Cases reported "Acute Kidney Injury"

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1/9. Acute abdomen and lupus enteritis: thrombocytopenia and pneumatosis intestinalis as indicators for surgery.

    Bowel symptoms occur often in systemic lupus erythematosus (SLE), but enteric complications in patients on steroid therapy are rare. We report a case of a 14-year-old Mexican girl with SLE on high-dose steroid therapy complicated by abdominal vasculitis and small bowel perforation. Accompanying this serious complication were thrombocytopenia and radiographic changes of pneumatosis intestinalis. These findings suggested necrotizing enteritis and prompted urgent surgery. Four jejunal perforations, pneumatosis intestinalis, and submucosal vasculitis were present in the resected specimen. Persistent SLE activity responded to cyclophosphamide, which is indicated in patients with digestive symptoms who fail to respond to high-dose steroids.
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2/9. Emphysematous pyelitis presenting as an acute abdomen in an end-stage renal disease patient treated with peritoneal dialysis.

    Emphysematous pyelitis is air in the renal collecting system in patients with urinary tract infections. This entity is uncommon and seen primarily in patients with diabetes mellitus. We report a case of a patient with end-stage renal disease treated with peritoneal dialysis who developed emphysematous pyelitis who presented with signs and symptoms that were more consistent with appendicitis. The spectrum of infections causing air in the urinary tract and the method by which end-stage renal disease patients are treated are discussed. patients receiving dextrose peritoneal dialysis are at risk for emphysematous pyelonephritis, pyelitis, and cystitis.
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keywords = pyelonephritis
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3/9. shigella flexneri bacteremia in a child.

    We report an unusual and lethal case of shigella flexneri septicemia in an 8-year-old Saudi handicapped child from a social home presenting with severe toxic megacolon and acute abdomen secondary to fulminant necrotizing enterocolitis.
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4/9. Severe acute necrotizing pancreatitis associated with lipoprotein lipase deficiency in childhood.

    An 11-year-old girl with lipoprotein lipase deficiency experienced recurring episodes of abdominal pain. She initially underwent appendectomy for suspected appendicitis; however, the appendix was normal. pancreatitis was subsequently identified as the cause of her pain.
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keywords = necrotizing
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5/9. Visceral larva migrans presenting as acute abdomen in a child.

    An unusual presentation of visceral larva migrans observed in a patient is reported. A 5-year-old boy suffering fever, abdominal pain, tenderness, and rigidity in the right lower and upper quadrant of the abdomen was operated on, with the false diagnosis of acute abdomen, and exploratory surgery was carried out. The pathological examination of the liver biopsy revealed eosinophil-rich necrotizing granulomatous inflammation with toxocara spp larva. The diagnosis was also confirmed by serologic results. Clinicians should remember that toxocaral visceral larva migrans may rarely mimic an acute abdomen and cause unnecessary operations.
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6/9. polyarteritis nodosa. An unusual cause of acute abdomen.

    Two cases of acute abdomen operated on twice and biopsy specimens confirmed are presented. The diagnosis of a systemic necrotizing vasculitis group of polyarteritis nodosa was established. The syndrome affects predominantly males between the second and forth decade of life. The gastrointestinal tract is involved in approximately 50% of the cases. While a negative laparotomy may be considered as a surgical pit-fall, nevertheless, it is the only way of establishing the diagnosis and treating the complications of the disease in some of the cases.
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7/9. Localized eosinophilic gastroenteritis with necrotizing granulomas presenting as acute abdomen.

    Eosinophilic gastroenteritis is a condition of unknown aetiology that has been frequently reported involving the stomach and bowel. The colon is rarely cited as a site for the condition. We report a patient suffering from allergic symptoms (asthma, atopic dermatitis, elevated serum IgE levels) who presented with colonic perforation due to eosinophilic colitis with necrotizing granulomas.
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8/9. Combination of "patch, drain, and wait" and home total parenteral nutrition for midgut volvulus with massive ischemia/necrosis.

    The successful use of a combination of "patch, drain, and wait" (PDW) and home total parenteral nutrition (TPN) in the management of a case of acute, catastrophic midgut volvulus in a 2-year-11-month-old boy with near-total ischemia/necrosis of his small intestine is reported. The PDW approach to the highly effective management of acute midgut ischemia/necrosis in infancy and childhood (necrotizing enterocolitis and midgut volvulus) involves maximum gut salvage by avoidance of resection, stoma formation, or both through the use of extensive peritoneal cavity drainage by Penrose drains, TPN, and broad-spectrum antibiotics. The extensive peritoneal drainage fosters capture of enteric fistulas with the formation of enterostomies at drain exit sites, while adhesions and ischemia/inflammation-induced hypervascular obliteration of the peritoneal cavity diminish the potential for peritonitis (no peritoneal cavity, no peritonitis) and facilitate impressive salvage of seemingly hopelessly lost ischemic/necrotic gut (a simulation of the in utero ischemic gut process leading to atresias and some varying, but generally mild, gut loss) while simultaneously contributing to the resorption of absolutely non-salvageable gut and the creation of a remarkably clean and adhesion-free peritoneal cavity resembling that of a newborn infant with midgut intestinal atresia.
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9/9. Necrotizing myofasciitis: an atypical cause of "acute abdomen" in an immunocompromised child.

    We report the case of an immunocompromised 15-year-old boy who presented with symptoms mimicking an "acute abdomen" related to necrotizing myofasciitis of the anterior abdominal wall. CT demonstrated the abdominal wall process as the cause of the patient's symptoms and sonographically guided aspiration confirmed the diagnosis. Despite prompt diagnosis and aggressive surgical debridement, the infection continued to progress and the patient died within 24 h of presentation.
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