1/9. Spontaneous rupture of adrenal pheochromocytoma with capsular invasion.A 67-year-old Japanese man developed a sudden onset of severe right-side upper abdominal pain, nausea and vomiting. On hospitalization, physical examination revealed sweating, tachycardia, hypertension and the appearance of peripheral vasoconstriction. An urgent computed tomography scan with contrast demonstrated a large hematoma in the right retroperitoneal space. A phentolamine test and an 131iodine metaiodobenzylguanidine scan suggested pheochromocytoma. An elective right adrenalectomy was successfully performed after pretreatment for sufficient volume replacement with continuous administration of alpha- and beta-adrenergic blocking agents. Pathological diagnosis was an adrenal pheochromocytoma 9.0 x 6.5 cm in diameter with evidence of capsular invasion, which could be associated with a tear in the capsule.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
2/9. Mesenteric ischemia and portal hypertension caused by splenic arteriovenous fistula.Splenic arteriovenous fistula is rare and usually presents with features of established portal hypertension (PHT). Presentation as acute mesenteric ischemia with features of acute PHT is uncommon. We report a 35-year-old lady who presented with severe abdominal pain, diarrhea and ascites, which was found to result from mesenteric ischemia and acute PHT secondary to splenic arteriovenous fistula. She underwent resection of fistula, which resulted in complete symptom relief.- - - - - - - - - - ranking = 5keywords = hypertension (Clic here for more details about this article) |
3/9. Malignant hypertension with intestinal ischemia secondary to juxtaglomerular cell tumor.Malignant hypertension is a well-defined condition associated with high blood pressure and acute target-organ damage. Although 95% of cases are secondary to essential hypertension, its etiological profile is broad. Juxtaglomerular cell tumor is a rare condition, with only approximately 65 cases reported to date. We describe a patient with malignant hypertension with acute renal failure and intestinal ischemia secondary to a juxtaglomerular cell tumor. We believe this is the first case of juxtaglomerular cell tumor causing malignant hypertension. The diagnostic approach and treatment are discussed.- - - - - - - - - - ranking = 8keywords = hypertension (Clic here for more details about this article) |
4/9. Repetitive bleeding from a pheochromocytoma presenting as an abdominal emergency. Case report.Recurrent abdominal pain was the only subjective manifestation in a case of pheochromocytoma with retroperitoneal bleeding. At emergency laparotomy the tumor, showing signs of fresh and earlier bleeding, was extirpated. Sinus-type tachycardia was treated with beta-blockade peroperatively, while the diagnosis was still obscure, but hypertension did not follow. Meta-oxedrine and dopamine infusion was continued for 48 hours to sustain the blood pressure. Recovery was uneventful.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
5/9. Segmental infarction of the omentum: a cause of the semi-acute abdomen.Segmental infarction of the omentum is an unusual cause of the acute or "semi-acute" abdomen. Because of its rarity, the nonspecificity of its signs and symptoms and the almost total lack of information regarding its natural history, it is very rarely diagnosed correctly prior to laparotomy or autopsy. We report a 51-year old obese woman with chronic hypertension, congestive heart failure and renal insufficiency, who developed recurrent severe abdominal pain. The diagnosis of primary omental disease was entertained because of the triad of persistent localized abdominal pain, lack of grossly disturbed visceral function and the presence of hemoperitoneum. This was confirmed by laparotomy.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
6/9. Polycythaemia vera presenting as an acute abdomen.A patient who presented with severe abdominal pain was found to have an intrahepatic haematoma complicating previously undiagnosed polycythaemia vera (PV). Full recovery followed treatment with bed rest, control of hypertension, daily venesection and 32P. The hazards of surgery in uncontrolled PV are discussed and re-emphasized.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
7/9. Two unusual cases of wandering spleen requiring splenectomy.The occurrence of wandering spleen is rarely referred to in the pediatric surgical literature. We treated two unusual cases with this anomaly. The first case had an acute abdominal problem associated to a wandering spleen and a diaphragmatic eventration. splenectomy was performed because of splenic infarction. In the second case the wandering spleen was associated with gastric bleeding due to left-sided portal hypertension, and splenectomy was inevitable.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
8/9. Acute abdominal symptoms caused by hemorrhagic necrosis of a pheochromocytoma: report of a case.The diagnosis of pheochromocytoma is often difficult in a patient presenting with acute illness but without the classical constitutional symptoms. We report herein the case of a woman who developed acute abdominal symptoms following hemorrhagic necrosis of a previously unsuspected pheochromocytoma. This patient underwent successful emergency resuscitation followed later by elective surgical resection of a right adrenal pheochromocytoma. A review of 27 other cases indicates that a fatal outcome is likely to result without the initiation of prompt and appropriate emergency treatment, followed later by removal of the tumor. Thus, early diagnosis is important not only for controlling hypertension, but also because performing a laparotomy on a patient with unrecognized hemorrhagic necrosis of pheochromocytoma can create a potentially lethal situation.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
9/9. Idiopathic acute portal vein thrombosis: a case report.There are few reported cases of acute portal vein thrombosis presenting as an acute abdomen in adolescent age group. Most published series concern chronic extrahepatic portal vein thrombosis. Acute portal vein thrombosis is rare, but can develop into serious complications. Hence, prompt diagnosis and heparinization can prevent the development of lethal complications such as venous gangrene of the bowel and portal hypertension.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |