1/101. Fatal polyarteritis nodosa with massive mesenteric necrosis in a child.polyarteritis nodosa (PAN) is a rare vasculitic syndrome in childhood. There are few reported cases of ischaemic necrosis of the intestine and even fewer survivors in adults. We report the case of a 10-year-old boy with PAN and an acute abdomen that required operative intervention. Evidence was found of mesenteric arteritis with large ischaemic segments resulting in infarction and perforation.- - - - - - - - - - ranking = 1keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis (Clic here for more details about this article) |
2/101. Spontaneous biliary perforation and necrotizing enterocolitis.A case of spontaneous bile-duct perforation in a 5-month-old boy with a history of necrotizing enterocolitis in his 1st week of life is reported. To our knowledge, this is the second case reported with such an antecedent, supporting a vascular etiology for some cases of spontaneous biliary perforation.- - - - - - - - - - ranking = 0.0079857976823212keywords = necrotizing (Clic here for more details about this article) |
3/101. Acute appendicitis complicated with necrotizing soft tissue infections in the elderly: report of a case.A case of acute appendicitis complicated with necrotizing soft tissue infections (NSTIs) in an extremely elderly woman (98 years-old) is reported. She was admitted to our hospital with a history of increasing pain localized in the right lower abdomen. Abdominal ultrasonography revealed appendicolithiasis and periappendiceal fluid. An appendectomy and closure of the perforated cecum was performed. On the 5th post-operative day, the patient developed skin erythemas and crepitation in the right lower quadrant. An exploration and drainage of the recent operative incision was performed under the diagnosis of NSTIs. Despite the declining overall incidence of appendicitis, it has been increasing among the elderly. The elderly patients are associated with underlying defects in immune function. NSTIs, which are characterized by rapidly progressing inflammation and necrosis of soft tissue, comprise a spectrum of disease ranging from necrosis of the skin to life-threatening infections. The most common etiology of NSTIs was post-operative infections of the abdominal wall, which primarily occurred after operations with extensive fecal contamination. NSTIs are no longer a rare post-operative complication in the elderly and initial treatment should be selected according to the condition of the patient.- - - - - - - - - - ranking = 0.0079857976823212keywords = necrotizing (Clic here for more details about this article) |
4/101. Non-traumatic liver rupture due to a perforated gastric ulcer.The case of a 57-year-old woman with a fatal liver rupture due to a necrotizing perihepatic abscess caused by a perforated gastric ulcer is presented. The ulcer had been treated successfully by surgical intervention 8 days before. The autopsy revealed a large perihepatic abscess and multiple ruptures of Glisson's capsule with a large subcapsular hematoma and underlying lacerations of the liver parenchyma. The patient had no history of previous abdominal trauma and the known etiological factors for spontaneous liver rupture were excluded by the autopsy findings or by clinical and laboratory data. No liver penetration by the gastric ulcer was found at autopsy and there were no clinical signs or symptoms for an infection or any degenerative or inflammatory diseases. Histologically abundant vegetable fibers, identified as stomach contents and a dense infiltrate of lymphocytes and granulocytes were found in the perihepatic abscess next to Glisson's capsule. Below Glisson's capsule there were hemorrhages, focal hepatocellular necrosis and a mixed cell inflammatory infiltration. In the present case, preceding perforation of the gastric ulcer with leaking of gastric acid into the peritoneal cavity resulted in peptic digestion of Glisson's capsule. Vascular lesions of the affected parts of Glisson's capsule and the liver parenchyma underneath resulted in intrahepatic hemorrhage and an increase in intrahepatic pressure with subsequent liver rupture. To the authors' knowledge no similar case of spontaneous liver rupture due to perforation of a gastric ulcer has been reported previously.- - - - - - - - - - ranking = 0.0015971595364642keywords = necrotizing (Clic here for more details about this article) |
5/101. Necrotizing fasciitis due to appendicitis.Necrotizing fasciitis, although rare, is one of the more serious, life-threatening complications of missed acute appendicitis. patients who are predisposed to developing necrotizing fasciitis, regardless of the cause, are typically immunocompromised. We present a case of a 49-year-old immunocompetent female whose diagnosis of acute appendicitis was missed and who subsequently developed necrotizing fasciitis of the abdominal wall and flank. She recovered 1 month after admission due to aggressive surgical and medical therapy.- - - - - - - - - - ranking = 0.0031943190729285keywords = necrotizing (Clic here for more details about this article) |
6/101. Spontaneous spleen rupture during typhoid fever.typhoid fever currently is an uncommon disease in western countries, and cases usually are imported from endemic areas.1 The most common complications are intestinal bleeding or perforation and necrotizing cholecystitis, although hepatitis, myocarditis, nephritis, and meningitis may occur. Spontaneous spleen rupture during typhoid fever is a known but rare complication. This report describes a new case and reviews the literature.- - - - - - - - - - ranking = 0.0015971595364642keywords = necrotizing (Clic here for more details about this article) |
7/101. Ruptured liver abscess with fulminant amoebic colitis: case report with review.Amoebic liver abscess is the commonest extra intestinal manifestation of amoebiasis. Intraperitoneal rupture of liver abscess and fulminant necrotizing amoebic colitis are rare occurrences which complicate a severe form of invasive disease caused by entamoeba histolytica. These complications are associated with a high morbidity and mortality. Synchronous pathological lesions in colon and liver are rare. Still rare is the occurrence of complicated colonic and hepatic invasive amoebiasis presenting as an acute abdomen. One such presentation of ruptured liver abscess and necrotizing amoebic colitis in a 70 year old male which was successfully managed is being reported.- - - - - - - - - - ranking = 0.0031943190729285keywords = necrotizing (Clic here for more details about this article) |
8/101. Undiagnosed renal abscess presenting as acute bacterial peritonitis: case report.A case of undiagnosed renal abscess complicated by intraperitoneal rupture with generalised bacterial peritonitis is presented. Prompt surgical intervention was essential for saving the patient's life. Early imaging of the kidney in unresolved renal infection is essential if renal abscess, its delayed presentation and complications are to be avoided. Most patients will be cured without operation by antibiotics and if necessary, by additional percutaneous drainage where an abscess has formed.- - - - - - - - - - ranking = 0.0002386511271819keywords = essential (Clic here for more details about this article) |
9/101. Spontaneous bilateral perirenal hematoma as a complication of polyarteritis nodosa in a patient with human immunodeficiency virus infection.We present a 29-year-old man with polyarteritis nodosa (PAN) having human immunodeficiency virus (hiv) infection. This patient fulfilled the American College of rheumatology (ACR) 1990 criteria for PAN, and the diagnosis was confirmed by typical arteriographic findings, including microaneurysms. Due to the rupture of microaneurysms, perirenal hematomas occurred in both kidneys. Unilateral nephrectomy was performed, and renal histology confirmed that aneurysm rupture was the etiology of the perirenal hematoma. The occurrence of renal hematomas is a usual complication of PAN. However, bilateral renal hematoma during the course of hiv-associated PAN is quite rare, and to our knowledge, this would be the second case reported in the literature. When compared with other viral agents, the association of hiv with PAN may be considered rare. However, as suggested by various reports in the literature, hiv infection should always be kept in mind while evaluating patients with PAN.- - - - - - - - - - ranking = 1.1973095228572keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis (Clic here for more details about this article) |
10/101. Spontaneous perforation of a non-aneurysmal visceral aorta.A 77 year-old woman with mild osteoarthritis and sjogren's syndrome presented to an outside hospital with mild abdominal and back pain. The initial computed tomography (CT) scan was essentially negative. The repeat CT scan after 1 week of medical therapy was suspicious for a contained rupture of the visceral aorta. She was emergently transferred to the University of chicago. Emergent aortography confirmed the diagnosis and revealed wide patency of the visceral and renal arteries. Upon exploration, there was obvious rupture of the entire right posterior aortic wall at the level of the celiac axis with a large right retroperitoneal hematoma. Aorto-aortic bypass was performed. The visceral and renal vessels were revascularized using separate jump grafts to this 'parallel aorta'. The patient tolerated the procedure well and was discharged after 12 days. Pathologic examination of the aortic wall was essentially negative. She is well on follow-up after 20 months. To our knowledge, this is the second reported case of spontaneous contained rupture of the visceral aorta.- - - - - - - - - - ranking = 0.0002386511271819keywords = essential (Clic here for more details about this article) |
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