1/46. Ureteric obstruction by shotgun pellet "pellet colic".Acute renal colic from retained missiles is an unusual and interesting delayed complication of missile injuries to the abdomen. It must be considered in patients who present with symptoms of renal colic following gunshot and shotgun wounds with retained missiles. We report a case of acute ureteral obstruction secondary to a migrating intraluminal projectile 3 days after a shotgun wound to the back.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
2/46. Colonic spasm and pseudo-obstruction in an elongated colon secondary to physical exertion: diagnosis by stress barium enema.Anatomic and functional abnormalities of the colon are known to cause a variety of abdominal complaints, including constipation, diarrhea, and pain. We describe a patient with dolichocolon (elongated colon) with transient spasm (pseudo-obstruction) associated with exertion. The diagnosis in this case rested with a novel approach and less invasive evaluation of the colon.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
3/46. A rare cause of biliary pain in belgium.ascaris lumbricoides is the most frequent human helminthic parasite. Usually human ascariasis is poorly symptomatic but complications can arise due to worm migration. Erratic worm migration into the biliary tree is a rare but threatening condition regarding the associated complications: cholecystitis, pancreatitis, obstruction of bile ducts, liver abcesses and recurrent pyogenic cholangitis. We describe a case of a young belgian women suffering from recurrent biliary colics over a period of eight months with repeated normal ultrasound findings. ERCP proved being the only effective diagnostic procedure for a living biliary worm, which was successfully removed with a balloon catheter.- - - - - - - - - - ranking = 1.2435045829576keywords = bile duct, obstruction, duct, bile (Clic here for more details about this article) |
4/46. Meckel's diverticulum mimicking infantile colic: sonographic detection.We report a case of Meckel's diverticulum in a 6-month-old girl who presented with a 5-month history of chronic screaming but no symptoms or signs of intestinal obstruction. Infantile colic was the presumptive diagnosis. Abdominal sonography at 6 months of age demonstrated an abdominal mass with an anechoic center and a double-layered wall, surrounded by bowel loops. Abdominal CT and barium enema x-ray studies demonstrated nonspecific findings of a cystic mass with compression of adjacent bowel loops. Histologic examination of the resected mass revealed a Meckel's diverticulum with a perforation sealed off by the neighboring bowel and mesentery to form an inflammatory mass.- - - - - - - - - - ranking = 0.2keywords = obstruction (Clic here for more details about this article) |
5/46. Three common presentations of ascariasis infection in an urban Emergency Department.In the united states, approximately 4 million people per year are infected with ascaris lumbricoides. We reviewed the common presentations of complications of ascariasis infection in the Emergency Department (ED) and the diagnostic tools and treatment available. This was a retrospective case review conducted on all patients diagnosed with ascariasis (using ICD-9 codes) over a 6-year period at los angeles County and University of Southern california Medical Center. Three patients with distinct complications secondary to ascariasis were chosen, and all ED and inpatient records were reviewed. The patient's age, sex, race, presenting symptoms, data, outcome, and ED course and diagnosis were recorded. The three cases included a periappendiceal abscess, Loeffler's syndrome, and biliary colic/choledocholithiasis. The first patient underwent a computed tomography-guided drainage of the abscess. The second patient received supportive care and antibiotic therapy secondary to a superimposed bacterial pneumonia. The third patient underwent endoscopic retrograde cholangiopancreatography with sphincterotomy. All three patients had a stool ova and parasites positive for A. lumbricoides, and all received a 3-day course of mebendazole. Symptomatic cases of ascariasis may present to EDs in the united states. Important diagnostic tools for the ED include chest X-ray, X-ray of the kidney-ureter-bladder and ultrasonography. Single-dose medications given in the ED are very effective in eradicating A. lumbricoides infection, thus avoiding hospitalization.- - - - - - - - - - ranking = 0.10043113710737keywords = duct (Clic here for more details about this article) |
6/46. Pyelocalyceal diverticulum: an unusual cause of acute renal colic.The differential diagnosis of acute flank pain includes kidney stones, urinary tract infection, dissecting abdominal aortic aneurysm (AAA), arterial or venous compromise of the kidney, renal abscess, renal carcinoma, and papillary necrosis. This is a report of an unusual cause of renal colic: pyelocalyceal diverticulum. Stasis of urine within a diverticulum promotes both calculus formation and urinary tract infection, either of which can lead to colic. Several radiographic findings may suggest a calyceal diverticulum, including, on plain X-ray, a very peripheral or mobile renal calculus, or on intravenous pyelogram, an early filling-defect and delayed or retained filing of a circular or ovoid mass.- - - - - - - - - - ranking = 0.098113738565797keywords = bile (Clic here for more details about this article) |
7/46. Toothpick injury mimicking renal colic: case report and systematic review.We describe a case of a patient with left flank pain that was caused by a perforation in the splenic flexure of the colon by a toothpick. We conducted a systematic review of the literature to examine the nature of injuries caused by ingested toothpicks. Articles were analyzed for the following outcome variables: presenting complaint, site of injury, recollection of toothpick ingestion, time to presentation, findings from imaging studies, and mortality. Most patients (70%) presented with abdominal pain. Few patients (12%) remember swallowing a toothpick. The onset of symptoms ranged from <1 day to 15 years. Toothpicks caused perforation most frequently at the duodenum and the sigmoid. In some cases, toothpicks migrated outside the gastrointestinal tract and were found in the pleura, pericardium, ureter, or bladder. Toothpicks were apparent on imaging studies in 14% of the cases. The definitive diagnosis was most commonly made at laparotomy (53%), followed by endoscopy (19%). overall mortality was 18%. Ingested toothpicks may cause significant gastrointestinal injuries, and must be treated with caution.- - - - - - - - - - ranking = 0.10043113710737keywords = duct (Clic here for more details about this article) |
8/46. Appendiceal colic: A rare complication of colonoscopy.We report a case of appendiceal colic presenting as chronic right lower quadrant abdominal pain, without leukocytosis or other inflammatory signs, following an uneventful colonoscopic exam without biopsy or polypectomy. The resected appendix appeared grossly abnormal and was engorged with fecal material. The patient was immediately relieved of pain and remains so four years postoperatively. We conclude that insufflation of the cecum caused inspissation of fecal material into the lumen of the appendix. The ensuing incomplete or partial obstruction of the appendiceal lumen resulted in development of appendiceal colic without any signs or symptoms of inflammation.- - - - - - - - - - ranking = 0.2keywords = obstruction (Clic here for more details about this article) |
9/46. "Lights and shadows" in ultrasonography.The case of a 40-year-old male patient come to the emergency service with symptoms suspicious of biliary colic, is presented. liver sonography was requested to evaluate the parenchyma, the gallbladder and bile duct caliber in the suspicion of lithiasis. During the examination a hyper-reflecting image with posterior shadowing was detected at the level of the gallbladder infundibulum. However, the shadowing was not typical of lithiasis. This aroused some doubts and the scan was repeated after some minutes: an absolutely normal infundibulum was visualized. The shadowing was therefore an artifact probably due to a partial volume effect of the air contained in the distended duodenum, in contact with the gallbladder. The formation process of the sonographic image is carefully analyzed with particular reference to the situations generating artifacts.- - - - - - - - - - ranking = 1.0435045829576keywords = bile duct, duct, bile (Clic here for more details about this article) |
10/46. A young man with a renal colic.We report the case of a 35-year-old man with no cardiovascular morbidity, presenting with acute flank pain, microscopic haematuria and normal blood pressure. Initially diagnosed as a ureteral colic, the patient was recovered 6 weeks later with severe hypertensive crisis. Further investigations revealed a massive renal infarction secondary to medial fibromuscular dysplasia (FMD). Several aspects of this presentation are intriguing. Renal infarcts are usually seen in older patients having cardiac problems and/or major atheromatous plaques. In addition, FMD is mainly observed in young females and rarely progresses to renal artery occlusion. Furthermore, in this case, FMD remained silent until the acute renal infarction occurred, despite a significant kidney size reduction at the time of diagnosis. Finally, the observation of a delayed hypertensive response to a major renovascular insult provides incentives to discuss possible pathophysiological mechanisms involved in renovascular hypertension.- - - - - - - - - - ranking = 0.10043113710737keywords = duct (Clic here for more details about this article) |
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