scholarly journals Black ascitic fluid in a patient with history of alcohol abuse: report of an unusual case and literature review

2020 ◽  
Vol 2020 (4-5) ◽  
Author(s):  
José Martín Alanís Naranjo ◽  
María de Lourdes Alanís Naranjo
Keyword(s):  
Alcohol Abuse ◽  
Ascitic Fluid ◽  
Unusual Case ◽  
Pancreatic Necrosis ◽  
Epigastric Pain ◽  
Abdominal Distension ◽  
Fluid Analysis ◽  
History Of ◽  
Bowel Rest ◽  
Tomography Scan

Abstract The differential diagnosis for black ascites include pancreatic ascites (PA). In majority of cases described the ascitic fluid as amber or black-colored. We report the case of a 33-year-old man with a history of alcohol abuse who presented with 24 h of epigastric pain and abdominal distension. Laboratory results showed lipase of 1270 U/l, amylase of 442 U/l and albumin of 2 g/dl. A contrast computed tomography scan of the abdomen showed pancreatic necrosis with atrophy and free abdominal fluid. Paracentesis was performed, yielding opaque black ascitic fluid. An ascitic fluid analysis demonstrated amylase of 2769 U/l, albumin of 1.6 g/dl, was negative for malignant cells and tuberculosis. Serum-Ascites Albumin Gradient was resulted in 0.4. The diagnosis of chronic pancreatitis was suspected, and he received supportive care with pain medication and bowel rest. He was discharged with symptom free on Day 14 after admission.

THERAPEUTIC MANAGEMENT OF ASCITES IN SPITZ DOG IN BANGLADESH WITH A BRIEF REVIEW ON CANINE ASCITES

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
M. A. Samad
Keyword(s):  
Ascitic Fluid ◽  
Clinical Examination ◽  
Clinical Case ◽  
Abdominal Distension ◽  
Multiple Organ ◽  
Therapeutic Management ◽  
Vitamin Supplement ◽  
Case Record ◽  
Successful Recovery ◽  
History Of

Background: Ascites is one of the most important clinical syndromes, caused by multiple organ disorders, characterized by abdominal distension with accumulation of fluid of various colors and consistencies depending on the etiology that are encountered commonly in canine practice worldwide. Although it has been reported from different countries including India but it has not yet been documented from Bangladesh. Objectives: To evaluate the successful therapeutic management of a clinical case of ascites in dog supported with its brief review for its appropriate application Materials and Methods: A female Spitz dog two and half years old brought for treatment with the history of abdominal distension on 1st November 2009. Clinical examination, abdominocentesis and laboratory examination of ascitic fluid were used for the diagnosis of ascites in dog. Results: Clinical examination revealed dyspnea, discomfort, lethargy, weakness, pale mucous membrane, normal rectal temperature 103.2 0F and distended abdomen with fluid thrill on palpation. Examination of ascitic fluid revealed clear white fluid (pure transudate) which is mainly hepatic origin resulting portal hypertension and hypoproteinaemia. Treatment with restricted sodium diet, antibiotic (amoxicillin), diuretic (furosemide; Lasix, Sanofi Aventis) and vitamin B-complex and C- vitamin supplement with regular monitoring assisted in successful recovery. The recovered dog survived for next five years up to 2014 and then died due to other reasons. Conclusions: This clinical case record on canine ascites with successful treatment along with review especially on the methods of diagnosis and cause-wise treatment would certainly help the clinician for proper management of the clinical cases of canine ascites. Keywords: Ascites, Spitz dog, Diagnosis, SAAG, Therapeutic management, Brief review

scholarly journals Fulminant amoebic colitis in the era of computed tomography scan: A case report and review of the literature

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Suman Mewa Kinoo ◽  
Vikesh V. Ramkelawon ◽  
Jaynund Maharajh ◽  
Bugwan Singh
Keyword(s):  
Computed Tomography ◽  
Bowel Wall ◽  
Abdominal Distension ◽  
Review Of The Literature ◽  
Computed Tomography Scan ◽  
Fulminant Colitis ◽  
Bowel Necrosis ◽  
Amoebic Colitis ◽  
History Of ◽  
Tomography Scan

Amoebic colitis, caused by ingestion of water or food contaminated with the protozoan Entamoeba histolytica, can progress to a fulminant colitis. Computed tomography (CT) findings reported in the literature on this type of colitis are sparse. We present a 59-year-old male patient with a one-week history of progressive abdominal pain, abdominal distension and associated watery and bloody diarrhoea. A CT scan revealed deep ulcerations with submucosal and intramural tracking of contrast. Colonoscopy and biopsy confirmed a diagnosis of Amoebic colitis. The patient required a laparotomy and demised. Deep ulcerations with submucosal and intramural tracking of contrast on CT are diagnostic of fulminant amoebic colitis. Although not demonstrated at CT in this case, discontinuous bowel necrosis, omental wrapping (seen at laparotomy in our case) and neovascularisation of the bowel wall may be other features to look out for.

scholarly journals Diagnostic Pitfalls and Therapeutic Strategies in the Treatment of Pancreatic Duct Haemorrhage

HPB Surgery ◽  
1997 ◽  
Vol 10 (5) ◽  
pp. 293-297 ◽  
Author(s):  
P. J. Gallagher ◽  
G. Mclauchlin ◽  
P. C. Bornman ◽  
J. E. J. Krige ◽  
J. Thomson ◽  
...  
Keyword(s):  
Alcohol Abuse ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Splenic Artery ◽  
Epigastric Pain ◽  
Gastroduodenal Artery ◽  
Diagnostic Dilemma ◽  
Artery Ligation ◽  
Men 2 ◽  
History Of

Haemorrhage via the pancreatic duct, a rare cause of upper gastrointestinal bleeding (GIB), often poses a diagnostic dilemma. We analysed our experience with 10 patients (8 men, 2 women; mean age 44 years, range 34 – 62) treated during a 12 year period. All had a history of alcohol abuse and presented with major upper GIB requiring a median of 8 units (range 2 – 40) blood, transfusion. Nine had upper abdominal pain at the time of admission and nine had a history of pancreatitis. Upper gastroduodenal endoscopy (median 4; range 1 – 9), was diagnostic in only one. Side-viewing endoscopy showed bleeding from the pancreatic duct in 7 of 8 patients. Visceral aneurysms were demonstrated in 7 of 9 patients in whom coeliac angiography was carried out: (splenic artery 4, gastroduodenal artery 2, and pancreaticoduodenal artery 1). Two of 4 selective embolisations were successful. Six patients underwent distal pancreatectomy, 1 had gastroduodenal artery ligation and 1 died of coagulopathy following a total pancreatectomy. Pancreatic duct haemorrhage should be considered in patients with unexplained recurrent upper GIB, alcohol abuse and epigastric pain, particularly in those with established chronic pancreatitis. Selective angiography is essential for diagnosis and management. For bleeding sites in the head of the pancreas, embolisation should be attempted to avoid major resection. Distal pancreatectomy is preferred for splenic artery lesions.

scholarly journals Ogilvie Syndrome Following Caesarean Section: A Case Report

2021 ◽  
Vol 28 (2) ◽  
pp. E202126
Author(s):  
Sanae Sninate ◽  
Habib Bellamlih ◽  
Soukaina Allioui ◽  
Leila Jroundi ◽  
Fatima Zahrae Laamrani
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Young Patients ◽  
Abdominal Distension ◽  
Intravenous Contrast ◽  
History Of ◽  
Ogilvie Syndrome ◽  
Fluid Levels ◽  
Tomography Scan

Background. Ogilvie syndrome is a rare postpartum complication. It is characterized by an acute colonic pseudo-obstruction which occurs in the absence of a mechanical cause. Early detection of the diagnosis is essential to avoid cecal perforation. Case report. We report a case of Ogilvie syndrome following caesarean section in a 39-year-old woman (gravida 2, para 2) with a history of secondary infertility 10 years ago due to tubal stenosis and subserous fibroma, which led to the indication for cesarean section in second pregnancy at 39 weeks of gestation. Three days after cesarean section, the patient presented with significant abdominal distension and tenderness, vomiting, weakness, and nausea; an abdominal X-ray showed cecal distension. Abdominal computed tomography scan with intravenous contrast revealed distension of the ascending and transverse colon with air-fluid levels but without transitional mechanical obstruction. The patient was successfully treated. Conclusions. Ogilvie syndrome is a rare but serious complication that should be considered in fit young patients who present with pain, severe abdominal distension and failure to pass flatus after caesarean section.

scholarly journals Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

2019 ◽  
Vol 2 (4) ◽  
pp. 208-211
Author(s):  
OM Okolo ◽  
GM Bot ◽  
IK Onyedibe ◽  
DJ Shilong ◽  
DJ Alfin ◽  
...  
Keyword(s):  
Immunocompetent Patient ◽  
Intracranial Extension ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Computer Tomography Scan ◽  
History Of ◽  
Antifungal Chemotherapy ◽  
Intracranial Aspergillosis ◽  
The Brain ◽  
Tomography Scan

Invasive aspergillosis that involves intra-orbital and intracranial extension occurs in immunodeficient and immunocompetent patients resulting in significant morbidity and mortality. We report the case of a 38year old farmer who had recurrent fronto-ethmoidal mucocoele and proptosis of the left eye. She presented with a history of hypertension and no other significant findings on examination. Computer tomography scan of the brain showed a left fronto-orbital uniform contrast-enhancing extra-axial lesion with thickened peripheral capsule and an associated left fronto-orbital skull defect. Cerebrospinal fluid analysis did not show any sign of infection. Intra-operative biopsy sample showed cheesy material which on culture grew Aspergillus species that was identified further using molecular methods. Antifungal agents were used to treat the patient. The present case strongly suggests that it is possible to control intracranial aspergillosis with a combination of surgery and antifungal chemotherapy.

scholarly journals An Unusual Case of Gastric Gnathostomiasis Caused by Gnathostoma spinigerum Confirmed by Video Gastroscopy and Morphological and Molecular Identification

2021 ◽  
Author(s):  
Kookwan Sawadpanich ◽  
Nitiwat Chansuk ◽  
Patcharaporn Boonroumkaew ◽  
Lakkhana Sadaow ◽  
Rutchanee Rodpai ◽  
...  
Keyword(s):  
Molecular Identification ◽  
Unusual Case ◽  
Epigastric Pain ◽  
Parasitic Infection ◽  
Clinical Manifestations ◽  
Surgical Removal ◽  
Its2 Region ◽  
Serological Tests ◽  
Gnathostoma Spinigerum ◽  
History Of

Human gnathostomiasis is a harmful foodborne parasitic infection caused by nematodes of the genus Gnathostoma. Here, we report an unusual case of gastric gnathostomiasis seen in a hospital in Thailand along with the clinical characteristics, treatment, and outcome. A 39-year-old man presented with complaints of epigastric pain, dizziness, and history of passing dark, tarry stools for 2 days. The patient had a history of consuming raw freshwater fish. Supplementary differential diagnosis was performed via rapid serological testing, and presence of the causative agent was confirmed based on video gastroscopy, morphology of the removed parasite, and molecular identification. After its surgical removal from the stomach, the parasite was morphologically identified as Gnathostoma species. Molecular identification was performed via DNA extraction from the recovered worm, and amplification and sequencing of the second internal transcribed spacer (ITS2) region and partial cytochrome c oxidase subunit I (cox1) gene. The ITS2 and cox1 sequences were consistent with those of Gnathostoma spinigerum. Clinicians in endemic areas should therefore be aware of the rare clinical manifestations and use of supplementary serological tests to facilitate early diagnosis and treatment of gastric gnathostomiasis.

scholarly journals Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

2019 ◽  
Vol 2 (4) ◽  
pp. 208-211
Author(s):  
OM Okolo ◽  
GM Bot ◽  
IK Onyedibe ◽  
DJ Shilong ◽  
DJ Alfin ◽  
...  
Keyword(s):  
Immunocompetent Patient ◽  
Intracranial Extension ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Computer Tomography Scan ◽  
History Of ◽  
Antifungal Chemotherapy ◽  
Intracranial Aspergillosis ◽  
The Brain ◽  
Tomography Scan

Invasive aspergillosis that involves intra-orbital and intracranial extension occurs in immunodeficient and immunocompetent patients resulting in significant morbidity and mortality. We report the case of a 38year old farmer who had recurrent fronto-ethmoidal mucocoele and proptosis of the left eye. She presented with a history of hypertension and no other significant findings on examination. Computer tomography scan of the brain showed a left fronto-orbital uniform contrast-enhancing extra-axial lesion with thickened peripheral capsule and an associated left fronto-orbital skull defect. Cerebrospinal fluid analysis did not show any sign of infection. Intra-operative biopsy sample showed cheesy material which on culture grew Aspergillus species that was identified further using molecular methods. Antifungal agents were used to treat the patient. The present case strongly suggests that it is possible to control intracranial aspergillosis with a combination of surgery and antifungal chemotherapy.

scholarly journals Obstructive Fecalomas in an Infant Treated with Successful Endoscopic Disimpaction

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Risa Kanai ◽  
Kengo Nakaya ◽  
Koji Fukumoto ◽  
Masaya Yamoto ◽  
Hiromu Miyake ◽  
...  
Keyword(s):  
Colonic Obstruction ◽  
Abdominal Distension ◽  
Fecal Impaction ◽  
Bowel Distension ◽  
Colon Wall ◽  
History Of ◽  
Gastrointestinal Food Allergy ◽  
One Year ◽  
Subsequent Passage ◽  
Tomography Scan

A fecaloma is a mass of accumulated feces with a consistency much harder than that of a fecal impaction. It is most frequently observed in the rectum and sigmoid area, and associated complications include colonic obstruction, ulceration, bleeding, and perforation. A one-year-old, previously healthy boy with no history of chronic constipation was admitted because of vomiting and abdominal distension. An abdominal computed tomography scan showed small and large bowel distension due to multiple obstructive fecalomas in the transverse colon. As the fecalomas could not be resolved by laxatives, enemas, or colonic lavage, endoscopic disimpaction under general anesthesia was attempted. Repeatedly shaving the fecalomas with biopsy forceps finally resulted in gradual fragmentation with subsequent passage. Gastrointestinal food allergy was later suggested as the cause because eosinophilic infiltration was found in a biopsy specimen of the colon wall. Endoscopic disimpaction is an effective treatment approach for addressing fecalomas to avoid more invasive surgical intervention.

scholarly journals Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

2019 ◽  
Vol 2 (4) ◽  
pp. 208-211
Author(s):  
OM Okolo ◽  
GM Bot ◽  
IK Onyedibe ◽  
DJ Shilong ◽  
DJ Alfin ◽  
...  
Keyword(s):  
Immunocompetent Patient ◽  
Intracranial Extension ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Computer Tomography Scan ◽  
History Of ◽  
Antifungal Chemotherapy ◽  
Intracranial Aspergillosis ◽  
The Brain ◽  
Tomography Scan

Invasive aspergillosis that involves intra-orbital and intracranial extension occurs in immunodeficient and immunocompetent patients resulting in significant morbidity and mortality. We report the case of a 38year old farmer who had recurrent fronto-ethmoidal mucocoele and proptosis of the left eye. She presented with a history of hypertension and no other significant findings on examination. Computer tomography scan of the brain showed a left fronto-orbital uniform contrast-enhancing extra-axial lesion with thickened peripheral capsule and an associated left fronto-orbital skull defect. Cerebrospinal fluid analysis did not show any sign of infection. Intra-operative biopsy sample showed cheesy material which on culture grew Aspergillus species that was identified further using molecular methods. Antifungal agents were used to treat the patient. The present case strongly suggests that it is possible to control intracranial aspergillosis with a combination of surgery and antifungal chemotherapy.

scholarly journals Pancreatic ascites managed with a conservative approach: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Raju Bhandari ◽  
Rajan Chamlagain ◽  
Saraswati Bhattarai ◽  
Eric H. Tischler ◽  
Rajesh Mandal ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Serum Alkaline Phosphatase ◽  
Epigastric Pain ◽  
Abdominal Distension ◽  
Alcoholic Pancreatitis ◽  
Rare Entity ◽  
Conservative Approach ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Pancreatic Ascites

Abstract Background Pancreatic ascites refers to the massive accumulation of pancreatic fluid in the peritoneal cavity and is a rare entity. Chronic alcoholic pancreatitis is the most common cause. Ascites is commonly seen in patients with alcoholic liver disease and is usually a consequence of portal hypertension. Biliary pancreatitis, pancreatic trauma and cystic duplications of biliopancreatic ducts, ampullary stenosis, or ductal lithiasis are the remaining causes. Case presentation A 53-year-old Chhetri man, a chronic alcoholic, presented with epigastric pain and abdominal distension. He had made several previous visits to a local hospital within the past 6 months for a similar presentation. Serum alkaline phosphatase 248 IU/L, serum amylase 1301 IU/L, and lipase 1311 IU/L were elevated while serum calcium was decreased (1.5 mmol/l). Ascitic fluid amylase was elevated (2801 IU/L). A computed tomography scan of his abdomen revealed features suggestive of acute-on-chronic pancreatitis. The case was managed with a conservative approach withholding oral feedings, starting total parenteral nutrition, paracentesis, octreotide, and pigtail drainage. Conclusion Pancreatic ascites is a rare entity. Diagnosis is suspected with raised ascitic fluid amylase in the presence of pancreatic disease. Such cases can be managed by conservative approach or interventional approach. We managed this case through a conservative approach.

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