scholarly journals Obstructive urosepsis secondary to ureteric herniation into the sciatic foramen

2018 ◽  
pp. bcr-2018-225523 ◽  
Author(s):  
Michael G Fadel ◽  
Chandran Louis ◽  
Andrea Tay ◽  
Marco Bolgeri

A 65-year-old female patient presented with a 2-day history of worsening right-sided abdominal pain and clinical signs of sepsis, on the background of a recent admission for pancolitis. Imaging revealed right ureteric herniation through the sciatic foramen with subsequent hydroureteronephrosis and radiological signs of severe pyelonephritis. The patient underwent emergency decompression with a percutaneous nephrostomy, followed by insertion of an antegrade stent to correct the ureteric hernia once the sepsis was appropriately treated. We describe the presentation and management of this unusual case of herniation of the right ureter into the sciatic foramen.

2020 ◽  
Vol 99 (3) ◽  
pp. 131-135

Introduction: Abdominal emergencies occur in pregnant women with the rate of 1:500−635 pregnancies. Such conditions usually develop from full health and worsen rapidly. Symptoms are often similar to those in physiological pregnancy (abdominal pain, vomiting, constipation). The diagnostic process is thus difficult and both the mother and her child are at risk. Our aim was to evaluate the frequency of abdominal emergencies in the Department of Surgery, University Hospital in Pilsen and to consider their impact on pregnancy and on the newborn. Methods: We acquired a set of patients by retrograde collection of data. We searched for pregnant patients suspected of developing an abdominal emergency admitted to the Department of Surgery, Faculty of Medicine, Pilsen between 2004 and 2015. We evaluated a number of clinical signs to statistically describe the set. Results: The set included 121 patients; 42 of the patients underwent a surgical procedure and 79 received conservative treatment. 38 patients underwent appendectomy; 6 appendixes were with no pathologies. McBurney’s incision was an approach of choice in most cases. The most frequent symptom was pain in the right lower abdominal quadrant. The foetus has been lost in none of the cases. Conclusion: Acute appendicitis was the most frequent abdominal emergency in our set and also the most frequent reason for surgical intervention. The most specific sign was pain in the right lower abdominal quadrant. No impact of appendicitis or appendectomy on the health of the newborn has been observed. Even though abdominal emergencies in pregnancy are relatively rare, the results of the department are very good.


2021 ◽  
pp. 112067212110104
Author(s):  
Mehmet Talay Koylu ◽  
Fatih Mehmet Mutlu ◽  
Alper Can Yilmaz

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.


Author(s):  
Benjamin Brunson

ABSTRACT A 10 yr old spayed female toy poodle was presented to a tertiary referral center for a 10 day history of waxing and waning lethargy, vomiting, diarrhea, and anorexia. An immune-mediated neutropenia (IMN) was suspected to be the underlying cause of her clinical signs. A bone marrow aspirate was obtained from the chostochondral junction of the 11th and 12th ribs on the right side and provided a definitive diagnosis of IMN. A positive response to therapy and repeat blood work further confirmed the diagnosis. Obtaining bone marrow aspirates from the chostochondral junction is a safe, cheap, and reliable method of diagnosing IMN and can be performed in the private practice setting with light sedation and minimal need for specialized equipment.


Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 321-323
Author(s):  
Ballal Mamatha ◽  
Shetty Vignesh ◽  
Agarwal Manali ◽  
Nayal Bhavna ◽  
Umakanth Shashikiran

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.


2021 ◽  
Vol 24 (3) ◽  
pp. 137-140
Author(s):  
Andreea Florentina Stoenescu ◽  
◽  
Geta Vancea ◽  
Dana Ispas ◽  
Nicoleta Voicu-Pârvu ◽  
...  

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.


2020 ◽  
Vol 4 (2) ◽  
pp. 19-23
Author(s):  
Orelvis Rodríguez Palmero ◽  
Liseidy Ordaz Marin ◽  
María Del Rosario Herrera Velázquez ◽  
Agustín Marcos García Andrade

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.


2021 ◽  
Author(s):  
Athar Rasekhjahromi ◽  
Sahand Goodarzi ◽  
Navid Kalani

Ovarian torsion occurs in 10%-22% of pregnant women, and miscarriage occurs in 11%-22% of all pregnancies, both of which are known as gynecological emergencies. The simultaneous occurrence of these two cases is rare. The present study reports a case of ovarian torsion and simultaneous abortion. In this case report, we present a 28-year-old woman in her third pregnancy with a history of two miscarriages. She was referred with an 18-week triplet pregnancy, vaginal pain and bleeding from the previous day, and colic abdominal pain with five episodes of nausea and vomiting. Upon admission to the hospital, despite performing cerclage at 13 weeks, labor pains begin, and 15 minutes later, the amniotic sac ruptures, and all three fetuses are expelled. Due to the persistence of colic pain and moderate tenderness in the lower right quadrant of the abdomen, pelvic ultrasound is reported, which shows an increase in echo parenchyma and the size of the right ovary compared to the left ovary. Doppler ultrasound showed decreased ovarian blood flow, which led to laparotomy with suspected ovarian torsion. The right ovarian peduncle had complete torsion, and the ovary appeared dark. The peduncle of ovarian torsion was opened and preserved. The patient was discharged two days after surgery and after re-color Doppler ultrasounds, which indicated ovarian blood flow.


2021 ◽  
Vol p5 (5) ◽  
pp. 3050-3054
Author(s):  
Shubha C ◽  
Amanda Kittie Kynshikhar ◽  
Pooja B A ◽  
Sangamitra Pattnaik ◽  
Abhishek Biswas

A Hindu female patient of age 30 yrs. with a history of dry scaly white patches over the skin since childhood with prevailing signs of swelling wounds over the patches on the right foot and left palm for six months, diagnosed as a case of Psoriasis came for treatment at Sushrutha Ayurvedic Medical College & Hospital, Bangalore. Considering the signs and symptoms patient was treated in the line of Ekakustha. Classical Virechana Karma followed by Shamana Aushadhi and Madhutailika Basti was administered. Significant relief was found in the signs and symp- toms with no recurrence after the treatment. Keywords: Ekakushta, Psoriasis, Classical Virechana, Madhutailika Basti, Shamana Aushadhi.


PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 711-712
Author(s):  
Miguel A. Oliveros ◽  
John J. Herbst ◽  
Patrick D. Lester ◽  
Fred A. Ziter

The gastrointestinal complications of dermatomyositis are well known. Reviews, however, do not mention pneumatosis intestinalis in this disorder).1-3 Although noted in progressive systemic sclerosis,4-7 its association with dermatomyositis has been documented in only one case,5 unreported in the pediatric literature. It is important to distinguish this apparently benign condition from pneumoperitoneum secondary to intestinal perforation, which is a grave complication of dermatomyositis.1 CASE REPORT W. W., an 8-8/12-year-old girl with a three-year history of dermatomyositis with prominent skin rash, disseminated subcutaneous calcification, muscle wasting and induration, also complained of occasional abdominal pain, recently localized to the right hypochondriurn and right shoulder. Inspite of continuous prednisone treatment and intermittent trials of azathioprine, methotrexate, and cyclophosphamide the patient's disease failed to remit.


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.


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