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Acute abdomen

Kyawzaw Lin, Aung Naing Lin, Won Jun Park, Pwint Phyu Hlaing, Cesar Ayala-Rodriguez
Splenic infarction is an unusual cause for a patient to present with left upper abdomen pain. A 47-year-old woman presented to the emergency department with left upper abdomen pain. She reported that she stopped taking warfarin two days prior to presentation. A physical examination revealed fine crackles within the left lower lobe and significant tenderness within the left upper abdomen. Computed tomography of the abdomen showed mild cardiomegaly with a 2.3 cm calcified thrombus in the left ventricular apex...
April 19, 2018: Curēus
Kyawzaw Lin, Emmanuel Ofori, Aung Naing Lin, Sithu Lin, Thinzar Lin, Ameer Rasheed, Viswanath Vasudevan, Madhavi Reddy
Acute pancreatitis (AP) is an inflammatory disease presenting from mild localized inflammation to severe infected necrotic pancreatic tissue. In the literature, there are a few cases of hypothermia-induced AP. However, the association between hypothermia and AP is still a myth. Generally, mortality from acute pancreatitis is nearly 3-6%. Here, we present a 40-year-old chronic alcoholic female who presented with acute pancreatitis induced by transient hypothermia. A 40-year-old chronic alcoholic female was hypothermic at 81°F on arrival which was improved to 91...
May 2018: Case Reports in Gastroenterology
Pedro D M Lourenco, Ryan Rawski, Mohammed F Mohammed, Faisal Khosa, Savvas Nicolaou, Patrick McLaughlin
OBJECTIVE: Sensitivity of CT of the abdomen for detection of acute bowel ischemia (ABI) can be as low as 60%. In this study, we assessed the diagnostic performance of iodine-map and monoenergetic (40-keV) images in patients with suspected ABI. MATERIALS AND METHODS: This retrospective study included 60 consecutive patients with suspected ABI who underwent a standardized imaging protocol dual-source dual-energy CT (DECT) over a 26-month period. Clinical and operative outcomes were recorded as the reference standard...
June 21, 2018: AJR. American Journal of Roentgenology
Y B Guo, L W Zhou, F L Chen, N Zou
Objective: To observe the effects of recombinant adenovirus with human thioredoxin (hTRX) on the inflammatory response in mice with viral myocarditis and explore the related mechanism. Methods: Sixty Balb/c male mice were randomly divided into control group, myocarditis group, and hTRX group according to the random number table ( n= 20 each group). The myocarditis group and hTRX group were injected with 100 TCID(50) Coxackie virus B3 (0.1 ml) in the abdomen and control group were injected with saline. Two days before the viral injection, the hTRX group were injected with recombinant adenovirus vector coding the human thioredoxin gene by pericardial puncture and the control group and myocarditis group were injected with recombinant adenovirus vector without coding gene by pericardial puncture, all these mice were killed and hearts were removed 7 days later...
June 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Subramanian Senthilkumaran, Narendra Nath Jena, Srinivasan Jayaraman, Florence Benita, Ponniah Thirumalaikolundusubramanian
Acute abdominal pain in women of reproductive age is common and frequent cause for visit to emergency department which warrants emergent evaluation. We present the case of a 23-year-old nulliparous women presenting with post-coital haemoperitoneum secondary to a ruptured corpus luteum cyst. This is a rare case demonstrating the need to elicit sexual history in patients presenting with an acute abdomen in emergency department.
June 2018: Turkish Journal of Emergency Medicine
Kelvin Yafan Wang, Omar Abbassi, Ali Warsi
We report the case of a 46-year-old woman who had presented with left-sided abdominal pain 21 days after undergoing a left-sided laparoscopic nephrectomy for donation. Initial haemoglobin and haematocrit levels were within normal range, and vital signs on admission were unremarkable. Significant intra-abdominal pathology was not suspected; however, inpatient CT scan of the abdomen showed a posterolateral subcapsular splenic haematoma with free abdominal fluid. Initial trial of conservative management was not successful as the patient became hypotensive on the third day of admission with a sudden decrease in haemoglobin and haematocrit...
June 15, 2018: BMJ Case Reports
Rosalie Yandell, Susan Wang, Peter Bautz, Alison Shanks, Stephanie O'Connor, Adam Deane, Kylie Lange, Marianne Chapman
BACKGROUND: Optimising nutrition support in critically ill patients with an open abdomen is challenging. OBJECTIVES: The aims of this study were to (i) quantify the amount and adequacy of nutrition support administered and (ii) determine any relationships that exist between mode of nutrition support delivery and clinical outcomes in critically ill patients with an open abdomen. METHODS: A retrospective review of critically ill patients mechanically ventilated for at least 48 h with an open abdomen in a mixed quaternary referral intensive care unit...
June 11, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Xinyu Li, Songhe Li, Zhiming Ma, Shutao Zhao, Xudong Wang, Dacheng Wen
RATIONALE: Gastrointestinal multiple metastases of lung cancer are extremely rare. The majority of gastrointestinal metastasis cases are diagnosed at a late stage and the prognosis is extremely poor. This report describes the clinical characteristics and outcomes of a patient with gastrointestinal multiple metastases from squamous-cell lung cancer, with special emphasis on the diagnosis and treatment of metastatic lung cancer. PATIENT CONCERNS: A 61-year-old man who presented with progressive abdominal distention was admitted to our hospital...
June 2018: Medicine (Baltimore)
Rajan Atwal, Charles Stewart
We describe the unique case of a child with pneumonia presenting with acute scoliosis and abdominal pain, without any typical features of the disease.A 10-year-old girl presented to the emergency department on 3 consecutive days with right-sided abdominal pain. There were no associated features, in particular, no fevers or respiratory symptoms. On the first 2 presentations, observation,examination, and blood test findings were unremarkable. Chest x-ray and abdominal ultrasound were also normal. On the third presentation a marked scoliosis was noted and abdominal examination revealed right-sided tenderness with rebound...
June 2018: Medicine (Baltimore)
Min Jang, Won-Gyun Son, Sang-Min Jo, Hyunseok Kim, Chi Won Shin, Inhyung Lee
OBJECTIVE: To evaluate a new balloon technique to induce intra-abdominal hypertension (IAH) and abdominal compartment syndrome in a conscious dog model, and to evaluate the effect of intra-abdominal pressure (IAP) on cardiovascular, respiratory, and arterial blood gas values in conscious dogs with IAH. DESIGN: Prospective, experimental study. SETTING: University-based small animal research facility. ANIMALS: Six healthy Beagle dogs, 4 males, and 2 females...
June 13, 2018: Journal of Veterinary Emergency and Critical Care
H Cinar, M Berkesoglu, M Derebey, E Karadeniz, C Yildirim, K Karabulut, T Kesicioglu, K Erzurumlu
Purpose: Anorectal foreign bodies (AFBs) inserted into anus constitute one of the most important problems needing surgical emergency due to its complications. We describe our experience in the diagnosis and treatment of AFBs retained in the rectosigmoid colon. Materials and Methods: Between the years 2006 and 2015, a total of 11 patients diagnosed with AFBs were admitted to an emergency room and general surgery clinics. They were diagnosed and treated in four different hospitals in four different cities in Turkey...
June 2018: Nigerian Journal of Clinical Practice
Tomoki Sempokuya, Dennis T Bolger
Hepatocellular carcinoma (HCC) is a highly aggressive malignancy in which tumor thrombus can invade portal and hepatic veins in late stages. However, an antemortem diagnosis of right atrial invasion by tumor thrombus is very rare and confers a poor prognosis. We report a patient with antemortem diagnosis of tumor thrombus in the right atrium incidentally found by transthoracic echocardiogram which was later confirmed with CT scan of abdomen with IV contrast. The patient was also noted to have an acute increase in alpha-fetoprotein (AFP)...
June 2018: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Huma Faiz Halepota, Muhammad Arif Mateen Khan, Noman Shahzad
OBJECTIVE: To determine the sensitivity and specificity of computed tomography scan for diagnosing small bowel obstruction among children. METHODS: The retrospective diagnostic test accuracy study was carried out at the Aga Khan University Hospital, Karachi, and comprised data of all patients aged 2-16 years who presented with clinical features of small bowel obstruction and underwent computed tomography scan of abdomen from January 2001 to December 2015Data was analyzed using SPSS19...
May 2018: JPMA. the Journal of the Pakistan Medical Association
Basmah A Rafie, Omar J AbuHamdan, Nawal S Trengganu, Badr H Althebyani, Bassam S Almatrafi
A wandering spleen is a condition characterized by excessive splenic mobility due to the mal-development or the laxity of its ligaments that leads to migration from its normal anatomical location. This condition renders its long mobile vascular pedicle liable to torsion and occasional infarction. Herein, we report a case of a 27-year-old nulliparous woman who presented with acute abdominal pain and a tender right-sided pelvi-abdominal mass. CT scan of the abdomen and pelvis revealed a torted, infarcted wandering spleen with portal hypertension and mesenteric varices that mandated an emergency splenectomy...
May 2018: Journal of Surgical Case Reports
Jordan W Greer, William C Beck, Avi Bhavaraju, Ben Davis, Mary K Kimbrough, Joseph Jensen, Anna Privratsky, Ronald Robertson, John R Taylor, Kevin W Sexton
A 30-year-old male presented to an outside facility with acute pancreatitis and triglycerides of 1594. He was transferred to our facility after becoming febrile, hypoxic and in acute renal failure with triglycerides of 4243. CT scan performed showed wall-off pancreatic necrosis. He underwent continuous renal replacement therapy and his acute renal failure resolved. He was treated with broad spectrum antibiotics and discharged. He developed a fever to 101 a week later and was found to have a large infected pancreatic pseudocyst...
May 2018: Journal of Surgical Case Reports
Onder Karabay, Mustafa Genco Erdem, Mustafa Hasbahceci
Partial necrosis of the cecum is a rare form of ischemic colitis with unknown etiology. A 68-year female patient was admitted due to a severe pain in the right lower quadrant of the abdomen for one week. One month ago, she had coronary artery bypass graft surgery with carotid endarterectomy. During physical examination, tenderness and rebound tenderness at the right lower quadrant were detected. Computed tomography showed a 7-mm tubular structure extending from the back of the cecum to the lower border of the liver...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ali Ezer, Alper Parlakgumus
Cecal diverticulum is a rare clinical condition which may present as acute abdomen through diverticulitis and perforation of diverticulitis. Surgical treatment of cecal diverticulitis has been controversial, with studies recommending options ranging from conservative management with antibiotics alone to aggressive resection. Two cases, one of which was pre- diagnosed with cecal tumor perforation and the other with cecal tumor leading to intestinal obstruction, were urgently operated. To both patients, right hemicolectomy was applied...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Andrew K Corse, Heather Kurtis
BACKGROUND Secondary polycythemia is a potential complication of an erythropoietin-secreting renal cell carcinoma. Increased red blood cell mass can elevate blood viscosity, which can impair blood flow, making individuals susceptible to vaso-occlusive events. One of the serious potential complications of a hyper-viscous state is ischemic stroke. CASE REPORT We present the case of a patient who was brought to the Emergency Department with right-sided extremity weakness and slurred speech consistent with acute ischemic stroke...
June 4, 2018: American Journal of Case Reports
Michael J Burla, Judith Boura, Lihua Qu, Jeffrey S Ditkoff, David A Berger
PURPOSE: Computed tomography (CT) is a standard imaging modality utilized during the evaluation of trauma patients in the emergency department (ED). However, while it is common to utilize intravenous (IV) contrast as an adjunct, the use of multiple CT scans and how it impacts patient flow can lead to changes in patient management. Our objectives are to assess length of stay (LOS) and rates of acute kidney injury (AKI), when two CT scans of the abdomen/pelvis are performed compared to one CT scan...
June 2, 2018: Emergency Radiology
Soichi Ito, Yuma Tsuchitani, Yuro Kim, Souhei Hashimoto, Yuichi Miura, Takuji Uemura, Kazunori Katsura, Takayuki Abe, Koichiro Sato, Hirotaka Kato
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. The small intestine is the second-most frequent location where GISTs occur after the stomach. Attention should be paid to small intestinal GISTs because they infrequently present with acute abdomen, which necessitates emergency surgery. This report describes a patient with a small intestinal GIST developing a giant intratumoral abscess, in whom emergency surgery was performed...
May 29, 2018: International Journal of Surgery Case Reports
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