Ischaemic colitis diagnosed by sigmoidoscopy during pregnancy

2021 ◽  
Vol 14 (5) ◽  
pp. e239975
Author(s):  
Tsubasa Ito ◽  
Kazuki Takasaki ◽  
Minori Takada ◽  
Akira Tomioka
Keyword(s):  
Abdominal Pain ◽  
Conservative Treatment ◽  
Clinical Presentation ◽  
Lower Abdominal Pain ◽  
Good Recovery ◽  
Ischaemic Colitis ◽  
Endoscopic Findings ◽  
Pregnancy And Postpartum ◽  
Intravenous Hydration ◽  
Multidisciplinary Teamwork

A 21-year-old woman visited out hospital for lower abdominal pain and bloody diarrhoea at 19 weeks of pregnancy. Endoscopic findings revealed longitudinal ulcerations with hyperaemia and oedema in the sigmoid colon. These findings and clinical presentation confirmed the diagnosis of ischaemic colitis. Conservative treatment, including fasting and intravenous hydration, was administered, and the patient made a good recovery. After discharge, there was no recurrence during pregnancy and postpartum period. It is important to make early diagnosis and treatment, and multidisciplinary teamwork between obstetricians, gastroenterologist and endoscopist is required.

scholarly journals Study of diagnosis and management of ectopic pregnancy

2019 ◽  
Vol 8 (6) ◽  
pp. 2465
Author(s):  
Seema Patel ◽  
Ajesh Desai
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Lower Abdominal Pain ◽  
Age Group ◽  
Obstetrics And Gynaecology ◽  
Beta Hcg ◽  
Adnexal Pathology ◽  
A Prospective Study

Background: Diagnosis of ectopic pregnancy was frequently missed. Aim of the study was to determine the clinical presentation, and treatment associated with ectopic pregnancy.Methods: This is a prospective study which was carried out at Obstetrics and Gynaecology department, GMERS SOLA civil hospital from August 2017 to October 2018. Total 416 patients were admitted during study period out of them 50 patients diagnosed with ectopic pregnancy were enrolled in the study and information was collected and analysed.Results: 80% patients were between the age group of 21-30 years. 56% patients were nulliparous. Amenorrhea (92%) with lower abdominal pain (94%) is the most common presenting symptom. 26% of patients show typical triad of amenorrhea, abdominal pain and bleeding per vagina. UPT and USG were most commonly performed investigations. 96% cases showed UPT positive. 100% USG showed adnexal pathology. Serum beta-hCG was done in 37 patients as an aid for diagnosis and to decide the line of management. Conservative medical management with Injection MTX was done in 4 patients of which 1 patients required laparotomy later on. Surgical management was done in 90% of patients. Laparoscopic management was done in 54% of cases.Conclusions: Early diagnosis and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.

scholarly journals Tube-ovarian abscess caused by Rothia aeria

2019 ◽  
Vol 12 (8) ◽  
pp. e229017
Author(s):  
Yusuke Taira ◽  
Yoichi Aoki
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Ribosomal Rna ◽  
Space Station ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Contraceptive Device ◽  
Intrauterine Contraceptive ◽  
Ovarian Abscess

Rothia aeria is a gram-positive amorphous bacillus and was discovered in the Russian space station ‘Mir’ in 1997. It shows phylogenetic similarity to Actinomyces israelii, and as determined using 16 s ribosomal RNA gene analysis R. aeria is classified as a bacteria of the genus Actinomyces. It was found to colonise in the human oral cavity, and there are some infectious reports but none specifies gynaecological infection. A 57-year-old woman, who had been continuously using intrauterine contraceptive device, presented with fever and lower abdominal pain. She was suspected tube-ovarian abscess caused by A. israelii, but the uterine cavity culture revealed R. aeria infection. Considering surgical treatment, conservative treatment by intravenous benzylpenicillin and subsequently oral ampicillin for 6 months improved the abscess, and she has no recurrence for over 1 year.

scholarly journals A Case Series on Epiploic Appendagitis: An Underdog in Acute Abdomen

2021 ◽  
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Pradeep Joshua Christopher ◽  
Sudha Kanthasamy ◽  
Jeyakumar Sundaraj
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Case Series ◽  
Lower Abdominal Pain ◽  
Surgical Excision ◽  
Epiploic Appendagitis ◽  
Common Causes ◽  
Epiploic Appendage

Epiploic appendagitis is an uncommon yet a significant surgical diagnosis that every surgeon should be aware. It occurs due to the torsion of the epiploic appendage which gives rise to acute abdominal pain that can mimic other common causes of acute abdominal pain like appendicitis or cholecystitis. The treatment of epiploic appendagitis depend on clinical presentation, severity and it varies from conservative management to surgical excision. This case series is about eight patients presented with complaints of lower abdominal pain. After clinical examination they were initially diagnosed to have appendicitis or diverticulitis. The Computed Tomography (CT) -based diagnoses were appendicitis, omental infarct, diverticulitis or epiploic appendagitis. All of them were subjected to diagnostic laparoscopy and found to have an inflammed epiploic appendage which was excised laparoscopically.

scholarly journals Infarto de omento mayor. Presentación de dos casos con un tratamiento conservador

2020 ◽  
Vol 50 (3) ◽  
Author(s):  
Nolberto Adrián Medina-Gallardo ◽  
Yuhamy Curbelo-Peña ◽  
Júlia Gardenyes-Martínez ◽  
Tomás Stickar ◽  
Javier De Castro-Gutiérrez ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Conservative Treatment ◽  
Emergency Service ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Ct Diagnosis ◽  
Abdominal Ct ◽  
Omental Infarction ◽  
Blood Tests ◽  
The Right

Omental infarction is a rare cause of acute abdominal pain. Cases. The report is based on two cases who attended to emergency, complaining of abdominal pain with CT diagnosis of omental infarction. We present a case of a 42 years old man who consulted to the emergency service for a pain in the right hemiabdomen, with elevated inflammatory markers in blood tests. Radiological examination by abdominal CT showed an omental torsion infarction. The patient evolved favourably with conservative treatment. The second case is a 85 years old man appendectomized who consulted for a pain in the left iliac foza with physical examination and complementary and radiological, it is concluded that it is an omental infarction, with a good evolution due to the treatment. Discussion. Clinical diagnosis remains a challenge, due to its rarity and clinical presentation mimicking acute appendicitis or cholecystitis. Hence in the absence of imaging test, intraoperative diagnosis takes place. It can occur due to two main pathogenic mechanisms: Secondary to vascular pedicle torsion (primary or secondary to another abdominal pathology) or situations that predispose to thrombosis. Conclusion. Omental infarction should be considered in the differential diagnosis of acute abdominal pain. Once confirmed by CT abdominal scan, conservative treatment could be considered, avoiding unnecessary surgery.

scholarly journals Appendicular tuberculosis: a less encountered clinical entity

2021 ◽  
Vol 14 (2) ◽  
pp. e237718
Author(s):  
Sachin Ambekar ◽  
Mohit Bhatia
Keyword(s):  
Abdominal Pain ◽  
Female Patient ◽  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Clinical Entity ◽  
The Right ◽  
Test Finding

A 21-year-old female patient presented with vague lower abdominal pain associated with nausea since 2 days. On examination, she was tender in the right iliac fossa. Based on clinical presentation and radiological test finding, she was diagnosed as appendicitis and was subjected for diagnostic laparoscopy and appendectomy. Histopathology proved it to be a tubercular appendix, which is a rarely encountered entity. However, in a country like India, tuberculosis (TB) is highly prevalent; however, TB of appendix is rare and less known.

Chronic lower abdominal pain is commonly associated with pelvic congestion syndrome

2016 ◽  
Vol 76 (10) ◽  
Author(s):  
A Jurga-Karwacka ◽  
GM Karwacki ◽  
FD Schwab ◽  
A Schötzau ◽  
C Zech ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lower Abdominal Pain ◽  
Pelvic Congestion Syndrome ◽  
Pelvic Congestion

scholarly journals Pyometra: An Atypical Cause of Abdominal Pain

2021 ◽  
Vol 9 ◽  
pp. 232470962110224
Author(s):  
Leonidas Walthall ◽  
Marc Heincelman
Keyword(s):  
Abdominal Pain ◽  
Vaginal Discharge ◽  
Elderly Women ◽  
Lower Abdominal Pain ◽  
Endometrial Biopsy ◽  
Laboratory Evaluation ◽  
Inpatient Service ◽  
Gynecologic Malignancy ◽  
Intravenous Contrast ◽  
Lower Quadrant

Pyometra, a purulent infection of the uterus, is a rare cause of a very common complaint—abdominal pain. Risk factors include gynecologic malignancy and postmenopausal status. The classically described presentation includes abdominal pain, fever, and vaginal discharge. In this article, we present an atypical presentation of nonperforated pyometra in an 80-year-old female who was admitted to the internal medicine inpatient service. She initially presented with nonspecific subacute right lower quadrant abdominal pain. Physical examination did not demonstrate vaginal discharge. Laboratory evaluation failed to identify an underlying etiology. Computed tomography scan of the abdomen and pelvis with oral and intravenous contrast demonstrated a 6.5 × 6.1 cm cystic containing structure within the uterine fundus, concerning for a gynecologic malignancy. Pelvis ultrasound confirmed the mass. Endometrial biopsy did not reveal underlying malignancy, but instead showed frank pus, leading to the diagnosis of pyometra. This report illustrates that pyometra should be considered in the differential diagnosis of lower abdominal pain in elderly women.

scholarly journals Enucleation of a giant symptomatic gastric lipoma, a safe surgical approach

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Rafaela Parreira ◽  
Tiago Rama ◽  
Teresa Eloi ◽  
Vítor Carneiro ◽  
Maria Inês Leite
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Clinical Presentation ◽  
Pyloric Obstruction ◽  
Asymptomatic Patients ◽  
Recurrent Vomiting ◽  
Low Incidence ◽  
Diagnostic Modalities ◽  
Benign Tumours ◽  
Gastric Lipoma

Abstract Gastric lipomas are rare, representing 2–3% of all benign tumours of the stomach. Most of these stomach neoplasms are small and detected incidentally during endoscopic or radiology evaluations. Computed tomography is highly specific imaging for lipoma diagnosis. Endoscopy and endoscopic ultrasound are other important diagnostic modalities to confirm the diagnosis. Identifying typical features can avoid biopsy or surgery in asymptomatic patients. In patients with larger lesions, usually more than 2 cm, clinical presentation may encompass haemorrhage, abdominal pain, pyloric obstruction and dyspepsia. As a result of its extreme low incidence, treatment is not standardized, though it is widely accepted that a symptomatic tumour mandates resection. Here, we present the case of a 60-year-old female presenting with abdominal pain and recurrent vomiting due to a giant gastric lipoma (80 × 35 × 35 mm). The patient underwent laparotomy and an enucleation was performed.

scholarly journals Successful treatment of recurrent volvulus in the afferent limb of the pouch following proctocolectomy for ulcerative colitis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Michio Itabashi ◽  
Yoshiko Bamba ◽  
Hisako Aihara ◽  
Kimitaka Tani ◽  
Ryousuke Nakagawa ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Abdominal Pain ◽  
Lower Abdominal Pain ◽  
Anterior Wall ◽  
Middle Part ◽  
Presacral Space ◽  
Previous Surgery ◽  
Afferent Limb ◽  
Radiographic Findings ◽  
Oral Side

Abstract Background Pouch volvulus after proctocolectomy for ulcerative colitis is a very rare postoperative complication. The common site of pouch volvulus has been reported to be the ileal pouch–anal anastomosis and the middle part of the pouch, but no reports on pouch volvulus in the afferent limb of the pouch have been observed. Here, we report the case of a patient with afferent limb volvulus who underwent afferent limbpexy, but required reoperation 7 months later. Case presentation A 38-year-old man with refractory ulcerative colitis had undergone open proctocolectomy 10 years ago at another hospital. He had been aware of lower abdominal pain and bowel movement difficulty for 2 years. After repeated bowel obstruction, he was referred to our hospital for surgery. Based on the radiographic findings, we diagnosed a pouch volvulus and performed an operation. Laparoscopically, counterclockwise rotation of the afferent limb of the pouch was recognized. Moreover, the ileal mesentery was adhered and fixed to the presacral space 20 cm from the oral side of the pouch. The antimesenteric side of the afferent limb was fixed using interrupted stiches on the left peritoneal wall of the pelvis. He was discharged uneventfully 18 days after surgery, and defecation improved immediately. However, he was readmitted 7 months after surgery with the same abdominal pain and defecation difficulty. A similar finding was found and diagnosed as recurrent volvulus. Therefore, we performed a laparoscopic surgery. The same volvulus as in the previous surgery was confirmed. The site fixed during the previous surgery showed scars, but the afferent limb was free. The dilated ileum that contained the volvulus was excised only on the oral side of the pouch and an intraluminal anastomosis was performed on the anterior wall of the pouch. He had a good postoperative course and was discharged. Conclusion Proper diagnosis of volvulus based on the characteristic imaging findings is important. In principle, bilateral row fixation of the rotated ileum is the basic procedure for volvulus. However, fixation with this technique is sometimes difficult. Therefore, this procedure is one of the useful options for the fixation of difficult or recurrent cases.

scholarly journals Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eyad Altamimi ◽  
Yousef Odeh ◽  
Tuka Al-quraan ◽  
Elmi Mohamed ◽  
Naif Rawabdeh
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Yield ◽  
Failure To Thrive ◽  
University Hospital ◽  
P Value ◽  
Upper Endoscopy ◽  
Detection Rates ◽  
Common Indication ◽  
Histopathological Findings ◽  
Endoscopic Findings

Abstract Background Upper endoscopy is an essential tool for diagnosing pediatric gastrointestinal issues. This study aimed to assess the indications, diagnostic yields, concordance between histopathological and endoscopic findings and suitability of upper endoscopies performed at a tertiary university hospital in Jordan. Methods Hospital records of children who underwent upper endoscopy were retrospectively reviewed. Demographics, endoscopic details (e.g., indications, findings and any complications), and histopathological findings were collected. The relationship between endoscopic findings and histopathological abnormalities was reported. Results The study included 778 patients (age, 92.5 ± 54.5 months; 380 girls, 48.8%). The most common age group was children younger than 60 months (273 patients, 34.3%). The most common indication for endoscopy was abdominal pain, followed by vomiting and failure to thrive or weight loss. Normal upper endoscopy was reported in 411 patients (52.8%). Age below 60 months, abdominal pain, dysphagia/odynophagia, and heartburn were predictive of abnormal endoscopy in multivariate analysis with p-value 0.000, 0.048, 0.001 and 0.01 respectively. Abnormal endoscopy showed 67.3% sensitivity and 69.9% specificity to predict histopathological abnormalities. Of those performed, 13.6% endoscopies were described as inappropriate indication. The suitability of the procedure was a sensitive predictor for abnormal endoscopic and histopathological findings. Conclusions Abdominal pain is the most common indication for upper endoscopy in our population. It is associated with a higher chance of abnormal endoscopy. Concordance between endoscopic and histopathological findings is not high. Normal endoscopic findings shouldn`t discourage the endoscopist from obtaining tissue biopsies. Considering more biopsies may improve pathological detection rates. Compliance with established endoscopy guidelines may reduce unnecessary procedures.

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