1/8. Primary idiopathic segmental infarction of the greater omentum: two cases of acute abdomen in childhood.Idiopathic segmental infarction of the greater omentum (ISIGO) is a rare cause of acute abdominal pain in childhood. The authors present the case histories of 2 children treated in their department. The children underwent surgery with preoperative diagnosis of acute appendicitis with atypical clinical presentation. The definitive diagnosis of segmental infarction of the great omentum was made intraoperatively and confirmed pathologically. Excision of the infracted omentum was curative.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/8. Isolated torsion of the fallopian tube: a case report and review of the literature.INTRODUCTION: Isolated torsion of the fallopian tube is a very rare condition. It occurs without ipsilateral ovarian involvement associated with pregnancy, haemosalpinx, hydrosalpinx, ovarian or paraovarian cysts and other adnexal alterations or even with an otherwise normal fallopian tube. We document a case of isolated torsion of the right fallopian tube associated with hydrosalpinx. CASE: The patient was a 39-year-old female, para 2, gravida 4, who was presented with acute pelvic pain, nausea and vomiting. Her medical history included an appendectomy and right hydrosalpinx diagnosed five months before admission by hysterosalpingography because of investigation for secondary infertility. The urinary pregnancy test was negative. Pelvic ultrasonography showed a dilated folded right tubular structure measuring 7.8 x 2.7 cm with thickened echogenic walls and mucosal folds protruding into the lumen; the ovaries and uterus were unremarkable. No free fluid in the cul-de-sac was noted. Preoperatively, a diagnosis of twisted right fallopian tube was suspected and an exploratory laparotomy confirmed the diagnosis of isolated torsion of the oviduct. The ipsilateral ovary appeared normal, but the fallopian tube was gangrenous and right salpingectomy was performed. The patient became pregnant three months after surgery. CONCLUSION: Isolated torsion of the fallopian tube should be considered in the differential diagnosis of patients with acute abdomen and previous medical history of hydrosalpinx.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |
3/8. Pancreatic schwannoma. A case report and review of the literature.CONTEXT: Pancreatic schwannomas are rare neoplasms. These tumors vary in size and two thirds are partially cystic which grossly mimic pancreatic cystic lesions. Computed tomography and magnetic resonance imaging are the primary initial imaging modalities. Definitive diagnosis is typically made at the time of laparotomy following biopsy. Surgical resection is the mainstay of treatment. CASE REPORT: A 69-year-old woman presented with abdominal pain in the epigastric and left upper quadrant. The patient had no systemic symptom and laboratory results including tumor markers were negative. A CT scan of the abdomen showed a 5 cm mass arising from the head of the pancreas. Needle biopsy revealed a mass consistent with schwannoma. At laparotomy, a large pancreatic head mass was found to encase the superior mesenteric artery, and portal vein confluence. Frozen biopsy showed schwannoma. Curative resection was deferred due to extensive vascular involvement and favorable tumor biology. A gastrojejunostomy was performed and radiation therapy was instituted post-operatively. CONCLUSIONS: Only 24 cases of pancreatic schwannoma had been previously reported. Definitive diagnosis is obtained with routine histology. Most tumors are benign and surgical resection is curative. The role of radiation therapy in the management of unresectable tumors is still unclear.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |
4/8. Isolated idiopathic ovarian vein thrombosis: a rare case.This article describes the case of a 36-year-old woman who presented with a 2-day history of abdominal pain and nausea. Laboratory investigations revealed no abnormalities. Ovarian vein thrombosis was detected on ultrasound examination, and computed tomography of the pelvis and abdomen confirmed this finding. The patient was placed on anticoagulant therapy with unfractionated heparin and warfarin. Within 40 days her thrombosis improved. Laboratory testing for coagulation disorder revealed nothing abnormal. Ovarian vein thrombosis must be recognized and treated early to reduce the risk of serious complications. This case of idiopathic ovarian vein thrombosis underlines the importance of including this condition in the list of differential diagnoses for abdominal pain.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |
5/8. Painless aortic dissection with bilateral carotid involvement presenting with vertigo as the chief complaint.A 63 year-old woman was admitted to the emergency department with vertigo, nausea, and vomiting. On arrival, she was fully oriented and cooperative. She denied any pain in her chest, neck, back, or abdomen. A bruit was heard on both sides of her neck. Cranial computed tomography (CT) revealed no abnormality, while thoracic CT disclosed dissection in the ascending aorta, aortic arch, and bilateral common carotid arteries. After several hours, the patient underwent vascular surgery. She had an uneventful course and was discharged without any sequelae after 10 days. vertigo is a rare presentation of aortic dissection with carotid involvement. Elderly patients presented with vertigo and nausea/vomiting should be evaluated for the condition and carotid dissection should be ruled out. Carotid bruit may be a clue to the diagnosis.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |
6/8. cytosine-arabinoside-induced colitis and peritonitis: nonoperative management.cytosine arabinoside is known to cause severe gastrointestinal side effects in an already very ill patient population. Three cases are reviewed in which apparent surgical peritonitis was managed conservatively, with very careful clinical monitoring. Two of the patients recovered completely, and one died of systemic fungal infection. No patient had a surgically remediable condition, and all were extremely poor surgical risks. A review of our experience and the literature leads us to recommend careful conservative management in patients receiving cytosine arabinoside who appear to have a "surgical abdomen," but in whom a definitive surgical diagnosis cannot be made.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |
7/8. A 33-year-old white female with abdominal pain, nausea, vomiting and hypotension.A thirty-three year old female presented to our emergency department complaining of severe abdominal pain, nausea, and vomiting. On physical examination she was hypotensive with a firm, tender abdomen, cervical motion tenderness and a diffuse erythematous rash. A surgical diagnosis of Acute pelvic inflammatory disease was made during laparoscopy. Coagulant studies, liver function tests, culture results, and the desquamation of the patient's palms led to the additional diagnosis of Toxic shock syndrome. A literature search failed to reveal any similar cases of pelvic inflammatory disease (PID) and Toxic shock syndrome (TSS) occurring concomitantly. patients may present severely ill with either of these disease entities but potential for serious illness is greater when both of these syndromes occur in the same patient. We conclude that in patients with a similar presentation, the symptoms should not be attributed completely to PID without further investigation and consideration of a concomitant disease process including TSS.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |
8/8. Retractile mesenteritis: to treat or not to treat.Retractile mesenteritis is a rare entity characterized by an inflammatory process of the mesenteric adipose tissue. The disease usually presents with abdominal pain or a palpable abdominal mass. In the majority of cases, the disease is self-limiting and the prognosis is favorable. In this paper we describe a patient who presented with a 7 x 8 cm mass in the left upper abdomen, nausea and pain in the lower back. Symptomatic treatment was given with good result. The literature on different therapeutic intervention is briefly discussed.- - - - - - - - - - ranking = 0.25keywords = abdomen (Clic here for more details about this article) |