Cases reported "Neuroacanthocytosis"

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1/361. Old and new infarction of an epiploic appendage: ultrasound mimicry of appendicitis.

    Epiploic appendagitis is a self-limiting disease. Depending on its location, it may simulate nearly any acute abdominal condition. The ultrasound and computed tomographic (CT) features are characteristic, enabling ready diagnosis and thus preventing an unnecessary laparotomy. We describe a patient with acute abdominal pain in the right lower quadrant, in whom the combination of an old and fresh infarction of an epiploic appendage simulated appendicitis on ultrasound. Subsequent CT examination made the correct diagnosis.
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2/361. Fatal polyarteritis nodosa with massive mesenteric necrosis in a child.

    polyarteritis nodosa (PAN) is a rare vasculitic syndrome in childhood. There are few reported cases of ischaemic necrosis of the intestine and even fewer survivors in adults. We report the case of a 10-year-old boy with PAN and an acute abdomen that required operative intervention. Evidence was found of mesenteric arteritis with large ischaemic segments resulting in infarction and perforation.
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3/361. Acute abdominal pain and urgency to defecate in the young and the old: a useful symptom-complex?

    In the belief that "pattern recognition" is an important first step of the diagnostic process, we report our observation of an uncommon and heretofore poorly documented symptom-complex in 10 patients, and suggest that the constellation of abdominal pain and urgency to defecate in the acutely ill surgical patient should raise the diagnostic possibility of intra-abdominal bleeding. In our experience, this is statistically likely to be associated with a ruptured abdominal aortic aneurysm in the old and a ruptured ectopic pregnancy in the young.
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4/361. Acute abdomen as an atypical presentation of meningococcal septicaemia.

    The clinical manifestations and course of meningococcal disease have been well described, but atypical presentations may, if unrecognized, lead to a delay in treatment. We describe here an unusual case of this disease in a 21-y-old woman who presented with an acute rigid abdomen, clinical and laboratory features of sepsis, shock and early DIC with no indication of meningococcal infection. She developed a rapidly spreading purpuric rash, conjunctival haemorrhages, hypotension and tachycardia and a low urine output. Laboratory investigations showed a low platelet count, low haemoglobin and normal WBC. A presumptive diagnosis of meningococcal septicaemia was made and recovery followed treatment with cefotaxime, fluids and inotropes. A fully sensitive neisseria meningitis Group C, type 2a, subtype NT was isolated from blood cultures, but not from CSF obtained after antibiotic treatment.
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5/361. Disseminated cystic lymphangiomatosis presenting with acute abdomen: report of a case and review of the literature.

    lymphangioma is an uncommon tumor. Lymphangiomatosis, a benign tumor consisting of a cluster of dilated lymphatic channels, is very unusual. Most lymphangiomatoses are found in the neck and head area. Less than 5% are diagnosed intraabdominally and they are very infrequently encountered in the retroperitoneal area. Herein, we report a rare case of a 32 year-old woman who had disseminated intra-abdominal and retroperitoneal cystic lymphangiomatosis, which presented as acute abdomen. She received exploratory laparotomy due to the suspicion of malignancy, which was finally confirmed as cystic lymphangiomatosis. The clinical manifestations, imaging features, and management of this patient are discussed and compared with previous literature.
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6/361. Pyogenic liver abscess as a cause of acute upper abdominal pain. A report of two cases.

    The clinical course of 2 patients with acute abdominal pain, which was eventually found to be due to pyogenic hepatic abscesses is described. One patient, operated on late in the course, died; the other, who was operated on early, recovered. The importance of considering this life-threatening disease in the differential diagnosis of acute abdominal pain is emphasized.
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7/361. intussusception in infants: an emergency in diagnosis and treatment.

    intussusception is an important cause of intestinal obstruction and bowel necrosis in infants under 2 years. Most frequently the ileocaecal junction is involved. Various aetiologic factors, such as Meckel's diverticulum and lymphoid hyperplasia have been identified. Hydrostatic reduction of the intussusception should be attempted, but delay in diagnosis frequently leads to surgical intervention, because of failing reduction. We report a case of a 4-month-old boy whose ileocaecal junction was intussuscepted into the rectum, and therefore could be palpated by rectal examination. Unsuccessful hydrostatic reduction and bowel necrosis because of delay in diagnosis, made surgical intervention necessary. A terminal ileostomy was performed. A second case report considers a 10-month-old boy whose ileocaecal junction was intussuscepted into the colon sigmoideum. Because there was no delay in diagnosis, this intussusception could be reduced hydrostatically. The procedure however was difficult because of a dolichosigmoideum. Recent literature is also reviewed.
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8/361. Acute abdominal pain and eosinophilia, two cases of eosinophilic gastroenteritis.

    Two patients are presented who were admitted with acute abdominal pain for which they underwent laparotomy. No clear-cut diagnosis could be established during operation. Eventually, eosinophilic gastroenteritis was diagnosed and treated with corticosteroids. The heterogeneous presentation of eosinophilic gastroenteritis is discussed, ranging from mild non-specific gastrointestinal symptoms to an acute abdominal emergency prompting surgical intervention. The pathogenesis and treatment of eosinophilic gastroenteritis are discussed.
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9/361. 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.
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10/361. Seldom found acute abdomen: perforated diverticulum in the transverse colon.

    The authors report a recently examined rare case of isolated perforated diverticulum of the transverse colon. At surgery, a perforated omentum-sealed diverticulum was found in the third distal wall of the transverse colon. A diverticulectomy was performed. The postoperative course was excellent.
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