1/44. Pelvic abscess in the second half of pregnancy after oocyte retrieval for in-vitro fertilization: case report.We describe a very late manifestation of pelvic abscesses after oocyte retrieval for in-vitro fertilization (IVF). In a twin pregnancy achieved after intracytoplasmic sperm injection, rupture of bilateral ovarian abscesses occurred at the end of the second trimester. An emergency laparotomy was necessary because of an acute abdomen. This complication led to severe maternal and neonatal morbidity, preterm birth and neonatal death. The rare occurrence of acute abdomen in pregnancy due to pelvic infection and the non-specific symptoms of a pelvic abscess after oocyte retrieval for IVF are discussed.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
2/44. Purulent pericarditis presenting as acute abdomen in children: abdominal imaging findings.Purulent pericarditis is rapidly fatal if untreated [1,2]. With increased development of bacterial resistance to antibiotics, severe bacterial infections in children are becoming more frequent [3,4]. We report two children with purulent pericarditis who presented in a 1-month period for evaluation of acute abdominal distention and signs of sepsis. In both, one evaluated with computed tomography (CT) and one with ultrasound, abdominal findings included periportal edema, gallbladder wall thickening, and ascites secondary to right heart failure from cardiac tamponade. Radiologists should be aware that children with purulent pericarditis may have a normal heart size on radiographs, present with acute abdominal symptoms, and demonstrate findings of right sided heart failure on abdominal imaging.- - - - - - - - - - ranking = 112.5484857061keywords = cardiac (Clic here for more details about this article) |
3/44. Perforation due to ileocaecal tuberculosis.A 40-year-old male patient was admitted in the intensive care Unit with complicated pulmonary tuberculosis. After 4 days he developed an acute abdomen with free air as demonstrated on plain abdominal films. A laparotomy was performed and an ileal perforation was found, located just before the ileocaecal valve. A right hemicolectomy was carried out and the resected specimen was send for further patho-anatomical examination. Our suspicion of ileocaecal perforation due to tuberculosis was confirmed. Despite further extensive medical treatment, the patient died 15 days after admission to the hospital. At autopsy, the cause of death was confirmed as being due to fulminant pulmonary tuberculosis.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
4/44. Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: report of case.Idiopathic or spontaneous segmental infarction of the greater omentum (ISIGO) is a rare cause of acute right-sided abdominal pain. The symptoms simulate acute appendicitis in 66% of cases and cholecystitis in 22%. Progressive peritonitis usually dictates laparotomy, and an accurate diagnosis is rarely made before surgery. The etiology of the hemorrhagic necrosis is unknown, but predisposing factors such as anatomic variations in the blood supply to the right free omental end, obesity, trauma, overeating, coughing, and a sudden change in position may play a role in the pathogenesis. We present herein the case of a 37-year-old man in whom ISIGO, precipitated by obesity and overeating, was successfully diagnosed and treated by laparoscopy. Resection of the necrotic part of the greater omentum is the therapy of choice, and ensures fast recovery and pain control. Serohemorrhagic ascites is a common finding in ISIGO, and careful exploration of the whole abdominal cavity should be performed. The laparoscopic approach allows both exploration and surgical intervention.- - - - - - - - - - ranking = 2.9301545319522keywords = sudden (Clic here for more details about this article) |
5/44. Idiopathic segmental infarction of the greater omentum as a cause of acute abdomen report of two cases and review of the literature.The segmental infarction of the greater omentum is a rare cause of acute abdomen. Its etiology is uncertain although several predisposing factors have been underlined such as congenital venous anomalies, sudden change of position and substantial meal. The clinical picture simulates an appendicitis or cholecystitis, thus being difficult to make a preoperative diagnosis. However, ultrasonography or computed tomography scan can help us make this diagnosis and then we alternatively perform a conservative treatment, laparoscopic approach or resection by laparotomy. We present two cases, preoperatively diagnosed by ultrasonography and computed tomography scan that were treated by laparotomy resection. We also review the published cases in the medical literature.- - - - - - - - - - ranking = 2.9301545319522keywords = sudden (Clic here for more details about this article) |
6/44. A preventable cause of acute abdomen.Haemoperitoneum is an extremely rare presentation of hepatocellular carcinoma in the industrialised world. We present the first reported case in the UK. In contrast, up to 10% of hepatocellular carcinomas in africa present in this way, the median time between presentation and death being just six weeks. hepatitis b infection at birth and during childhood is the major cause of hepatocellular carcinoma in the developing world. The world health Organisation, UNICEF and the World Bank have all advocated routine hepatitis b vaccination of children. This can reduce the burden of disease in these communities, among people in their productive years of life.- - - - - - - - - - ranking = 1keywords = death (Clic here for more details about this article) |
7/44. Spontaneous rupture of hepatocellular carcinoma during pregnancy.BACKGROUND: Hepatocellular carcinoma associated with pregnancy is unusual. CASE: A 33-year-old woman presented at 25 weeks' gestation with sudden, severe epigastric pain for 6 hours. Abdominal ultrasonography and magnetic resonance imaging showed multiple liver tumors with a small amount of ascites. Exploratory laparotomy revealed an unresectable ruptured liver tumor that was treated by packing. Although a biopsy was nondiagnostic, ultrasound-guided needle biopsy 6 days after cesarean delivery at 41 weeks' gestation showed hepatocellular carcinoma, which was treated with transarterial embolization. At 3.5 years posttherapy, both mother and infant are well. CONCLUSION: Ruptured hepatocellular carcinoma during pregnancy is rare but should be included in the differential diagnosis of sudden, severe epigastric pain.- - - - - - - - - - ranking = 5.8603090639044keywords = sudden (Clic here for more details about this article) |
8/44. Giant ureteral stone in association with primary megaureter presenting as an acute abdomen.A 20-year-old woman presented with abdominal pain of 4-h duration and of sudden onset. A plain abdominal radiograph showed a giant ureteral stone measuring 12 cm causing ureteral obstruction. Abdominal ultrasound revealed severe dilatation of the two upper thirds of the left ureter and a hydronephrotic ipsilateral kidney. Subsequent renal scan demonstrated that it was a non-functional kidney while the contralateral kidney was normal. A left nephroureterectomy was performed.- - - - - - - - - - ranking = 2.9301545319522keywords = sudden (Clic here for more details about this article) |
9/44. Torsion of the fallopian tube in an adolescent female: a case report.BACKGROUND: Torsion of the fallopian tube is an infrequent but significant cause of acute lower abdominal pain in adolescent females that is difficult to recognize preoperatively, although prompt diagnosis and timely surgical treatment are vital to salvage the oviduct. CASE REPORT: A 17-yr-old virgin presented with sudden and severe right-sided lower abdominal pain with guarding and tenderness, fever, nausea, and vomiting at mid-cycle. Ultrasound scan showed a right ovarian cyst measuring 3 cm in diameter and a normal appendix. There was no leucocytosis. Presumptive diagnosis was a cystic ovarian follicle with ovulatory pain. Her condition improved but did not resolve with supportive treatment. At laparotomy, the right fallopian tube was twisted completely, distended with blood, and necrotic, with a small fimbrial cyst. The left tube, ovaries, appendix, and uterus were normal. Right salpingectomy was performed. Histologic examination revealed diffuse hemorrhagic infarction of the tube and a cyst of the hydatid of Morgagni. She remains well at follow-up. CONCLUSION: Unless a high index of suspicion is maintained for torsion of the fallopian tube in adolescent females, this disorder may not be detected until after tubal destruction.- - - - - - - - - - ranking = 2.9301545319522keywords = sudden (Clic here for more details about this article) |
10/44. Spontaneous rupture of a dissection of the left ovarian artery.A 53-year-old female was suddenly hospitalized with acute left lateral abdominal pain. There was no history of trauma to the abdomen. She had received no abdominal operation. X-ray showed a soft tissue shadow in the left flank which displaced the bowel shadows medially. Plain abdominal CT showed a left retroperitoneal hematoma. Dynamic abdominal CT showed an outflow of medium from a blood vessel in the hematoma. At laparotomy, the source of bleeding was found to be the left ovarian artery. The ovarian artery was dilated and meandered remarkably. The ovarian artery and vein were ligated proximally and left adenectomy was performed. The patient made an uneventful recovery. Histological examination suggested a spontaneous rupture of a dissection of the left ovarian artery.- - - - - - - - - - ranking = 2.9301545319522keywords = sudden (Clic here for more details about this article) |
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