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https://www.readbyqxmd.com/read/28820866/-surgical-treatment-of-choledocholithiasis-in-a-patient-with-situs-inversus-totalis-a-case-report-and-literature-review
#1
Jerson Francisco Morales-Rodríguez, Estefania Corina Cotillo, Oscar Moreno-Loaiza
Situs inversus totalis (SIT) is a rare condition, in which there is transposition of the thoraco-abdominal organs. This situation leads to diagnostic and therapeutic difficulties in patients with acute surgical abdomen. The objective of this report is to present the case of a patient who presented with colonic pain in the epigastrium and left hypochondrium, in which the diagnosis of SIT, cholelithiasis and choledocholithiasis was reached after the respective imaging studies. Once the diagnosis was made, treatment was performed through retrograde endoscopic cholangiopancreatography (ERCP) and subsequent surgical exploration of bile ducts...
July 26, 2017: Medwave
https://www.readbyqxmd.com/read/28819577/the-role-of-laparoscopy-in-the-management-of-a-diagnostic-dilemma-jejunal-ectopic-pancreas-developing-into-jejunojejunal-intussusception
#2
Alessio Giordano, Giovanni Alemanno, Carlo Bergamini, Paolo Prosperi, Alessandro Bruscino, Andrea Valeri
Ectopic pancreas (EP) is a rare congenital anomaly defined as the presence of pancreatic tissue in topographic anomaly. It is usually silent but it may become clinically evident when complicated by acute conditions. The development of laparoscopic surgery has changed the way to manage such conditions, especially in the setting of emergency surgery, thanks to its diagnostic and therapeutic role with excellent results. We decided to perform an emergency diagnostic exploratory laparoscopy in a 29-year-old man with an acute abdomen and nonspecific radiological images for intestinal occlusion...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28819499/multiple-jejunal-perforation-secondary-to-intestinal-tuberculosis-infection-a-case-report
#3
Anthony Lyonga Ngonge, Domin Sone Majunda Ekaney, Carlson-Babila Sama, Joffi Musonge-Effoe, Valery Sammah Effoe, Gerald Ekwen
Abdominal tuberculosis (TB) may affect any part of the gastrointestinal tract resulting in significant morbidity and mortality. There is an increase in the incidence of abdominal TB favored by the emergence of multi-drug resistant Mycobacterium tuberculosis and immunosuppression especially from HIV co-infection. Our case is that of a 31 year old HIV-positive woman, adherent to antiretroviral therapy, who presented with a 2 month history of progressive abdominal distention, drenching night sweat and fatigue, but without fever...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28819497/-volvulus-of-the-small-intestine-caused-by-mesenteric-lipoma
#4
Papa Alassane Mbaye, Aime Lakh Faye, Aloise Sagna, Ndeye Aby Ndoye, Ndeye Fatou Seck, Oumar Ndour, Gabriel Ngom
We report the case of a 7-year old girl presenting with sub-occlusive syndrome associated with acute paroxysmal abdominal pain at the level of the upper abdomen, vomiting and no evacuation of faeces. Physical examination showed discomfort with palpation of the upper abdomen. Abdominal ultrasound showed poorly limited intraperitoneal tissue formation without vascular features on doppler, exercising a mass effect on the neighborhood structures; mesenteric vessels were in their normal position. This mass on CT scan scorresponded to a well limited lipomatous formation exercising a mass effect on the caecum associated with volvulus of the small intestine...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28818586/a-rare-presentation-of-the-syndrome-of-inappropriate-antidiuretic-hormone-in-a-12-year-old-female-as-the-initial-presentation-of-an-immature-ovarian-teratoma
#5
Anoop Mohamed Iqbal, W Frederick Schwenk
BACKGROUND: Immature ovarian teratoma is very rare in childhood. We are reporting 12 yo female with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. CASE: A 12 yo female presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium -123 mmol/L), that did not respond to fluid management. Computerized tomography showed a 15 cm x 9 cm x 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications...
August 14, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28816211/a-study-of-events-between-the-onset-of-symptoms-and-hospital-admission-in-patients-with-acute-abdomen
#6
Shubhada Khanapure, Sanjay Nagral, Aditya J Nanavati
BACKGROUND: Acute abdomen is a common surgical emergency. Prompt investigation and treatment, including surgical intervention, is critical in reducing morbidity and mortality. METHODS: We carried out a prospective observational study at a large urban secondary healthcare centre in India. Patients with surgical acute abdomen were consecutively enrolled in the study over a period of 2 years. Data were collected regarding the onset of symptoms, time of presentation to the hospital and events in the intervening period...
March 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28814938/superior-mesenteric-artery-syndrome-in-association-with-abdominal-tuberculosis-an-eye-opener
#7
Shuchi Bhatt, Biswajit Mishra, Anupama Tandon, Smita Manchanda, G Parthsarathy
Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge...
May 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28812114/-thoracic-and-abdominal-imaging-in-immunocompromised-patients
#8
REVIEW
J R Kroeger, D Maintz, D-H Chang
The number of patients with immunosuppression is rising worldwide. The spectrum of diseases and pathogens in these patients differs widely from that of immunocompetent patients due to frequent opportunistic infections. Symptoms are sometimes unspecific, and imaging plays a key role in the management of these patients. The lungs are a frequent site of infection in immunosuppressed patients. Chest X‑ray is the starting point for radiological diagnostics, but shows only limited sensitivity and specificity for infections with atypical pathogens...
August 15, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28804662/fungal-bezoar-a-rare-cause-of-ureteral-obstruction
#9
Nabil Zeineddine, Wissam Mansour, Sandy El Bitar, Marco Campitelli, Neville Mobarakai
A 52-year-old male, with diabetes mellitus and alcoholic liver disease, presented to the Emergency Room for right flank pain of 3 days' duration, associated with dysuria. Physical examination revealed right flank tenderness with fever and hypotension; laboratory findings showed acute kidney injury and large blood and leucocytes in the urine. A CT abdomen and pelvis showed hydronephrosis of the right collecting system of a horseshoe kidney with air and hyperdense debris in the renal pelvis. Patient was treated for multisensitive Proteus mirabilis emphysematous pyelonephritis, and a right nephrostomy tube was inserted...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28804005/performance-assessment-of-the-saps-ii-and-sofa-scoring-systems-in-hanta-virus-hemorrhagic-fever-with-renal-syndrome
#10
Zhenjun Yu, Ni Zhou, Ali Li, Jie Chen, Huazhong Chen, Zebao He, Fei Yan, Haihong Zhao, Jiansheng Zhu
BACKGROUND: Hemorrhagic Fever with Renal Syndrome (HFRS), caused by the hantavirus, is a natural infectious disease characterized by fever, hemorrhage and renal damage. China is the most severely endemic area for HFRS in the world. In recent years, critical scoring systems based on quantitative classification have become an important clinical tool for predicting and evaluating the prognosis of critical illness, and provide guidelines for clinical practice. METHODS: The sample comprised 384 patients with HFRS treated in the Taizhou Hospital from January 2006 to February 2017...
August 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28790101/splenic-rupture-following-synchronised-direct-current-cardioversion
#11
Nicholas Kaufman, David Ferraro
Atraumatic rupture of the normal spleen is a rare entity. Often, a triggering factor or minor physical event can be ascribed as the aetiology for rupture, including coughing, vomiting or minor medical procedures not involving the spleen. A 65-year-old man who was hospitalised for eosinophilic pneumonia developed haemodynamically unstable atrial flutter that necessitated urgent synchronised direct current cardioversion (DCCV). Two hours after successful cardioversion, he developed signs of an acute abdomen with free intraperitoneal fluid identified on bedside ultrasonography...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28790029/twisted-intra-abdominal-cyst-in-a-neonate-a-surprise-revelation
#12
Ferzine Mohamed, Ramesh Babu Telugu, Immanuel Sampath Karl
We, herein, present a male neonate with an antenatally detected intra-abdominal cyst who presented at 18 days of life at which time, the ultrasound revealed a 5×4 cm cyst. Since he was asymptomatic, we planned to repeat the ultrasound a month later and operate if the cyst showed no regression. However, a week later, he presented with an acute abdomen, irritable cry and a repeat ultrasound showing a larger (8×6 cm) cystic mass with debris within. He was taken up for an emergency laparotomy. Intraoperatively, the cyst was found arising from the left lateral abdominal wall free from all structures with a twisted pedicle...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28790028/staged-retroperitoneal-mesenteric-revascularisation-and-aortobifemoral-bypass-after-endovascular-rescue-for-acute-mesenteric-ischaemia
#13
Shepard Peir Johnson, Melani Lighter, Harry Linne Anderson, Abdulhameed Aziz
Visceral artery revascularisation through a retroperitoneal approach provides an infrequent yet viable, alternative means of managing mesenteric ischaemia in patients with previous abdominal operations. We present a unique case implementing this surgical approach in a 55-year-old man in which we performed a retroperitoneal aortobifemoral bypass with concomitant retrograde jump graft from the aortic prosthesis to the superior mesenteric artery (SMA) for bilateral lower extremity rest pain and chronic mesenteric ischaemia...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28782748/ileostomy-site-approach-for-adhesiolysis-and-laparoscopic-cholecystectomy-in-a-hostile-abdomen-a-novel-technique
#14
Deeplaxmi Purushottam Borle, Nikhil Agrawal, Asit Arora, Senthil Kumar, Tushar Kanti Chattopadhyay
INTRODUCTION: Gallstones are an etiological factor in 23%-54% of patients with acute pancreatitis. A small proportion of these patients will also have intestinal complications requiring necrosectomy with diverting loop ileostomy. Later, these patients require cholecystectomy and ileostomy reversal. Laparoscopic cholecystectomy is fraught with difficulty in these patients due to dense intra-abdominal adhesions, and many surgeons resort to an open approach. We describe a technique which takes advantage of the ileostomy site for initial access...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28765791/coronary-artery-disease-presenting-with-left-upper-quadrant-pain-in-a-patient-with-chronic-cervical-tetraplegia
#15
Lianne Michelle Nier, Peter S Hansen
INTRODUCTION: This single-subject case report aims to describe and discuss a case of a patient with established C5 tetraplegia with acute coronary syndrome presenting with left upper quadrant pain and tenderness. CASE PRESENTATION: A 65-year-old male with chronic C5 American Spinal Injury Association Impairment Scale (AIS) A tetraplegia presented to the emergency department with severe left upper quadrant pain radiating across the chest to the right upper limb with associated dyspnoea and diaphoresis...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#16
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28764263/acute-pyelonephritis-correlation-of-clinical-parameter-with-radiological-imaging-abnormalities
#17
Leelavathi Venkatesh, Ramalingiah Karadakere Hanumegowda
INTRODUCTION: Pyelonephritis (PN) is a suppurative infection of the kidney, most commonly due to bacterial infection and may be either acute or chronic. Acute PN (APN) subdivided into uncomplicated and complicated. Severity of PN cannot be assessed by clinical or laboratorial parameters alone, radiological imaging such as Ultrasound (USG) abdomen, Computed Tomography (CT) is required to know the nature, extent and severity of disease and for planning interventions. AIM: The aim of this study was to compare clinical and biochemical parameters with radiological findings (USG/CT) among patients diagnosed to have PN...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28764244/a-rare-case-of-intestinal-malrotation-and-volvulus-of-jejunum-with-coexisting-carcinoid-tumour-of-appendix
#18
Priyanka Tiwari, Darshan Patel, Vimal Dhaduk, Prasanna Kumar Reddy, Jainudeen Khalander Abdul Jameel
Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. Patients may present with symptoms of acute bowel obstruction or chronic abdominal pain. Barium study, Contrast Enhanced Computed Tomography (CECT), Magnetic Resonance Imaging (MRI), diagnostic laparoscopy and sometimes explorative laparotomy are used for diagnosis. Ladd's procedure through the open approach has been the treatment of choice for complete malrotation of midgut, however there are reports on successful outcome for both complete and incomplete malrotation after laparoscopic approach as well...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28764241/small-intestinal-lymphangioma-presenting-as-an-acute-abdomen-with-relevant-review-of-literature
#19
Basant Kumar, Ankur Bhatnagar, Vijai Datta Upadhyaya, Ajay Narayan Gangopadhyay
Cystic lymphangioma of small bowel mesentery is rare with clinical features ranging from an asymptomatic abdominal lump to acute intestinal obstruction. We discuss two cases of lymphangioma of small bowel mesentery who presented to us as acute intestinal obstruction. In the first case exploratory laparotomy revealed a large multicystic lesion arising from small bowel mesentery just distal to the duodenojejunal junction having multiple small cysts filled with milky white fluid. The involved region of the bowel was excised...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761894/gastric-pneumatosis-from-isolated-gastric-calciphylaxis
#20
Aditi Mulgund, Sanam Razeghi, Sampath Poreddy
A 58-year-old man with end-stage renal disease presented with hypotension and emesis, pale conjunctivae, and a distended abdomen. Labs revealed hypercalcemia and leukocytosis. Abdominal imaging showed gastric pneumatosis. Endoscopy demonstrated significant hemorrhage and necrosis in the gastric cardia and fundus. Biopsies revealed acute ulcerative gastritis and focal intravascular calcium phosphate crystals. The patient remained nil per os and was placed on omeprazole and sucralfate. Repeat endoscopy demonstrated mucosal healing...
2017: ACG Case Reports Journal
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