scholarly journals Appendiceal fat stranding on CT: a red herring in a post-caesarean section woman with Ogilvie’s syndrome (OS)

2019 ◽  
Vol 12 (5) ◽  
pp. e229228
Author(s):  
Kay Tai Choy ◽  
Heng-Chin Chiam
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Exploratory Laparotomy ◽  
Right Hemicolectomy ◽  
Ogilvie's Syndrome ◽  
Ogilvie’S Syndrome ◽  
X Ray ◽  
Intravenous Antibiotics ◽  
The Right ◽  
Fat Stranding

A 30-year-old woman was referred for a surgical review with abdominal pain and distension 2 days post-caesearean section. Abdominal X-ray showed dilated bowel loops. CT of her abdomen however showed fat stranding around a thickened appendix, suggesting a differential diagnosis of acute appendicitis on top of a postoperative ileus. Failure to respond to intravenous antibiotics led to an emergent surgical exploratory laparotomy, by which time the progressive caecal dilatation had led to patchy necrosis and perforation of the right hemicolon intra-operatively. The patient required a right hemicolectomy and histological examination of the excised bowel supported the diagnosis of Ogilvie’s syndrome. This case highlights the red herrings that one can encounter when faced with a woman with post-caesarean section abdominal pain and aims to raise awareness among clinicians of this condition—where timely diagnosis and management is key.

scholarly journals Abdominal pain and two x-rays: spot the difference

2012 ◽  
Vol 94 (2) ◽  
pp. e95-e95 ◽  
Author(s):  
Z Rajković ◽  
D Papeš ◽  
S Altarac ◽  
N Arslani
Keyword(s):  
Abdominal Pain ◽  
Portal Vein ◽  
Elective Surgery ◽  
Exploratory Laparotomy ◽  
X Rays ◽  
X Ray ◽  
Artery Embolism ◽  
The Difference ◽  
Bilioenteric Fistula ◽  
The Right

We present two patients with air found in the right upper quadrant on standard abdominal x-ray. One was diagnosed with pneumobilia and underwent elective surgery for a bilioenteric fistula. The other was diagnosed with portal vein gas and underwent an emergency exploratory laparotomy at which a superior mesenteric artery embolism was found. The differential diagnostic criteria for pneumobilia and portal vein gas are described. If portal venous gas is found on x-ray in patients with abdominal pain, it is recommended that management is aggressive, meaning an emergency exploratory laparotomy, because mortality in such cases is approximately 75%.

scholarly journals OGILVIE'S SYNDROME-RELATED RIGHT COLON PERFORATION AFTER CESAREAN SECTION: A CASE SERIES

2021 ◽  
pp. 37-39
Author(s):  
Konappa. V ◽  
Bharath Guntupalli ◽  
Bhavishya Gollapalli
Keyword(s):  
Caesarean Section ◽  
Case Series ◽  
Right Hemicolectomy ◽  
Water Soluble ◽  
Colon Perforation ◽  
Ogilvie's Syndrome ◽  
Right Colon ◽  
Ogilvie’S Syndrome ◽  
Mortality And Morbidity ◽  
Diagnostic Modalities

The objective of this article is to discuss and report three cases of right colon perforation secondary to post cesarean Ogilvie's syndrome (OS; colonic pseudo-obstruction) requiring right hemicolectomy. We retrospectively reviewed the case notes of three patients who underwent caesarean section and postoperatively developed OS. OS is an uncommon problem in patients undergoing caesarean section. Abdominal X-ray and water-soluble contrast enemaare the main diagnostic modalities. Drip-suck therapy along with endoscopic or pharmacological decompression should be performed in early stages. In a significant percentage of patients, diagnosis is delayed resulting in bowel ischemia and perforation requiring surgical resection and adding significant mortality/morbidity. We recommend our obstetric colleagues to involve surgical team in earlier stages to avoid surgery-related mortality and morbidity. We also advocate general surgeons to be aware of OS in patients after caesarean section and recommend a stepwise systematic approach toward the diagnosis and management of OS

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

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.

scholarly journals Induced by infection? A case of acute myocardial infarction with hypothermia

2019 ◽  
Vol 47 (8) ◽  
pp. 3963-3967
Author(s):  
Liang Li ◽  
Shudong Xia ◽  
Chao Feng
Keyword(s):  
Myocardial Infarction ◽  
Abdominal Pain ◽  
Body Temperature ◽  
Vital Signs ◽  
Reactive Protein ◽  
St Segment ◽  
Intravenous Antibiotics ◽  
St Elevation ◽  
Electrocardiographic Findings ◽  
The Right

A 52-year-old man was admitted to our hospital because of abdominal pain, nausea, and vomiting. On arrival, his body temperature was <35°C. Although his other vital signs and electrocardiographic findings were normal, his white blood cell count and C-reactive protein concentration were elevated. He was diagnosed with severe infectious disease and treated with intravenous antibiotics and rewarming therapy. Two hours later, his body temperature had increased to 38.4°C, but his abdominal pain persisted. A repeat electrocardiographic examination showed an elevated ST-segment in leads II, III, and aVF. He was then diagnosed with ST-elevation myocardial infarction. Coronary angiography showed occlusion of the right coronary artery, and he underwent implantation of two stents. His symptoms were relieved soon thereafter, and his body temperature returned to normal without antibiotics.

scholarly journals Aseptic abscess syndrome

2020 ◽  
Vol 13 (10) ◽  
pp. e236437
Author(s):  
Hannah Fillman ◽  
Patricio Riquelme ◽  
Peter D Sullivan ◽  
André Martin Mansoor
Keyword(s):  
Abdominal Pain ◽  
Immunosuppressive Agents ◽  
High Dose ◽  
Cross Sectional ◽  
Abdominal Abscesses ◽  
Intravenous Antibiotics ◽  
Cross Sectional Imaging ◽  
Aseptic Abscess ◽  
Intravenous Steroids ◽  
The Right

A 43-year-old woman with Crohn’s disease was admitted to the hospital with weight loss and 1 week of fever, abdominal pain and diarrhoea. At presentation, the patient was not on steroids or other immunosuppressive agents. Cross-sectional imaging of the abdomen revealed active colitis and multiple splenic and hepatic abscesses. All culture data were negative, including aspiration of purulent material from the spleen. Despite weeks of intravenous antibiotics, daily fever and abdominal pain persisted, the intra-abdominal abscesses grew, and she developed pleuritic chest pain and consolidations of the right lung. The patient was ultimately diagnosed with aseptic abscess syndrome, a rare sequelae of inflammatory bowel disease. All antimicrobials were discontinued and she was treated with high-dose intravenous steroids, resulting in rapid clinical improvement. She was transitioned to infliximab and azathioprine as an outpatient and repeat imaging demonstrated complete resolution of the deep abscesses that had involved her spleen, liver and lungs.

scholarly journals Pictorial quiz: A 2-year-old boy with abdominal pain

2019 ◽  
Vol 26 (5) ◽  
pp. 314-316
Author(s):  
Hsin-Ju Huang ◽  
Ming-Jen Tsai
Keyword(s):  
Abdominal Pain ◽  
Pediatric Emergency ◽  
C Reactive Protein ◽  
X Ray ◽  
High Attenuation ◽  
Reactive Protein ◽  
Calcified Lesion ◽  
Coffee Ground ◽  
Atypical Presentations ◽  
The Right

A 2-year-old boy presented with abdominal pain and non-coffee-ground emesis for 1 day. He was afebrile and without decreased activity. Examination showed lower abdominal tenderness, but psoas and obturator signs were negative. Laboratory test showed mildly elevated C-reactive protein (1.321 mg/dL) without leukocytosis. An abdominal X-ray revealed a high-attenuation-calcified lesion near the right sacroiliac joint which was highly suspected as an appendicolith. Subsequent abdominal computed tomography proved an appendicitis with appendicolith inside. He underwent laparoscopic appendectomy and was discharged uneventfully 4 days later. Acute appendicitis is a commonly misdiagnosed pediatric emergency because of the atypical presentations. Appendicoliths are presented in more than half of pediatric appendicitis and are highly associated with perforation. Surgery is recommended instead of antibiotics therapy alone to manage appendicolith-related appendicitis. A careful interpretation of the plain abdominal films and keeping a high suspicion are vital to early diagnosis of this disease.

Sign in / Sign up

Export Citation Format

Share Document