1/40. 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) |
2/40. Langerhans cell histiocytosis of the stomach with atypical morphological features.We report the unique case of a 52-year-old patient with atypical morphological features of gastric Langerhans cell histiocytosis. The man was admitted because of increasing upper abdominal pain and weight loss. The upper gastrointestinal endoscopy showed a submucous, hemispherical tumor of the stomach wall along the lesser curvature. The tumor was completely removed and the patient was discharged 11 days later. Two months later, he died at home. The cause of death is unknown, because the autopsy was denied by the relatives. Macroscopically, the stomach showed a 4.5 x 2.5 cm large, spherical tumor of the lesser curvature of the corpus, which infiltrated the perigastric omenta and lymph nodes, the distal pancreas and the glissonian liver capsule. The vast majority of neoplastic cells were intensely positive for S-100 and CD1a. Typical Birbeck granules could be identified in almost all cells. Cell nuclei analyzed by flow cytometry showed an aneuploid peak, a feature typically associated with malignant disease.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
3/40. False-positive cytology in diagnostic laparoscopy due to ectopic pancreas.BACKGROUND: Report on a case of incorrect diagnosis after laparoscopy and peritoneal fluid sampling. methods: Case description and literature review. RESULTS: Diagnostic laparoscopy is a frequently used tool. In a patient with chronic abdominal pain, a diagnostic laparoscopy was performed, and a peritoneal fluid sample was taken. Cytology of the aspirated peritoneal fluid revealed an adenocarcinoma. At laparotomy, ectopic pancreas was found as the source of the false-positive cytology. CONCLUSION: In the diagnosis of adenocarcinomas from peritoneal fluid aspirates without an obvious clinical location (tumor), ectopic pancreatic tissue should be considered in the differential diagnosis. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
4/40. Acute jejunogastric intussusception: report of five cases.The purpose of this study was to investigate the clinical manifestations and diagnosis of patients with acute jejunogastric intussusception. From May 1986 to June 1999, a total of 5 men (54-76 years old) were collected. Their initial presentations included epigastralgia (4), coffee-ground vomitus (3), frank hematemesis (1), and tarry stool (1). All patients had gastric surgeries 10-30 years previously. Radiograph of the abdomen showed a soft tissue density at the left upper quadrant in one patient. Panendoscopies were done in 4 patients. An obstructed efferent loop with a distended hyperemic small bowel protruding into the remnant of stomach was found in 3 cases, gangrenous change of the bowel wall in one of them. Stump cancer was diagnosed initially in the other patient. barium study (3/5) showed efferent loop obstruction with "coil spring sing" and a central defect in the stomach. All 5 patients underwent segmental resection and end-to-end anastomosis between the 2nd to 6th hospital day. Operative findings were type II jejunogastric intussusception with retrograde invagination of a segment of efferent loop (30-100 cm in length) into the stomach. In conclusion, acute jejunogastric intussusception is an emergent condition. Early and accurate diagnosis is important. A high susception must be kept in mind in patients having a history of gastrojejunostomy with severe abdominal pain or upper gastrointestinal bleeding.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
5/40. crack cocaine-related prepyloric perforation treated laparoscopically.Perforation, which occurs in seven to 10 patients per 100,000 population annually, complicates 5-10% of peptic ulcers. crack cocaine has been associated with many gastrointestinal disorders, including ulcer perforation. Crack-related gastroduodenal perforations, typically prepyloric, have been on the rise in the last decade. Suggested mechanisms include ischemia, motility disorders, increased air swallowing, platelet-related thrombosis, and increased ACTH and corticosterone secretion. A 28-year-old man presented with vomiting and sudden generalized abdominal pain 3 h after smoking a "rock" (a 100-mg cube of crack). physical examination revealed generalized guarding, and plain films showed free intraperitoneal air. laparoscopy confirmed the diagnosis of generalized peritonitis secondary to a 5-mm perforation of the prepyloric anterior wall of the gastric antrum. omentum-patched primary closure and thorough abdominal irrigation were undertaken. The postoperative course was uneventful. omeprazole and anti-H. pylori treatment, including erythromycin and metronidazole, were maintained for 8 weeks and 1 week, respectively. Although drug addicts are not easily compliant with long-term medical treatment, in the particular case of crack addiction, the vasoconstrictive and dismotility effects of cocaine may precipitate gastric necrosis and paralysis, respectively, in the case of vagotomy. Although distal gastrectomy was the wisest choice when open ulcer surgery was adopted, the laparoscopic treatment of perforated ulcer, with either suture or sutureless techniques, has been found to be comparable to open surgery with regard to postoperative morbidity, reoperation rates, and mortality. The potential advantages of laparoscopy include the avoidance of large incisions, less attendant pulmonary morbidity, less wound infection, and possibly fewer postoperative adhesions.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
6/40. A gastric duplication cyst with an aberrant pancreatic ductal system: report of a case.We report an extremely rare case of a gastric duplication cyst together with an aberrant pancreatic ductal system, which communicated with the stomach rather than the pancreatic ductal system with no evidence of pancreatitis. A 46-year-old woman developed severe abdominal pain after a 10-year history of occasional mild abdominal pain. Upper gastrointestinal barium radiography showed a rigidity of the stomach wall, and gastroscopy revealed a fistula orifice at a greater curvature of the gastric body. Subsequent endoscopic suction of mucous secretion from within the fistula provided immediate pain relief. Abdominal computed tomography and ultrasonography showed a cystic mass contiguous with the stomach wall. Surgical exploration revealed an uncommon anomaly of a gastric duplication cyst with the aberrant pancreatic lobe. The patient made an uneventful recovery and remains well 4 years after surgery. We also herein review ten other similar cases of this uncommon congenital anomaly reported in the literature.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
7/40. Gastric volvulus and gastroduodeno-jejunal intussusception (an unusual cause of acute abdomen).An elderly man who presented with colicky abdominal pain had gastric volvulus which was reduced after barium meaL More than a year later the symptoms recurred and at laparotomy a gastroduodenojejunal intussusception was found and its apex was formed by a polypoidal gastric tumour (leiomyoma). The patient did very well without any recurrence after the resection of the tumour.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
8/40. Case report: gastroduodenal intussusception of a gastrointestinal stromal tumour.Gastrointestinal stromal tumours (GISTs), previously termed leiomyomas and leiomyosarcomas are relatively common tumours of the gastrointestinal tract, most commonly found in the stomach. Most GISTs are asymptomatic but may cause abdominal pain or bleeding from ulceration of the overlying mucosa. A rare case of gastroduodenal intussusception of a large gastric stromal tumour, which presented with intermittent abdominal pain and gastric outlet obstruction, is reported. Pre-operative diagnosis was made on abdominal CT and confirmed at laparotomy. Pre-operative diagnostic difficulties and management are discussed.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
9/40. Gastric toxoplasmosis in a patient with acquired immunodeficiency syndrome. A case report and review of the literature.toxoplasmosis is a common opportunistic pathogen in patients with acquired immunodeficiency syndrome (AIDS). It usually presents with ocular, central nervous system, or pulmonary disease. Gastric toxoplasmosis is uncommon in AIDS patients, especially in the absence of central nervous system manifestations. In the few reported cases, patients have presented with abdominal pain and other digestive complaints that usually are attributed to the more common gastrointestinal manifestations of human immunodeficiency virus infection. We describe a 49-year-old man with AIDS who presented with abdominal pain, diarrhea, dry cough, and systemic symptoms and was diagnosed with toxoplasmosis by a gastric biopsy.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
10/40. Laparoscopic treatment of a gastric duplication cyst: report of a case.Gastric duplications are rare benign tumors that are mainly discovered in relatively young patients. Although laparoscopic surgery, a less invasive surgical procedure, should be used for this condition, its application in the treatment of this disease has not yet been reported. A 14-year-old girl visited our hospital with the chief complaint of repeated episodes of upper abdominal pain. Because diagnostic imaging revealed a cystic tumor in the dorsal stomach, laparoscopic surgery was performed. The cystoma was intraoperatively found to contiguous with the posterior wall of the gastric cardia and was thus diagnosed to be a gastric duplication. With the intraoperative aid of gastroscopy, we were able to remove the cystoma from the continuous gastric wall safely without causing either a perforation or any other injury to the stomach. Gastric duplication is a congenital disease, and thus the majority of such cases are diagnosed in childhood. A laparoscopic resection of a duplicated stomach is less invasive and esthetically superior to other methods, and therefore it is considered to be a useful therapeutic modality.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
| | Next -> |