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conferenceseries.com
Volume 8 Surgery: Current Research Open Access Surgery Asia Pacific 2018
August 17-18, 2018
August 17-18, 2018 Singapore
12th International Conference on
Surgery and Anesthesia
Robert A Bancod, Surgery Curr Res 2018, Volume 8
DOI: 10.4172/2161-1076-C3-041
An intestinal bezoar rare cause of intussusception in the adult: Case report and management in
Lautoka Hospital, Fiji
Robert A Bancod
Umanand Prasad Medical School, Fiji
Statement of the Problem: A 31-year-old, male, presently residing in suburbs of Nadi. He presented with severe right lower
abdominal pain, episodes of vomiting, mild abdominal distension, and obstipation. He had a history of recurrent attack of
shortness of breath with chest pain. He was febrile, hypotensive, having tachycardic and tachypneic. His nutritional status
appeared adequate. His systemic reviewed of chest and CVS revealed orthopnea and hypotension. He had a grade 3 murmur
on the left side of the chest. On abdominal examination, he had mildly distended no visible scars, tender, guarded, with
palpable mass on the right iliac fossa. Examination of external genitalia, hernia orifice and renal angle were normal. On rectal
examination, the rectal vault was empty. Appendicular mass with intestinal obstruction was considered.
Purpose: To investigate the clinical manifestation of gastrointestinal bezoar which mimic appendicular mass causing intestinal
obstruction?
Methodology &Theoretical Orientation: A retro perspective clinical study using patient observation, in-depth interview, age,
gender, symptom and sign, abdominal imaging study, surgical procedure, size and location of obstruction is recorded.
Findings: The patient was a 31-year-old male, with sign and symptom of abdominal pain, vomiting and abdominal fullness.
Investigation showed leukocytosis, small bowel dilatation on radiograph and ultrasound scan confirmed an elongated appendix
indicative of infective pathology. On plain chest X-ray showed moderate cardiomegaly and absence of free air under the
diaphragm. Intraoperative findings revealed an inflamed appendix and dilatation of small bowel to the terminal ileum and
caecum where there was an ileocecal intussusception.
Conclusion & Significance: In view of emergency setting, unprepared bowel, lack of preoperative diagnosis, with a high risk
of grade 3 murmurs and pulmonary hypertension, a limited resection of the affected ileum. The ileocecal valve is preserved.
Recommendation: The treatment of adult intussusception is surgical. The frequent coexistence of underlying pathology makes
surgical exploration mandatory.
Biography
Robert A Bancod is the Associate Professor in the Department of Surgery at the Umanand Prasad Medical School at the University of Fiji. He has obtained his
Bachelor of Science majoring in chemistry in 1979 from Manila Central University. He has received his Doctor of Medicine in 1983 from Virgin Milagrosa University,
where he also pursued his internship. He then undertook rural rotation for two years. In 1987, he received his licensure to medical practice and joined the Kalinga-
Apayao Provincial Hospital as a junior physician. He initially held the position of Senior Registrar and later was appointed the Principal Medical Officer at Labasa
Hospital. He was then promoted to Chief Surgical Registrar at the Lautoka Hospital. He also, at times, held the Acting Surgical Consultant position at both the
Labasa and Lautoka Hospital. September 2010 saw his move from the Ministry of Health to his current position as Associate Professor in Surgery. While pursuing
his academic career, he is also a consultant in surgery at the Lautoka Hospital as well as an active practicing general practitioner at the United Doctors Medical
Clinic, Lautoka.