Laparoscopic Resection and Anastomosis of the Enteric Duplication Cyst - Case Study

By, Dr Harsh Sheth, Bariatric Surgeon in Mumbai

1. OVERVIEW

Diagnostic laparoscopy is a minimally invasive surgical procedure. This means that, instead of making a large incision (surgical cut), the doctor creates several tiny incisions to insert the laparoscope and other surgical tools to examine the abdominal or pelvic organs.

During a diagnostic laparoscopy, the surgeon first fills the patient’s abdomen (belly) with gas and uses a laparoscope, a long, thin tube having an inbuilt video camera to view the internal organs.

If you undergo a laparoscopy rather than an open surgery, you may experience minor discomfort and bleeding after your procedure.

People who have laparoscopic surgery can usually go home and resume their routine activities sooner than those who have an open procedure.

An anastomosis is a surgical connection created among two tubular structures, such as blood vessels or loops of the intestine.

It may be performed when there is a blockage in an artery, vein, or any part of the intestine. The surgeon will remove the blocked portion in a procedure called resection.

II. DOCTOR NAME

Dr. Harsh Sheth

III. PATIENT DETAILS

Age : 60

IV. SYMPTOMS

  • Pain in abdomen
  • Abdominal distension
  • Vomiting
  • Fever
  • Constipation

V. TEST PERFORMED

  • X-ray abdomen erect- Revealed dilated small bowel loops with a collapsed large bowel.
  • CT scan- Revealed multiple fecaliths in the small bowel with an enteric duplication cyst.

VI. DIAGNOSIS

  • Enteric duplication cyst with fecaliths causing small bowel obstruction

VII. TREATMENT

  • Laparoscopic Resection and Anastomosis of the Enteric Duplication Cyst

VIII. DESCRIPTION OF THE TREATMENT

  • The patient presented with 8-day history of abdominal pain, vomiting, and fever. He was unable to pass stools and flatus.
  • Dr. Harsh Sheth, a highly qualified and skilled bariatric and laparoscopic surgeon in Mumbai, examined the patient and recommended a CT scan.
  • The CT scan revealed a small bowel obstruction secondary to fecaliths in the small bowel.
  • Further, Dr. Harsh Sheth planned for a diagnostic laparoscopy. It confirmed the presence of an enteric duplication cyst with multiple fecaliths.
  • Enteric duplication cysts are rare congenital malformations of the GI tract. Primarily they develop in the small intestine, particularly the ileum, but can occur anywhere in the GI tract. Often, doctors remove duplications surgically, as there is a high risk of complications if left untreated.
  • Fecaliths are stones formed by the hardening of faeces into lumps of varied sizes. They may develop anywhere in the intestinal tract but are commonly found in the colon.Laparascopic GI
  • Dr. Harsh Sheth laparoscopically resected the bowel adjacent to the duplication cyst and the duplication cyst. He also performed bowel anastomosis to establish continuity.
  • The patient recovered well postoperatively. He had only four small incisions of 5-10 mm in size, with a 5 cm incision made in the lower abdomen to remove the specimen.

IX. POST TREATMENT GUIDELINES

The patient was instructed to introduce the diet gradually.