964 Prevalence of Opioid Analgesic Use Among Patients Presenting to Emergency Department With Abdominal Pain That Is Investigated With Emergent Abdominal CT Scan

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

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Cecal Epiploic Appendagitis: A Diagnostic and Therapeutic Dilemma

The American Surgeon ◽

10.1177/000313480707300821 ◽

2007 ◽

Vol 73 (8) ◽

pp. 828-830 ◽

Cited By ~ 4

Author(s):

Vijaykumar G. Patel ◽

Arundathi Rao ◽

Reginald Williams ◽

Radha Srinivasan ◽

James K. Fortson ◽

...

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Ct Scan ◽

Abdominal Ct ◽

Lower Quadrant ◽

Radiographic Findings ◽

Epiploic Appendagitis ◽

Abdominal Symptoms ◽

Abdominal Ct Scan ◽

Limiting Condition

Acute epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. Though a benign and often self-limiting condition, EA's ability to mimic other disease processes makes it an important consideration in patients presenting with acute abdominal symptoms. Careful evaluation of abdominal CT scan findings is crucial in the accurate diagnosis of epiploic appendagitis, thus avoiding unnecessary surgical intervention. We report a case of a 29-year-old male presenting with a two day history of generalized abdominal pain. Physical exam revealed a diffusely tender abdomen with hypoactive bowel sounds. The patient had a leukocytosis of 18,000 and abdominal CT scan revealed right lower quadrant inflammatory changes suggestive of acute appendicitis. Laparoscopic exploration revealed an inflamed gangrenous structure adjacent to the ileocecal junction. Pathologic evaluation revealed tissue consistent with epiploic appendagitis. Retrospective review of the CT scan revealed a normal appearing appendiceal structure superolateral to the area of inflammation. The patient recovered uneventfully with resolving leukocytosis. We present a case of cecal epiploic appendagitis mimicking acute appendicitis and review the current literature on radiographic findings, diagnosis, and treatment of this often misdiagnosed condition. General surgeons should be aware of this self-limiting condition and consider this in the differential diagnosis.

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What is the Diagnostic Utility of an Abdominal CT Scan in the Hospitalized Medical Patient With Nonspecific Abdominal Pain?

Gastroenterology ◽

10.1016/s0016-5085(11)62337-8 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-565

Author(s):

Imran Sheikh ◽

Maya Merheb ◽

Amy Soloman ◽

Wen Zhang ◽

Catherine Curley ◽

...

Keyword(s):

Abdominal Pain ◽

Ct Scan ◽

Medical Patient ◽

Diagnostic Utility ◽

Abdominal Ct ◽

Abdominal Ct Scan

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Omental infarction following colonoscopy

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.159243 ◽

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.

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TRAUMA GINJAL

Jurnal Radiologi Indonesia ◽

10.33748/jradidn.v4i1.89 ◽

2020 ◽

Vol 4 (1) ◽

pp. 52-57

Author(s):

Noflih Sulistia ◽

Bambang Soeprijanto ◽

Indrastuti Normahayu ◽

Lenny Violetta

Keyword(s):

Ct Scan ◽

Pediatric Patients ◽

Radiological Examination ◽

Renal Trauma ◽

Abdominal Ct ◽

Abdominal Ct Scan

Renal trauma in children is more common than in adults. Clinically in pediatric patients with renal trauma do not always describe the degreeof trauma. Radiological examination, especially abdominal CT-scan with contrast, can help evaluate the damage to the kidneys so that it candetermine the degree of trauma.

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Study on the Radiation Dose of Abdominal CT Scan Using Dual Energy

Korean Society of Computed Tomographic Technology ◽

10.31320/jksct.2018.20.2.123 ◽

2018 ◽

Vol 20 (2) ◽

pp. 123-132

Author(s):

Dae-hyun Park ◽

Young-Kyoon Kim ◽

Jong-Ho Ahn ◽

Kwang-Hyun Chang ◽

Yoon-Chul Nam ◽

...

Keyword(s):

Radiation Dose ◽

Ct Scan ◽

Dual Energy ◽

Abdominal Ct ◽

Abdominal Ct Scan

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Splenic abscess caused by Streptococcus anginosus bacteremia secondary to urinary tract infection: a case report and literature review

Open Medicine ◽

10.1515/med-2020-0117 ◽

2020 ◽

Vol 15 (1) ◽

pp. 997-1002

Author(s):

Hao Wu ◽

Rui Zheng

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Ct Scan ◽

Splenic Abscess ◽

Low Density ◽

Abdominal Ct ◽

Streptococcus Anginosus ◽

Abdominal Ct Scan ◽

Tract Infections

AbstractOrgan abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.

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Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

BMC Gastroenterology ◽

10.1186/s12876-021-01627-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhicheng Zhang ◽

Xiaowei Huang ◽

Qian Chen ◽

Demin Li ◽

Qi Zhou ◽

...

Keyword(s):

Small Intestine ◽

Case Report ◽

Literature Review ◽

Ct Scan ◽

Duplication Cyst ◽

Abdominal Ct ◽

Case Presentation ◽

Abdominal Ct Scan ◽

Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

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COVID-19 as the cause of thrombosis: recognising COVID-19 infection in apparently asymptomatic patients

BMJ Case Reports ◽

10.1136/bcr-2020-241027 ◽

2021 ◽

Vol 14 (1) ◽

pp. e241027

Author(s):

Kyle B Varner ◽

Emily J Cox

Keyword(s):

Emergency Department ◽

Direct Result ◽

Abdominal Ct ◽

Call To Action ◽

Asymptomatic Patients ◽

Pulmonary Manifestations ◽

Abdominal Ct Scan ◽

Thrombotic Complications ◽

Work Up ◽

Renal Thrombosis

COVID-19 has serious thrombotic complications in critically ill patients; however, thrombus is not a typical presenting symptom. This case report describes a patient with no respiratory symptoms who presented to the emergency department with abdominal pain. The pain was attributed to renal thrombosis, but the patient was found to have no risk factors for thrombotic disease and subsequent hypercoagulable work-up was unremarkable. Pulmonary manifestations of COVID-19 infection were detected incidentally on the abdominal CT scan and confirmed via PCR test. The patient was isolated and went on to develop mild respiratory failure secondary to COVID-19 infection. This case suggests that unexplained thrombus in otherwise asymptomatic patients can be a direct result of COVID-19 infection, and serves as a call to action for emergency department clinicians to treat unexplained thrombotic events as evidence of COVID-19.

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