1/17. pneumorrhachis, subcutaneous emphysema, pneumomediastinum, pneumopericardium, and pneumoretroperitoneum after proctocolectomy for ulcerative colitis: report of a case.This article presents the first known case of pneumorrhachis (spinal air), pneumomediastinum, pneumopericardium, pneumoretroperitoneum, and subcutaneous emphysema after proctocolectomy for ulcerative colitis. We review the patient's medical history, clinical and laboratory findings, radiographic data, and operative records, as well as the relevant literature. We describe the case of a young male with ulcerative colitis who developed pneumorrhachis, subcutaneous emphysema, pneumoretroperitoneum, pneumomediastinum, and pneumopericardium after a proctocolectomy with ileal pouch-anal anastomosis. Unlike the case we report, previously described episodes of pneumomediastinum and subcutaneous emphysema in patients with ulcerative colitis developed before operative intervention. We offer possible explanations for these unusual complications based on analysis of this case and thorough review of the literature.- - - - - - - - - - ranking = 1keywords = ulcer (Clic here for more details about this article) |
2/17. pneumopericardium due to intrapericardial perforation of a gastric ulcer.A 88-year-old male patient presented with fever, singultus and retrosternal pain. After 8 days of antibiotic therapy not resulting in clinical improvement, he suddenly developed a pneumopericardium. Contrast swallow and endoscopy showed intrapericardial perforation of a benign gastric ulcer. Excision of the ulcer and suturing of both the stomach and the diaphragm as well as lavage of the pericardium were done over a left thoracotomy. The patient recovered uneventfully.- - - - - - - - - - ranking = 95.812571148343keywords = gastric ulcer, ulcer, stomach (Clic here for more details about this article) |
3/17. Spontaneous tension pneumopericardium.A 29-year-old man presented to the accident and emergency department complaining of a sudden onset of chest and upper abdominal pain. He had a past history of intravenous drug abuse and a previous stab wound to the left hypochondrium that had required laparotomy. On arrival he was distressed with grunting respiration. Initial chest X-ray showed a pneumopericardium. Despite titrated doses of opiate analgesia he became increasingly distressed, agitated and dyspnoeic. Repeat chest X-ray demonstrated an increase in the volume of air present within the pericardial sac. His clinical condition improved rapidly after needle pericardiocentesis decompression. A water-soluble contrast swallow revealed a diaphragmatic hernia with a filling defect in the greater curve of the stomach and contrast medium entering the pericardial sac. A thoraco-abdominal laparotomy confirmed a pre-existing diaphragmatic defect from the previous stab wound, with surrounding adhesions. A small portion of the stomach had herniated through this defect with a perforated gastric ulcer communicating directly into the pericardial sac.- - - - - - - - - - ranking = 19.169097431496keywords = gastric ulcer, ulcer, stomach (Clic here for more details about this article) |
4/17. Perforation of the esophagus caused by the insertion of an intragastric balloon for the treatment of obesity.obesity is an enduring chronic disease, with multifactorial etiology. Many procedures and solutions have been proposed in the last 25 years. If patients do not meet the criteria for bariatric surgery, intragastric balloons may be used to achieve weight reduction. Contraindications to balloon therapy are a large hiatal hernia, severe esophagitis, peptic ulceration and previous gastric surgery. Although intragastric balloons are advocated as safe devices, major complications such as intestinal obstruction, gastric perforation and gastric ulceration have been described. We report a case of esophageal rupture due to insertion of an intragastric balloon for the treatment of morbid obesity, for which no contraindication existed. When abnormal pain or discomfort arises, or esophageal damage is noted after insertion of an intragastric balloon, patients must be closely monitored to diagnose a possible esophageal rupture early and thereby prevent severe complications.- - - - - - - - - - ranking = 19.27289387391keywords = gastric ulcer, ulcer (Clic here for more details about this article) |
5/17. Pyopneumopericardium attributed to an esophagopericardial fistula: report of a survivor and review of the literature.Herein we describe a case of pyopneumopericardium that resulted from formation of an acquired esophagopericardial fistula in a patient with silent, benign esophageal ulcer disease. Atypical features on initial examination suggested congestive heart failure or a pneumonic process (or both). The delayed development of pneumopericardium disclosed on a chest roentgenogram led to the clinical recognition of the esophagopericardial fistula. Subsequent emergent pericardiocentesis relieved cardiac tamponade and enabled us to diagnose pyopneumopericardium. A radiographic contrast study with use of meglumine diatrizoate revealed the site of the fistula in the midesophagus. The esophagopericardial fistula was surgically closed, and our patient had a good final result. Formation of an esophagopericardial fistula is a relatively uncommon finding; of the 60 previously reported cases, only 10 patients have survived. As illustrated in the current case, early diagnosis and treatment, including pericardial drainage and intense antibiotic therapy followed by a well-planned operative closure of the fistula, are paramount for the successful management of esophagopericardial fistulas.- - - - - - - - - - ranking = 0.14285714285714keywords = ulcer (Clic here for more details about this article) |
6/17. Penetration of the pericardium by a gastric ulcer--survival after pericardiocentesis.Elderly patients often have unusual manifestations of common illnesses. We describe a geriatric patient having a pneumopericardium from pericardial penetration by a gastric ulcer. Benign gastric ulceration causing perforation of the pericardium or other cardiac structures was recognized as early as 1854; however, until 1964, the condition was invariably fatal. Our patient survived the episode after early pericardiocentesis and medical treatment. Aspects of this uncommon clinical entity and a brief review of the literature are described.- - - - - - - - - - ranking = 114.78022038632keywords = gastric ulcer, ulcer (Clic here for more details about this article) |
7/17. zollinger-ellison syndrome with pneumopericardium.A 55-year-old white male was found to have the zollinger-ellison syndrome in 1971. Supposed total gastrectomy was performed at that time. When an esophageal ulcer was found, six years later, esophagoscopic biopsy revealed residual gastric mucosa. The patient was given cimetidine 300 mg qid because it was felt he could not tolerate further surgery. After eight months of cimetidine therapy, the patient was admitted to the hospital because of retrosternal pain. pneumopericardium was discovered, and at autopsy a large penetrating gastrojejunal ulcer was demonstrated.- - - - - - - - - - ranking = 0.28571428571429keywords = ulcer (Clic here for more details about this article) |
8/17. Hydropneumopericardium and oesophagitis: a non-fatal case.Hydropneumopericardium is a very rare and usually fatal complication of peptic oesophageal ulceration. The patient reported here survived and the report resembles one previously made about a child. In both patients failure to show the fistula radiologically or on endoscopy suggests that rapid spontaneous healing had occurred, and that this was responsible for survival.- - - - - - - - - - ranking = 0.14285714285714keywords = ulcer (Clic here for more details about this article) |
9/17. Pneumopyopericardium.Pneumopyopericardium is a rare disease, the etiology of which can be traumatic or non-traumatic. Today the most common cause of non-traumatic disease seems to be ulceration or carcinoma in the lower esophagus or upper stomach. The present cases were caused by ulcerations in two patients and a postoperative penetrating abscess in the third. All had connections with surgery in the region. Chest radiography disclosing fluid and gas in the expanded pericardium was the main diagnostic method. The prognosis is poor and all three patients died.- - - - - - - - - - ranking = 0.30524463593575keywords = ulcer, stomach (Clic here for more details about this article) |
10/17. Esophagopericardial fistula in a scleroderma patient with peptic esophagitis.esophageal perforation from peptic ulceration is rare. A patient with scleroderma who had an esophagopericardial fistula caused by peptic esophagitis is described. The fistula mimicked an acute myocardial infarction.- - - - - - - - - - ranking = 0.14285714285714keywords = ulcer (Clic here for more details about this article) |
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