1/27. Metastasis from small cell carcinoma of the lung producing acute appendicitis.A case of acute gangrenous appendicitis with perforation caused by metastatic small cell carcinoma of the lung in a 65 year old man is reported. The manifestation of appendicitis occurred more than 4 years after the diagnosis of the bronchogenic carcinoma. With longer survival of patients with disseminated tumors it is probable that new manifestations of those malignancies will be discovered. Acute appendicitis due to metastasis from a distant neoplasm should be considered in the differential diagnosis of right lower abdominal pain in the oncology patient.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/27. adult Wilms' tumor presenting as acute abdomen with elevated serum lactate dehydrogenase-4 and -5 isoenzymes: case report.Wilms' tumor, an embryonic neoplasm, is the most frequent renal tumor in childhood but is rare in adults. The prognosis of adult Wilms' tumor is worse than pediatric Wilms' tumor. The preoperative diagnosis of adult Wilms' tumor is extremely difficult to make because diagnostic imaging techniques, such as intravenous pyelography, computed tomography, ultrasound, renal angiography, and nuclear magnetic resonance imaging, only confirm the presence of a renal mass. diagnosis usually depends on histological characteristics, such as the presence of blastemic, epithelial, and mesenchymal components. A 27-year-old female presented with acute abdomen and with elevated serum lactate dehydrogenase (LDH) at 212 U/l (normal range: 47-140), and 2 of 5 LDH isoenzymes, namely LDH-4 at 13.6% (normal range: 6.8%-10.2%) and LDH-5 at 20% (normal range: 6.5%-9.7%). In this patient, stage I Wilms' tumor was managed by radical nephrectomy. The levels of LDH returned to its normal range. In conclusion, in cases of acute abdomen with a renal mass in young adults, the possibility of Wilms' tumor should be considered. serum LDH and its isoenzymes, LDH-4 and LDH-5, could be used as tumor markers for either differential diagnosis or monitoring the response of treatment.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/27. Giant ureteral stone in association with primary megaureter presenting as an acute abdomen.A 20-year-old woman presented with abdominal pain of 4-h duration and of sudden onset. A plain abdominal radiograph showed a giant ureteral stone measuring 12 cm causing ureteral obstruction. Abdominal ultrasound revealed severe dilatation of the two upper thirds of the left ureter and a hydronephrotic ipsilateral kidney. Subsequent renal scan demonstrated that it was a non-functional kidney while the contralateral kidney was normal. A left nephroureterectomy was performed.- - - - - - - - - - ranking = 1.558807780725keywords = kidney (Clic here for more details about this article) |
4/27. Acute abdomen during adjuvant chemotherapy: superior mesenteric artery thrombosis associated with CMF chemotherapy.We report a case of superior mesenteric artery thrombosis in a 57-year-old woman undergoing chemotherapy for T1N1M0, breast cancer. Although cancer itself is associated with an increased risk of thrombotic events, treatment with chemotherapy and/or tamoxifen in breast cancer patients increases this risk. Most cases reported are of venous thromboembolism; arterial events are rare.- - - - - - - - - - ranking = 13.656436049369keywords = cancer (Clic here for more details about this article) |
5/27. pseudomyxoma peritonei.pseudomyxoma peritonei is a relatively rare and poorly understood condition in which mucus accumulates within the peritoneal cavity. The presence of cells in the mucin, either inflammatory or neoplastic, distinguishes it from simple acellular mucus ascites caused by mucinous spillage. There is widespread seeding of the peritoneal and omental surfaces with a heavy cancerous glaze. This is principally a complication of borderline or malignant neoplasm of the ovary and/or appendix. This paper describes two cases of previously healthy women who both presented with an acute abdomen, and were diagnosed postoperatively with pseudomyxoma peritonei. In addition, literature on the clinical presentation, diagnostic procedures, and treatment options has been briefly reviewed.- - - - - - - - - - ranking = 5.5521453497897keywords = cancer, neoplasm (Clic here for more details about this article) |
6/27. Adnexal torsion presenting as an acute abdomen in a patient with bilateral cystic teratoma of the ovary.Benign cystic teratomas are the most common ovarian neoplasms in women. Teratomas are usually benign, unilateral, and most often found in young and premenopausal women. Most are 5 cm to 10 cm in diameter when diagnosed, and on sectioning, they usually contain thick sebaceous material, tangled hair, and various dermal structures. One of the major complications seen in cystic teratoma is torsion, a partial or complete twisting of the ovarian suspensary pedicle causing severe pain, nausea, and tissue necrosis. The patient described had bilateral cystic teratomas, one uncommonly large and torsed, causing an acute abdomen. Discussion includes the diagnosis, operative management, and postoperative findings.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/27. Ruptured giant liver cyst: a rare cause of acute abdomen in a haemodialysis patient with autosomal dominant polycystic kidney disease.Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder. Although liver involvement is the most frequent extra-renal manifestation, serious complications due to liver cysts are very rare. We report the occurrence of an acute abdomen caused by massive haemoperitoneum resulting from rupture of a giant liver cyst in ADPKD. Data suggest that chronic anticoagulation therapy should be avoided where possible in the presence of a giant liver cyst.- - - - - - - - - - ranking = 2.598012967875keywords = kidney (Clic here for more details about this article) |
8/27. Acute loss of the small bowel in a school-age boy. Difficult choices: to sustain life or to stop treatment?A 9-year-old boy lost almost all his small bowel after an acute volvulus due to a congenital, but previously unsuspected malrotation. survival using total parenteral nutrition is possible in these cases, but the medical burden is heavy. Small intestinal transplantation was performed for the first time in the netherlands in 2001 and this patient was treated 3 years earlier. The results of bowel transplantation are not as good as in kidney or liver transplantation. A method of Ethical Case Deliberation helped to elucidate the importance of each contribution in the discussion and provided space and a broad basis for decision-making. The parents refused to allow parenteral nutrition to be started because of the bad prospects for quality of life in the future and the medical team, after thorough deliberation with specialists throughout the country, and consultation of the literature, agreed. CONCLUSION: Despite the many different opinions, the parents felt accepted in their refusal of treatment for their son and the team accepted the decision.- - - - - - - - - - ranking = 0.519602593575keywords = kidney (Clic here for more details about this article) |
9/27. Small intestinal angiosarcoma leading to perforation and acute abdomen: a case report and review of the literature.A 76-year-old man presented to the emergency room with abdominal pain and fatigue. The patient had a history of gastrointestinal bleeding. An abdominal computed tomographic scan showed collections of free air in the abdomen with obstruction of the distal small intestine and multiple masses in the liver. laparotomy revealed a widespread malignant neoplasm in the abdomen, with multiple tumor nodules in the ileal wall, mesentery, and liver. The ileal wall was perforated within the area of one of the tumors. Pathologic examination of the lesion showed a neoplasm composed of solid sheets of spindle and undifferentiated cells, forming interlacing delicate vascular channels with atypical endothelial cells. The tumor cells were positive for the endothelial marker CD31, whereas reactivity for a broad panel of epithelial and other endothelial markers was negative. This case demonstrates that although angiosarcomas of the gastrointestinal tract are rare, they should be considered in cases of intestinal perforation or severe bleeding, especially in the elderly. A broad panel of immunochemical markers might be necessary to establish the pathologic diagnosis.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
10/27. Unusual causes of acute abdomen in a Nigerian hospital.Acute abdomen is the most common abdominal emergency associated with high morbidity and mortality in General surgical practice. Over a 7-year period, a study of unusual causes of acute abdomen was undertaken, with the aim of identifying these causes and outcome of operative management. Eleven cases were identified accounting for 4% of cases of acute abdomen seen during the period of the study. Four cases of liver diseases (33.3%) comprising 2 patients (16.7%) with ruptured primary liver cell carcinoma, 1 (one) case each of haemoperitoneum due to ruptured liver haemangioma and haemorrhagic disorders from liver cirrhosis. One patient had acute leukaemia with massive haemoperitoneum and acute abdomen. Five (45.5%) had gastrointestinal perforations; 1 patient (9%) each had multiple jejunal perforations, perforation of stomal ulcer at gastrojejunostomy site, perforation of gastric cancer; perforated carcinoid tumour of sigmoid colon and idiopathic perforation of the caecum. There was also a case of caecal volvulus. mortality was 7 patients (63.6%). All patients with liver pathology and acute leukaemia died. The cases of malignant tumour perforation were well and alive 4-6 years after the operation. CONCLUSION: Operation could have been avoided in 45.5% of these cases if the appropriate investigations, had been available and carried out.- - - - - - - - - - ranking = 4.5521453497897keywords = cancer (Clic here for more details about this article) |
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