1/74. Spontaneous bladder rupture: rare cause of peritonitis.Spontaneous rupture of the urinary bladder is an uncommon, but important, cause of generalized peritonitis. It is a surgical emergency which may be rapidly fatal if diagnosis and treatment are delayed. Bladder disease or obstruction, coupled with a sudden increase in intra-abdominal pressure usually accounts for the rupture. Characteristic symptoms are acute lower abdominal pain followed by generalized peritonitis. In most cases, the rupture is intra-peritoneal.- - - - - - - - - - ranking = 1keywords = rupture (Clic here for more details about this article) |
2/74. Spontaneous splenic rupture due to subcutaneous heparin therapy.We report a case of spontaneous splenic rupture in a 59-year-old woman who was receiving 15,000 units of heparin subcutaneously (s.c. ) twice a day for deep venous thrombosis (DVT) prophylaxis. Her past medical history included multiple DVT, pulmonary emboli, and ovarian cancer stage III-C with known ascites. The diagnosis of splenic rupture was initially missed because of the ascites. This case illustrates both a previously undescribed complication of s.c. heparin therapy and a failure of ultrasound diagnosis. We emphasize the unique presentation, difficulty in diagnosis, and need for early surgical involvement to ensure the most favorable outcome.- - - - - - - - - - ranking = 0.85714285714286keywords = rupture (Clic here for more details about this article) |
3/74. Generalized peritonitis due to spontaneously perforated pyometra presenting as pneumoperitoneum: report of a case.We report a rare case of generalized peritonitis due to a ruptured pyometra in an 86-year-old woman, and also conduct a review of the previous Japanese literature. The patient presented with muscle guarding and rebound tenderness. Computed tomography (CT) disclosed a cystic mass in the peritoneal cavity, in which an air-fluid level was noted. pneumoperitoneum around the uterus due to gas production of anaerobic bacteria was noted on a CT. At laparotomy, the uterus was markedly enlarged with a necrotic area on the uterine fundus, which was found to be perforated. A supravaginal hysterectomy and drainage were performed. We found only eight cases of a ruptured pyometra presenting as pneumoperitoneum in the Japanese literature between 1977 and 1999. The most common cause of pneumoperitoneum is a perforation of the gastrointestinal tract. However, other possible causes, as seen in our patient, should also be taken into consideration. Although it is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.- - - - - - - - - - ranking = 0.28571428571429keywords = rupture (Clic here for more details about this article) |
4/74. Spontaneous rupture of choledochal cyst.choledochal cyst in an uncommon congenital anomaly with classic presentation triad of abdominal pain, jaundice and right upper abdominal mass. Presentation due to biliary peritonitis following cyst rupture is extremely rare. One such case which was successfully treated is being reported.- - - - - - - - - - ranking = 0.71428571428571keywords = rupture (Clic here for more details about this article) |
5/74. Sigmoid colon rupture secondary to Crede's method in a patient with spinal cord injury.Crede's method is a manual suprapubic pressure exerted with a clenched fist or fingers, used to initiate micturition, in patients with spinal cord injury (SCI) who have neurovesical dysfunction. It is usually a benign maneuver unassociated with any major complications. This paper will illustrate a case report involving a sigmoid colon rupture secondary to Crede's method in a patient with SCI. Various techniques of Crede's method are briefly described. It is recommended that patients with quadriplegia avoid forceful use of Crede's method, as it may cause contusion of the abdominal wall and injuries to internal viscera, possibly leading to colonic rupture. It is believed that this is the first reported case of such an unusual complication of Crede's method in patients with SCI.- - - - - - - - - - ranking = 0.85714285714286keywords = rupture (Clic here for more details about this article) |
6/74. Emergency stent-graft repair of a ruptured hepatic artery secondary to local postoperative peritonitis.PURPOSE: To describe the use of a stent-graft for emergent repair of life-threatening hepatic artery hemorrhage. methods AND RESULTS: A 57-year-old man with a 17-year history of myxoid liposarcoma underwent surgery for a recurrent abdominal mass. Multivisceral resection including a Kausch-Whipple procedure with an extended right hemicolectomy was performed. Three weeks later, an episode of gastrointestinal bleeding prompted surgical repair of the hepatic artery, which had been eroded by infection due to a leaking bilioenteric anastomosis. After 3 weeks of programmed abdominal lavage, bleeding recurred. angiography documented another rupture of the proximal hepatic artery. After an unsuccessful attempt at coil embolization, a Hemobahn stent-graft was implanted percutaneously during simultaneous cardiopulmonary resuscitation. hemostasis was secured, and the patient recovered. Over the 10-month follow-up, no bleeding or infection has been observed at the site of the repair, and flow through the hepatic artery endograft remains satisfactory. CONCLUSIONS: Percutaneous stent-graft placement can be employed for emergent treatment of visceral artery rupture in patients at high risk for conventional surgical repair.- - - - - - - - - - ranking = 0.85714285714286keywords = rupture (Clic here for more details about this article) |
7/74. Spontaneous uterine perforation of pyometra. A report of three cases.BACKGROUND: Spontaneous perforation of pyometra is a rare cause of generalized peritonitis; only 17 cases have been reported. CASES: Three cases of spontaneous perforation of pyometra occurred; two were associated with carcinoma of the cervix. All were treated with exploratory laparotomy and drainage. The first patient died of recurrent carcinoma of the cervix five months after laparotomy. The second patient died of septic shock shortly after the operation. The third patient made a good postoperative recovery. CONCLUSION: pyometra is a serious medical condition, because of both its association with malignant disease and the danger of spontaneous perforation, which carries significant morbidity and mortality. Although rare, ruptured pyometra should be considered in the differential diagnosis of acute abdomen in elderly women, especially those with malignant disorders of the genital tract. The treatment of pyometra rupture is immediate laparotomy, peritoneal lavage and drainage, or simple hysterectomy.- - - - - - - - - - ranking = 0.28571428571429keywords = rupture (Clic here for more details about this article) |
8/74. Acute complications of jejuno-ileal pseudodiverticulosis: surgical implications and management.Acute inflammatory complications of jejuno-ileal pseudodiverticulosis that necessitate surgical intervention are attended by excessive mortality rates of 20 to 40 per cent primarily because of delay in diagnosis. early diagnosis is confused by the frequent coexistence of other gastrointestinal pathology, most commonly perforated gastric or duodenal ulcers, colonic pseudodiverticulitis, and acute appendicitis with rupture. Resection of pseudodiverticula-containing segments with primary reanastomosis is the preferred method of surgical management for perforation, bleeding, and obstruction. Recommendations are made for more accurate and earlier detection and management.- - - - - - - - - - ranking = 0.14285714285714keywords = rupture (Clic here for more details about this article) |
9/74. peritonitis caused by a ruptured infected mesenteric cyst.Perforation of a mesenteric cyst is a very rare complication of a very unusual lesion. Acute presentation is the rule in half of all affected children. ultrasonography and computed tomography are the best preoperative diagnostic tools. The treatment of choice is an urgent laparotomy and complete cyst removal. Results are good in cases that are operated on in a timely manner.- - - - - - - - - - ranking = 0.57142857142857keywords = rupture (Clic here for more details about this article) |
10/74. A spontaneously ruptured gastric stromal tumor presenting as generalized peritonitis: report of a case.Among the diverse clinical presentations of gastrointestinal stromal tumor (GIST), spontaneous rupture with peritonitis is extremely rare. We report herein the unusual case of a 75-year-old man found to have a spontaneously ruptured gastric stromal tumor after presenting with generalized peritonitis. The patient was brought to the emergency department of our hospital by ambulance, with generalized severe abdominal pain. On examination, his abdomen was extensively distended with generalized severe rebound tenderness. Abdominal computed tomography scan showed a giant mass arising from the anterior gastric wall with an irregular internal low-density area and a small amount of ascites. An emergency laparotomy revealed a ruptured gastric tumor with dissemination of its necrotic tissue throughout the peritoneal cavity. The tumor was excised together with normal gastric tissue around its base. The tumor, which was 15 x 11 x 4.4cm in size, had a coarse laceration over its well-capsulated smooth serosal surface with massive necrosis and clotted blood inside. Immunohistochemical examination revealed positive reactivity to C-kit protein, which was consistent with the newly introduced diagnostic criteria of GIST. The patient had an uneventful postoperative course and remains well.- - - - - - - - - - ranking = 1keywords = rupture (Clic here for more details about this article) |
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