Should routine spiral computed tomography be performed in adult patients with acute abdominal pain of the right lower quadrant?

2003 ◽  
Vol 18 (2) ◽  
pp. 126-130 ◽  
Author(s):  
J. Regimbeau ◽  
Y. Panis ◽  
P. Lê ◽  
P. Soyer ◽  
M. Kardache ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Spiral Computed Tomography ◽  
Adult Patients ◽  
Spiral Computed ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

scholarly journals Jejunal perforation caused by abdominal angiostrongyliasis

1999 ◽  
Vol 41 (5) ◽  
pp. 325-328 ◽  
Author(s):  
Jaques WAISBERG ◽  
Carlos Eduardo CORSI ◽  
Marisa Valente REBELO ◽  
Vilma Therezinha Trench VIEIRA ◽  
Sansom Henrique BROMBERG ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Intermediate Hosts ◽  
Lower Quadrant ◽  
Benign Nature ◽  
The Subject ◽  
Forest Rodents ◽  
The Right ◽  
Right Lower Quadrant ◽  
Peripheral Blood Eosinophilia

The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.

Plain Abdominal Radiography as a Routine Procedure for Acute Abdominal Pain of the Right Lower Quadrant: Prospective Evaluation

1999 ◽  
Vol 23 (3) ◽  
pp. 262-264 ◽  
Author(s):  
Emmanuel Boleslawski ◽  
Yves Panis ◽  
Stéphane Benoist ◽  
Christine Denet ◽  
Pascal Mariani ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Prospective Evaluation ◽  
Routine Procedure ◽  
Abdominal Radiography ◽  
Lower Quadrant ◽  
Plain Abdominal Radiography ◽  
The Right ◽  
Right Lower Quadrant

scholarly journals Omental infarction following colonoscopy

2015 ◽  
Vol 06 (02) ◽  
pp. 073-075
Author(s):  
Antonio Gangemi ◽  
Aqsa Durrani ◽  
Brian R. Boulay
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdominal Pain ◽  
Abdominal Ct ◽  
Lower Quadrant ◽  
Omental Infarction ◽  
Abdominal Ct Scan ◽  
The Right ◽  
Inflammatory Changes ◽  
Right Lower Quadrant

AbstractDiagnosis of omental infarction, while rare, has become increasingly common likely due to improvements in diagnostic imaging. Reported incidence of omental infarction varies; however, omental infarction has not yet been described in association with colonoscopy. Common complications of colonoscopy include complications of sedation, complications of bowel preparation, and bleeding following polypectomy, and rarely, perforation or infection. We describe herein a case of a 63-year-old female who developed acute right lower quadrant abdominal pain following a colonoscopy. Abdominal computed tomography (CT) scan revealed omental infarction in the right lower quadrant. Conservative management was employed, and the patient was observed for resolution of symptoms. Repeat abdominal CT scan 2 weeks following initial presentation showed resolution of inflammatory changes associated with omental infarction. The patient also improved clinically. Omental infarction should be considered in patients presenting with acute abdominal pain following colonoscopy.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

scholarly journals Isolated intestinal Ganglioneuromatosis: case report and literature review

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Angela Mauro ◽  
Letizia Zenzeri ◽  
Francesco Esposito ◽  
Giovanni Gaglione ◽  
Caterina Strisciuglio ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Polypoid Lesion ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Ileal Loop ◽  
Lower Quadrant ◽  
Blood Tests ◽  
Fecal Occult ◽  
The Right ◽  
Right Lower Quadrant

Abstract Background Intestinal Ganglioneuromatosis (IG) is a rare disorder of the enteric nervous system. In pediatric age it is often associated with genetic syndromes such as Neurofibromatosis 1 (NF1), multiple endocrine neoplasia type 2B (MEN2B) and Cowden syndrome (PTEN mutation), and ganglioneuromas (GNs) may be sometimes the first sign of the disease. Isolated GNs are rare and sporadic. Clinical symptom vary and depend on the size and on the location of the GNs. This disorder affects intestinal motility and it, consequently, causes changes in bowel habits, abdominal pain, occlusive symptoms and rarely lower gastrointestinal bleeding secondary to ulceration of the intestinal mucosa. On the other hand, patients can remain asymptomatic for many years. Case presentation We describe a 9-year-old boy referred to our emergency department for right lower quadrant abdominal pain. No familial history for gastrointestinal disorders. No history of fever or weight loss. At physical examination, he had diffused abdominal pain. Abdominal ultrasonography showed a hypoechoic formation measuring 41.8 mm by 35 mm in the right lower quadrant of the abdomen. Routine blood tests were normal, but fecal occult blood test was positive. Abdominal TC confirmed the hypodense formation, of about 5 cm in transverse diameter, in the right hypochondrium that apparently invaginated in the caecum-last ileal loop. Colonoscopy showed in the cecum an invaginated polypoid lesion of the terminal ileal loop. Laparoscopic resection of the polypoid lesion was performed. Histological diagnosis of the large neoplasm observed in the terminal ileum was diffuse ganglioneuromatosis. NF1, RET and PTEN gene tests resulted negative for specific mutations. At the 1 year follow-up, the patient presented good general condition and blood tests, fecal occult blood test, esophagogastroduodenoscopy, colonoscopy and MR-enterography were negative. Conclusions Only few cases are reported in literature of IG in pediatric age. Although rare, the present case suggests that this disorder must be taken in consideration in every patient with GI symptoms such as abdominal pain, constipation, lower intestinal bleeding, in order to avoid a delayed diagnosis.

A 73-Year-Old Woman With Abdominal Pain in the Right Lower Quadrant

JAMA ◽  
1987 ◽  
Vol 257 (11) ◽  
pp. 1513 ◽  
Author(s):  
Jeffrey R. Bond
Keyword(s):  
Abdominal Pain ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

scholarly journals Adult intestinal malrotation: a case report

2019 ◽  
Vol 7 (12) ◽  
pp. 4807
Author(s):  
Nyoman T. Pradiptha ◽  
Ketut Wiargitha
Keyword(s):  
Abdominal Pain ◽  
X Rays ◽  
Foetal Development ◽  
Lower Quadrant ◽  
Ladder Pattern ◽  
Intestinal Peristalsis ◽  
Ligament Of Treitz ◽  
The Right ◽  
High Index Of Suspicion ◽  
Right Lower Quadrant

Midgut malrotation is an incomplete rotation of the intestine which occurs during foetal development and usually presents in the neonatal period. The bowel is not fixed adequately and is thus held by a precariously narrow-based mesentery. The incidence of malrotation has been estimated at 1 in 6000 live births, it is rare for malrotation to present in adulthood. Author report a 40-year-old man presented to emergency department with generalized abdominal pain. His symptoms began 2 days before admission. The patient really weak and his mental state was somnolence. His abdomen was slightly extended, and intestinal peristalsis was obscure. Abdominal X-rays revealed dilatation of gastric, coiled spring appearance without free air and step ladder pattern. The patient then underwent laparotomy exploration. Upon entering the abdomen, ileum was noted to completely mobilized and founded volvulus segment, a clockwise twisting three times, about 30 cm proximal from ICJ, and soon author released it. The ligament of Treitz misplaced, there was in the right lower quadrant, close by ICJ. Then about 110 cm segment of ileum necrotic, the rest of the small bowel was normal, author found internal hernia in the right lower quadrant and there was Ladd's band. Clinicians should be aware of this serious cause of abdominal pain. The diagnosis of malrotation in adulthood is often delayed. Complete resolution of acute obstruction or chronic abdominal pain is the result of a high index of suspicion for malrotation, appropriate diagnostic studies, and aggressive treatment.

scholarly journals The use of ultrasonographic and Alvarado scores in evaluating abdominal pain suggestive of acute appendicitis

2017 ◽  
Vol 4 (2) ◽  
pp. 757 ◽  
Author(s):  
Jorge Fernández Álvarez ◽  
José Manuel Gómez López ◽  
Alberto M González Chávez ◽  
Benjamín Valente Acosta ◽  
Diego Abelardo Álvarez Hénandez ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Area Under The Curve ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Efficient Alternative ◽  
Two Parameters ◽  
The Right ◽  
Right Lower Quadrant

Background: Ultrasonographic scores for appendicitis to determine if, combined with Alvarado scores, they can increase the sensitivity and specificity of the diagnosis of appendicitis.Methods: All cases of abdominal pain suggestive of appendicitis presented between 2013 and 2015 were analysed. An Alvarado score was obtained. All patients underwent ultrasound, and an ultrasonographic score was determined, including the appendicitis classical findings.Results: Two hundred and fifty-one patients with abdominal pain in the right lower quadrant were analysed. Appendicitis was confirmed in 211 (84%) patients. For these patients, the average Alvarado score was 7.95/10 (±1.25) vs. 5.7/10 (± 1.11) for patients who did not have appendicitis (p < 0.001). In patients with confirmed appendicitis, the average ultrasonographic score was 2.48/6 (± 1.06) vs. 0.6/6 (± 0.92) for patients who did not have acute appendicitis (p < 0.001). The ultrasonographic score has a sensitivity of 90% and a specificity of 87% with only two parameters. The combination of the Alvarado and ultrasonographic scores decreased the percentage of negative appendectomies to 2.36% and increased the area under the curve by 0.970.Conclusions: The sum of the Alvarado and ultrasonographic scores provides an efficient alternative for diagnosing abdominal pain suggestive of appendicitis and predicts which patients should undergo surgery with good certainty.

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