Gut malrotation and mesenteric thrombosis in adult: a rare presentation of chronic abdominal symptoms

A 31-year-old Canadian Aboriginal man from northwestern Ontario presented with left upper quadrant pain and a tender left upper quadrant mass. Evaluation with a computed tomography scan showed multiple lesions within the spleen, a collection between the splenic tip and splenic flexure of the colon, and several small adrenal lesions. Computed tomographic-guided needle biopsy showed necrotizing granulomatous inflammation and multinucleated giant cells. Gomori’s methenamine silver stain showed broad-based budding yeast consistent withBlastomyces dermatitidis. Abdominal symptoms resolved after two months of oral itraconazole. Multiple splenic abscesses are a rare presentation of blastomycosis and should be considered in the differential diagnosis of left upper quadrant abdominal pain in a patient with a history of travel or residence in a region endemic forB dermatitidis.

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Splenic Syndrome in a Young Man at High Altitude with Undetected Sickle Cell Trait

Journal of Patient Experience ◽

10.1177/2374373517747905 ◽

2017 ◽

Vol 5 (2) ◽

pp. 153-155 ◽

Cited By ~ 1

Author(s):

CHKA Fernando ◽

S Mendis ◽

AP Upasena ◽

YJ Costa ◽

HS Williams ◽

...

Keyword(s):

Sickle Cell Disease ◽

High Altitude ◽

Sickle Cell ◽

Sickle Cell Trait ◽

Carrier State ◽

Splenic Infarction ◽

Cell Disease ◽

Rare Presentation ◽

Abdominal Symptoms ◽

Life Threatening

Introduction: Splenic syndrome is a rare presentation of sickle cell disease. It is important to rule out this possibility when an ethnically vulnerable patient presents with an acute abdominal symptoms in a background of precipitating events. Case Report: A 26-year-old man who developed a severe abdominal pain at high altitude, found to have a tender splenomegaly. However, further inquiry revealed he is from an area where sickle cell disease is prevalent. Screening for sickle cell disease was positive. Radiological investigations confirmed a massive splenic infarction keeping with a diagnosis of splenic syndrome. Patient was managed conservatively. Conclusion: Sickle cell trait is considered a benign carrier state. However, rarely they can present with life-threatening conditions. Therefore, a high degree of clinical suspicion is required for early diagnosis of these specific entities to avoid increased morbidity and mortality of these patients.

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Toxic Haemorrhagic Colitis: A Rare Presentation of Eosinophilic Colitis

Case Reports in Gastrointestinal Medicine ◽

10.1155/2012/279813 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3

Author(s):

Shen-Ann Eugene Yeo ◽

Yon Kuei Lim ◽

Kiat Hon Tony Lim ◽

Choong-Leong Tang

Keyword(s):

Bowel Resection ◽

Rare Condition ◽

Hemorrhagic Colitis ◽

Rare Presentation ◽

Haemorrhagic Colitis ◽

Eosinophilic Colitis ◽

Abdominal Symptoms ◽

Surgical Emergency

Eosinophilic colitis is a rare condition that usually presents with non specific abdominal symptoms. Very uncommonly it presents with an acute surgical emergency such as peritonitis or haemorrhage. We present a rare presentation of eosinophilic colitis with toxic hemorrhagic colitis and ischaemic bowel requiring laparotomy and bowel resection.

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Sphacelation with auto-anastomosis of the intestine: a rare outcome of intussusception in a child—a case report

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00103-w ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Shung Ken Tan ◽

Chee Wei Tan ◽

Junaidah Hassan ◽

Mohan Arunasalam Nallusamy ◽

Jian An Boo ◽

...

Keyword(s):

Histopathological Examination ◽

Abdominal Mass ◽

Stage Iv ◽

Abdominal Distension ◽

Distal Segment ◽

High Grade Fever ◽

Rare Presentation ◽

Neutropenic Sepsis ◽

Abdominal Symptoms ◽

Bloody Stools

Abstract Background Intussusception is the telescoping of a proximal segment of the bowel into a distal segment. It can be idiopathic or pathological. Children commonly present with colicky abdominal pain, vomiting, a palpable abdominal mass, and bloody stools. Our case describes the unusual presentation of bowel sphacelation with auto-anastomosis in a child with intussusception and its clinical progression. Case presentation A 3-year-old boy with underlying stage IV rhabdomyosarcoma of the left orbit presented with high-grade fever and diarrhea for 1 day. He was treated for neutropenic sepsis in view of low absolute neutrophil count and recent history of chemotherapy. During his admission, he developed abdominal distension, high bilious aspirates, and diarrhea with bloody stools. Abdominal X-ray showed dilated bowel loops. Impression was septic ileus with coagulopathy. He was treated with blood transfusion and bowel rest. On the 6th day of illness, he passed out a tubular structure per rectum which was confirmed to be a segment of gangrenous bowel by histopathological examination. A diagnosis of intussusception with bowel sphacelation was made. He was treated conservatively, and his obstruction was resolved. He was discharged well with no abdominal symptoms during follow-up. Conclusion Intussusception is a common cause of small bowel obstruction in children. A high index of suspicion of intussusception should be maintained in children presenting with vomiting and bloody stools complemented by ultrasound to avoid missing this diagnosis. Sphacelation of the intussuscepted bowel with auto-anastomosis is a rare presentation of intussusception with a favorable outcome.

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