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Elderly abdominal pain

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https://www.readbyqxmd.com/read/29201469/perforated-duodenal-diverticulum-with-subtle-pneumoretroperitoneum-on-abdominal-x-ray
#1
Yuzeng Shen, Mark Kwok Fai Leong
Abdominal pain is one of the most common presenting complaints at the Emergency Department (ED). Given the myriad of possible differential diagnoses for abdominal pain, it becomes more important to diagnose conditions requiring emergent surgical intervention early. We present a case of an elderly male patient with abdominal pain secondary to perforated hollow viscus, subtle evidence of pneumoretroperitoneum on the initial supine abdominal X-ray, and review the signs of pneumoperitoneum and pneumoretroperitoneum on plain abdominal X-rays...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29194065/delayed-respiratory-depression-secondary-to-opioid-overdose-after-multimodal-analgesia-with-transversus-abdominis-plane-blocks-in-postanesthesia-care-unit-a-case-report
#2
Michael O'Rourke, Emily S Schmidt, Jonathan E Metry, Michael B Majewski
Pain control after open abdominal surgery often includes multimodal analgesia with thoracic epidural or transversus abdominis plane (TAP) block. After liposomal bupivacaine was approved for TAP blocks in 2015, it became an alternative to indwelling catheters. However, the pharmacokinetics and safety of its use during the perioperative period have not been thoroughly investigated, especially in conjunction with parenteral opioids. We present a case report of an elderly patient having urgent laparoscopic converted to open abdominal surgery, who experienced postoperative respiratory depression in the recovery room after multimodal therapy with liposomal bupivacaine TAP blocks, intravenous (IV) opioids, and ketorolac...
November 30, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29184050/a-rare-case-of-bochdalek-hernia-with-concomitant-para-esophageal-hernia-repaired-laparoscopically-in-an-octogenarian
#3
Sergio Susmallian, Asnat Raziel
BACKGROUND A Bochdalek hernia (BH) is a rare congenital condition consisting of a posterolateral defect in the diaphragm. A para-esophageal hernia (PEH) is a rare variant of hiatus hernia. BH and PEH may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The occurrence of BH with concomitant PEH is a very rare event. We describe a case of an octogenarian patient with BH and concomitant PEH treated laparoscopically...
November 29, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29176541/diffuse-peritoneal-and-bowel-wall-infiltration-by-light-chain-al-amyloidosis-with-omental-calcification-mimicking-abdominal-carcinomatosis-an-elderly-female-with-incidental-finding-of-light-chain-monoclonal-gammopathy-of-undetermined-significance-lc-mgus
#4
Shoaib Junejo, Yasir Ali, Sandeep Singh Lubana, Sandeep S Tuli
BACKGROUND Amyloidosis is the extracellular tissue deposition of plasma proteins, which after conformational changes, forms antiparallel beta pleated sheets of fibrils. Amyloid light-chain (AL) is a type of amyloidosis that is due to deposition of proteins derived from immunoglobulin (Ig) light chains. Gastrointestinal tract (GIT) involvement most often found in amyloid A (AA) amyloidosis type. There have been no reports of obstructive GIT AL amyloid patients having monoclonal gammopathy of undetermined significance (MGUS)...
November 25, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29161796/-small-bowel-perforation-caused-by-press-through-package
#5
Jung Seok Kim, Jae Myung Cha, Min Seob Kwak, Jin Young Yoon, Jung Won Jeon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Hye Young Kim
With an increased use of the press-through package (PTP) tablet, there has also been an increase in mis-swallowing cases, especially in elderly patients. We report a rare case of PTP-induced small bowel perforation and fistula formation with adjacent small bowel in a healthy elderly patient, who experienced persistent abdominal pain of unknown cause. A 62-year-old healthy man was admitted to our hospital with left abdominal pain that started one month ago. Neither abdominal tenderness nor rebound tenderness was present on physical examination...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29157471/case-reports-on-integrated-management-of-tubercular-disease
#6
Kusum S Chand, Priya Kapoor
BACKGROUND: Host immunity plays an important role in prevention of disease as is evident by the increased incidence of Tuberculosis (TB) in immuno-compromised population of HIV infected, diabetes inflicted, immune-suppressant therapy and elderly people. Rising incidence of antibiotic resistance has led to resurgence of TB of epidemic proportions. Integrated treatment with add on homeopathy in addition to anti-tuberculosis treatment (ATT) appears to improve outcome in TB. The intervention has been integrated treatment with homeopathy regime, which is using a patient specific, disease specific and supportive medicine simultaneously, all individualized for the patient and the disease...
November 2017: Homeopathy: the Journal of the Faculty of Homeopathy
https://www.readbyqxmd.com/read/29147478/abdominal-pain-with-a-twist-a-rare-presentation-of-acute-gastric-volvulus
#7
David P Chen, Saqib Walayat, Imran L Balouch, Daniel K Martin, Teresa J Lynch
Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29134518/erector-spinae-plane-block-for-the-management-of-chronic-shoulder-pain-a-case-report
#8
Mauricio Forero, Manikandan Rajarathinam, Sanjib Das Adhikary, Ki Jinn Chin
PURPOSE: The erector spinae plane (ESP) block has been described in the successful management of both thoracic and abdominal pain. Since the erector spinae muscle extends to the cervical spine, the ESP block may be potentially useful in painful conditions of the shoulder girdle. CLINICAL FEATURES: We performed a series of ESP blocks at the T2/T3 level in an elderly male patient with chronic shoulder pain. Immediate and profound analgesia with improved range of motion was consistently observed following the block...
November 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29123864/right-sided-bochdalek-hernia-in-an-elderly-patient-a-case-review-of-adult-bochdalek-hernias-from-1982-to-2015-in-japan
#9
Yasuhiro Ohtsuka, Tiberiu H Suzuki
Case: An 89-year-old woman was admitted to our hospital because of dyspnea following abdominal pain and vomiting. According to chest computed tomography findings, a diagnosis of acute respiratory failure due to right-sided Bochdalek hernia was made. Outcome: Emergency laparotomy revealed that a bowel loop from the terminal ileum to the transverse colon had herniated into the right thoracic cavity through the foramen of Bochdalek. The herniated organs were reduced to the abdominal cavity and the foramen was repaired by direct suturing...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29075132/urinary-protein-profiles-in-ketorolac-associated-acute-kidney-injury-in-patients-undergoing-orthopedic-day-surgery
#10
Filippo Mariano, Chiara Cogno, Fulvia Giaretta, Ilaria Deambrosis, Simona Pozza, Maurizio Berardino, Giuseppe Massazza, Luigi Biancone
BACKGROUND: Parenteral administration of ketorolac is very effective in controlling postoperative pain for orthopedic surgery. Ketorolac can induce clinically relevant renal alterations in elderly patients, whereas its short course is considered safe for young adults with normal preoperative renal function. In this study, of a cohort of young adults undergoing elective orthopedic day surgery, we sought cases complicated by readmission due to acute kidney injury (AKI). PATIENTS AND METHODS: Among 1397 young adults, aged 18-32 years who were admitted to undergo orthopedic day surgery from 2013 to 2015, four patients (0...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29063057/clinical-epidemiological-survey-of-gallbladder-carcinoma-in-northwestern-china-2009-2013-2379-cases-in-17-centers
#11
Hao-Xin Shen, Hu-Wei Song, Xin-Jian Xu, Zuo-Yi Jiao, Zhen-Yu Ti, Zhao-Yu Li, Bin Ren, Chen Chen, Li Ma, Ya-Ling Zhao, Guan-Jun Zhang, Jian-Cang Ma, Xi-Lin Geng, Xiao-Di Zhang, Jing-Sen Shi, Lin Wang, Zhi-Min Geng
OBJECTIVE: To analyze the clinical epidemiological characteristics of patients with gallbladder carcinoma recruited from 17 hospitals in five northwestern provinces of China (Shaanxi Province, Gansu Province, Qinghai Province, Ningxia Hui Autonomous Region, and Xinjiang Uygur Autonomous Region) from 2009 to 2013, and to summarize the clinical diagnosis and treatment data of gallbladder carcinoma. METHODS: Clinical information of 2379 patients with gallbladder carcinoma from 17 hospitals in five northwestern provinces of China was retrospectively collected and analyzed using the "Questionnaire for Gallbladder Carcinoma Patients in Northwestern Area of China...
March 25, 2017: Chronic diseases and translational medicine
https://www.readbyqxmd.com/read/29062389/use-of-peg-asparaginase-in-monomorphic-epitheliotropic-intestinal-t-cell-lymphoma-a-disease-with-diagnostic-and-therapeutic-challenges
#12
Cesar Gentille, Qian Qin, Andreia Barbieri, Pingali Sai Ravi, Swaminathan Iyer
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), previously known as enteropathy associated T-cell lymphoma (EATL) type II, is a rare haematological malignancy with a difficult and delayed diagnosis. Symptoms can include abdominal pain, weight loss, and chronic diarrhoea. However, most patients are only diagnosed after complications, such as perforation or obstruction, have developed. There is no standard treatment for MEITL; most accepted regimens consist of surgical resection and anthracycline-based chemotherapy...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/29045981/renal-ewing-s-sarcoma-primitive-neuroectodermal-tumor-a-case-report-and-literature-review
#13
C Liu, L G Cui, H L Wang
Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET) in the kidney is a rare but high-grade malignant tumor that affects predominantly elder children and adolescents. Patients mostly present with nonspecific symptoms such as abdominal pain and gross hematuria. Since EWS/PNET has a rapid clinical progression with early metastasis and death, it is essential to make an accurate and early diagnosis. Once diagnosed, multimodality treatment, including radical surgery combined with adjuvant chemotherapy, and radiotherapy if necessary, is recommended...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29033764/non-meckel-small-intestine-diverticulitis
#14
Shamim Ejaz, Raghu Vikram, John R Stroehlein
Non-Meckel small intestine diverticulitis can have many manifestations and its management is not well-defined. We report 4 unselect cases of small intestine diverticulitis; all patients were seen by the same physician at the Emergency Center at The University of Texas MD Anderson Cancer Center between 1999 and 2014. The median age at diagnosis of these patients was 82 years (range, 76-87 years). All 4 patients presented with acute onset of abdominal pain, and computed tomography scans showed characteristics of small intestine diverticulitis unrelated to cancer...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29030793/right-sided-bochdalek-hernia-in-an-elderly-adult-a-case-report-with-a-review-of-surgical-management
#15
Kazuki Moro, Mikako Kawahara, Yusuke Muneoka, Yu Sato, Chie Kitami, Shigeto Makino, Atsushi Nishimura, Yasuyuki Kawachi, Emmanuel Gabriel, Keiya Nikkuni
BACKGROUND: Bochdalek hernias are one of the most common types of diaphragmatic hernia, with most cases diagnosed during the neonatal period. In contrast, diagnosis of a Bochdalek hernia in an adult is rare and is typically observed on the left side of the diaphragm. Even more rare is the diagnosis of a right-sided Bochdalek hernia in an adult, where there is concurrent visceral malformation in most cases. CASE PRESENTATION: We describe a case of an 89-year-old female who presented with abdominal pain...
October 13, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29018646/hernia-of-morgagni-in-the-elderly-a-case-report
#16
Tushar Patial, Sunil Negi, Vikrant Thakur
Congenital diaphragmatic hernias are infrequently encountered in adult patients. A rare type of this hernia is the Morgagni's hernia. Although they remain asymptomatic in a majority of patients, we present the case of an elderly patient who presented to us with abdominal pain and upper gastrointestinal bleeding.
August 8, 2017: Curēus
https://www.readbyqxmd.com/read/29018146/anca-and-iga-glomerulonephritis-all-in-one-prognosis-and-complications
#17
Pitchaphon Nissaisorakarn, Vivette D'Agati, Kisra Anis, Belinda Jim
We present the case of a 75-year-old Hispanic woman with known stage 3 chronic kidney disease, long-standing hypertension and type 2 diabetes mellitus who presented with right-sided abdominal pain and acute kidney injury, nephrotic range proteinuria with positive antimyeloperoxidase antibody. A renal biopsy revealed IgA nephropathy with superimposed pauci-immune antineutrophilic cytoplasmic antibody (ANCA)-associated crescentic glomerulonephritis. The patient was treated with pulse intravenous methylprednisolone, cyclophosphamide and plasmapheresis...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28988188/enterobius-vermicularis-pinworm-infestation-in-a-child-presenting-with-symptoms-of-acute-appendicitis-a-wriggly-tale
#18
Louise Dunphy, Zoe Clark, Mazhar H Raja
Acute appendicitis is the most common surgical emergency worldwide. However, it can still present a challenging diagnosis especially in the young, elderly and those individuals of reproductive age, thus encompassing a wide spectrum of varied clinical presentations. Parasitic infections of the appendix are a rare cause of acute appendicitis. However, they must be considered in children presenting with abdominal pain. We report a case of Enterobius vermicularis infestation mimicking the features of acute appendicitis in a 10-year-old girl...
October 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28988021/two-concurrent-appendiceal-neoplasms-in-an-elderly-patient-a-case-report
#19
Riva Das, Joshua P Cantor, Thai Q Vu
INTRODUCTION: Acute appendicitis, one of the commonest surgical diagnoses, is rare and more complex presentation in the elderly. Physicians must consider atypical causes appendicitis in this population, which could affect the management of the patient. PRESENTATION OF CASE: An elderly female presented with a two-day history of lower abdominal pain, associated with low-grade fevers and chills. Studies showed leukocytosis and computed tomography (CT) findings consistent with appendicitis...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28948703/gastrointestinal-solitary-fibrous-tumor-from-lesser-omentum-an-elderly-from-malaysia-with-an-unusual-huge-painful-intra-abdominal-mass
#20
C S Ng, M Luqman, Z Q Wong, C S Ngiu, R A Raja Affendi
No abstract text is available yet for this article.
October 2017: Journal of Gastroenterology and Hepatology
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