Primary enterolith and jejunal diverticula causing small bowel obstruction- A case report

Small bowel obstruction secondary to gallstone ileus accounts for about 0.3% to 0.5 % of all patients with gallstone disease. Formation of primary intestinal stones causing obstruction and requiring laparotomy is very rare, and the presence of the diverticula adjacent to the stone precipitating in the stone formation is a rare phenomenon. A rare case of primary enterolith and jejunal diverticula is presented here. An older women presented with small bowel obstruction found to have dual pathology; operated for removal of stone and had uneventful recovery

Portomesenteric venous thrombosis: A rare but probably under-reported complication of laparoscopic surgery: A case series

Portomesenteric venous thrombosis (PMVT) is a rare but well-reported complication following laparoscopic surgery. We present three cases of PMVT following laparoscopic surgery. Our first case is a 71-year-old morbidly obese woman admitted for elective laparoscopic giant hiatus hernia (LGHH) repair. Post-operatively, she developed multi-organ dysfunction and computed tomography scan revealed portal venous gas and extensive small bowel infarct. The second patient is a 51-year-old man with known previous deep venous thrombosis who also had elective LGHH repair. He presented 8 weeks post-operatively with severe abdominal pain and required major bowel resection. Our third case is an 86-year-old woman who developed worsening abdominal tenderness 3 days after laparoscopic right hemicolectomy for adenocarcinoma and was diagnosed with an incidental finding of thrombus in the portal vein. She did not require further surgical intervention. The current guidelines for thromboprophylaxis follow-up in this patient group may not be adequate for the patients at risk. Hence, we propose prolonged period of thromboprophylaxis in the patients undergoing major laparoscopic surgery