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https://www.readbyqxmd.com/read/28550278/torsion-of-a-giant-antimesenteric-lipoma-of-the-ileum-a-rare-cause-of-acute-abdominal-pain
#1
Ta-Wei Yang, Yi-Wei Tsuei, Chung-Cheng Kao, Wen-Hsien Kuo, Yan-Lin Chen, Yen-Yue Lin
BACKGROUND Torsion of an intra-abdominal lipoma is rarely the cause of acute abdominal pain. Most of the previously reported cases of intra-abdominal lipoma torsion originated in the mesentery or omentum. However, an antimesenteric lipoma of the ileum with torsion has not been reported before. CASE REPORT A 67-year-old man presented to the emergency department with acute abdominal pain. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis only showed a giant fat-containing, soft-tissue, intra-abdominal tumor, suspected to be a lipoma...
May 27, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28548201/-morphine-induced-biliary-pain-case-report
#2
Zoltán Berger, Mario Arcos, Fernanda Matamala, Claudia Rojas
Morphine produces contraction of Oddi’s sphincter, which can be severe and of longer duration in some pathological conditions. This exaggerated response can manifest as a colicky biliary pain, frequently accompanied by a dramatic increase in hepatic enzymes. We report a 32 years old female who consulted in the emergency room for severe low abdominal pain of gynecologic origin, which was completely controlled by morphine. However, she presented a sudden epigastric colicky pain irradiating in the back, which persisted for several hours in spite of the repeated administration of analgesics...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28547753/the-cost-effectiveness-of-patient-controlled-analgesia-vs-standard-care-in-patients-presenting-to-the-emergency-department-in-pain-who-are-subsequently-admitted-to-hospital
#3
C Pritchard, J E Smith, S Creanor, R Squire, A Barton, J Benger, L Cocking, P Ewings, M Rockett
The clinical effectiveness of patient-controlled analgesia has been demonstrated in a variety of settings. However, patient-controlled analgesia is rarely utilised in the emergency department. The aim of this study was to compare the cost-effectiveness of patient-controlled analgesia vs. standard care in participants admitted to hospital from the emergency department with pain due to traumatic injury or non-traumatic abdominal pain. Pain scores were measured hourly for 12 h using a visual analogue scale. Cost-effectiveness was measured as the additional cost per hour in moderate to severe pain avoided by using patient-controlled analgesia rather than standard care (the incremental cost-effectiveness ratio)...
May 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#4
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28545408/importance-of-correctly-interpreting-magnetic-resonance-imaging-to-diagnose-posterior-reversible-encephalopathy-syndrome-associated-with-hellp-syndrome-a-case-report
#5
Syuichi Tetsuka, Hiroaki Nonaka
BACKGROUND: Severe haemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome in pregnancy are possible underlying trigger factors for posterior reversible encephalopathy syndrome (PRES). Magnetic resonance imaging (MRI) shows diffuse signal abnormalities involving the subcortical white matter in the parieto-occipital lobes. Although the diagnosis of RPES was clearly established by the distinctive reversibility of clinical and radiological abnormalities, it is difficult to distinguish from differential diagnosis...
May 25, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28540290/biomarkers-and-microscopic-colitis-an-unmet-need-in-clinical-practice
#6
REVIEW
Laura Francesca Pisani, Gian Eugenio Tontini, Beatrice Marinoni, Vincenzo Villanacci, Barbara Bruni, Maurizio Vecchi, Luca Pastorelli
One of the most common causes of chronic diarrhea is ascribed to microscopic colitis (MC). MC is classified in subtypes: collagenous colitis (CC) and lymphocytic colitis (LC). Patients with MC report watery, non-bloody diarrhea of chronic course, abdominal pain, weight loss, and fatigue that may impair patient's health-related quality of life. A greater awareness, and concomitantly an increasing number of diagnoses over the last years, has demonstrated that the incidence and prevalence of MC are on the rise...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28539975/does-attending-general-practice-prior-to-the-emergency-department-change-patient-outcomes-a-descriptive-observational-study-of-one-central-london-general-practice
#7
S Morton, R Hames, I Kelso, A Newth, S Gnani
BACKGROUND: The challenge of keeping Emergency Department (ED) attendances down continues and timely access to general practice (GP) is often portrayed as a potential solution. SETTING: One London general practice (registered population = 4900). QUESTION: Does seeing a GP before attending the ED affect the outcome of a patient's ED care? METHODS: Routine clinical data were extracted using SystmOne primary care computer system for all registered patients with an ED attendance between 1 October 2014 and 31 September 2015...
May 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/28536687/abdominal-and-pelvic-actinomycosis-due-to-longstanding-intrauterine-device-a-slow-and-devastating-infection
#8
Evelyn Sue Nakahira, Linda Ferreira Maximiano, Fabiana Roberto Lima, Edson Yassushi Ussami
Actinomycosis is a chronic or subacute bacterial infection characterized by large abscess formation, caused mainly by the gram-positive non-acid-fast, anaerobic, or microaerophilic/capnophilic, obligate parasites bacteria from the Actinomyces genus. Although pelvic inflammatory disease is an entity associated with the longstanding use of intrauterine devices (IUDs), actinomycosis is not one of the most frequent infections associated with IUDs. We present the case of a 43-year-old female patient who was referred to the emergency facility because of a 20-day history of abdominal pain with signs of peritoneal irritation...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28536666/acute-torsion-of-appendicular-mucocele
#9
Farshid Ejtehadi, James Brooks, Hebah Hassan Ali, Vardhini Vijay
We present the case of an 81-year-old man with a known appendicular mucocele who presented to the emergency department with acute abdominal pain. A CT scan showed a change in orientation of the previously seen ovoid mass with surrounding fat stranding suggesting torsion. An emergency laparotomy with appendicectomy and resection of the caecal pole was performed. We discuss the findings and histopathology.
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28536663/endometriosis-nodule-causing-spontaneous-haemoperitoneum-in-pregnancy-a-case-report-and-literature-review
#10
Junaid Rafi, Geetha Mahindrakar, Debjani Mukhopadhyay
Spontaneous haemoperitoneum in pregnancy (SHiP) due to endometriosis is a very rare condition and this is a case of a 41-year-old primigravida, who presented at 32 weeks with sudden onset of severe lower abdominal pain without any uterine activity. This was a dichorionic-diamniotic twin pregnancy, following in vitro fertilisation for subfertility secondary to severe endometriosis. On admission, pain score was eight, with ten being the maximum of the scale. The vital signs were stable. Abdominal palpation revealed generalised tenderness with no guarding or palpable contraction...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#11
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533582/angular-ectopic-pregnancy-presenting-as-rupture-of-lateral-wall-of-the-uterus-late-presentation-in-gestation-week-20
#12
Malihe Hasanzadeh, Salme Dadgar, Yalda Arian, Yousef Yousefi
The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations that are due to the anatomic distortions and physiologic changes of pregnancy. Due to the lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This is a case report of a 34-year-old woman who was referred to the obstetrics emergency department with sudden abdominal pain and in a state of hypovolemic shock...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28531869/a-rare-case-of-subacute-appendicitis-actinomycosis-as-the-final-pathology-reports-a-case-report-and-literature-review
#13
G A Gómez-Torres, O S Ortega-Gárcia, E G Gutierrez-López, C A Carballido-Murguía, J A Flores-Rios, C R López-Lizarraga, C A Bautista López, C F Ploneda-Valencia
INTRODUCTION: Acute appendicitis is the most common indication for an emergency abdominal surgery in the world, with a lifetime incidence of around 10%. Actinomycetes are the etiology of appendicitis in only 0.02%-0.06%, having as the final pathology report a chronic inflammatory response; less than 10% of the cases are diagnosed before surgery. Here, we present the case of a subacute appendicitis secondary to actinomycosis. CASE REPORT: A 39-year-old male presented with a twelve-day evolution of intermittent abdominal pain in the right lower quadrant, treated at the beginning with ciprofloxacin and urinary analgesic...
May 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28530770/diagnostic-value-of-appendicular-doppler-ultrasonography-in-acute-appendicitis
#14
Hüseyin Uzunosmanoğlu, Yunsur Çevik, Şeref Kerem Çorbacıoğlu, Emine Akıncı, Hakan Buluş, Kadir Ağladıoğlu
BACKGROUND: Acute appendicitis is one of the most common causes of acute abdominal pain prompting emergency department (ED) visits. It is critical for the physicians to promptly and accurately diagnose acute appendicitis. The present study aimed to evaluate the diagnostic efficacy of Doppler ultrasonography (USG) in patients with acute appendicitis and compare this new method with other commonly used radio-diagnostic tools. METHODS: All patients who were diagnosed with acute appendicitis at the Kecioren Training and Research Hospital ED and later underwent appendectomy between October 2012 and April 2013 were included in the study...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530107/leptomeningeal-carcinomatosis-in-a-young-patient-with-obstructive-colorectal-signet-ring-cell-adenocarcinoma
#15
Alejandro Lusilla, Jorge de Tomás
We present the case report of a twenty-five-year-old Moroccan male patient who suffered from leptomeningeal carcinomatosis related to a signet-ring cell carcinoma of the rectum. He presented to the emergency department with abdominal pain, constipation, weight loss and rectal bleeding. The rectal examination showed a rectal tumor and a CT scan revealed a large bowel obstruction due to rectal diffuse thickening. An emergency transverse colostomy was performed, with a rectal biopsy and a cytological sample collection...
May 22, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28528536/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-and-rectus-sheath-block-with-ropivacaine-and-dexmedetomidine-in-elderly-high-risk-patients-undergoing-emergency-abdominal-surgery
#16
Lili Xu, Zhiyong Hu, Jianjun Shen, Patrick M McQuillan
BACKGROUND: This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery. METHODS: Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 ml of 0.25% ropivacaine+0...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28528364/a-randomized-double-blind-placebo-controlled-trial-of-a-multi-strain-probiotic-in-treatment-of-symptomatic-uncomplicated-diverticular-disease
#17
Charlotte L Kvasnovsky, Ingvar Bjarnason, Ana Nora Donaldson, Roy A Sherwood, Savvas Papagrigoriadis
BACKGROUND: Diverticular disease is a significant burden on healthcare systems that is managed, surgically or medically, mainly as an emergency or acute condition. There are no standardized treatment recommendations for symptomatic uncomplicated disease. We hypothesized that a probiotic would reduce abdominal pain in such patients. METHODS: We conducted a single-center, double-blind, placebo-controlled trial of probiotic treatment (Symprove) in adult patients with moderate-to-severe chronic, non-acute symptomatic diverticular disease...
May 20, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#18
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28525249/-a-less-known-cause-of-incoercible-vomiting
#19
S Guyoundouzian, R Attou, P Guérisse, T Préseau
Cannabis is a widely spread drug which chronic abuse may cause diverse adverse effects on the body, in the short and long term. Among these effects, we can cite digestive disorders, mainly characterized by the onset of cyclical vomiting illness. Vomiting symptoms can be temporarily relieved by hot water showers. As a matter of fact, many patients adopt a compulsive bathing behavior characterized by the irrepressible need of having showers or baths at a high temperature. We describe the case of two patients (22 and 23 years-old) who consume cannabis on a regular basis...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28523473/young-colorectal-cancer-patients-often-present-too-late
#20
Jia-Hao Law, Frederick H Koh, Ker-Kan Tan
PURPOSE: Current screening and health education strategies on colorectal cancer (CRC) remain focused on individuals >50 years old. However, CRC in young adults is not uncommon. This paper aims to explore how CRC presents in young adults and their clinical outcomes. METHODS: All patients aged <50 years diagnosed with CRC from January 2007 to December 2015 were reviewed. Patient demographics, clinical symptoms, and outcomes of treatment were collected. RESULTS: Of 1367 patients diagnosed with CRC, 154 (11...
May 18, 2017: International Journal of Colorectal Disease
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