi-systemic Burkitt's lymphoma.Chemotherapy was immediately started with complete remission.

Bowel obstruction is a common cause of acute abdominal pain. The development of algorithms for automated detection and characterization of bowel obstruction on CT has been limited by the effort required for manual annotation. Visual image annotation with an eye tracking device may mitigate that limitation. The purpose of this study is to assess the agreement between visual and manual annotations for bowel segmentation and diameter measurement, and to assess agreement with convolutional neural networks (CNNs) trained using that data. Sixty CT scans of 50 patients with bowel obstruction from March to June 2022 were retrospectively included and partitioned into training and test data sets. An eye tracking device was used to record 3-dimensional coordinates within the scans, while a radiologist cast their gaze at the centerline of the bowel, and adjusted the size of a superimposed ROI to approximate the diameter of the bowel. For each scan, 59.4 ± 15.1 segments, 847.9 ± 228.1 gaze locations, and 5.8 ± 1.2 m of bowel were recorded. 2d and 3d CNNs were trained using this data to predict bowel segmentation and diameter maps from the CT scans. For comparisons between two repetitions of visual annotation, CNN predictions, and manual annotations, Dice scores for bowel segmentation ranged from 0.69 ± 0.17 to 0.81 ± 0.04 and intraclass correlations [95% CI] for diameter measurement ranged from 0.672 [0.490-0.782] to 0.940 [0.933-0.947]. Thus, visual image annotation is a promising technique for training CNNs to perform bowel segmentation and diameter measurement in CT scans of patients with bowel obstruction.