1/67. Acute abdominal pain as a leading symptom for Degos' disease (malignant atrophic papulosis).We report a case of a 16-yr-old white female patient with acute abdominal pain due to visceral involvement of Degos' disease that required extensive small bowel resection. skin manifestations of her disease had been present for 2 yr before the correct diagnosis. She died as a result of central nervous system involvement from Degos' disease.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
2/67. Primary repair of cornual rupture occurring at 21 weeks gestation and successful pregnancy outcome.The successful delivery in a 31 year old woman at 33 weeks gestation is reported, after repair to a cornual rupture which occurred at 21 weeks gestation. The patient exhibited acute abdominal pain and pending shock. Emergency laparotomy showed a cornual rupture and an intrauterine vital fetus having intact amnion membrane. On the patient's family's insistence, primary repair for a cornual rupture was performed and preservation of the fetus attempted. Postoperatively, tocolytic agent with ritodrine hydrochloride was administered and close follow-up of the patient was uneventful. The patient had a smooth obstetric course until 33 weeks gestation when premature rupture of the membranes occurred, soon followed by the onset of labour. She underwent an elective Caesarean section and delivered a normal male fetus weighing 2140 g with Apgar scores at 1, 5 and 10 min of 6, 8, and 9 respectively. Because of this successful outcome, we suggest that primary repair for such an unusual patient should be accepted.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
3/67. Inflammatory (pseudosarcomatous) myofibroblastic tumor of the urinary bladder causing acute abdominal pain.Inflammatory myofibroblastic tumor is a reactive proliferation of myofibroblasts that rarely involves the urinary bladder. The cause of inflammatory myofibroblastic tumor is unknown but may represent an initial reactive process to an infectious agent or trauma that transforms into neoplastic growth. Cases reported in children, however, often lack any preexisting bladder pathology. The authors present a case in a young child that presented as acute abdominal pain. In general, these tumors follow a benign clinical course after resection, although close monitoring is essential given the rarity of this bladder lesion.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
4/67. Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: report of case.Idiopathic or spontaneous segmental infarction of the greater omentum (ISIGO) is a rare cause of acute right-sided abdominal pain. The symptoms simulate acute appendicitis in 66% of cases and cholecystitis in 22%. Progressive peritonitis usually dictates laparotomy, and an accurate diagnosis is rarely made before surgery. The etiology of the hemorrhagic necrosis is unknown, but predisposing factors such as anatomic variations in the blood supply to the right free omental end, obesity, trauma, overeating, coughing, and a sudden change in position may play a role in the pathogenesis. We present herein the case of a 37-year-old man in whom ISIGO, precipitated by obesity and overeating, was successfully diagnosed and treated by laparoscopy. Resection of the necrotic part of the greater omentum is the therapy of choice, and ensures fast recovery and pain control. Serohemorrhagic ascites is a common finding in ISIGO, and careful exploration of the whole abdominal cavity should be performed. The laparoscopic approach allows both exploration and surgical intervention.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
5/67. Acute abdomen with colonic necrosis induced by Kayexalate-sorbitol.Colonic necrosis is an unusual complication after treatment of hyperkalemia with sodium polystyrene sulfonate (SPS, Kayexalate) in sorbitol. To increase awareness of this complication, we report a case of necrosis of the transverse colon in a patient given oral and rectal SPS-sorbitol for hyperkalemia. Colonic necrosis was manifested as an acute abdomen within 24 hours of initial administration. Prompt surgical resection of the necrotic transverse colon permitted rapid recovery of bowel function. Although SPS crystals are seen microscopically in the necrotic bowel, experimental evidence implicates the sorbitol component of the SPS-sorbitol in the pathogenesis of colonic necrosis. A high index of suspicion for the unusual complication of colonic necrosis after oral or rectal administration of SPS-sorbitol may allow prompt recognition and surgical cure.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
6/67. Intramural haemorrhage of the colon.Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a 69-year-old Caucasian woman with a haemorrhage in the colonic splenic flexure and descending colon. Both had a one-stage resection with anastomosis. The child survived; the woman died two days after the operation. The preoperative diagnosis of bleeding colonic lesions remains difficult especially when facilities for investigation are scarce. It is re-emphasized that in patients with acute abdomen it is not necessary to insist on accurate preoperative diagnosis before offering appropriate treatment.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
7/67. Perforation of acute calculous Meckel's diverticulitis: a rare cause of acute abdomen in elderly.Complications of the Meckel's diverticula are well-known and defined. However, acute inflammation and perforation secondary to a calculus is a rare clinical presentation. A case of acute calculous Meckel's diverticulitis with perforation in a 58-year old man is presented and possible pathological conditions are discussed. Location of the perforation, apical microscopic focal ulcers, and ischaemic changes in the diverticulum remind the pathogenesis comparable to that of acute calculous cholecystitis. This case report with major complications related to Meckel's diverticulum strengthens the concept of prophylactic resection of Meckel's diverticulum in adults, incidentally discovered at laparotomy.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
8/67. A new etiology of acute abdominal emergencies in cirrhotic patient: secondary pneumococcal peritonitis with jejunitis.We report the first case of secondary pneumococcal peritonitis associated with acute jejunitis in a 52-year-old homeless child-Pugh C cirrhotic man without ascitis. The patient was admitted with clinical signs of peritonitis, and jaundice. Morphologic examination was unremarkable. A laparotomy revealed a diffuse peritonitis, and an acute jejunitis with prenecrotic lesion. The lesion was located within the first centimeters of the jejunum, immediately after the duodeno-jejunal angle, extented on 15 cm. A resection of the first 15 cm of the jejunum was performed with duodeno-jejunal side-to-side manual anastomosis. Gram-stain and cultures of blood, peritoneal pus, and jejunal mucosa revealed a penicillin-sensitive streptococcus pneumoniae. Appropriate parenteral antibiotic treatment was initiated (aminopenicillin). The postoperative course was marked by a transient hepatic failure associated with an ascitis controlled by diuretics. The patient was discharged on the 26th day after surgery. This case reports a new etiology of acute abdominal emergencies in cirrhotic patients.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
9/67. ganglioneuroma of small intestine presenting with perforation peritonitis.We report a 42-year-old man with benign solitary small intestinal ganglioneuroma presenting with perforation peritonitis. The patient had no evidence of MEN IIB syndrome. Simple segmental resection was done; the patient is well on follow up one year later.- - - - - - - - - - ranking = 1keywords = section (Clic here for more details about this article) |
10/67. intestinal obstruction caused by an ectopic fallopian tube in a child: case report and literature review.The authors present the case of a prepubertal 14-year-old girl who was admitted for an acute abdominal pain, fever, and vomiting. She was in a poor general state, having recently suffered a weight loss of 5 kg. A plain abdominal x-ray disclosed signs of mechanical ileus. An abdominal ultrasound scan showed a normal uterus, a normal right-sided ovary, but no left ovary. An emergency laparoscopy found a normal uterus with complete absence of the left ovary and salpinx, the upper left dome of the uterus being smooth with no visible horn. The right ovary and salpinx were normal. intestinal obstruction was caused by a strangulating cordlike structure of unclear origin. After converting to a laparotomy, we found an abnormal fallopian tube inserted in the left parieto-colic groove. The tube extended next on the lateral sigmoid mesentery and wrapped itself around the ileum, provoking a local strangulation and an ischemic covered bowel perforation. The bowel perforation was treated by a segmental bowel resection. Careful dissection of the cordlike structure disclosed a true rudimentary fallopian tube with hypotrophic fimbriae and a small distal round structure containing ovarian tissue. These structures were removed entirely. A review of the literature on this rare situation is presented and discussed.- - - - - - - - - - ranking = 2keywords = section (Clic here for more details about this article) |
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