1/331. Old and new infarction of an epiploic appendage: ultrasound mimicry of appendicitis.Epiploic appendagitis is a self-limiting disease. Depending on its location, it may simulate nearly any acute abdominal condition. The ultrasound and computed tomographic (CT) features are characteristic, enabling ready diagnosis and thus preventing an unnecessary laparotomy. We describe a patient with acute abdominal pain in the right lower quadrant, in whom the combination of an old and fresh infarction of an epiploic appendage simulated appendicitis on ultrasound. Subsequent CT examination made the correct diagnosis.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
2/331. Fatal polyarteritis nodosa with massive mesenteric necrosis in a child.polyarteritis nodosa (PAN) is a rare vasculitic syndrome in childhood. There are few reported cases of ischaemic necrosis of the intestine and even fewer survivors in adults. We report the case of a 10-year-old boy with PAN and an acute abdomen that required operative intervention. Evidence was found of mesenteric arteritis with large ischaemic segments resulting in infarction and perforation.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
3/331. Acute abdominal pain and urgency to defecate in the young and the old: a useful symptom-complex?In the belief that "pattern recognition" is an important first step of the diagnostic process, we report our observation of an uncommon and heretofore poorly documented symptom-complex in 10 patients, and suggest that the constellation of abdominal pain and urgency to defecate in the acutely ill surgical patient should raise the diagnostic possibility of intra-abdominal bleeding. In our experience, this is statistically likely to be associated with a ruptured abdominal aortic aneurysm in the old and a ruptured ectopic pregnancy in the young.- - - - - - - - - - ranking = 3keywords = sti (Clic here for more details about this article) |
4/331. Acute abdomen as an atypical presentation of meningococcal septicaemia.The clinical manifestations and course of meningococcal disease have been well described, but atypical presentations may, if unrecognized, lead to a delay in treatment. We describe here an unusual case of this disease in a 21-y-old woman who presented with an acute rigid abdomen, clinical and laboratory features of sepsis, shock and early DIC with no indication of meningococcal infection. She developed a rapidly spreading purpuric rash, conjunctival haemorrhages, hypotension and tachycardia and a low urine output. Laboratory investigations showed a low platelet count, low haemoglobin and normal WBC. A presumptive diagnosis of meningococcal septicaemia was made and recovery followed treatment with cefotaxime, fluids and inotropes. A fully sensitive neisseria meningitis Group C, type 2a, subtype NT was isolated from blood cultures, but not from CSF obtained after antibiotic treatment.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
5/331. Disseminated cystic lymphangiomatosis presenting with acute abdomen: report of a case and review of the literature.lymphangioma is an uncommon tumor. Lymphangiomatosis, a benign tumor consisting of a cluster of dilated lymphatic channels, is very unusual. Most lymphangiomatoses are found in the neck and head area. Less than 5% are diagnosed intraabdominally and they are very infrequently encountered in the retroperitoneal area. Herein, we report a rare case of a 32 year-old woman who had disseminated intra-abdominal and retroperitoneal cystic lymphangiomatosis, which presented as acute abdomen. She received exploratory laparotomy due to the suspicion of malignancy, which was finally confirmed as cystic lymphangiomatosis. The clinical manifestations, imaging features, and management of this patient are discussed and compared with previous literature.- - - - - - - - - - ranking = 7keywords = sti (Clic here for more details about this article) |
6/331. intussusception in infants: an emergency in diagnosis and treatment.intussusception is an important cause of intestinal obstruction and bowel necrosis in infants under 2 years. Most frequently the ileocaecal junction is involved. Various aetiologic factors, such as Meckel's diverticulum and lymphoid hyperplasia have been identified. Hydrostatic reduction of the intussusception should be attempted, but delay in diagnosis frequently leads to surgical intervention, because of failing reduction. We report a case of a 4-month-old boy whose ileocaecal junction was intussuscepted into the rectum, and therefore could be palpated by rectal examination. Unsuccessful hydrostatic reduction and bowel necrosis because of delay in diagnosis, made surgical intervention necessary. A terminal ileostomy was performed. A second case report considers a 10-month-old boy whose ileocaecal junction was intussuscepted into the colon sigmoideum. Because there was no delay in diagnosis, this intussusception could be reduced hydrostatically. The procedure however was difficult because of a dolichosigmoideum. Recent literature is also reviewed.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
7/331. Acute abdominal pain and eosinophilia, two cases of eosinophilic gastroenteritis.Two patients are presented who were admitted with acute abdominal pain for which they underwent laparotomy. No clear-cut diagnosis could be established during operation. Eventually, eosinophilic gastroenteritis was diagnosed and treated with corticosteroids. The heterogeneous presentation of eosinophilic gastroenteritis is discussed, ranging from mild non-specific gastrointestinal symptoms to an acute abdominal emergency prompting surgical intervention. The pathogenesis and treatment of eosinophilic gastroenteritis are discussed.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
8/331. Abdominal pregnancy in a 67-year-old woman undetected for 37 years. A case report.BACKGROUND: Abdominal pregnancy is an exceedingly rare occurrence, but even more unusual is prolonged retention of an advanced abdominal pregnancy with lithopedion formation. We present the case of prolonged retention of an advanced abdominal pregnancy in an elderly women. CASE: A 67-year-old, white woman presented to the emergency department with abdominal pain. An acute abdominal series revealed a fetal skeleton extending from the patient's pelvis to her lower costal margins. Pelvic examination revealed a normal postmenopausal uterus, and human chorionic gonadotropin was negative. On further questioning the patient reported that she had become pregnant 37 years earlier and was diagnosed as having a "missed" pregnancy. She refused intervention at that time but suffered no untoward consequences. She reported having had later a healthy intrauterine pregnancy, delivered vaginally at term. No attempt was made to remove the prior missed abdominal pregnancy. The acute pain episode resolved, and there was no surgical intervention. CONCLUSION: Abdominal pregnancies can have a complex course, and management decisions can be difficult. This case presents an unusual outcome of an advanced abdominal pregnancy and illustrates a unique approach to management.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
9/331. Perforated jejunal diverticulitis as a rare cause of acute abdomen.Jejunal diverticula is rare and in most cases without any symptoms. They become clinically relevant when complications, such as diverticulitis, malabsorption caused by bacterial overgrowth, intestinal hemorrhage, or obstruction, occur. In this case report a case of perforated jejunal diverticulitis is presented and the problems in finding the correct diagnosis are discussed.- - - - - - - - - - ranking = 1keywords = sti (Clic here for more details about this article) |
10/331. Fishbone perforation through a Meckel's diverticulum: a rare laparoscopic diagnosis in acute abdominal pain.The use of diagnostic laparoscopy in acute abdominal pain, especially when patients have been admitted for acute pain in the lower abdominal quadrants, improves the accuracy of diagnosis and leads to improvements in treatment procedures. A case is reported of a 24-year-old woman admitted under suspicion of appendicitis. The appendix was found to be normal, and a perforation caused by a fishbone was discovered in a Meckel's diverticulum. The diverticulum was resected by a combined laparoscopic and open procedure. Diagnostic laparoscopy should be performed routinely in cases of acute abdominal pain in the lower quadrants of suspected appendiceal origin to avoid overlooking other causes of the symptoms.- - - - - - - - - - ranking = 2keywords = sti (Clic here for more details about this article) |
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