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https://www.readbyqxmd.com/read/27908462/a-rare-case-of-perforated-sub-hepatic-appendicitis-a-challenging-differential-diagnosis-of-acute-abdomen-based-on-the-combination-of-appendicitis-and-maldescent-of-the-caecum
#1
Costanza Chiapponi, Olof Jannasch, Manuela Petersen, Wiebke Lessel, Christiane Bruns, Frank Meyer
Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume...
November 21, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27906797/non-cirrhotic-portal-fibrosis-in-pediatric-population
#2
Vikrant Sood, Bikrant Bihari Lal, Rajeev Khanna, Dinesh Rawat, Chhagan Bihari Sharma, Seema Alam
BACKGROUND: Non-cirrhotic portal fibrosis (NCPF) has been classically described as a disease of young to middle age with limited literature regarding its occurrence, onset or clinical presentation in children. We hereby present a series of 19 patients diagnosed and managed as NCPF in pediatric age group. METHODS: A retrospective review of all the patients presenting to the pediatric hepatology department (age < 18 years) and diagnosed as NCPF was done and data was evaluated...
November 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27900755/incidental-18f-fdg-pet-ct-bilateral-breast-uptake-due-to-carcinoma
#3
Domenico Albano, Mattia Bertoli, Maria Laura Morassi, Giovanni Bosio, Emanuela Orlando, Francesco Bertagna
We report a case of 71-year-old female patient, previously treated with chemotherapy and surgical resection of sigmoid tract of the large bowel for adenocarcinoma (pT3N1M0), who underwent a 18F-FDG PET/CT for a suspicious hepatic lesion detected at CT scan during follow-up. 18F-FDG PET/CT showed no abnormal uptake in the liver both at 60 minutes and 120 minutes after injection but revealed a pathological uptake in two breast nodules, (one localized in upper-internal-quadrant of the right breast and the other in the upper-external-quadrant of the left breast)...
2016: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/27898677/collagen-fiber-orientation-and-dispersion-in-the-upper-cervix-of-non-pregnant-and-pregnant-women
#4
Wang Yao, Yu Gan, Kristin M Myers, Joy Y Vink, Ronald J Wapner, Christine P Hendon
The structural integrity of the cervix in pregnancy is necessary for carrying a pregnancy until term, and the organization of human cervical tissue collagen likely plays an important role in the tissue's structural function. Collagen fibers in the cervical extracellular matrix exhibit preferential directionality, and this collagen network ultrastructure is hypothesized to reorient and remodel during cervical softening and dilation at time of parturition. Within the cervix, the upper half is substantially loaded during pregnancy and is where the premature funneling starts to happen...
2016: PloS One
https://www.readbyqxmd.com/read/27891271/intrahepatic-cholestasis-of-pregnancy-with-severe-elevation-of-bile-acids-in-the-setting-of-acute-hepatitis-c-infection
#5
Megan L Lawlor, Agatha S Critchfield
Intrahepatic cholestasis of pregnancy (ICP) is a complication of pregnancy resulting in elevation of serum bile acid levels. ICP is often associated with underlying liver disease, including hepatitis C. Bile acids in relationship to the acute infection of hepatitis C virus have not yet been delineated in the literature. A 26-year-old gravida 4 para 2103 with dichorionic, diamniotic twin gestation and history of intravenous drug abuse developed ICP in the setting of acute hepatitis C infection. In addition to clinical symptoms of pruritus and right upper quadrant pain, she developed severe elevation in bile acids, 239 micromol/L, and transaminitis aspartate aminotransferase 1033 U/L, and alanine aminotransferase 448 U/L...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27886969/a-pilot-study-to-gauge-effectiveness-of-standardized-patient-scenarios-in-assessing-general-surgery-milestones
#6
REVIEW
Denise W Gee, Roy Phitayakorn, Avni Khatri, Kathryn Butler, John T Mullen, Emil R Petrusa
PURPOSE: Some General Surgery Milestones can be difficult to assess in traditional clinical settings and especially difficult to assess in junior residents. The purpose of this pilot study was to METHODS: A total of 9 categorical interns participated in a comprehensive, 4-module, SP scenario designed to evaluate and manage right upper quadrant pain. SP checklist scores (SP%) were converted to Milestone-equivalent scores for direct comparison (SP-C). Milestone scores were analyzed from 3 different sources: SP, faculty (FAC), and CCC...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27886676/chromosomal-rearrangements-in-myoepithelial-carcinoma-of-the-breast-that-presented-as-metachronic-double-cancer-with-invasive-ductal-carcinoma-in-the-ipsilateral-breast
#7
Hiroyuki Kawashima, Takashi Ariizumi, Yasuo Saijo, Masato Moriyama, Hajime Umezu, Yoshiyuki Ikeda, Akira Ogose, Naoto Endo
Myoepithelial carcinoma of the breast is an extremely rare tumor composed entirely of malignant spindle cells with myoepithelial differentiation. The majority of previously reported cases have mainly described the clinicopathological features of the disease, and few have presented cytogenetic data. We herein present the case of a 48-year-old woman who was admitted with a left-sided breast lump in the inner upper quadrant that was initially diagnosed as a myoepithelioma with potentially malignant disorder. At 12 months after resection, she complained about a newly developed solid mass in the subareolar region of the ipsilateral breast that was diagnosed as an invasive ductal carcinoma...
November 2016: Cancer Genetics
https://www.readbyqxmd.com/read/27878404/inter-rater-agreement-between-trained-emergency-medicine-residents-and-radiologists-in-the-examination-of-gallbladder-and-common-bile-duct-by-ultrasonography
#8
Javad Seyedhosseini, Azade Nasrelari, Narges Mohammadrezaei, Ehsan Karimialavijeh
STUDY OBJECTIVES: Bedside emergency ultrasonograAmerican Society of Emergency Radiologyphy is a rapid diagnostic tool in the emergency department (ED). Nevertheless, the learning curve for ultrasound (US) training in various indications has to date not been clearly defined. The aim of the present study was to assess how much a short specialized training program in hepatobiliary US might impact the skills of novice emergency medicine residents. METHODS: This was a prospective observational study conducted at a university-affiliated ED from May 2014 to January 2015...
November 22, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27876238/thermography-examination-of-abdominal-area-skin-temperatures-in-individuals-with-and-without-focal-onset-epilepsy
#9
Hollis H King, Charles Thomas Cayce, Jeph Herrin
: Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures...
October 21, 2016: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/27872786/congenital-diaphragmatic-hernia-with-delayed-presentation
#10
Alireza Malekzadegan, Alireza Sargazi
Congenital diaphragmatic hernia (CDH) is caused due to abnormal formation of the muscular parts of diaphragm. The incidence of CDH in common births ranges from 1/25000 to 1/30000. Pulmonary hypoplasia and pulmonary hypertension are factors that associate with the increase of mortality and morbidity due to CDH. We presented a 68-year-old Iranian woman with abdominal pain and tenderness in right upper quadrant who was diagnosed as having CDH. The disease was detected using chest X-ray and chest and abdomen sonography and confirmed with chest and abdomen CT scan with and without oral contrast...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27871294/newly-designed-retentive-posts-of-mandibular-reconstruction-plate-in-oral-cancer-patients-based-on-preliminary-fem-study
#11
Ik Jae Kwon, Mi Young Eo, Sung Jae Park, Soung Min Kim, Jong Ho Lee
BACKGROUND: The reconstruction of a large mandibular defect poses a challenging issue in oral cancer ablation surgery. One popular option for mandibular continuity reconstruction after tumor resection involves the use of a reconstruction plate (R-plate), which maintains space and contour without bone harvesting. An R-plate, however, cannot provide final functional loading rehabilitation with implants or dentures. METHODS: We suggest a new method of functional mandibular reconstruction using retentive posts and an upper prosthesis...
November 21, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#12
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27862628/history-physical-exam-laboratory-testing-and-emergency-department-ultrasonography-for-the-diagnosis-of-acute-cholecystitis
#13
Ashika Jain, Ninfa Mehta, Michael Secko, Joshua Schecter, Dimitri Papanagnou, Shreya Pandya, Richard Sinert
BACKGROUND: Acute Cholecystitis (AC) is a common differential for patients presenting to the Emergency Department (ED) with abdominal pain. The diagnostic accuracy of history, physical exam and bedside lab tests for AC have not been quantitatively described. OBJECTIVES: We performed a systematic review to determine the utility of History/Physical exam (H&P), Laboratory studies and Ultrasonography (US) in diagnosing AC in the ED. METHODS: We searched medical literature from January 1965 to March 2016 in PubMed, EMBASE and SCOPUS using a strategy derived from the following formulation of our clinical question: Patients: ED patients suspected of AC...
November 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27858902/accessory-gallbladder-in-an-intrahepatic-location-mimicking-a-cystic-tumor-of-the-liver-a-case-report
#14
Ji-Hye Won, Seo-Youn Choi, Hae Kyung Lee, Boem Ha Yi, Min Hee Lee, Min Jung Jung
BACKGROUND: Double gallbladder (GB) is a rare congenital anomaly of the biliary system characterized by the presence of an accessory GB. CLINICAL FINDINGS: A 38-year-old female presented with a history of right upper quadrant (RUQ) pain. Computed tomography (CT) showed a lobulated cystic mass involving the center portion of liver. Magnetic resonance imaging (MRI) additionally revealed a tubular structure of T2 bright signal intensity (SI), which connected the cystic lesion of the liver to the bile duct...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27847657/rare-case-of-an-epithelial-cyst-in-an-intrapancreatic-accessory-spleen-treated-by-robot-assisted-spleen-preserving-distal-pancreatectomy
#15
Willemijn P M van Dijck, Vincent P Groot, Lodewijk A A Brosens, Jeroen Hagendoorn, Inne H M Borel Rinkes, Maarten S van Leeuwen, I Quintus Molenaar
Epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted with right upper quadrant abdominal pain. A cystic lesion in the pancreatic tail was discovered and evaluated by computed tomography and magnetic resonance images. Based on clinical and radiological features a solid pseudopapillary neoplasm was suspected...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27847538/gastrointestinal-stromal-tumour-of-the-stomach-in-an-8-year-old-boy
#16
James Dc Coates
We report a case of an 8-year-old boy who underwent an ultrasound for investigation of a left upper quadrant mass and who was subsequently diagnosed with gastrointestinal stromal tumour of his stomach. Abdominal ultrasound showed a large cystic mass in the left upper abdomen which was further characterised by magnetic resonance imaging. At laparotomy, a large cystic lesion was excised from his stomach, which was confirmed at histology to be a gastrointestinal stromal tumour. We briefly discuss the presentation and imaging findings of paediatric gastrointestinal stromal tumour and how it differs from the adult form of the disease and treatments...
November 2016: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/27846664/laparoscopic-splenectomy-in-children-a-modified-technique-with-joint-sealing-of-segmental-splenic-arteries-and-veins-favorably-compared-with-the-classic-technique
#17
Sara Silvaroli, Marianne De Montalembert, Frédérique Sauvat, Valentine Brousse, Sabine Sarnacki, Sabine Irtan
Introduction Splenectomy in children is nowadays widely performed by laparoscopy, the major risk being operative hemorrhage. We hereby compare the results of two different techniques of vascular control. Materials and Methods We retrospectively reviewed all patients undergoing a laparoscopic splenectomy (LS) for hematologic disease at a single institution from 2004 to 2013. LS was performed by a lateral approach. The 10-mm optic port was placed in the umbilicus and two 5-mm working ports were placed in the left lower quadrant and in the right upper quadrant near the midline...
November 15, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27846330/recurrent-right-upper-quadrant-abdominal-pain
#18
Pradeepa Vimalachandran, Jayashree Paknikar
A minimally tender mass was detected during palpation of the abdomen, but a Murphy's test was negative. An abdominal x-ray revealed the cause of the patient's pain.
October 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/27834503/upper-quadrant-field-tests-and-isokinetic-upper-limb-strength-in-overhead-athletes
#19
Dorien Borms, Annelies Maenhout, Ann M Cools
CONTEXT:  Isokinetic testing is used to determine possible deficits in upper extremity strength in overhead athletes. Given that isokinetic testing is restricted to a laboratory setting, field tests, such as the Seated Medicine Ball Throw (SMBT) and were developed to assess upper body performance. The relationship between these field tests and isokinetic strength has not been examined. OBJECTIVE:  To investigate the relationship between isokinetic strength testing for shoulder external and internal rotation and elbow flexion and extension and SMBT distance and YBT-UQ performance in overhead athletes...
November 11, 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/27822956/porcelain-gallbladder
#20
Diogo Albergaria, Nuno Carvalho, Filipe Borges, António Folgado, João Corte Real
A 62-year-old female was referenced to our outpatient clinic for a single episode of right upper quadrant pain and weight loss of 3 kg in the last 6 months. No other complaints were reported. Her past medical history was unremarkable except for total hysterectomy. The upper abdominal ultrasonography and abdominal plain X-ray revealed a porcelain gallbladder.
November 2016: Revista Española de Enfermedades Digestivas
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