Cases reported "Pregnancy, Heterotopic"

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1/4. adult Wilms' tumor presenting as acute abdomen with elevated serum lactate dehydrogenase-4 and -5 isoenzymes: case report.

    Wilms' tumor, an embryonic neoplasm, is the most frequent renal tumor in childhood but is rare in adults. The prognosis of adult Wilms' tumor is worse than pediatric Wilms' tumor. The preoperative diagnosis of adult Wilms' tumor is extremely difficult to make because diagnostic imaging techniques, such as intravenous pyelography, computed tomography, ultrasound, renal angiography, and nuclear magnetic resonance imaging, only confirm the presence of a renal mass. diagnosis usually depends on histological characteristics, such as the presence of blastemic, epithelial, and mesenchymal components. A 27-year-old female presented with acute abdomen and with elevated serum lactate dehydrogenase (LDH) at 212 U/l (normal range: 47-140), and 2 of 5 LDH isoenzymes, namely LDH-4 at 13.6% (normal range: 6.8%-10.2%) and LDH-5 at 20% (normal range: 6.5%-9.7%). In this patient, stage I Wilms' tumor was managed by radical nephrectomy. The levels of LDH returned to its normal range. In conclusion, in cases of acute abdomen with a renal mass in young adults, the possibility of Wilms' tumor should be considered. serum LDH and its isoenzymes, LDH-4 and LDH-5, could be used as tumor markers for either differential diagnosis or monitoring the response of treatment.
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2/4. Nonrotation of the midgut presenting in the adolescent and adult.

    The most common abnormality of midgut rotation and fixation is nonrotation of the midgut. This most commonly presents in the neonatal period with duodenal obstruction or midgut volvulus. However, this condition can present outside the neonatal period as chronic abdominal pain, or as an abdominal emergency. Two such cases are reported. Normal and abnormal embryology is described, and diagnosis and management are discussed.
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3/4. Acute abdomen following dermoid cyst rupture during transvaginal ultrasonographically guided retrieval of oocytes.

    We report a case of acute abdomen due to puncture of a dermoid cyst during oocyte aspiration, which required laparotomy. A woman who had undergone an in-vitro fertilization and embryo transfer required hospitalization due to onset of an acute abdomen. An ultrasonographic scan showed a pelvic mass with the features of dermoid cyst. The patient required diagnostic laparotomy which confirmed the presence of a ruptured dermoid cyst with subsequent peritonitis.
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4/4. Spontaneous rupture of a vesicourachal diverticulum manifesting as acute abdominal pain.

    Urachal abnormalities are rare clinical entities. This article reports a case of a spontaneously ruptured vesicourachal diverticulum manifesting as acute abdominal pain in a healthy 38-year-old man. The embryology, clinical diagnosis, and management of urachal abnormalities are discussed. Emergency physicians should include this clinical entity in their differential diagnoses of patients who develop acute abdominal pain in the absence of trauma, especially when the pain immediately follows a maneuver that increases intra-abdominal pressure.
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