1/13. Generalized peritonitis with pneumoperitoneum caused by the spontaneous perforation of pyometra without malignancy: report of a case.Spontaneous perforation is a very rare complication of pyometra. We report herein the case of an 88-year-old woman who presented with muscular rigidity and free air on abdominal X-ray films. Perforation of the gastrointestinal tract was diagnosed preoperatively, and an emergency laparotomy was performed. A total hysterectomy with bilateral salpingo-oophorectomy was carried out under the diagnosis of generalized peritonitis caused by the spontaneous perforation of pyometra. The culture of purulent fluid from the abdominal cavity showed only escherichia coli, with no anaerobic bacteria. Histological examination revealed pyometra with necrosis of the endometrium and no evidence of malignancy. The patient was discharged on postoperative day 68 without any major complications. pyometra is an unusual cause of peritonitis, but it must be considered as a possible diagnosis in elderly women presenting with an acute abdomen. Following this case report, we discuss the problems associated with establishing a correct preoperative diagnosis of generalized peritonitis caused by the spontaneous perforation of pyometra.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/13. Computed tomography features of spontaneously perforated pyometra: a case report.Spontaneous perforation of pyometra is an extremely rare emergent gynecologic disease. We report a 73-year-old woman with a spontaneously perforated pyometra presenting with acute abdomen in the emergency department. A dedicated computed tomography examination of the abdominal and pelvic regions revealed the diagnosis. The patient recovered well after surgical intervention and antibiotic treatment.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
3/13. Phlegmonous duodenitis complicating multiple myeloma: a successfully treated case.A patient receiving chemotherapy for multiple myeloma suddenly developed an acute abdomen, fever, and neutrophil leukocytosis. At laparotomy, the distal two-thirds of the duodenum was swollen and hemorrhagic and was surgically excised. The specimen displayed an acute phlegmonous (suppurative) duodenitis with submucosal and transmural acute inflammation and edema despite an intact mucosa. blood cultures grew Group B, beta-hemolytic streptococci and gram-positive cocci were present histologically. The patient recovered uneventfully following the surgery and a course of broad spectrum antibiotic therapy. This case illustrates that localized suppurative intestinal infection should be considered when immunosuppressed patients present with an acute abdomen, and that aggressive surgical and antibiotic therapy is warranted.- - - - - - - - - - ranking = 2keywords = abdomen (Clic here for more details about this article) |
4/13. Spontaneous rupture of pyometra due to leiomyomata. A case report.pyometra, an accumulation of purulent material in the uterus, is a rare pathologic entity. Spontaneous rupture of pyometra occurred secondary to degenerating leiomyomata; that is an extremely rare complication. pyometra, the diagnosis of which is based on the classic symptoms of uterine enlargement, vaginal discharge and acute abdomen, requires rapid supportive therapy and surgical intervention.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
5/13. Spontaneous rupture of the uterus associated with pyometra.A case is reported in which an elderly patient was admitted with signs and symptoms of an acute abdomen. A laparotomy revealed uterine rupture with free pus in the peritoneal cavity and subsequent histology of the uterus showed no evidence of malignancy.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
6/13. Spontaneously perforated pyometra. A differential diagnosis in acute abdomen.Spontaneously perforated pyometra is rare, but the condition must be born in mind in women with acute abdomen. Two cases are reported, one resembling perforated peptic ulcer, the other was mistaken for acute appendicitis.- - - - - - - - - - ranking = 5keywords = abdomen (Clic here for more details about this article) |
7/13. Transient neonatal pustular melanosis.A Mexican-American boy presented at birth with an extensive eruption consisting of 0.5 to 1.0 cm hyperpigmented macules with a distinct peripheral scale involving primarily the forearms, abdomen and lower back (Fig. 1). Rare intact vesicopustules were also identified. There was an unremarkable prenatal history, and the infant was a product of a normal vaginal delivery. With the exception of the skin lesions and moderate hepatosplenomegaly, the physical examination was normal. Gram stains of the pustules showed numerous neutrophils but no bacteria. Bacterial cultures, of the skin and blood, TORCH screen (toxoplasmosis, rubella, cytomegalic virus, and herpes virus) and a VDRL were negative. On the second day of life, the patient developed several pustules with surrounding erythema consistent with erythema toxicum neonatorum. Wright-stained smears of these lesions showed abundant eosinophils. Hepatosplenomegaly resolved by the third day of life and at the time of discharge only hyperpigmented macules persisted. Follow-up visit six weeks later showed no evidence of skin lesions.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
8/13. Occult purulent pericarditis detected by indium-111 leukocyte imaging.Leukocyte imaging with indium-111 is a relatively new technique which, to this point in time, has been discussed almost exclusively in the radiologic literature. Although this procedure has been used mainly to detect intra-abdominal infection, the thorax is routinely imaged along with the abdomen, and therefore detection of cardiac disease may be feasible. This case report is of a young woman after liver transplantation who developed occult purulent pericarditis initially detected by a leukocyte scan with indium-111. This case demonstrates that striking pericardial uptake on a whole-body indium-111 leukocyte scan can occur with purulent pericarditis, and it reemphasizes how insidiously purulent pericarditis may present in an immunosuppressed patient.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
9/13. Suppurative pylephlebitis and pylethrombosis: the role of anticoagulation.Suppurative thrombophlebitis of the portal vein resulting from inflammatory intra-abdominal conditions is a rare complication that may result in pylethrombosis and portal hypertension. A case is presented with documented pylethrombosis caused by diverticulitis. color flow Doppler scanning was used to establish the diagnosis. Systemic anticoagulation therapy was added to the antibiotic regimen because of postoperative propagation of the clot. Anticoagulation therapy prompted resolution of the episode. Long-term follow-up studies demonstrated recanalization of the portal vein. Anticoagulation should be instituted with documented acute pylethrombosis caused by inflammatory disease of the abdomen.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
10/13. Spontaneously perforated pyometra presenting as diffuse peritonitis: report of a case.We report herein a rare case of spontaneously perforated pyometra found in a 72-year-old woman who was admitted to our hospital with abdominal pain and vomiting. A distended abdomen with muscular rigidity, a positive Blumberg sign, and a WBC count of 11,900/mm3 indicated diffuse peritonitis, although a plain abdominal x-ray film revealed no free air in the peritoneal cavity. An emergency laparotomy was performed, which revealed a lot of pus, and perforation in the fundus of a distended uterus. The patient was therefore diagnosed as having suffered uterine perforation associating with a pyometra, and a total hysterectomy with bilateral salpingo-oophorectomy was carried out. Histological examination revealed a pyometra with inflammation and destruction of the endometrium and myometrium, and cervical occlusion with no evidence of malignancy. Postoperatively, the patient developed a subcutaneous abscess and pneumonia, but recovered and was discharged on the 74th day after her operation. Thus, although rare, spontaneously perforated pyometra should be considered when elderly women present with acute abdominal symptoms.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
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