1/213. Perforation of acquired small bowel diverticulum.A 77-year old woman was seen with an unusual pathologic entity after emergent abdominal exploration--a ruptured small bowel diverticulum. This patient had a known previous history of colonic diverticulosis when she had acute onset of severe abdominal pain. The patient underwent an exploratory laparotomy with resection of representative segments of small and large bowel. The large bowel had evidence of diverticulosis, while the small bowel resected segment had evidence of diverticulitis with rupture. An extensive review of the literature revealed a very small number of reported cases in the world literature (less than 150 cases). We reviewed the history of reported cases of ruptured and nonruptured small bowel diverticular disease, as well as this case.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/213. Spontaneous gastrointestinal perforation in patients with lymphoma receiving chemotherapy and steroids. Report of three cases.Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain roentgenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24 h. Emergency operations were carried out; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
3/213. Spontaneous bladder rupture: rare cause of peritonitis.Spontaneous rupture of the urinary bladder is an uncommon, but important, cause of generalized peritonitis. It is a surgical emergency which may be rapidly fatal if diagnosis and treatment are delayed. Bladder disease or obstruction, coupled with a sudden increase in intra-abdominal pressure usually accounts for the rupture. Characteristic symptoms are acute lower abdominal pain followed by generalized peritonitis. In most cases, the rupture is intra-peritoneal.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
4/213. Spontaneous rupture of bladder diverticula in a girl with ehlers-danlos syndrome.A 5-year-old girl with ehlers-danlos syndrome presented with acute abdominal pain and anuria caused by a spontaneous perforation of bladder diverticula. Conservative treatment was successful.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/213. Spontaneous rupture of splenic hamartoma: a case report.Splenic hamartomas are rare. The authors report a case of spontaneously ruptured splenic hamartoma in a 5-month-old boy. This rupture led to the death of the child. If abdominal pain is present and a mass is palpated, the splenic hamartoma should be managed surgically in an expeditious manner. There have been only two known previous reports of spontaneous rupture of splenic hamartoma in adults, but none in children.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
6/213. Simultaneous rupturing heterotopic pregnancy and acute appendicitis in an in-vitro fertilization twin pregnancy.The presentation of acute abdominal pain in young women is not an unusual occurrence in casualty and gynaecology departments. Both acute appendicitis and ectopic pregnancy have to be considered and investigated, as these two conditions are accepted as the most common surgical causes of an acute abdomen. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case report presented here describes the extremely unusual occurrence of both these acute conditions happening simultaneously with the added complication of an ongoing twin pregnancy and it highlights the need to look beyond the most obvious diagnosis and always to expect the unexpected.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
7/213. Ruptured tuboovarian abscess in late pregnancy. A case report.BACKGROUND: Tuboovarian abscess is an unusual obstetric complication that causes maternal and fetal morbidity and mortality. CASE: A woman, G1, P0, with a 32-week pregnancy presented with abdominal pain. physical examination on admission revealed fever and unremarkable abdominal signs. Eleven hours after admission, signs of peritonitis became prominent, necessitating emergency laparotomy. Surgical findings included an 8-cm, right, ruptured tuboovarian abscess with massive purulent contamination of the abdominal cavity. Cesarean hysterectomy with bilateral salpingo-oophorectomy was performed. Neither the newborn nor the mother had postoperative complications. CONCLUSION: Since there are discrepancies in the incidences of tuboovarian abscess in pregnant and nonpregnant groups, the pathogenesis of tuboovarian abscess may be different in the two populations. In pregnancy, diagnosis and management are also more difficult than in the nonpregnant state. Clinical data may not reveal the diagnosis until surgery is mandatory. Because most pregnant women with tuboovarian abscesses are young, conservative surgery should be attempted if the pathology is limited to only one side of the adnexa and further reproduction is desired.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/213. Primary repair of cornual rupture occurring at 21 weeks gestation and successful pregnancy outcome.The successful delivery in a 31 year old woman at 33 weeks gestation is reported, after repair to a cornual rupture which occurred at 21 weeks gestation. The patient exhibited acute abdominal pain and pending shock. Emergency laparotomy showed a cornual rupture and an intrauterine vital fetus having intact amnion membrane. On the patient's family's insistence, primary repair for a cornual rupture was performed and preservation of the fetus attempted. Postoperatively, tocolytic agent with ritodrine hydrochloride was administered and close follow-up of the patient was uneventful. The patient had a smooth obstetric course until 33 weeks gestation when premature rupture of the membranes occurred, soon followed by the onset of labour. She underwent an elective Caesarean section and delivered a normal male fetus weighing 2140 g with Apgar scores at 1, 5 and 10 min of 6, 8, and 9 respectively. Because of this successful outcome, we suggest that primary repair for such an unusual patient should be accepted.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/213. Erythropoietic protoporphyria with fatal liver failure.A 33-year-old woman with a history of photosensitivity, persistent abdominal pain, and liver dysfunction was admitted to our department because of abdominal pain and progression of liver dysfunction. On admission, levels of protoporphyrin and coproporphyrin within erythrocytes were markedly increased. Autofluorescent erythrocytes were also detected, leading to a diagnosis of erythropoietic protoporphyria. A liver biopsy specimen revealed cirrhosis with dark brown granules filling hepatocytes, bile canaliculi, and bile ductules. Transfusion of washed erythrocytes, hemodialysis, and administration of cholestyramine and beta-carotene transiently improved levels of porphyrins and liver function. The patient died of rupture of esophageal varices followed by multiple organ failure. However, the treatments were believed to have extended survival.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
10/213. Mechanic intestinal obstruction--a possible presentation of perforated appendicitis.A 61-year-old man presented with diffuse abdominal pain, diarrhea, vomiting and fever. On the initial diagnosis of gastroenteritis the patient received the antibiotic ofloxacine for one week. On admission plain abdominal radiograph suggested a mechanic intestinal obstruction. In computed tomography a conglomerate tumor in the ileocecal region was seen and the patient underwent laparotomy. The conglomerate tumor was mobilized and an abscess opened, which was caused by a perforated appendicitis. After the operation the patient improved immediately and had an uneventful postoperative course. He was released and did not suffer from gastrointestinal symptoms the following 16 months of follow-up. The present case shall set forth that perforated appendicitis can clinically present as intestinal obstruction. Although a rare complication, perforated appendicitis should therefore even be considered in cases of mechanic intestinal obstruction of unknown cause.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
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