Cases reported "Acute Pain"

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1/26. Case report: portal vein thrombosis associated with hereditary protein c deficiency: a report of two cases.

    protein c deficiency is one of the causes of curable or preventable portal vein thrombosis. We report two patients of portal vein thrombosis associated with hereditary protein c deficiency. The first patient presented with continuous right upper quadrant pain and high fever. The abdominal sonography revealed normal liver parenchyma but portal vein and superior mesenteric vein thrombosis. Based on a 55% (normal 70-140%) plasma protein C level, he was diagnosed as having protein c deficiency. A trace of his family history showed that his elder brother also had protein c deficiency with a 50% plasma C level. Both patients received anticoagulant therapy. The younger brother showed good response. Unfortunately, the elder one suffered from recurrent episodes of variceal bleeding and received a life-saving splenectomy and devascularization. We herein remind clinicians that early screening and therapy are helpful in preventing late complications of protein c deficiency with portal vein thrombosis.
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keywords = thrombosis, vein thrombosis, vein
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2/26. Acute abdomen during adjuvant chemotherapy: superior mesenteric artery thrombosis associated with CMF chemotherapy.

    We report a case of superior mesenteric artery thrombosis in a 57-year-old woman undergoing chemotherapy for T1N1M0, breast cancer. Although cancer itself is associated with an increased risk of thrombotic events, treatment with chemotherapy and/or tamoxifen in breast cancer patients increases this risk. Most cases reported are of venous thromboembolism; arterial events are rare.
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ranking = 0.31329514162682
keywords = thrombosis
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3/26. Spontaneous rupture of a dissection of the left ovarian artery.

    A 53-year-old female was suddenly hospitalized with acute left lateral abdominal pain. There was no history of trauma to the abdomen. She had received no abdominal operation. X-ray showed a soft tissue shadow in the left flank which displaced the bowel shadows medially. Plain abdominal CT showed a left retroperitoneal hematoma. Dynamic abdominal CT showed an outflow of medium from a blood vessel in the hematoma. At laparotomy, the source of bleeding was found to be the left ovarian artery. The ovarian artery was dilated and meandered remarkably. The ovarian artery and vein were ligated proximally and left adenectomy was performed. The patient made an uneventful recovery. Histological examination suggested a spontaneous rupture of a dissection of the left ovarian artery.
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ranking = 0.0017428344455712
keywords = vein
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4/26. Portal venous air in an adult patient with obstructive small bowel volvulus.

    BACKGROUND: diagnosis of small bowel volvulus is frequently delayed often resulting in bowel ischaemia and infarction and impairing clinical outcome. Instant and correct diagnosis and subsequent adequate surgery may improve the outcome. methods: We describe a 19-year-old female with small bowel obstruction due to volvulus in whom the diagnosis was suspected based on the finding of air in the bowel wall and in the portal vein on a plain abdominal radiograph. CONCLUSIONS: air, present in the portal vein and bowel wall on a plain abdominal X-ray, suggests bowel ischaemia or necrosis and that the need for laparotomy is urgent.
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ranking = 0.0034856688911425
keywords = vein
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5/26. Midgut volvulus in an adult patient.

    The authors report on a case of midgut volvulus in a 27-year-old man who presented with bilious vomiting and acute abdominal pain. US demonstrated a reversal of the normal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV). A clockwise whirlpool sign, diagnostic for midgut volvulus, was not visualised. In a further assessment, upper gastrointestinal series demonstrated obstruction in the second part of the duodenum highly suspicious of Ladd's bands. Malpositioning of bowel structures, as already suggested by the reversal of the SMA and SMV on ultrasound, and a distinctive whirl pattern due to the bowel wrapping around the SMA was demonstrated on CT. Furthermore angiography revealed focal twisting of the SMA. US is the first imaging modality to perform in suspicion of midgut volvulus. When inconclusive, CT is in our opinion the next stage in the diagnostic work-up.
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ranking = 0.0017428344455712
keywords = vein
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6/26. Antiphospholipid antibodies and splenic thrombosis in a patient with idiopathic myelofibrosis (antiphospholipid antibodies and thrombosis).

    A case of idiopathic myelofibrosis and hepatosplenic myeloid metaplasia associated with antiphospholipids antibodies is described. The patient developed a lethal complete splenic vein thrombosis in spite of an intravenously heparin treatment had been started soon after a clinical pattern of "acute abdomen".
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ranking = 0.62605437229721
keywords = thrombosis, vein thrombosis, vein
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7/26. Conservative laparoscopic management of ovarian teratoma torsion in a young woman.

    Benign cystic tumors, specifically dermoid or mucinous cysts, are the most frequent causes of ovarian torsion. In clinical practice, adnexal torsion is usually subjected to adnexectomy to prevent embolism of thrombosed ovarian veins and its sequelae. However, this intervention is unsatisfactory for young women who want to preserve their fertility. In such situations, conservative management with untwisting of the adnexa, followed by cystectomy to preserve part of the ovary, would be a better option. In this report, we present a case of adnexal torsion due to cystic teratoma. A 25-year-old unmarried woman with lower abdominal pain and nausea was referred to our emergency room with suspicion of an ovarian mass. ultrasonography showed a left ovarian mass measuring 9.7 x 6.5 x 6.2 cm with heterogeneous components within it. laparoscopy showed an enlarged, dusky left ovary with torsion. Detorsion was performed and followed by cystectomy. The pathology revealed cystic teratoma of the ovary. We report this case to emphasize that untwisting of potentially viable adnexa, followed by cystectomy, in patients with adnexal torsion appears to be a safe procedure. This conservative approach should be encouraged in women of childbearing age to reduce the possibility of premenopausal loss of ovarian function.
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ranking = 0.0017428344455712
keywords = vein
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8/26. Computed tomography findings in fatal cases of enormous hepatic portal venous gas.

    AIM: To assess the computed tomography (CT) findings in the patients with hepatic portal venous gas (HPVG) who presented with a short fatal clinical course in our hospital in order to demonstrate if there was any sign for prediction. methods: Between January 1997 and December 2000, CT scan of the abdomen was performed on 949 patients with acute abdominal pain in our emergency department. Five patients were found having HPVG. The CT images and clinical presentations of all these five patients were reviewed. RESULTS: In reviewing the CT findings of the cases, HPVG in bilateral hepatic lobes, abnormal gas in the superior mesenteric veins, small bowel intramural gas, and bowel distension were observed in all patients. Dry gas in multiple branches of the mesenteric vein was also revealed in all cases. All the patients expired due to irreversible septic shock within 48 h after their initial clinical presentation in emergency room. Two patients had acute pancreatitis with grade D and E Balthazar classification and they expired within 24 h due to progressing septic shock under aggressive medical treatment and life support. Two patients with underlying end stage renal disease expired within 48 h even though emergent surgical intervention was undertaken. The excited bowels revealed severe ischemic change. One patient expired only a few hours after the CT examination. CONCLUSION: HPVG is a diagnostic clue in patients with acute abdominal conditions, and CT is the most specific diagnostic tool for its evaluation. The dry mesenteric veins are the suggestive fatal sign, especially for the deteriorating patients, with the direct effect on gastrointestinal perfusion.
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ranking = 0.0052285033367137
keywords = vein
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9/26. infarction of an accessory spleen presenting as acute abdomen in a neonate.

    An accessory spleen is a relatively common condition, but the torsion thereof is extremely rare, with only nine pediatric cases reported in the literature. This paper describes a case of an accessory spleen that was found to be necrotic during an emergency laparotomy in a 14-day-old female infant with signs of acute abdomen. To our knowledge, this is the youngest reported patient. The etiology of the necrosis was thrombosis of its trophic vessels, secondary to its pedicle torsion. The literature is also reviewed.
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ranking = 0.062659028325363
keywords = thrombosis
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10/26. A rare case of splenic infarct presenting with acute abdominal pain due to polyarteritis nodosa: case report and review of the literature.

    A 44 year-old man presented to the Emergency Department of American Hospital with severe pain persisting in the left upper quadrant for several hours. A computed tomographic scanning (CT scan) and celiac digital substraction angiography (DSA) of the abdomen demonstrated a splenic infarct. Histopathological examinations showed diffuse acute vasculitis, thrombosis, panvasculitis which led us to diagnose the case as "polyarteritis nodosa". The diagnosis is usually difficult to establish and it is usually delayed due to variable clinical manifestations dependent on the site and the extent of arterial involvement.
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ranking = 0.062659028325363
keywords = thrombosis
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