Severe Epigastric Abdominal Pain

Surgery ◽  
2019 ◽  
pp. 563-568
Author(s):  
Viktor Gabriel ◽  
Sahil Aggarwal ◽  
Brian R. Smith
Surgery ◽  
2015 ◽  
pp. 493-499
Author(s):  
Michael D. Sgroi ◽  
Brian R. Smith

2019 ◽  
Vol 7 ◽  
pp. 232470961985276
Author(s):  
Manasi Singh ◽  
Ashley Duckett ◽  
Marc Heincelman

Porphyria cutanea tarda (PCT) is a condition of dysregulated heme synthesis that leads to accumulation of photosensitizing precursors with resultant fragility and blistering of the skin. It can be hereditary or acquired and has been known to be associated with hepatic C virus, alcohol, HIV, and estrogen. In this article, we report an unusual presentation of PCT associated with acute hemorrhagic pancreatitis in a 57-year-old man. He presented initially to a community hospital with acute onset of epigastric abdominal pain and new-onset ascites. Lipase was elevated. Diagnostic paracentesis was grossly bloody. He was then transferred to our institution for concern for acute hemorrhagic pancreatitis. On arrival, physical examination demonstrated vesicles and bullae with erythematous bases, in different stages of healing seen over the dorsal aspects of both hands with scaling, scarring, and hypopigmentation and hyperpigmentation of the skin. Laboratory evaluation and skin biopsy confirmed the diagnosis of PCT. Search for an underlying etiology failed to reveal typical predisposing factors. This report illustrates that acute hemorrhagic pancreatitis may be an underlying etiology for PCT.


2018 ◽  
Vol 57 (10) ◽  
pp. 1250-1253 ◽  
Author(s):  
Maria Josefina Sanchez ◽  
Benjamin C. Lee

PEDIATRICS ◽  
1971 ◽  
Vol 47 (3) ◽  
pp. 594-598
Author(s):  
Richard M. Buchta ◽  
J. M. Kaplan

In 1955, Zollinger and Ellison1 described a syndrome consisting of peptic ulceration, marked gastric hypersecretion, and non-beta islet cell tumor of the pancreas. Although there have been over 300 cases in the adult literature2-5 only 19 patients, 16 years old or younger have been reported. We add one more child to this growing list and review the clinical data of the known cases described. Case Report The patient (R.L.) was a 9-year-old Negro male with a 7-month history of intermittent episodes of mid-epigastric abdominal pain. The pain was somewhat relieved by eating, or the use of antispasmodics. During this period of time, the child had occasional episodes of vomiting, but no melena or hematemesis.


2019 ◽  
Vol 12 (10) ◽  
pp. e231087
Author(s):  
Yousaf Zafar ◽  
Laura Meidl ◽  
Maddison Lonney ◽  
Waqas Ullah ◽  
Mamoon Ur Rashid

We describe the case of a 49-year-old man who presented with a 6-day history of epigastric abdominal pain radiating to his right shoulder which started suddenly after swinging a golf club. A CT angiography of the abdomen was performed which showed dissection of the coeliac trunk extending into the splenic artery and splenic infarct. Anticoagulation was initially started but discontinued due to a small retroperitoneal haemorrhage. The patient remained stable and was discharged on aspirin 325 mg for 1 month followed by aspirin 81 mg. We present this case as well as a review of previously reported cases of splenic infarct due to spontaneous coeliac trunk dissection with the treatments employed as well as the outcomes.


2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Soraya López López ◽  
Carlos Marra-López Valenciano ◽  
Federico Bolado Concejo

Mumps are a preventable disease by vaccination, caused by a Paramyxovirus. Even though we are in the vaccination era, different phenomena as the migratory movements, are generating a new rebound of this highly transmissible viral infection. We present a female with a severe epigastric abdominal pain and elevation of alpha-amylase and triacylglycerol lipase in blood analysis, after 48 hours of mumps infection. After the exclusion of more frequent causes, the patient was diagnosed with acute pancreatitis related to mumps. This case shows that, despite it is a rare cause, acute pancreatitis should be considered in patients with mumps who present acute abdominal pain. An early diagnosis and an appropriate treatment are necessary to prevent and minimise morbi-mortality related to acute pancreatitis.


2020 ◽  
pp. 119-121

Volvulus of the gallbladder or gallbladder torsion (GT), is a condition in which an organ twists along its long axis leading to the vascular source compromise. The GT was first diagnosed in 1898 as a rare cause of idiopathic cholecystitis. Some 500 cases have been reported ever since, and they account for 0.1% in acute cholecystitis cases. An 85-year-old male patient presented with epigastric abdominal pain that was referred to as the upper abdominal quadrant (UAQ). The pain did not radiate elsewhere but was constant and severe. Moreover, it did not change with eating; nonetheless, the patient had anorexia, nausea, and biliary vomiting that occur two times. Fever and chills, weight loss, and icterus were not observed. According to the ultrasound report, flat cholecystitiswas diagnosed, and the patient underwent cholecystectomy. During the operation, GT was confirmed. Diagnosis of GT in elderly patients without symptoms of acute abdomen and cholecystitis should be considered in differential diagnosis to prevent complications and mortality.


2018 ◽  
Vol 154 (4) ◽  
pp. e12-e14
Author(s):  
Jana G. Hashash ◽  
Aline El-Haddad ◽  
Kassem Barada

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