EP.TH.714Adult Spontaneous Choledochal Cyst Rupture: A Case Report of a Rare Presentation

Abstract Background Choledochal cysts are uncommon congenital biliary duct dilatation involving either intra-hepatic, extra-hepatic ducts or both. The presentation varies among pediatric age groups compared to adults, in which pediatrics present mostly with jaundice whereas adults present with abdominal pain. It carries high-risk complications and related malignancy depending on the type of cyst. There were few reported cases of spontaneous rupture of choledochal cyst in adults. Case Description A 35-year-old female, medically and surgically free. Presented to Emergency Department with recurrent episodes of non-bilious vomiting for three weeks, managed conservatively. One day later, she presented with generalized abdominal pain with persistent vomiting. The patient mentioned a history of chronic abdominal pain for 6 years. On examination, the abdomen was tender all over with signs of peritonitis. A Computed Tomography scan revealed a septated intra-hepatic duct cyst measuring 9 x 11 cm. Therefore, she was taken to the operating room for exploratory laparoscopy, washout was done and drains were inserted. Afterward, Endoscopic Retrograde Cholangio-Pancreatography with sphincterotomy and stenting performed. Six weeks later, she underwent elective left hepatectomy and histopathology confirmed the choledochal cyst. She had an uneventful postoperative course with two weeks follow up with no complications. Conclusion Ruptured choledochal cyst is a rare presentation and high clinical suspicion is warranted in adult patients who present with a surgical abdomen along with a history of chronic abdominal pain. This case report represents the importance of conservative treatment before the definitive operation, to allow resolution of the peritonitis and lower the consequences.

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An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

Perspectives in Surgery ◽

10.33699/pis.2019.98.8.326-327 ◽

2019 ◽

Vol 98 (8) ◽

pp. 326-327 ◽

Cited By ~ 1

Keyword(s):

Liver Cirrhosis ◽

Abdominal Pain ◽

Case Report ◽

Portal Hypertension ◽

Liver Disease ◽

Epigastric Pain ◽

Umbilical Vein ◽

History Of ◽

Clinically Significant ◽

Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

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Myofascial pain syndrome as a diagnosis of chronic abdominal pain. Case report

Brazilian Journal Of Pain ◽

10.5935/2595-0118.20210021 ◽

2021 ◽

Author(s):

Elisa Jaime de Menezes ◽

Eloisa Gasparini Saque ◽

Graciele Bianchi Marcon

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Myofascial Pain ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Chronic Abdominal Pain

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Unusual case of Giardia lamblia causing eosinophilic ascites along with Plesiomonasshigelloides gastroenteritis

Biomedicine ◽

10.51248/.v41i2.806 ◽

2021 ◽

Vol 41 (2) ◽

pp. 321-323

Author(s):

Ballal Mamatha ◽

Shetty Vignesh ◽

Agarwal Manali ◽

Nayal Bhavna ◽

Umakanth Shashikiran

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Giardia Lamblia ◽

Complete Resolution ◽

Unusual Case ◽

Peripheral Eosinophilia ◽

Short Trip ◽

Eosinophilic Ascites ◽

History Of

A case report of a healthy, immunocompetent male,an international traveller from Germany who had visited India for a short trip,presented at our OPD with a history of loose stools, fever and abdominal pain,for two months. After thorough investigations, he was diagnosed to have an infection withGiardia lambliaacute gastroenteritis (AGE) along witheosinophilic ascites with peripheral eosinophilia, withassociatedPlesiomonasshigelloidesdiarrhoea. He was then treated with metronidazole and cotrimoxazole, which resulted in complete resolution of the symptoms.

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Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

Journal of Clinical Imaging Science ◽

10.25259/jcis-17-2019 ◽

2019 ◽

Vol 9 ◽

pp. 23

Author(s):

Giulia Frauenfelder ◽

Annamaria Maraziti ◽

Vincenzo Ciccone ◽

Giuliano Maraziti ◽

Oliviero Caleo ◽

...

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Bile Duct ◽

Common Bile Duct ◽

Acute Abdominal Pain ◽

Imaging Modality ◽

Biliary Duct ◽

History Of ◽

The Common ◽

Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

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Abdominal intussusception associated with coeliac disease: case report and literature review

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211904 ◽

2021 ◽

Author(s):

Rashid Hameed ◽

Noshine Irrum ◽

Subodhini P. Arachchige ◽

Edwin Tan ◽

Jacinta Tobin

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Literature Review ◽

Coeliac Disease ◽

Recurrent Abdominal Pain ◽

Immune Infiltration ◽

Disease Case ◽

Classical Pattern ◽

History Of

In genetically susceptible individuals, gluten ingestion triggers and immune infiltration and bowel damage in the classical pattern of coeliac disease, with variable symptoms. Intussusception is a condition where one segment of intestine ‘telescopes’ inside of another portion of intestine, which may cause symptoms of abdominal pain due to obstruction. Intussusception has been associated with coeliac disease. We report a 4-year-old girl presented with recurrent abdominal pain of variable severity and found to have intussusception on two occasions, which on both occasions reduced spontaneously during ultrasound examinations. She was later diagnosed with coeliac disease. This case highlights the importance of considering coeliac screening in patients with a history of recurrent abdominal pain and intussusception.

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Disseminated Histoplasmosis in an Elderly Man Presented with Fever, Weight loss, Abdominal Pain and Haemoptysis - A Case Report with Literature Review

Journal of Medicine ◽

10.3329/jom.v12i1.6745 ◽

2011 ◽

Vol 12 (1) ◽

pp. 81-85

Author(s):

Mohammad Robed Amin ◽

Farzana Shumi ◽

Hasibuddin Khan ◽

Syed Ahmed Abdullah ◽

Shafiul Alam ◽

...

Keyword(s):

Elderly Patient ◽

Weight Loss ◽

Abdominal Pain ◽

Case Report ◽

Literature Review ◽

Disseminated Histoplasmosis ◽

History Of ◽

Background History ◽

Recurrent Haemoptysis ◽

High Index Of Suspicion

An elderly patient presented with prolonged fever, gross weight loss, recurrent haemoptysis and abdominal pain. He had a background history of adrenal tuberculosis with completion of treatment without any obvious improvement. Clinically he was diagnosed as a case of adrenocotical insufficiency. Evaluation including histopathology revealed the diagnosis as disseminated histoplasmosis involving adrenal gland and lungs. The disease is a rarity without any underneath immunosuppression and hence high index of suspicion with appropriate steps for investigation is the key to achieve a diagnosis of disseminated histoplasmosis in Bangladesh. Keyword: . DOI: 10.3329/jom.v12i1.6936J Medicine 2011; 12 : 81-85

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Extramedullary haematopoiesis presenting as a periportal mass

BMJ Case Reports ◽

10.1136/bcr-2020-235064 ◽

2020 ◽

Vol 13 (7) ◽

pp. e235064

Author(s):

Faranak Rafiee ◽

Sara Haseli ◽

Seyed Hamed Jafari ◽

Pooya Iranpour

Keyword(s):

Bone Marrow ◽

Abdominal Pain ◽

Histopathological Examination ◽

Final Diagnosis ◽

Extramedullary Haematopoiesis ◽

Abdominal Ct ◽

Rare Presentation ◽

Abdominal Ct Scan ◽

History Of ◽

Vague Abdominal Pain

Extramedullary haematopoiesis (EMH) is defined as haematopoiesis occurring in organs outside the bone marrow. The liver is one of the rare sites of EMH, and to the best of our knowledge, a few cases of adult EMH of the liver have been reported in the last 20 years. Here, we reported the case of a 68-year-old man with a known history of myelofibrosis presented with vague abdominal pain. An abdominal CT scan showed a hypoattenuating periportal mass encasing the portal vein. The final diagnosis of EMH was made through the histopathological examination. This is a rare presentation of EMH, which may be easily mistaken for other pathologies such as metastases. Familiarity with this type of presentation aids in correctly diagnosing it in an appropriate clinical setting.

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