1/8. Acute abdomen due to torsion of a pedunculated mesenteric fibroma.A case history of a boy with an acute abdomen due to torsion of a pedunculated mesenteric fibroma is presented. A review of the literature shows that only a relatively small number of mesenteric fibromata have been reported. In these cases the tumor was described as growing between the two leaves of the mesentery. The symptoms these tumors gave usually were due to the size of the tumor and compression of adjacent organs. The present case is unusual because of the pedunculated nature of the fibroma and its presentation as an acute abdomen.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/8. Traumatic intramural hematoma of the duodenum: report of one case.Traumatic intramural hematoma of the duodenum is a rare entity in children. A high clinical index of suspicion is necessary for early and accurate diagnosis. We report a 10-year-old girl presenting with a sudden onset of epigastralgia after impact on the epigastrium by the edge of a wooden bed while playing on it. Symptoms of high gastrointestinal obstruction were severe, with bilious and large amounts of nasogastric effluent. Image studies revealed a large hematoma extending from the second to the third portion of the duodenum. Her condition was managed successfully by conservative treatments with nasogastric decompression and total parenteral nutrition. Her hospital course was uneventful. This report serves as a reminder to clinicians to consider intramural hematoma of the duodenum in the differential diagnosis of blunt abdominal trauma.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
3/8. Radiological reasoning: incidentally discovered liver mass.OBJECTIVE: A 49-year-old woman presented to the emergency department after a fall in which she sustained a right subcapital hip fracture. During her hospital stay she developed abdominal pain, and a hypoechoic liver mass was found on sonography. Multiphase CT showed a hepatic mass with brisk arterial phase enhancement, rapid washout on the portal venous phase, and delayed phase hypodensity. The final pathology diagnosis was hepatocellular carcinoma. CONCLUSION: Incidental lesions are frequently discovered during routine radiographic evaluations. Correlation with clinical history and additional confirmatory imaging is essential for appropriate diagnosis and management.- - - - - - - - - - ranking = 9.7153720195346keywords = fracture (Clic here for more details about this article) |
4/8. Acute abdomen as the first presentation of pseudomembranous colitis.Acute abdomen was the presenting manifestation of pseudomembranous colitis in six men who had previously been treated with antibiotics and presented with abdominal distention, pain, fever, and leukocytosis with absent or mild diarrhea. Plain abdominal radiographs revealed megacolon in two, combined small and large bowel dilation in three, with one of them showing volvuluslike pattern, and isolated small bowel ileus in one. Emergency colonoscopy was performed successfully in all patients and revealed pseudomembranes in five and nonspecific colitis in one. All patients had positive latex test results for clostridium difficile, and two tested positive for cytotoxicity. All patients were treated with IV metronidazole, resulting in resolution of symptoms and abdominal findings. In addition, two patients underwent colonoscopic decompression with improvement. Endoscopically, complete resolution of the pseudomembranes occurred at 4 weeks in all cases. No patient had a recurrence. It is concluded that (a) pseudomembranous colitis may present as abdominal distention mimicking small bowel ileus. Ogilvie's syndrome, volvulus, or ischemia; (b) in such cases, emergency colonoscopy is safe and useful for diagnosis and therapeutic decompression and may obviate the need for surgery; and (c) treatment with IV metronidazole is effective. colitis due to C. difficile should be considered in the differential diagnosis of acute abdomen in patients previously treated with antibiotics.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
5/8. A rare presentation of systemic salmonellosis.We are reporting an unusual case of disseminated salmonella enteritidis D, phage group E2 infection in an 18-year-old male, which was resistant to massive antibiotic treatment. Rare complications such as pylephlebitis, mediastinal adenopathy, osteomyelitis with pathological clavicular fracture, osteitis and spondylitis were observed. We found an immunological defect that no doubt contributed to this severe illness.- - - - - - - - - - ranking = 9.7153720195346keywords = fracture (Clic here for more details about this article) |
6/8. Porcelain appendix. A calcified mucocele fractures to produce an acute abdomen.mucocele of the appendix is rare and occasionally is accompanied by calcification. In a recent case, an eggshell-thin calcified mucocele fractured to produce an acute abdomen. This situation was not found in a review of the literature. A brief summary of the properties of mucocele is presented.- - - - - - - - - - ranking = 48.576860097673keywords = fracture (Clic here for more details about this article) |
7/8. ventriculoperitoneal shunt infection masquerading as an acute surgical abdomen.Shunting of cerebrospinal fluid to the peritoneal cavity has brightened the outlook for children with hydrocephalus. Nine hundred sixty-nine primary ventriculoperitoneal shunts were inserted for hydrocephalus between 1970 and 1981. During this same period, 2205 shunt revisions were performed in 847 children, some of whose primary shunt had been inserted prior to 1970 or at other institutions. Nineteen patients with a ventriculoperitoneal shunt infection persented with abdominal pain, fever, and abdominal tenderness; each had acute peritonitis. Three underwent laparotomy with the preoperative diagnosis of appendicitis; however, only infected peritoneal fluid and nonobstructing adhesions were found. A fourth child underwent an unnecessary intestinal resection at another hospital and required prolonged nutritional support and treatment of severe postoperative complications. Fifteen children who presented with an "acute surgical abdomen" were managed with intravenous fluids, gastric decompression, antibiotics, and removal of the intraperitoneal shunt. External ventricular drainage was employed until the cerebrospinal fluid was sterile. The shunt was then internalized in the peritoneal cavity. The abdominal signs and symptoms improved after removing the peritoneal tubing in all children. This plan of therapy has eliminated unnecessary laparotomy in those who may require repeated procedures for control of hydrocephalus.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
8/8. Posttransplant lymphocele presenting as 'acute abdomen'.Lymphoceles occurring after renal transplantation are frequently asymptomatic and are usually identified on routine ultrasonography of the allograft. A small percentage of them may increase in size and manifest due to their compression effects on adjacent structures or as lymphocutaneous fistula. An infected lymphocele would, in addition, give rise to local and systemic features. A case of infected lymphocele occurring 4.5 months after cadaveric renal transplant is reported. The patient presented in septicemia and features of generalized peritonitis. Emergency diagnostic laparoscopy revealed fluid collection in the peritoneal cavity. However, on exploratory laparotomy no intra-abdominal pathology was detected. Further evaluation revealed a large perigraft lymph collection which was drained percutaneously. Fluid and blood cultures grew staphylococcus aureus. The patient recovered completely following external drainage and antibiotic administration.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |