Delayed intestinal stricture following non-resectional treatment for XXXX associated with @entity99 : a case report.

@entity1 @entity39 @entity75 @entity326 @entity298 @entity391 @entity843 @entity8442 @entity1744 @entity14515 @entity490 @entity99 @entity221 @entity5327
BACKGROUND: Hepatic portal venous gas associated with @entity5327 is indicative of a serious pathology that leads to @entity39 and it has a high mortality rate. Although @entity5327 is acknowledged as a condition that requires early surgical treatment, it has been reported that @entity39 and surgical resection of the @entity75 may be avoided if the condition is identified quickly and the cause is detected at an early phase. However, no reports or guidelines have been published that describe the management of @entity1 in whom @entity39 and surgical treatment were avoided. We report the case of a @entity1 who presented with @entity5327 who was managed with non-resectional treatment at an early phase and had a delayed small-bowel stricture. CASE PRESENTATION: A 24-year-old @entity1 presented to the hospital with @entity221 , @entity490 , and @entity391 . Abdominal computed tomography confirmed a diffuse gaseous distention with small-bowel @entity14515 and @entity99 . An urgent laparotomy was performed, because @entity326 associated with @entity298 and @entity39 was strongly suspected. Although we found @entity843 and a perforated appendix at the time of surgery, gangrenous and transmural ischemic changes were not evident in the small bowel and colon. We performed an appendectomy without a bowel resection, and the @entity1 was discharged on an oral diet. However, he was re-admitted to hospital, because 4  days after discharge he developed postoperative @entity8442 . Non-operative management was chosen, but his symptoms did not improve. We decided to perform a laparotomy 40  days after the initial operation, and a considerable adhesion was detected. Therefore, only a synechotomy was performed. On day 57, he experienced symptoms that were associated with @entity1744 . On day 59, a partial resection of the jejunum was performed. Severe luminal strictures were apparent within the jejunum, and marked structural changes were evident. CONCLUSION: While non-surgical management can be chosen for selected @entity1 with @entity5327 , continuous observation to evaluate the development of delayed strictures that lead to @entity1744 is required in @entity1 who undergo non-resectional treatment.
