EP.FRI.48 Right iliac fossa pain in females: more than appendixes and ovarian cysts; Haemorrhagic Cyst in the Canal of Nuck: A Case Report

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Heather Davis ◽  
Caitlin Marshall ◽  
Md Abu Kamal Nahid ◽  
Ankur Shah
Keyword(s):  
Case Report ◽  
Ovarian Cyst ◽  
Case Reports ◽  
Iliac Fossa ◽  
Correct Diagnosis ◽  
Acute Onset ◽  
Canal Of Nuck ◽  
Right Iliac Fossa Pain ◽  
First Year Of Life ◽  
Groin Swelling

Abstract Case report A 43-year-old woman presented with acute onset migratory right iliac fossa pain, on a background of intermittently painful right groin swelling. CT demonstrated differential diagnosis of appendicitis besides an ovarian cyst. Diagnostic laparoscopy was undertaken with a view to diagnosis and treat possible appendicitis, ovarian cyst and inguinal hernia. To our surprise, a haemorrhagic nuchal cyst was seen intraoperatively, and duly aspirated. Post-operatively she recovered well and was discharged the same day. Introduction The Canal of Nuck is a small evagination of parietal peritoneum which accompanies the round ligament through the inguinal canal, in females. It is obliterated in the first year of life. When this remains patent, it can fill with fluid and result in the formation of cysts (akin to hydroceles in patent processus vaginalis). In current literature there are only sixteen case reports of Nuck hydroceles in adults, with only one haemorrhagic cyst reported. These are typically diagnosed in children, but occasionally present in women (aged 35.18 ± 3.27) with groin swelling and are frequently misdiagnosed as hernias. It is only when these woman are taken to theatre, that the correct diagnosis is discovered. Conclusion This case highlights the importance of considering Canal of Nuck cysts when women present with groin swellings, to ensure quick diagnosis and appropriate management is delivered under the correct speciality.

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

Abstract 1122‐000051: Isolated Diplacusis Due to Ipsilateral Temporal Lobe Infarction: A Case Report

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Ali Kerro ◽  
Reza Bavarsad Shahripour
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Case Reports ◽  
Sensorineural Deafness ◽  
Screen Test ◽  
Acute Onset ◽  
First Case ◽  
Ischemic Infarct ◽  
Pubmed Search ◽  
The Right

Introduction : Double hearing or Diplacusis is a synchronous double perception of a sound and can have Binauralis or Monauralis pattern, with inner ear disorders being the main culprit [1] . Other forms of Auditory illusions have been reported as a co‐manifestation of stroke syndromes, but none as an isolated presentation [1][2] . This is a case of a 77‐year‐old male with acute onset isolated Diplacusis in a patient due to a right temporal lobe ischemic infarct. To our knowledge, this is the first case report of an isolated diplacusis due to cortical infarct. Methods : A case presentation with Pubmed search of review articles and case reports. Results : The patient had a past medical history of sensorineural deafness in his left ear. He described any sound heard as the same quality but occurring with an echo heard a fraction of a second later in his right ear. There was no decreased hearing quality or tinnitus reported in his right ear. His drug screen test was negative. His examination was only remarkable for a sensorineural hearing loss pattern on his left ear. His (NIHSS) was zero, and no other cranial nerve abnormalities were detected. His MRI was significant for a punctate restricted diffusion on the right temporal lobe, resembling an ischemic infarct (Figure). Conclusions : Isolated diplacusis can present as acute ischemic stroke in the temporal lobe. Further studies are needed to understand its pathophysiology.

scholarly journals Case Report: Intussepting mucocele appendix

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1939
Author(s):  
Tom Crawley-Smith
Keyword(s):  
Case Report ◽  
Iliac Fossa ◽  
Rare Condition ◽  
Operative Management ◽  
Right Hemicolectomy ◽  
Malignant Potential ◽  
Rare Presentation ◽  
Mucocele Of The Appendix ◽  
Right Iliac Fossa Pain

Background: A case study of a presentation of a mucocele appendix, a rare condition accounting for 0.2% of appendicectomies. The case and operative management are discussed along with the possible progression to pseudomyxoma peritoneii and its differing management. Case: A 15-year-old girl had two presentations with atypical Right Iliac Fossa pain over 2 months. This was investigated with ultrasound and CT which revealed a calcified, intussusepting mucocele of the appendix. This was surgically resected with partial Right Hemicolectomy. The patient was discharged on day 3 with no complications. Discussion: The presentation, malignant potential, investigation and management of the mucocele appendix are discussed. The rare presentation of a mucocele appendix necessitates care to eliminate the risk of pseudomyxoma peritoneii. The operative management should minimise disturbance of the peritoneum in this presentation. In this case, due to an intersussepting nature a limited Right Hemicolectomy had to be performed. This is compared to the literature.

scholarly journals Tubo-Ovarian Inguinal Hernia with Ruptured Bleeding Follicle: A Case Report

2021 ◽  
pp. 1-2
Author(s):  
Faruk Hernández Sampayo ◽  
Gabriela Carvajales Lozano ◽  
María Yuliana Amell Wilches
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Ovarian Cyst ◽  
Clinical Case ◽  
Iliac Fossa ◽  
Incarcerated Hernia ◽  
Left Iliac Fossa ◽  
Pelvic Organs ◽  
Inguinal Hernias

Introduction: Hernias are abnormal protrusions of any abdominal-pelvic or fat organ, which are produced by a defect in the abdominal wall, the most frequent are inguinal hernias and their content is generally of the omentum or intestinal loops, the presence of pelvic organs is very infrequent and the majority of cases described are in children under five years of age. Objective: To analyze the entity in connection with a case of a patient with a tubo-ovarian inguinal hernia. Clinical case: The case of a 34-year-old female patient is presented, who was under follow-up by the gynecology service due to the presence of a left ovarian cyst, with symptoms of pain in the left iliac fossa for more than 6 months of evolution. which is performed an ultrasound, which reports left inguinal hernia for what is electively scheduled by the general surgery service, when performing the herniorrhaphy incarcerated hernia with left ovary with bleeding follicle and fallopian tube is evidenced. Conclusions: These types of findings are infrequent, documented in the literature with a global incidence of Tubo-ovarian inguinal hernias ranging from 0-8-4.4%, however it is worth clarifying that these studies are in infant patients, so its presentation in adults associated with a hemorrhagic follicle is anecdotal as in this case.

scholarly journals Rapidly Progressive Periorbital Oedema: A Case of Cutaneous Angiosarcoma

2021 ◽  
pp. 531-537
Author(s):  
Kuan Yee Chow ◽  
Soe Ko ◽  
Qiao Wei Melissa Ang
Keyword(s):  
Case Report ◽  
Endothelial Cell ◽  
Case Reports ◽  
Palliative Radiotherapy ◽  
Acute Onset ◽  
Rare Form ◽  
Periorbital Oedema ◽  
Facial Swelling ◽  
Uncommon Case ◽  
Skin Conditions

Angiosarcoma is a rare form of malignant endothelial cell tumour characterised by rapidly infiltrating anaplastic cells of vascular or lymphatic origin. We report an uncommon case of cutaneous angiosarcoma (cAS) manifesting as rapidly progressive unilateral periorbital oedema. Due to the acute onset of disease, the patient was initially treated with antibiotics for presumed periorbital cellulitis. The lack of response to conservative management raised the suspicion of a more serious condition, which eventually revealed the diagnosis of angiosarcoma through skin biopsy. As suggested by several previous case reports, the subtle manifestation of cAS made it a great mimicker of benign skin conditions. This case report serves as a reminder to the aggressive nature of angiosarcoma which can lead to marked facial swelling within several weeks. As the tumour was not resectable by the time of diagnosis, the patient was offered palliative radiotherapy.

scholarly journals Bilateral Varicocele Co-Existing With Sub-Acute Appendicitis : A Case Report

2021 ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Regional Anaesthesia ◽  
Iliac Fossa ◽  
Open Appendicectomy ◽  
Scrotal Pain ◽  
Case Presentation ◽  
Right Iliac Fossa Pain ◽  
Operative Recovery

Abstract IntroductionThe diagnosis of bilateral varicocele and sub-acute appendicitis co-existing in the same patient is rare and we report the management of a patient who presented to Lily Hospitals Limited, Warri, Delta State, Nigeria with both recurrent right iliac fossa pain and scrotal pain.Case presentation A 27 year old male who presented with recurrent scrotal pain of 3 years duration and recurrent right iliac fossa pain of 2 years duration. Following evaluation, the diagnosis of bilateral varicocele and sub-acute appendicitis was made and he subsequently had open bilateral inguinal varicocelectomy and open appendicectomy at the same sitting under regional anaesthesia. He had uneventful post-operative recovery and was subsequently discharged.ConclusionA thorough evaluation of patients presenting with scrotal and right iliac fossa pains is invaluable to avoid missing the diagnosis of both bilateral varicocele and appendicitis when they co-exist in the same patient.

Left iliac fossa pain

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Ovarian Cyst ◽  
Acute Diverticulitis ◽  
Iliac Fossa ◽  
Sudden Onset ◽  
Left Iliac Fossa ◽  
Ureteric Calculi ◽  
Right Iliac Fossa Pain ◽  
Colicky Pain ◽  
Menstruating Women ◽  
Irritable Bowel

In Figure 17.1 the differential diagnosis is arranged in order of likelihood in a woman of this age, with more likely diagnoses in larger font and less likely diagnoses in smaller font. Pathologies that should be excluded at the earliest possible opportunity are shown in bold. There are a number of gynaecological pathologies that can cause acute LIF pain. Some, such as ectopic pregnancy, mittelschmerz (mid-cycle pain), or haemorrhage into a functional ovarian cyst, can only occur in menstruating women. Others, such as pelvic inflammatory disease or torsion/rupture of an ovarian cyst, are far more likely to be seen in women younger than Mrs Hamilton, but can be kept in mind as rare differentials for someone of her age. Testicular torsion can cause referred pain to either the left or right iliac fossa and tends to occur in boys and young men. Haemorrhage into a testicular tumour can also cause left or right iliac fossa pain. Thus, don’t forget to examine the testes. You should ask the standard array of questions about the pain—remember the mnemonic SOCRATES: Site: Where is the pain, and has it always been there? Pain that is initially poorly localized, midline, and colicky but which then migrates to the LIF and becomes constant is highly suggestive of acute diverticulitis (akin to left-sided appendicitis). Pain that migrates down the left flank and iliac fossa is more consistent with the migration of a ureteric stone. Onset: Gradual or sudden? Sudden onset of pain is suggestive of perforation of a viscus, or of acute haemorrhage (e.g. into an ovarian cyst or from a ruptured AAA) or torsion (of an ovary or testis). Character: Is the pain colicky or constant? Is it sharp or dull? Acute diverticulitis is often preceded by colicky midline pain. Ureteric calculi may result in colicky pain. Established diverticulitis, and the other differential diagnoses from our list would all produce constant abdominal pain. Sharp pain is most suggestive of haemorrhage, perforation, or torsion. Radiation: Does the pain radiate to the groin (typical of ureteric pain)? Alleviating factors: Does anything make the pain better? Discomfort due to irritable bowel syndrome (IBS) may be relieved by defecation.

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