Myositis ossificans in the right inferior thoracic wall as an unusual cause of lower thoracic-upper abdominal pain: Report of a case

Acute or recurrent pain in the right upper part of the abdomen is a common cause for visits to physicians. Not less than two thirds of episodes of pain in this area are conditioned by biliary colic and acute cholecystitis. Other most common causes include diseases of the liver, pancreas, prepyloric and pyloric parts of the stomach and the beginning portion of the small intestine, the right kidney, and also subhepatic appendicitis. Some cases of developing pain are associated with the right lung affection and involvement of the diaphragmatic pleura, with heart diseases, involvement of the locomotor system and nerves. Taking into account a high prevalence of cholelithiasis in Russia – around 10–12% – we can conclude that episodes of biliary colic develop every year in 1 of 500–1000 individuals. In Russia, approximately half a million cholecystectomies are performed annually. The prevalence of gall stones among the paediatric population amounts to 2%. As distinct from adults, who in 80% of cases have an asymptomatic course of disease, pain episodes in children manifest themselves in 60–67% of cases. The diiagnosis of acute cholecystitis might meet with considerable difficulties; a scale for assessment of the likelihood of acute cholecystitis has been developed. Unlike in adults, in children a significantly large proportion of cases occur due to acalculous cholecystitis. Differentiating the causes of pain might be difficult, therefore, its character and concomitant symptoms should be thoroughly analysed, and the findings of additional examinations should also be taken into consideration (at the first step – assessment of haematological and biochemical parameters, urinalysis, electrocardiogram and abdominal ultrasonography). Key words: right upper abdominal pain, biliary colic, biliary dyskinesia, cholelithiasis

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Role of Cholecystectomy in Symptomatic Hyperkinetic Gallbladder Patients

Case Reports in Surgery ◽

10.1155/2021/5569850 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Jai P. Singh

Keyword(s):

Abdominal Pain ◽

Complete Resolution ◽

Biliary Colic ◽

Quadrant Pain ◽

Gallbladder Ejection Fraction ◽

Hida Scan ◽

Upper Abdominal ◽

The Right ◽

Upper Abdomen

Introduction. Biliary dyskinesia is defined by a gallbladder ejection fraction (EF) of less than 35% on HIDA scan, and these patients have shown a good response to cholecystectomy. Management of patients with biliary colic symptoms who have a hyperkinetic gallbladder ( EF > 80 % ) is not clearly defined. Herein, I report three cases of the symptomatic hyperkinetic gallbladder that were successfully managed with cholecystectomy. Case Report. Patient 1was a 56-year-old female presented with pain in the right upper abdomen for one month. Her workup was unremarkable except for the gallbladder EF of 86%. Patient 2 was a 33-year-old female with similar symptoms and workup with gallbladder EF of 97%. Patient 3 was a 20-year-old female with right upper abdominal pain and gallbladder EF of 91%. Patients 1 and 3 had the normal US, normal CT scan, and normal EGD. Patient 2 had normal US and CT but did not undergo EGD. All three patients underwent laparoscopic cholecystectomy and had complete resolution of their symptoms. Conclusion. The hyperkinetic gallbladder is a rare phenomenon, which can cause debilitating right upper quadrant pain. All three patients had an excellent response to cholecystectomy. Therefore, it is concluded that the patients with biliary colic and gallbladder EF of 80% or higher should be strongly considered for surgery.

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An Unusual Case of Monolobar Caroli’s Disease

Canadian Journal of Gastroenterology ◽

10.1155/1994/768974 ◽

1994 ◽

Vol 8 (3) ◽

pp. 185-188

Author(s):

Anthony J Gomez ◽

Robert J Bailey

Keyword(s):

Abdominal Pain ◽

Unusual Case ◽

Pathological Examination ◽

Right Hepatectomy ◽

Radiological Evaluation ◽

Caroli's Disease ◽

Caroli’S Disease ◽

Hepatic Lobe ◽

Upper Abdominal ◽

The Right

A 27-year-old male with recurrent upper abdominal pain was found to have a suspicious mass in the right hepatic lobe. Right hepatectomy was performed. Pathological examination and further radiological evaluation proved this to be a focal form of Caroli’s disease.

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Torsion of Hydrosalpinx with Concurrent Acute Cholecystitis: Case Report and Review of Literature

Case Reports in Surgery ◽

10.1155/2016/5424092 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Preeti R. John ◽

Amelia M. Pasley

Keyword(s):

Abdominal Pain ◽

Acute Cholecystitis ◽

Fallopian Tube ◽

Bladder Wall ◽

Age Groups ◽

Lower Abdominal Pain ◽

Abdominal Ultrasound ◽

Acute Calculous Cholecystitis ◽

Upper Abdominal ◽

The Right

Introduction.Isolated torsion of the Fallopian tube is an uncommon cause of acute lower abdominal pain and can occur in women of all age groups. Cholecystitis is a frequent cause of upper abdominal pain. We present an unusual case with the presence of these two distinct pathological entities occurring concurrently in the same patient, causing simultaneously occurring symptoms. To our knowledge, this is the first reported presentation of such a case.Methods.We describe a 34-year-old premenopausal woman who presented with right sided upper and lower abdominal pain and nausea. Abdominal ultrasound (US) revealed acute cholecystitis. Vaginal US was suggestive of right hydrosalpinx. Intravenous antibiotics were administered and consent was obtained for operative intervention. During laparoscopy, the right Fallopian tube with hydrosalpinx was noted to be twisted three times. The right ovary appeared normal. The gall bladder wall was thickened and inflamed. Laparoscopic right salpingectomy and cholecystectomy were performed.Results.Surgical pathology revealed hydrosalpinx with torsion and acute calculous cholecystitis. The patient had an uneventful postoperative course and was discharged home on the first postoperative day. Her symptoms resolved after the procedure.Conclusions.In women with abdominal pain, both gynecologic and nongynecologic etiologies should be considered in the differential diagnoses. Concurrent presence of symptomatic gynecologic and nongynecologic intra-abdominal pathology is rare. Isolated Fallopian tube torsion is rare and is associated most often with hydrosalpinx. Some torqued Fallopian tubes can be salvaged. Laparoscopy is useful in management of both Fallopian tube torsion and cholecystitis.

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Upper abdominal pain

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738018776334 ◽

2018 ◽

Vol 11 (8) ◽

pp. 428-434

Author(s):

Rodrick Babakhanlou

Keyword(s):

General Practice ◽

Abdominal Pain ◽

Hospital Admission ◽

Wide Range ◽

Life Threatening ◽

Upper Abdominal ◽

The Right

Abdominal pain is a frequent presentation to general practice; it comprises a wide range of different abdominal and extra-abdominal causes. Upper abdominal pain can be located in the epigastrium, the right and left upper quadrants, and renal angles. It may be associated with back or shoulder tip pain. Causes of abdominal pain can be benign or malignant, and may be life-threatening. Patients with upper abdominal pain may need urgent hospital admission, but many patients can be managed in the community. This article gives an overview of the important causes of upper abdominal pain, their assessment and management.

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Acute abdomen in pregnancy: a retrospective study of pregnant patients hospitalised for abdominal pain

Perspectives in Surgery ◽

10.33699/pis.2020.99.3.131-135 ◽

2020 ◽

Vol 99 (3) ◽

pp. 131-135

Keyword(s):

Abdominal Pain ◽

Clinical Signs ◽

University Hospital ◽

Diagnostic Process ◽

Abdominal Emergency ◽

Lower Abdominal Quadrant ◽

Abdominal Emergencies ◽

The Right ◽

Abdominal Quadrant ◽

In Pregnancy

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.

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Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

Journal of Case Reports in Medicine ◽

10.25149/jcrm.v8i2.178 ◽

2019 ◽

Vol 8 (2) ◽

Author(s):

Peter Wang

Keyword(s):

Abdominal Pain ◽

Digestive Enzymes ◽

Gallbladder Disease ◽

Hepatobiliary Scintigraphy ◽

Hepatobiliary Imaging ◽

Upper Gi ◽

Gi Symptoms ◽

Upper Abdominal ◽

Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

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A case of right hepatic duct entering cystic duct successfully treated by laparoscopic subtotal cholecystectomy through preoperatively placed biliary stent

Surgical Case Reports ◽

10.1186/s40792-020-00994-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Hiroki Hirao ◽

HiroHisa Okabe ◽

Daisuke Ogawa ◽

Daisuke Kuroda ◽

Katsunobu Taki ◽

...

Keyword(s):

Cystic Duct ◽

Hepatic Duct ◽

Magnetic Resonance Cholangiopancreatography ◽

Endoscopic Retrograde ◽

Case Presentation ◽

Endoscopic Nasobiliary Drainage ◽

Subtotal Cholecystectomy ◽

Upper Abdominal ◽

The Right ◽

Nasobiliary Drainage

Abstract Background Laparoscopic cholecystectomy is a well-established surgical procedure and is one of the most commonly performed gastroenterological surgeries. Therefore, strategy for the management of rare anomalous cystic ducts should be determined. Case presentation A 56-year-old woman was admitted to our hospital owing to upper abdominal pain and diagnosed with acute cholecystitis. Magnetic resonance cholangiopancreatography suspected that several small stones in gallbladder and the right hepatic duct drained into the cystic duct. Endoscopic retrograde cholangiopancreatography confirmed the cystic duct anomaly, and an endoscopic nasobiliary drainage catheter (ENBD) was placed at the right hepatic duct preoperatively. Intraoperative cholangiography with ENBD confirmed the place of division in the gallbladder, and laparoscopic subtotal cholecystectomy was safely performed. Conclusions The present case exhibited rare right hepatic duct anomaly draining into the cystic duct, which might have caused biliary tract disorientation and bile duct injury (BDI) intraoperatively. Any surgical technique without awareness of this anomaly preoperatively might insufficiently prevent BDI, and preoperative ENBD would facilitate safe and successful surgery.

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Intestinal obstruction caused by pericecal internal herniation

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa003 ◽

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.

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Primitive Neuroectodermal Tumor of the Liver: A Case Report

Case Reports in Medicine ◽

10.1155/2011/748194 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Eduardo Cambruzzi ◽

Enilde Eloena Guerra ◽

Hamilton Cardoso Hilgert ◽

Herbert Jorge Schmitz ◽

Vinícius Lopes Silva ◽

...

Keyword(s):

Primitive Neuroectodermal Tumor ◽

Soft Tissues ◽

Young Patients ◽

Neuroectodermal Tumor ◽

Solid Mass ◽

Resected Liver ◽

The Central Nervous System ◽

Right Lobe ◽

Upper Abdominal ◽

The Right

Primary liver sarcomas represent a rare group of neoplasias, with angiosarcoma being the most common histological type. Primitive neuroectodermal tumor (PNET) represents a high malignant neoplasia that usually affects the central nervous system and soft tissues. An 18-year-old male patient was admitted with clinical complains of pain in the right upper abdominal quadrant. The clinical evaluation revealed a solid mass in the right hepatic lobe. On the gross examination of the resected liver specimen, the right lobe of the liver was replaced by a yellow-red solid mass measuring 21 cm in its largest dimension. On the histopathology, a tumor composed of small round blue cells with little cytoplasm and round nuclei was identified. The lesion revealed positive immunoexpression for vimentin and CD99 and negative immunostaining for desmin, CD45, cytokeratin, and neuroblastoma protein, suggesting, then, the diagnosis of PNET. Although it is an unusual tumor, it should be considered in the differential diagnosis of liver masses, especially in young patients.

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