Esophageal Perforation during Gastric Bypass: Delayed Diagnosis and Management

2007 ◽  
Vol 17 (7) ◽  
pp. 986-988 ◽  
Author(s):  
Santiago A. Endara ◽  
Armando J. Serrano ◽  
Bernardo A. Sandoval ◽  
Gerardo A. Davalos
Keyword(s):  
Gastric Bypass ◽  
Esophageal Perforation ◽  
Delayed Diagnosis ◽  
Diagnosis And Management

scholarly journals Adult onset Still’s disease in the elderly: a case-based literature review

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Arash Mollaeian ◽  
Jingjing Chen ◽  
Nina N. Chan ◽  
Gregory A. Nizialek ◽  
Christopher J. Haas
Keyword(s):  
Delayed Diagnosis ◽  
The Elderly ◽  
Adult Onset Still’S Disease ◽  
Inflammatory Disorder ◽  
Adult Onset ◽  
Still’S Disease ◽  
Diagnosis And Management ◽  
Still's Disease ◽  
Area Of Interest ◽  
Adult Onset Still's Disease

Abstract Background Adult onset Still’s disease (AOSD) is a rare inflammatory disorder that classically presents with high spiking fevers, evanescent rash, and arthritis. The diagnosis is one of exclusion and can be further complicated by atypical presentations, particularly in elderly patients in whom AOSD is very rare. Case presentation A case of AOSD in a 73-year-old woman with a non-classic presentation, leading to delayed diagnosis and management, is presented along with a review of the English literature for AOSD cases in elderly people over 70 years of age. Thirty nine case reports and series were identified and the current case was added, totaling 42 individual cases. Significant findings included a four-times higher prevalence in females, a higher prevalence of macrophage activation syndrome despite lower mortality, the presence of pruritic rash in almost one fifth of the cases, and high prevalence of delayed diagnosis. Conclusions AOSD in the elderly may vary from the classic criteria described in the medical literature and may lead to delayed diagnosis and management. Further evaluation and better characterization of AOSD in the elderly remains an area of interest.

scholarly journals RETRACTED ARTICLE: Conservative management for an esophageal perforation in a patient presented with delayed diagnosis: a case report

Cases Journal ◽  
2009 ◽  
Vol 2 (1) ◽  
Author(s):  
Konstantinos Tsalis ◽  
Konstantinos Blouhos ◽  
Dimitrios Kapetanos ◽  
Theodore Kontakiotis ◽  
Charalampos Lazaridis
Keyword(s):  
Case Report ◽  
Conservative Management ◽  
Esophageal Perforation ◽  
Delayed Diagnosis ◽  
Retracted Article

One-stage operation for treatment after delayed diagnosis of thoracic esophageal perforation

1992 ◽  
Vol 53 (4) ◽  
pp. 617-620 ◽  
Author(s):  
Chau-Hsiung Chang ◽  
Pyng Jing Lin ◽  
Jen-Ping Chang ◽  
Ming-Jang Hsieh ◽  
Ming-Chung Lee ◽  
...  
Keyword(s):  
Esophageal Perforation ◽  
Delayed Diagnosis ◽  
One Stage

scholarly journals Huge Ovarian Cyst- A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 87-90
Author(s):  
Sunita Maharjan ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Tissue ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Ultrasound Finding ◽  
Emergency Laparotomy ◽  
Diagnosis And Management ◽  
The Right

Ovarian cyst torsion (also termed as adnexal torsion) refers to partial or complete rotation of the ovary and a portion of fallopian tube along with its supply to vascular pedicle. It occurs commonly in females of all age group, more on the right side (60%) and often with acute lower abdominal pain lasting for few hours up to 24 hours. Ovarian cyst torsion is one of the devastating conditions hampering blood supply of ovary which may lead to total necrosis of ovarian tissue like in our case. Delayed diagnosis and management can lead to various complications. Here, we present a case of 46 years old perimenopausal female, para 2, living 2 who presented to our emergency department with complain of sudden onset severe pain abdomen since morning. Emergency exploratory laparotomy was done due to high clinical suspicion of torsion based on previous ultrasound finding of ovarian cyst done a day prior to the presentation. On intraoperative finding, the cyst was already necrosed. Due to timely diagnosis and management by emergency laparotomy, anticipated complications were reduced.    

806 CERVICAL ESOPHAGEAL PERFORATION: MULTIMODAL APPROACH TO A RARE AND MORBID CONDITION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Chee Chuan Tang ◽  
Kelvin Voon ◽  
Nagalingam Premnath
Keyword(s):  
Esophageal Perforation ◽  
Treatment Options ◽  
High Morbidity ◽  
Contrast Study ◽  
Oral Contrast ◽  
Multimodal Approach ◽  
Early Management ◽  
Iatrogenic Perforation ◽  
Diagnosis And Management ◽  
Cervical Esophageal Perforation

Abstract   Cervical esophageal perforation (CEP) is an uncommon but serious surgical condition. It is associated with a high morbidity and mortality if not managed timely, partly due to its close proximity with vital structures in the neck and mediastinum. The common causes include trauma, foreign body ingestion and iatrogenic perforation. The diagnosis and management of CEP remain challenging despite advances in surgery. Methods We present a series of 3 cases of CEPs, with multimodal approach for the management. Results In this series of 3 cases of CEPs with different presentations, tailored management strategies resulted with successful outcomes. Post-procedure/operative oral contrast study revealed no contrast leakage. Conclusion The diagnosis and management of CEP remain challenging despite advances in surgery. Contrasted CT scan and endoscopy are the mainstay of investigations. The treatment options of CEP range from conservative management to endoscopic intervention to surgical repair often with drainage procedures due to its frequent association with collections in the neck, pleural or mediastinal cavity. Prompt detection and early management with multimodal intervention ensure a better outcome in these patients.

Hypoglycemia

2020 ◽  
Author(s):  
F John Service ◽  
Adrian Vella
Keyword(s):  
Gastric Bypass ◽  
Blood Glucose ◽  
Diagnostic Test ◽  
Clinical Syndrome ◽  
Diagnosis And Management

Hypoglycemia is a clinical syndrome that has diverse causes and is characterized by episodes of low blood glucose and typically marked by autonomic and neuroglycopenic manifestations. This review discusses the classification, etiology, and diagnosis for hypoglycemia, including the Whipple triad, and the classic diagnostic test, the prolonged (72-hour) fast. Specific attention is given to the conditions that cause hypoglycemia, including insulinomas, factitious hypoglycemia, insulin autoimmune hypoglycemia, and post–gastric bypass hypoglycemia, as well as the diagnosis and management of these conditions.  This review contains 2 figures, 6 figures, and 43 figures.  Keywords: Blood glucose, hypoglycemia, neuroglycopenic manifestations, Whipple triad, 72-hour fast, insulinoma, post-gastric bypass, factitious hypoglycemia

scholarly journals Analysis and Follow up of Endoscopy Results in 1099 Patients with Terminal Ileum Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Qinglian Zhong ◽  
Anye Zhang ◽  
Jian Huang ◽  
Wen Yan ◽  
Jiayu Lin ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Diagnostic Accuracy ◽  
Clinical Diagnosis ◽  
Terminal Ileum ◽  
Diagnostic Yield ◽  
Delayed Diagnosis ◽  
Clinical Treatment ◽  
Diagnosis And Management

Objective. We aim to analyze the diagnostic yield, diagnostic accuracy, and delayed diagnosis of patients with terminal ileum lesions, providing follow-up suggestions for suspected patients. Methods. We carried out an analysis of 1099 patients who had terminal ileum lesions in our hospital from 2009 to 2019. The endoscopy reports and histopathology reports of terminal ileal biopsies were recorded. Clinical diagnosis and management were reviewed to determine whether there was a need to correct after a follow-up endoscopy result. Results. A total of 1099 patients were found to have terminal ileum lesions, among which 959 in 1099 patients (87.26%) were diagnosed as benign, 17 in 1099 patients (1.55%) were diagnosed as malignant, and 123 in 1099 patients (11.19%) were diagnosed as suspected. The diagnostic accuracies of terminal ileal polyp, cyst, cancer, eosinophilic enteritis, parasite, lymphofollicular hyperplasia, and amyloidosis were 100%. The diagnosis was delayed in 9.93% of Crohn’s disease (CD) and 12.5% of lymphoma. Among the definite cases, the diagnosis was corrected during the follow-up in 12.5% of the patients, while the clinical treatment was corrected during the follow-up in 17.86% of the patients. Among the suspected cases, the diagnosis and treatment was corrected in 61.11% of the patients during the follow-up. Conclusion. Coincident diagnosis of ileitis and ileum ulcer is low. Delayed diagnosis of Crohn’s disease and lymphoma were observed in a certain proportion of patients with terminal ileum lesions. A follow-up endoscopy was strongly recommended for these suspected patients with terminal ileum lesions.

scholarly journals Expert Perspectives on Hereditary Angioedema: Key Areas for Advancements in Care across the Patient Journey

2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0165 ◽  
Author(s):  
Aleena Banerji ◽  
Murat Baş ◽  
Jonathan A. Bernstein ◽  
Isabelle Boccon-Gibod ◽  
Maria Bova ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Hereditary Angioedema ◽  
Delayed Diagnosis ◽  
Scientific Data ◽  
Online Information ◽  
Care Providers ◽  
C1 Inhibitor Deficiency ◽  
Patient Journey ◽  
Diagnosis And Management ◽  
Awareness Campaigns

Background Published literature documents the substantial burden of hereditary angioedema (HAE) with C1 inhibitor deficiency on the quality of life and work productivity of patients. However, despite advances in the field and the availability of guidelines to advise health care providers (HCP) on the diagnosis and management of HAE, there are still many challenges to overcome. For example, delayed diagnosis and misdiagnosis are common, and treatment practices vary worldwide. Objective An international expert panel was convened to consider opportunities for improvements that would benefit patients with HAE. Methods Based on professional and personal experiences, the experts developed schematics to describe the journey of patients through the following stages: (1) onset of symptoms and initial evaluation; (2) referral/diagnosis; and (3) management of HAE. More importantly, the panel identified key areas in which it was possible to optimize the support provided to patients and HCPs along this journey. Results Overall, this approach highlighted the need for wider dissemination of algorithms and scientific data to more effectively educate HCPs from multiple disciplines and the need for more research to inform appropriate treatment decisions. Furthermore, HAE awareness campaigns, accurate online information, and referral to patient advocacy groups were all considered helpful approaches to support patients. Conclusion More detailed and widespread information on the diagnosis and management of HAE is needed and may lead to advancements in care throughout the journey of the patient with HAE.

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