11/42. Cryptorchid testicular tumour presenting with torsion.An undescended, cryptorchid testis is predisposed to 3 to 40 times risk of malignancy. Torsion of a cryptorchid testis is more difficult to diagnose than a normally placed testis. We present a case of a 25-year-old man with acute abdomen due to the torsion of an intra-abdominal testis. Subsequent histopathology of the testis revealed seminoma, making this single testis the seat for triple pathology. Orchidectomy was done followed by radiotherapy. A follow-up of upto nine months showed no recurrence or metastases.- - - - - - - - - - ranking = 1keywords = single (Clic here for more details about this article) |
12/42. Midgut volvulus in an adult patient.The authors report on a case of midgut volvulus in a 27-year-old man who presented with bilious vomiting and acute abdominal pain. US demonstrated a reversal of the normal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV). A clockwise whirlpool sign, diagnostic for midgut volvulus, was not visualised. In a further assessment, upper gastrointestinal series demonstrated obstruction in the second part of the duodenum highly suspicious of Ladd's bands. Malpositioning of bowel structures, as already suggested by the reversal of the SMA and SMV on ultrasound, and a distinctive whirl pattern due to the bowel wrapping around the SMA was demonstrated on CT. Furthermore angiography revealed focal twisting of the SMA. US is the first imaging modality to perform in suspicion of midgut volvulus. When inconclusive, CT is in our opinion the next stage in the diagnostic work-up.- - - - - - - - - - ranking = 1.099162281029keywords = artery (Clic here for more details about this article) |
13/42. Strangulated umbilical hernia including a mesenteric cyst: a rare cause of acute abdomen.Mesenteric cysts are rare intra-abdominal lesions. They are usually diagnosed as an incidental laparotomy finding in adults but in childhood, they may present with acute abdomen. In this report, a 72-year old female was referred to our hospital, suffering from acute abdominal pain, several episodes of nausea and vomiting. Clinical abdominal examination revealed an irreducible recurrent umbilical hernia. The patient had both muscular defense and abdominal tenderness. Plain abdominal radiography showed multiple air-fluid levels. With these findings, a diagnosis of acute abdominal pathology was accepted and an urgent laparotomy was performed. A 5-cm-diameter mesenteric cyst was excised from the mesentery of the proximal jejunum and a prosthetic mesh was placed for incisional hernia. This is the first report of a strangulated umbilical hernia complicated with a mesenteric cyst.- - - - - - - - - - ranking = 1148.0263605184keywords = umbilical (Clic here for more details about this article) |
14/42. A case of a ruptured pheochromocytoma with an intratumoral aneurysm managed by coil embolization.Although the spontaneous rupture of adrenal pheochromocytoma is rare, it can be lethal because it can induce serious changes in the circulation. We describe a 32 year old man with bilateral pheochromocyroma presenting as abdominal pain. In the emergency room, an abdominal MRI showed an aneurysmal vessel in the right adrenal mass and accompanying hemorrhage around the tumor capsule. The bleeding site was found by transfemoral abdominal angiography. Coil embolization was done in the bleeding vessels, specifically branches of the right adrenal artery. The hemorrhage was successfully controlled and vital signs of the patient were restored. Following emergency care, biochemical and imaging studies showed compatible findings of a bilateral adrenal pheochromocytoma. Postoperative histologic findings confirmed these observations. A ruptured pheochromocytoma should be considered as a cause of acute abdomen in cases of a concomitant adrenal mass. Intratumoral aneurysmal bleeding may be a cause of ruptured tumor, and careful angiographic intervention will help to ensure safe control of bleeding in such an emergency situation, even in cases of bilateral tumor.- - - - - - - - - - ranking = 1.099162281029keywords = artery (Clic here for more details about this article) |
15/42. Inguinal mass due to an external supravesical hernia and acute abdomen due to an internal supravesical hernia: a case report and review of the literature.Although supravesical hernias were described as early as 1804, there have been fewer than 100 cases reported in the literature. The supravesical fossa is a triangular area bounded laterally and above by median and medial umbilical ligaments, and below by the peritoneal reflection that passes from the anterior abdominal wall to the dome of the bladder. A hernia starting in this fossa usually protrudes through the abdominal wall as a direct inguinal hernia (external supravesical hernia). Less commonly, it remains within the abdomen, passing into spaces around the bladder (internal supravesical hernia). A 43-year-old mill worker presented with an enlarged painful mass in the left groin. He underwent a surgical repair of a direct inguinal hernia without addressing an unrecognized supravesicular component. Eight hours after his discharge next morning, he presented with acute abdomen, nausea, vomiting, and abdominal distention. The second surgery revealed the presence of a left lateral internal supravesical hernia with incarcerated small bowel. This was also repaired, and the patient was discharged in stable condition. This report aims to review and discuss the surgical anatomy of these rare supravesical hernias and calls attention to this type of hernia as an unusual cause of small bowel obstruction.- - - - - - - - - - ranking = 191.33772675306keywords = umbilical (Clic here for more details about this article) |
16/42. Abdominal apoplexy: a case study of the spontaneous rupture of the gastroepiploic artery.This is a case report of abdominal apoplexy (AA) or spontaneous rupture of a visceral vessel, without associated aneurysmal dilation of the vessel. Spontaneous rupture of the left gastroepiploic artery (LGEA) resulting in a hemoperitoneum is discussed. The clinical presentation of left lower quadrant abdominal pain, along with the histologic findings of medial degeneration of the LGEA, makes this case an unusual one. The incidence, origin, associated predisposing medical conditions, clinical presentation, and treatment of abdominal apoplexy are discussed.- - - - - - - - - - ranking = 5.4958114051449keywords = artery (Clic here for more details about this article) |
17/42. A penny for your thoughts: small bowel obstruction secondary to coin ingestion.We report a case of small bowel obstruction secondary to coin ingestion. A 22-year-old woman presented to the Emergency Department (ED) with a 3-week history of abdominal pain. Upon initial history the patient denied any foreign body ingestion. Only after computed tomography (CT) scanning of the abdomen and pelvis did the patient admit to deliberate ingestion of a single united states penny coin. During surgical evaluation it was found that the coin had lodged near the ileocecal valve and an inflammatory mass had formed around the intraluminal coin, causing a 10 x 7 cm fibrous tumor to completely obstruct the small bowel. It is thought that oxidation of the coin, with subsequent exposure of its high zinc content, instigated the inflammatory cascade.- - - - - - - - - - ranking = 1keywords = single (Clic here for more details about this article) |
18/42. Bilateral theca lutein cysts: a rare cause of acute abdomen in pregnancy.Theca lutein cysts (hyperreactio luteinalis) are benign cysts usually associated with molar pregnancy. We report a case of bilateral theca lutein cysts with normal intrauterine singleton pregnancy presenting as an acute abdomen requiring surgical intervention. laparotomy revealed bilateral theca lutein cysts one of which was torted, necessitating salpingo-ovariotomy.- - - - - - - - - - ranking = 1keywords = single (Clic here for more details about this article) |
19/42. Delayed rupture of the middle colic artery secondary to blunt abdominal trauma.The case of a 46-year-old man complaining of acute abdominal discomfort is presented. The patient fell 3 ft and injured his abdomen in the right upper quadrant four days before his emergency department visit. The complete workup revealed an acutely ruptured middle colic artery. The presenting symptoms, laboratory work, differential diagnosis, computed tomography scan, treatment, and follow-up are reviewed. This case is unusual in that delayed rupture of the middle colic artery secondary to blunt abdominal trauma had not been described previously.- - - - - - - - - - ranking = 6.5949736861739keywords = artery (Clic here for more details about this article) |
20/42. intestinal obstruction from a forgotten artery forceps: a case report.A 43-year-old multiparous patient p2 0 all alive who had abdominal hysterectomy secondary to ruptured uterus 2 1/2 years prior to presentation, was seen with acute (surgical) abdomen. An artery forceps was seen on plain abdominal X-ray and subsequent laparotomy revealed gangrenous ileum. The entire length of the ileum was involved, including the ileocecal valve and part of the cecum. The patient had limited right hemicolectomy and anastomosis of the distal part of the jejunum with the proximal section of the transverse colon. The post-operative period was uneventful and she was discharged to outpatient clinic 2 weeks post operatively.- - - - - - - - - - ranking = 5.4958114051449keywords = artery (Clic here for more details about this article) |
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