1/94. Inflammatory cysts of the pelvic peritoneum.Three young women with abdominal distension due to pelvic masses were investigated using ultrasound and conventional radiographic techniques. While the latter revealed masses of soft tissue density arising from the pelvis and displacing bowel, the sonogram indicated the morphologic features of thin-walled multiloculated cysts. They were located entirely within the peritoneal cavity and contained serous to serosanguineous fluid. The mesholelial lined walls were infiltrated with chronic inflammatory cells and were adherent to chronically inflamed fallopian tubes. Although these acquired cysts are familiar to pathologists and gynecologists, the literature contains little information about them.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/94. Disseminated intravascular meconium in a newborn with meconium peritonitis.A 3-day-old premature infant with meconium peritonitis, periventricular leukomalacia, and pulmonary hypertension died with respiratory insufficiency. An autopsy disclosed intravascular squamous cells in the lungs, brain, liver, pancreas, and kidneys. Numerous pulmonary capillaries and arterioles were occluded by squamous cells, accounting for pulmonary hypertension. brain parenchyma surrounding occluded cerebral vessels showed infarct and gliosis. A mediastinal lymph node filled with squamous cells alluded to the mechanism by which these cells from the peritoneal cavity likely entered the bloodstream--namely, via diaphragmatic pores connecting with lymphatics. Thus, disseminated intravascular meconium rarely may complicate meconium peritonitis and have devastating consequences.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
3/94. Generalized peritonitis with pneumoperitoneum caused by the spontaneous perforation of pyometra without malignancy: report of a case.Spontaneous perforation is a very rare complication of pyometra. We report herein the case of an 88-year-old woman who presented with muscular rigidity and free air on abdominal X-ray films. Perforation of the gastrointestinal tract was diagnosed preoperatively, and an emergency laparotomy was performed. A total hysterectomy with bilateral salpingo-oophorectomy was carried out under the diagnosis of generalized peritonitis caused by the spontaneous perforation of pyometra. The culture of purulent fluid from the abdominal cavity showed only escherichia coli, with no anaerobic bacteria. Histological examination revealed pyometra with necrosis of the endometrium and no evidence of malignancy. The patient was discharged on postoperative day 68 without any major complications. pyometra is an unusual cause of peritonitis, but it must be considered as a possible diagnosis in elderly women presenting with an acute abdomen. Following this case report, we discuss the problems associated with establishing a correct preoperative diagnosis of generalized peritonitis caused by the spontaneous perforation of pyometra.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/94. Abdominal, scrotal, and thoracic calcifications owing to healed meconium peritonitis.meconium peritonitis is a form of chemical peritonitis resulting from in utero perforation of the gastrointestinal tract, with subsequent leakage of sterile meconium into the peritoneal cavity and the potential spaces connected with it. Involvement of the tunica vaginalis may be the sole presenting clinical manifestation of the gut perforation resolving spontaneously. In such instances, radiologically detectable calcifications in the abdomen, scrotum, and thorax are essential diagnostic points. In this study, a 4-month-old baby with abdominal, scrotal, and thoracic calcifications owing to healed meconium peritonitis is presented.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
5/94. Anaesthetic management of a patient with pemphigus vulgaris for emergency laparotomy.A 45-year-old man with a long-standing history of duodenal ulcer presented with symptoms and signs of perforation peritonitis. He also had lesions of pemphigus vulgaris throughout the body, involving both skin and mucous membranes. Care was taken to avoid pressure and friction during placement of monitoring devices, intravenous and arterial lines. Since the patient had to undergo exploratory laparotomy, intubation was performed in an atraumatic manner after rapid sequence induction. However, there was minor bleeding from the mucous lesions of the oral cavity, which was controlled by a saline adrenaline throat pack. The patient was extubated at the end of the surgery and steroids were continued in the peri-operative period.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
6/94. Ultrasonographic detection of intrauterine intussusception resulting in ileal atresia complicated by meconium peritonitis.A neonate with ileal atresia (IA) complicated by meconium peritonitis (MP) whose prenatal ultrasonography (US) detected an intrauterine intussusception (IUI) is reported. Fetal ascites, dilated bowel loops, and abdominal calcifications were identified on serial US from 25 weeks of gestation. Intestinal loops with high echogenecity and a "target-like" appearance suggestive of IUI were detected in the right lower quadrant. The 2,680-g male was delivered vaginally at term and underwent a laparotomy. Fibrous adhesions and small calcifications were scattered throughout the peritoneal cavity. IA (interrupted type) was confirmed 17.0 cm cranial to the ileocecal valve (ICV). An ileo-ileal intussusception was also found between 16.5 cm and 9.0 cm cranial to the ICV. Partial resection of the ileum and an ileo-ileal anastomosis was performed. The postoperative course was uneventful. In this case, the pathological process of IUI resulting in IA and MP was demonstrated sonographically by identifying the "target-like" appearance in the fetus.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
7/94. Unusual fatal mechanisms in nonasphyxial autoerotic death.The diagnosis of autoerotic death is most often made when there has been accidental asphyxia from ropes or ligatures used by the deceased as a part of his or her autoerotic ritual. Three cases of probable autoerotic death are reported in which the mechanisms of death involved hyperthermia, sepsis, and hemorrhage, respectively. Case 1: A 46-year-old man was found dead in bushland clothed in a dress, female undergarments, and seven pairs of stockings/pantyhose. The underwear had been cut to enable exposure of the genitals. The recorded daily maximum temperature was 39 degrees C, and the deceased had been taking the drug benztropine. death was attributed to hyperthermia due to a combination of excessive clothing, high ambient temperature, and prescription drug side effect. Case 2: A 40-year-old man was found dead in his boarding house. At autopsy, a pencil was found within his abdominal cavity with perforation of the bladder and peritonitis. death was attributed to peritonitis/sepsis following intraurethral introduction of a pencil. Case 3: A 56-year-old man was found dead lying on his bed following massive rectal hemorrhage. A blood stained shoe horn was found nearby. death was attributed to hemorrhage following laceration of the anal canal with a shoe horn. The diagnosis of autoerotic death may be difficult when typical features are absent, however, any unusual injury associated with genitourinary manipulation must raise this possibility.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
8/94. A minimally invasive approach to bile peritonitis after blunt liver injury.The advent of nonoperative management of liver injuries has made it imperative that surgeons be familiar with the potential delayed complications of this approach. In this report, we describe a minimally invasive strategy for the management of bile peritonitis following nonoperative management of blunt liver injuries. Two cases are presented in which bile peritonitis with massive bile ascites was managed with laparoscopic localization and drainage of the bile leak, irrigation of the peritoneal cavity, and postoperative endoscopic retrograde cholangiography with bile duct stenting. In both cases the bile leak ceased, and the patients recovered without adverse sequelae. The combination of laparoscopic surgery and endoscopic stenting provides a minimally invasive approach to this entity.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
9/94. Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: report of a case.We report a rare case of generalized peritonitis due to a ruptured pyometra in an 86-year-old woman, and also conduct a review of the previous Japanese literature. The patient presented with muscle guarding and rebound tenderness. Computed tomography (CT) disclosed a cystic mass in the peritoneal cavity, in which an air-fluid level was noted. pneumoperitoneum around the uterus due to gas production of anaerobic bacteria was noted on a CT. At laparotomy, the uterus was markedly enlarged with a necrotic area on the uterine fundus, which was found to be perforated. A supravaginal hysterectomy and drainage were performed. We found only eight cases of a ruptured pyometra presenting as pneumoperitoneum in the Japanese literature between 1977 and 1999. The most common cause of pneumoperitoneum is a perforation of the gastrointestinal tract. However, other possible causes, as seen in our patient, should also be taken into consideration. Although it is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
10/94. Spontaneous bacterial peritonitis induced by intraarterial vasopressin therapy.Two patients developed spontaneous bacterial peritonitis after infusions of vasopressin into the superior mesenteric or gastroduodenal arteries for upper gastrointestinal hemorrhage. The peritonitis in these patients differed from the typical picture in which a single aerobic organism is responsible, by the presence of multiple organisms, some of which were anaerobic. These findings suggest that the arterial vasoconstriction decreased the integrity of the intestinal mucosal barrier and permitted the transmural migration of enteric organisms from the lumen of the bowel into the ascites-filled peritoneal cavity.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
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