1/17. Rare complication of intestinal Crohn's disease: giant fibroid polyp.A 25-year-old male patient who had a brother with Crohn's disease was referred to our clinic with bloody diarrhea and crampy abdominal pain. After a plain erect abdominal X-ray, enteroclysis was performed, followed by abdominopelvic CT. Besides the radiological features of CD, both enteroclysis and CT revealed a big polypoid filling defect in the small intestine. The patient was surgically treated and the histopathology of the specimen revealed a giant fibroid polyp superimposed on CD, an extremely rare complication heretofore unmentioned in the radiology literature. In this report we discuss the role of enteroclysis in the diagnosis of complicated cases of long-standing CD. In addition, we also shed light on the importance of both enteroclysis and CT, with their complementary findings, in the radiological diagnosis of rare complicated cases of CD.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/17. Metastatic osteosarcoma presenting as a small-bowel polyp. A case report and review of the literature.Gastrointestinal metastases of osteosarcoma are an extraordinarily rare event and, as far as we can determine, have been reported previously only 5 times; these cases represent an unusual pattern of progression. We describe a 21-year-old man with an osteosarcoma of the right tibia that was removed 4 years previously. Two years later, the patient showed lung metastases. At his most recent presentation, he complained of abdominal pain, nausea, vomiting, and anorexia. Radiologic examination revealed an abdominal mass close to the jejunum and 3 nodules in the liver. One metastasis was an ulcerated and pedunculated polypoid mass located in the mucosa of the bowel, and the other involved the entire thickness of the jejunum. This unusual phenomenon represents an alteration in the natural history of osteosarcoma as a result of increased long-term survival.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
3/17. The use of ultrasound to demonstrate small bowel polyps in a patient with peutz-jeghers syndrome.A 21-year-old woman presented to the accident and emergency department with a 2-day history of lower abdominal pain. Her lips had the stigma of melanosis. Previously, she had received a diagnosis of peutz-jeghers syndrome, although no polyps had been detected in small and large bowel barium studies performed approximately 8 years before. Clinically, the patient had mild deep lower abdominal tenderness, and a mass was palpable in the suprapubic region. Urgent ultrasound showed ileoileal intussusception and small polyps in the lumen of the small bowel. At laparotomy, ileoileal intussusception was confirmed. It was not possible to reduce it because of nonviable small bowel, so 20 cm of the ileum, including the intussusception, was excised. After this, intraoperative enteroscopy was performed, showing further polyps in the small bowel distal and proximal to the intussusception, which were excised locally. Only a few reports in the literature describe ultrasound used to diagnose to condition. Intraoperative enteroscopy has been recommended as the treatment of choice because it allows identification of polyps that previously would have been missed.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
4/17. A rare case of multiple lymphomatous polyposis with widespread involvement of the gastrointestinal tract.Multiple lymphomatous polyposis (MLP) is an uncommon type of primary non-Hodgkin gastrointestinal (GI) B-cell lymphoma characterized by the presence of multiple polyps along the GI tract. Malignant cells of MLP have mantle cell characteristics and thus are considered to be the counterpart of the mantle cell lymphoma (MCL) in the GI tract. Since 1961, no more than 70 well-documented cases have been published. We report the case of 53-year-old man diagnosed as having MLP. The patient presented with diffuse abdominal pain, chronic lower GI bleeding, peripheral lymphadenopathy, and weight loss. The lymphomatous polyps extended from the esophagus to the rectum, with bone marrow infiltration. Immunohistologic findings were characteristic of MCL. The patient was treated with a combined cyclophosphamide, vincristine, and prednisone chemotherapy regimen, resulting in a partial response.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/17. Epigastraglia with tarry stools in a middle-aged female caused by jejunal intussusception due to a hamartoma.Upper gastrointestinal (GI) hemorrhage is a common presentation to an emergency department. Often, the diagnosis is peptic ulcer disease in which vague or sharp abdominal pain is associated with bleeding. In contrast, intussusception is a rare cause of abdominal pain and coincident GI bleeding. In this case, we report a 41-year-old woman who had an intussuscepting jejunal obstruction due to a hamartoma of the small bowel. The diagnosis was established by ultrasonography. In review of the literature, abdominal pain and bleeding are two common manifestations of intussusception when the lesion originates in the small bowel. intussusception is frequently included in the differential diagnosis of pediatric patients with coincident abdominal pain and bleeding. However, it is rarely mentioned as an adult cause of these two findings. Because of the delayed and nonspecific presentations of abdominal discomfort in adult patients with intussusception, the diagnosis is often delayed. This case points out the need for considering intussusception even in middle-aged patients whose initial presentation is concomitant bleeding and pain.- - - - - - - - - - ranking = 4keywords = abdominal pain (Clic here for more details about this article) |
6/17. endoscopy-assisted resection for multiple polyps of the small intestine in peutz-jeghers syndrome: a father and daughter story.peutz-jeghers syndrome is an infrequently encountered disease with potential complications including bleeding, intestinal obstruction, intussusception, and malignant transformation. We report on two patients, father and daughter, with peutz-jeghers syndrome who were admitted to hospital with similar complaints of abdominal pain. The father was 37 years old and the daughter was 17. physical examination and laboratory tests revealed small intestinal intussusception in both patients. In the daughter, the intussuscepted segment was resected. An electrosurgical snare was also used for enteroscopic excision of multiple jejunal and ileal polyps. In the father, two 4-cm polyps were surgically resected while an enteroscopic surgical snare was used for polyps of smaller size. Both patients were discharged on postoperative day 7.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
7/17. adult ileal intussusception: an unusual emergency condition.adult intussusception occurs infrequently and differs from the childhood condition in its presentation, cause, and treatment. Nonspecific symptoms can delay diagnosis; most cases are diagnosed at emergency laparotomy. Increased use of computed tomographic scanning to evaluate patients with abdominal pain can enhance reliable preoperative diagnosis. Treatment entails simple bowel resection in most cases. Reduction is controversial, especially in cases of colonic intussusception. This report describes the diagnosis and management of a case of adult ileal intussusception caused by an inflammatory fibroid polyp-a rare lesion of the gastrointestinal tract.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/17. Inflammatory fibrous polyp (pseudotumor) of ileum, a rare cause of intestinal obstruction.Inflammatory fibrous polyp of the ileum is a rare condition. This report adds one patient to the 11 previously reported. These lesions usually involve intermittent, colicky abdominal pain, often of several weeks duration and occasionally as a cause of acute intestinal obstruction. x-rays usually show small bowel obstruction or intussusception, but may be completely normal. The pathological diagnosis is seldom made before microscopic examination of resected specimens. They are clinically interpreted to be neoplasm and treated by segmental resection. No recurrences have been reported after treatment. Etiology is unknown.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/17. Juvenile polyp in a 10-month-old infant.A 10-month-old boy had episodes of apparent colic with bloody diarrhea. On investigation after prolapse of a rectal mass, a pedunculated polyp was found and removed by transanal ligation. The abdominal pain had been caused by the polyp intussuscepting the sigmoid colon into the rectum. Although rectal bleeding in children under age 1 is rarely caused by rectal polyps, physicians should consider this diagnosis in children of any age when recurrent colic and blood-streaked diarrhea occur.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
10/17. Cecal polyp and appendiceal intussusception in a child with recurrent abdominal pain: diagnosis by colonoscopy.A 7-year-old boy developed recurrent abdominal pain. He was eventually discovered to have an inverted appendix via colonoscopy. At surgery, a polyploid intracecal mass was palpated at the base of the partially invaginated appendix. Resection of the cecal mass (histologically, a juvenile polyp) and appendix was easily accomplished. The types of clinical presentation and treatment of children with appendiceal intussusception are discussed.- - - - - - - - - - ranking = 5keywords = abdominal pain (Clic here for more details about this article) |
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