Cases reported "Asymptomatic Diseases"

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1/3. Appendiceal diverticulitis in a youth.

    Appendiceal diverticulitis as the etiology of right lower quadrant pain is an uncommon entity in younger populations. The incidence is <1 per cent among patients under 30 years of age undergoing appendectomy. Herein, we present a case of a 17-year-old male with perforated appendiceal diverticulitis. The history, physical findings, diagnosis, and treatment are outlined. Additionally the literature concerning appendiceal diverticulitis is reviewed.
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2/3. Agnogenic venous mesenteric thrombosis.

    One of the most difficult diagnoses to establish is that of agnogenic venous mesenteric thrombosis (AVMT). This disorder occurs chiefly in elderly patients and, unless diagnosed promptly, leads to death in most instances. AVMT may follow surgical operations or occur during a prolonged illness. In the past five years at St. Clare's Hospital and health Center in new york city, this diagnosis was established in five patients. In reviewing these cases, it was noted that some of the signs and symptoms such as those due to hypotension and shock with marked leukocytosis, were out of proportion to those usually observed when the preoperative diagnosis is being considered. The pathologic and radiologic characteristics of this disorder are outlined, and the recommended operative procedure for treatment is discussed. The importance is stressed of prompt, vigorous and prolonged anticoagulation therapy in order to minimize the chance of recurrence in the early postoperative period. Anticoagulant therapy is also effective preoperatively, if the disease is diagnosed sufficiently early. As greater numbers of elderly patients are being treated in hospitals, this dire complication should be uppermost in the minds of physicians and surgeons if a fatal outcome is to be avoided following a successful operative procedure.
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3/3. A case presentation and review of neutropenic enterocolitis.

    Neutropenic enterocolitis (NE) is an unusual complication of neutropenia. Its presentation is dramatic, treatment is controversial, and the outcome may be devastating. The available literature about this entity is mainly case reports and autopsy studies. We have recently performed a celiotomy on a patient who developed sepsis and an acute surgical abdomen three days following chemotherapy and radiotherapy for a metastatic adenocarcinoma with no known primary tumor. At surgery he was found to have a boggy right and recto-sigmoid colon with a grossly normal transverse colon. Intraoperative colonoscopy revealed mucosal ulceration and necrosis extending from the dentate line to the cecum. A total abdominal colectomy, closure of the rectal stump, and an ileostomy was performed. Postoperatively, the patient recovered from the abdominal septic process only to succumb to multiple system organ failure secondary to pulmonary sepsis. Upon review of the literature, we found 65 cases of NE that were suspected or diagnosed in the antemortem state and confirmed at surgery or autopsy. In this review, we intend to analyze these case reports, summarize the salient features of the disease and outline the optimal therapeutic approach.
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