Delayed presentation of a congenital duodenal web managed successfully with incision of web

2020 ◽  
Vol 13 (12) ◽  
pp. e237307
Author(s):  
Mahendra Kumar Jangid ◽  
Reyaz Ahmad ◽  
Sujeet Pandre
Keyword(s):  
Abdominal Pain ◽  
Duodenal Obstruction ◽  
Accurate Diagnosis ◽  
Unusual Presentation ◽  
Contrast Study ◽  
Delayed Presentation ◽  
History Of ◽  
Duodenal Web ◽  
High Index Of Suspicion ◽  
The Web

One of the causes of congenital incomplete duodenal obstruction is the presence of congenital duodenal web with fenestration. This condition requires a high index of suspicion for an early and accurate diagnosis. We present an unusual presentation of duodenal web in a 6-year-old girl who presented with a 3-year history of cyclical and seasonal vomiting and abdominal pain. The diagnosis of congenital duodenal web with fenestration was made on contrast study and endoscopy and was treated surgically by incision of the web.

scholarly journals Spontaneous Uterine Rupture in a Preterm Pregnancy following Myomectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Claire Sutton ◽  
Prue Standen ◽  
Jade Acton ◽  
Christopher Griffin
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Uterine Rupture ◽  
Good Condition ◽  
Acute Onset ◽  
Uterine Wall ◽  
Unusual Presentation ◽  
Postoperative Course ◽  
Spontaneous Uterine Rupture ◽  
History Of

A 44-year-old nulliparous woman was transferred to a tertiary obstetric hospital for investigation of acute onset abdominal pain. She was at gestation of 32 weeks and 2 days with a history of previous laparoscopic fundal myomectomy. An initial bedside ultrasound demonstrated oligohydramnios. Following an episode of increased pain early the following morning, a formal ultrasound diagnosed a uterine rupture with the fetal arm extending through a uterine rent. An uncomplicated classical caesarean section was performed and the neonate was delivered in good condition but with a bruised and oedematous right arm. The neonate was transferred to the Special Care Nursery for neonatal care. The patient had an uncomplicated postoperative course and was discharged home three days following delivery. This is an unusual presentation of uterine rupture following myomectomy where the fetal arm had protruded through the uterine wall.

scholarly journals Disseminated Histoplasmosis in an Elderly Man Presented with Fever, Weight loss, Abdominal Pain and Haemoptysis - A Case Report with Literature Review

2011 ◽  
Vol 12 (1) ◽  
pp. 81-85
Author(s):  
Mohammad Robed Amin ◽  
Farzana Shumi ◽  
Hasibuddin Khan ◽  
Syed Ahmed Abdullah ◽  
Shafiul Alam ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Disseminated Histoplasmosis ◽  
History Of ◽  
Background History ◽  
Recurrent Haemoptysis ◽  
High Index Of Suspicion

An elderly patient presented with prolonged fever, gross weight loss, recurrent haemoptysis and abdominal pain. He had a background history of adrenal tuberculosis with completion of treatment without any obvious improvement. Clinically he was diagnosed as a case of adrenocotical insufficiency. Evaluation including histopathology revealed the diagnosis as disseminated histoplasmosis involving adrenal gland and lungs. The disease is a rarity without any underneath immunosuppression and hence high index of suspicion with appropriate steps for investigation is the key to achieve a diagnosis of disseminated histoplasmosis in Bangladesh. Keyword: . DOI: 10.3329/jom.v12i1.6936J Medicine 2011; 12 : 81-85

scholarly journals Congenital Duodenal Obstruction, Situs Inversus Totalis, and Gastric Perforation in a Neonate

2017 ◽  
Vol 6 (2) ◽  
pp. 35 ◽  
Author(s):  
Rajat Piplani ◽  
Samir Kant Acharya ◽  
Deepak Bagga
Keyword(s):  
Situs Inversus ◽  
Duodenal Obstruction ◽  
Gastric Perforation ◽  
Duodenal Atresia ◽  
Situs Inversus Totalis ◽  
Contrast Study ◽  
Congenital Duodenal Obstruction ◽  
Duodenal Web ◽  
Lesser Curvature

We report a rare case of incomplete congenital duodenal obstruction (Type 1 duodenal atresia) in association with situs inversus totalis presenting with gastric perforation in a neonate. The infantogram was suggestive of perforation with air under diaphragm along with dextrocardia. On exploration, a pin point perforation at fundus near lesser curvature along with situs inversus was noted. Primary closure of gastric perforation was done. Patient was then discharged on full breast feeds but was readmitted with intolerance to feeds and recurrent bilious vomiting. Further, upper GI contrast study revealed partial duodenal obstruction. On re-exploration, duodenal web with central aperture was seen and duodeno-duodenostomy was done.

scholarly journals Paraspinal and Extensive Epidural Abscess: The Great Masqueraders of Abdominal Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Andrew Chu ◽  
Thu Thu Aung ◽  
Uday Shankar
Keyword(s):  
Abdominal Pain ◽  
Previous History ◽  
Disease Process ◽  
Radicular Pain ◽  
Motor Deficits ◽  
Delayed Presentation ◽  
Repeat Magnetic Resonance Imaging ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Paraspinal Abscess

Paraspinal and epidural abscesses are rare conditions often diagnosed later in the disease process that can have significant morbidity and mortality. Predisposing risk factors include diabetes, human immunodeficiency virus, intravenous drug abuse, and previous history of spinal surgery or injection. They can threaten the spinal cord by compressive effect, leading to sensory motor deficits and ultimately paralysis and death. Diagnosis may be a challenge due to the delayed presentation of nonspecific back pain or radicular pain such as chest pain or abdominal pain. We present a rare case on a patient with periumbilical pain, constipation, and urinary retention who was ultimately diagnosed with a paraspinal abscess extending into the epidural space from T1 to S2. He underwent decompressive laminectomy with incision and drainage of the abscesses. The patient made an excellent recovery postoperatively, and repeat magnetic resonance imaging at six weeks showed resolution of the abscess.

scholarly journals An Unusual Presentation of a Child with Scurvy: A Case Report

2021 ◽  
Vol 08 (02) ◽  
pp. 12-14
Author(s):  
BS Mahapatra ◽  
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Early Diagnosis ◽  
Knee Joint ◽  
Pediatric Patients ◽  
Lower Limbs ◽  
Unusual Presentation ◽  
Cortical Thinning ◽  
History Of ◽  
High Index Of Suspicion

Nutritional deficiency is very common in pediatric patients, especially in developing countries. A 4-year-old Maldivian boy presented with pain in major joints of lower limbs since two months and was unable to stand and walk since one month. There was no history of fever or fall. The growth was average with mild pallor. There was no joint swelling. Xray knee joint showed epiphyseal separation, cortical thinning suggesting a radiological diagnosis of Scurvy and after Vit C supplementation the child showed clinical and radiological improvement in two weeks. So, a high index of suspicion is required for early diagnosis and treatment.

scholarly journals Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mihiri Chami Wettasinghe ◽  
Shanthini Rosairo ◽  
Samantha Kiriwattuduwa ◽  
Nuwan Darshana Wickramasinghe
Keyword(s):  
Duodenal Obstruction ◽  
Gastric Wall ◽  
Abdominal Distension ◽  
Duodenal Wall ◽  
Emergency Laparotomy ◽  
Contrast Study ◽  
Imaging Features ◽  
Rare Presentation ◽  
Duodenal Web ◽  
Portal Venous Air

Congenital duodenal web causing proximal duodenal obstruction leading to gastroduodenal emphysema is a very rare presentation in infancy. Due to persistent 
peristalsis against the duodenal membrane, there is progressive stretching of the duodenal web leading to windsock deformity. We describe a rare case of a child with gastroduodenal emphysema and portal venous air due to duodenal obstruction secondary to a duodenal web. An eighteen-month-old male child, who was under investigation for failure to thrive, presented with a history of persistent projectile vomiting and progressive abdominal distension for two days. The abdominal ultrasound scan revealed air within the portal vein and in the wall of the stomach. Plain X-ray abdomen confirmed the presence of gas in the gastric wall and in the proximal duodenal wall. Upper gastrointestinal contrast study revealed complete obstruction at the second part of the duodenum. The child underwent emergency laparotomy, which revealed a duodenal web as the cause of the duodenal obstruction. During the surgery, windsock deformity was noted. This case illustrates that although rare, proximal duodenal obstruction due to duodenal web may present in early childhood and that alarming imaging features such as gastric emphysema and portal venous air could be associated with benign conditions.

scholarly journals Uterine Rupture on MRI Presenting as Nonspecific Abdominal Pain in a Primigravid Patient with 28-Week Twins Resulting in Normal Neurodevelopmental Outcomes at Age Two

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kathryn L. Ponder ◽  
Rosa Won ◽  
Laurel Clymer
Keyword(s):  
Abdominal Pain ◽  
Uterine Rupture ◽  
Pelvic Surgery ◽  
Multiple Gestation ◽  
Neurodevelopmental Outcomes ◽  
Unique Case ◽  
Emergency Cesarean ◽  
History Of ◽  
High Index Of Suspicion

Background. Uterine rupture is a rare occurrence that requires a high index of suspicion, particularly in a primigravid patient who presents prior to the onset of labor. Mortality rates are particularly high in primigravid patients. Case. A 36-year-old gravida 1, para 0 patient with dichorionic diamniotic twins presented at 28-weeks of gestation with abdominal pain. The pain was initially intermittent and felt to be musculoskeletal in origin. Ultrasound imaging after 3 days of worsening abdominal pain revealed extrauterine fluid, prompting an urgent MRI. MRI diagnosed the uterine rupture with hemoperitoneum and herniation of both amniotic sacs outside of the uterus, including one twin’s torso and extremities, prompting emergency cesarean section. The premature twins required 2-month hospitalizations and had no neurodevelopmental impairments at 2-year follow-up. Conclusion. We present a unique case of rupture of an unscarred uterus in a primigravid patient prior to the onset of labor. Multiple gestation is a risk factor. This report adds to a handful of cases in which a history of endometriosis or extrauterine pelvic surgery was also present. The use of ultrasound and MRI to evaluate nonspecific abdominal pain led to the diagnosis and survival of both the mother and her premature twins.

Left gastric artery pseudoaneurysm as a sequelae of chronic pancreatitis: recognizing a life-threatening complication

Open Medicine ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. 370-373
Author(s):  
Deepak Pattanshetty ◽  
Pradeep Bhat
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Early Recognition ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Artery Pseudoaneurysm ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication ◽  
High Index Of Suspicion

AbstractLeft gastric artery pseudoaneurysm is a rare but important life-threatening complication of chronic pancreatitis. We report a case of a 54-year-old male with chronic pancreatitis who presented with history of severe abdominal pain. Following an initial suspicion of acute pancreatitis, a computed tomography of abdomen was obtained that showed a large left gastric artery pseudoaneurysm (4×4 cm) with circumferential thrombosis. The patient then underwent successful angiographic coiling of the aneurysm, thus preventing a potentially life-threatening hemorrhage. In conclusion, in patients with a history of chronic pancreatitis who present with abdominal pain, a high index of suspicion should be maintained for alternate causes of abdominal pain such as visceral aneurysms involving left gastric artery. Early recognition is critical and consequences of missing these lesions can be catastrophic.

scholarly journals Spontaneous Splenic Rupture in Severe Dengue

2013 ◽  
Vol 1 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Ahmad Mursel Anam ◽  
Mohammad Mufizul Islam Polash ◽  
Md Motiul Islam ◽  
Muhammad Mahbubur Rahman Bhuiyan ◽  
ARM Nooruzzaman ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Febrile Illness ◽  
Acalculous Cholecystitis ◽  
Severe Dengue ◽  
Spontaneous Splenic Rupture ◽  
History Of ◽  
Plasma Leakage ◽  
Laboratory Investigations ◽  
High Index Of Suspicion

Dengue is a mosquito-borne systemic viral infection with variety of clinical presentation, ranging from mild febrile illness to severe and fatal disease. A patient presented with history of fever and abdominal pain, and later developed shock. From clinical and epidemiological features, he was diagnosed as a patient of severe dengue, later confirmed by laboratory investigations. In dengue, shock can result from plasma leakage, and abdominal pain may be a feature of acalculous cholecystitis or pancreatitis, recognised presentations of dengue and usually managed conservatively. But high index of suspicion persuaded abdominal imaging, revealing a potentially fatal complication of dengue- spontaneous splenic rupture. Aggressive resuscitation and early surgery saved the patient. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14373 Bangladesh Crit Care J March 2013; 1: 59-62

scholarly journals Pyomyoma as a Rare Source of Postpartum Sepsis

2015 ◽  
Vol 2015 ◽  
pp. 1-2 ◽  
Author(s):  
A. DeMaio ◽  
M. Doyle
Keyword(s):  
Abdominal Pain ◽  
Unusual Case ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Clinical Suspicion ◽  
Subsequent Infection ◽  
Severe Morbidity ◽  
History Of ◽  
High Index Of Suspicion ◽  
Obvious Source

Pyomyoma, also known as suppurative leiomyoma, is a rare clinical complication that occurs when a leiomyoma undergoes infarction and subsequent infection. A high index of suspicion is required to make the diagnosis and can be guided by a classic triad of symptoms that includes abdominal pain, sepsis without an obvious source, and a history of leiomyoma. In the vast majority of these cases, total abdominal hysterectomy is required to avoid severe morbidity and potential mortality. We present an unusual case of a postpartum pyomyoma that was successfully treated without the need for hysterectomy. With strong clinical suspicion, early diagnosis, and appropriate management, some affected patients may preserve fertility.

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