Case 11.17

Author(s):  
Christine U. Lee ◽  
James F. Glockner

51-year-old woman with a 1-month history of increasing lower abdominal pain Axial oblique FSE T2-weighted images (Figure 11.17.1) reveal enlarged ovaries bilaterally that contain elements of high and low signal intensity, as well as a small cystic component in the inferior right ovary. Axial oblique postgadolinium 2D SPGR images (...

Author(s):  
Christine U. Lee ◽  
James F. Glockner

35-year-old man with a long history of diabetes mellitus and recent episode of peritonitis now presents with recurrent abdominal pain and fever Axial fat-suppressed FSE T2-weighted images (Figure 5.1.1) show multiple hyperintense lesions in the spleen. The diffuse, decreased signal intensity throughout the remainder of the spleen is due to hemosiderosis and iron deposition. Gadolinium-enhanced axial 3D SPGR images (...


Author(s):  
Christine U. Lee ◽  
James F. Glockner

70-year-old woman with 20-lb weight loss over the past 6 months and crampy lower abdominal pain Axial fat-suppressed FSE T2-weighted images (Figure 9.20.1) and postgadolinium axial (Figure 9.20.2) and sagittal (Figure 9.20.3) 3D SPGR images demonstrate a large, heterogeneously enhancing mass in the pelvis, with markedly increased T2-signal intensity and multiple cystic regions on postcontrast images. The origin of the lesion from the sigmoid colon is difficult to discern, but it is probably best appreciated on the axial postgadolinium images. Note the invasion of the bladder dome, with a gas pocket in the anterior bladder....


2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.


Author(s):  
Christine U. Lee ◽  
James F. Glockner

54-year-old postmenopausal woman with vague pelvic pain Axial T2-weighted images from a DWI acquisition (b=0 s/mm2) (Figure 11.13.1) demonstrate a complex central pelvic mass containing an anterior cystic component, as well as a lobulated posterior solid component with mixed, but predominantly low, signal intensity. Corresponding axial diffusion-weighted images (b=800 s/mm...


Author(s):  
Christine U. Lee ◽  
James F. Glockner

27-year-old woman with left lower quadrant pain and a history of endometriosis Axial FSE T2-weighted images (Figure 11.5.1) demonstrate a large, lobulated left adnexal lesion with regions of high and low signal intensity. Coronal fat-suppressed FSE T2-weighted images (Figure 11.5.2) reveal similar findings. Coronal fat-suppressed FSE T1-weighted images (...


Author(s):  
Christine U. Lee ◽  
James F. Glockner

58-year-old man with a history of prostate cancer and a possible pancreatic mass on CT Axial fat-suppressed FSE T2-weighted images obtained before (Figure 4.5.1) and after (Figure 4.5.2) administration of an SPIO contrast agent demonstrate an ovoid mass in the pancreatic tail with intermediate signal intensity that becomes significantly hypointense after SPIO administration and matches the signal intensity of the spleen....


2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.


2019 ◽  
Vol 13 (3) ◽  
pp. 364-368
Author(s):  
Vishnu Charan Suresh Kumar ◽  
Kishore Kumar Mani ◽  
Hisham Alwakkaa ◽  
James Shina

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.


KYAMC Journal ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 262-264
Author(s):  
Mst Atia Sultana ◽  
Monira Akter ◽  
Shafiul Anam

Mrs. Lalbanu 65 years old lady presented to us with the complaints of something coming down per vagina for 10 years, foul smelling discharge for 2 months, fever & maggot formation for 5 days, she  also gave history of applying some chemical substances on her prolapsed mass of genitalia, and she also complains of lower abdominal pain for last 5 days. On examination, prolapsed mass was distorted, edematous, infected, irreducible & there were maggots, her temperature was raised & having lower abdominal tenderness. She was treated at first conservatively & then surgically. Now  she is well & with our follow up.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13662 KYAMC Journal Vol. 3, No.-1, June 2012 pp.262-264


Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 9 ◽  
Author(s):  
Atsushi Kohga ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
Kimihiro Yamashita ◽  
Jun Isogaki ◽  
...  

Isolated cecal necrosis (ICN) is a rare condition which is developed under decreased mesenteric perfusion. Only a few dozen cases of ICN have been reported previously. The patient was a 59-year-old male with a previous history of atrial fibrillation. He presented to our emergency room with the chief complaint of lower abdominal pain. Computed tomography imaging revealed a dilated cecum and presence of free air. With a preoperative diagnosis of perforation of the cecum; an urgent surgery was conducted. Intraoperative findings revealed an ischemic change of the cecum and a laparoscopic-assisted ileocecal resection was performed. The pathological findings showed transmural ischemic change on the anti-mesenteric side of the cecum, and the diagnosis of ICN was achieved. Preoperative diagnosis of ICN is difficult because of its non-specific radiological features. In patients with right lower abdominal pain, ICN should be considered as a differential diagnosis especially if the patient has a comorbidity causing hypotension attack.


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