Enterocutaneous fistula secondary to retained intraperitoneal fragment of a ventriculoperitoneal shunt in a 48-year-old man with spina bifida

2021 ◽  
Vol 14 (4) ◽  
pp. e240634
Author(s):  
Andrew Webster ◽  
Rishabh Singh ◽  
John Stebbing
Keyword(s):  
Spina Bifida ◽  
Enterocutaneous Fistula ◽  
Vp Shunt ◽  
Surgical Department ◽  
History Of ◽  
Delayed Complications ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

We report the case of a 48-year-old man with spina bifida and history of previous ventriculoperitoneal (VP) shunt placement for hydrocephalus. On attempted removal of the shunt 2 years prior to presentation at a neurosurgical unit, the peritoneal component was left in situ due to difficulties with removal. He presented acutely to our general surgical department with an enterocutaneous fistula precipitated by the retained fragment discharging to the right upper abdominal quadrant that required urgent surgical intervention. Although abdominal complications of VP shunts are documented, there is minimal literature as to the risks of remnant catheters being left in situ. This case demonstrates the possible risks with retained VP shunt catheters and the necessity to remove any redundant foreign bodies to prevent significant delayed complications.

scholarly journals Primary squamous cell carcinoma of the liver: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110212
Author(s):  
Yu Sun ◽  
Guangyu Jin
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Imaging Features ◽  
Primary Squamous Cell Carcinoma ◽  
History Of ◽  
Loss Of Appetite ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

Primary squamous cell carcinoma of the liver is extremely rare, very difficult to diagnose, and carries an extremely poor prognosis. In this study, we discuss the imaging features of a patient with primary hepatic squamous cell carcinoma. The patient was admitted to hospital owing to discomfort in the right upper abdominal quadrant and a loss of appetite. He had no previous risk factors associated with hepatic squamous cell carcinoma and no history of systemic squamous cell carcinoma. We diagnosed primary hepatic squamous cell carcinoma by pathological analysis. Primary hepatic squamous cell carcinoma is rare, and its histological features are controversial, which makes the clinical and imaging diagnosis difficult. Therefore, it is urgent to improve the understanding of this disease in clinical practice to avoid misdiagnosis, and to identify the best treatment. This case provides a basis for the clinical diagnosis of primary hepatic squamous cell carcinoma.

scholarly journals The Adventitia Resection in Treatment of Liver Hydatid Cyst: A Case Report of a 15-Year-Old Boy

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Zhenhua Ma ◽  
Wei Yang ◽  
Yingmin Yao ◽  
Qingguang Liu
Keyword(s):  
Hydatid Cyst ◽  
Bile Leakage ◽  
Virtual Space ◽  
Liver Hydatid Cyst ◽  
Computed Tomographic ◽  
History Of ◽  
Right Lobe ◽  
Upper Abdominal ◽  
The Right ◽  
Significant Health

Human hydatid disease is a significant health problem in endemic regions caused by the larval form ofEchinococcus granulosus. In this paper, we report a case of liver hydatid cyst. The patient, a 15-year-old boy, presented with a history of intermittent upper abdominal pain of a few-month duration was referred to our hospital for investigation. Computed tomographic scan and laboratory test suggested a hydatid cyst in the right lobe of liver. The adventitia resection of hydatid cyst was smoothly performed as there was a less bloody virtual space between adventitia and outer membrane. Our diagnosis was made using an imaging approach and was confirmed during surgery. We proposed the adventitia resection of hydatid cyst could be safe and easy to perform with low risk of bleeding and bile leakage.

scholarly journals Sterile osteomyelitis in the ulnar diaphysis of a young indoor cat

2020 ◽  
Vol 6 (1) ◽  
pp. 205511691989975
Author(s):  
Domenico Sainato ◽  
Filippo Cinti ◽  
Helen Renfrew
Keyword(s):  
Initial Period ◽  
In Situ Hybridisation ◽  
Radiographic Examination ◽  
Lytic Lesion ◽  
Fungal Culture ◽  
Fluorescence In Situ Hybridisation ◽  
History Of ◽  
Hybridisation Analysis ◽  
The Right

Case summary A 3-year-old neutered male indoor British Shorthair cat was referred for a 2-week history of intermittent right forelimb lameness. Radiographic examination showed a diaphyseal monostotic, expansile, fusiform, lytic lesion in the right ulna. CT further defined the lesion and also demonstrated ipsilateral pulmonary consolidation. Histology was conclusive of osteomyelitis, and microbiology and fluorescence in situ hybridisation analysis (FISH) were negative on aerobic and anaerobic bacterial culture, as well as fungal culture. Clinical and radiographic improvement was seen after anti-inflammatory treatment and a short initial period of antibiosis. Relevance and novel information This is an unusual monostotic diaphyseal cortical location for osteomyelitis in cats and, moreover, may represent a rare case of sterile osteomyelitis. To our knowledge, non-traumatic osteomyelitis in this location in cats has not been reported in the veterinary literature.

scholarly journals Hepatic Rupture Induced by Spontaneous Intrahepatic Hematoma

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jin-bao Zhou ◽  
Wei-bo Chen ◽  
Feng Zhu
Keyword(s):  
Lupus Erythematosus ◽  
Vena Cava ◽  
Caudate Lobe ◽  
Posterior Lobe ◽  
Hepatic Rupture ◽  
Arterial Bleeding ◽  
Daily Dose ◽  
History Of ◽  
Upper Abdominal ◽  
The Right

The etiology of hepatic rupture is usually secondary to trauma, and hepatic rupture induced by spontaneous intrahepatic hematoma is clinically rare. We describe here a 61-year-old female patient who was transferred to our hospital with hepatic rupture induced by spontaneous intrahepatic hematoma. The patient had no history of trauma and had a history of systemic lupus erythematosus for five years, taking a daily dose of 5 mg prednisone for treatment. The patients experienced durative blunt acute right upper abdominal pain one day after satiation, which aggravated in two hours, accompanied by dizziness and sweating. Preoperative diagnosis was rupture of the liver mass. Laparotomy revealed 2500 mL fluid consisting of a mixture of blood and clot in the peritoneal cavity. A 3.5 cm × 2.5 cm rupture was discovered on the hepatic caudate lobe near the vena cava with active arterial bleeding, and a 5  × 6 cm hematoma was reached on the right posterior lobe of the liver. Abdominal computed tomography (CT) and laparotomy revealed spontaneous rupture of intrahepatic hematoma with hemorrhagic shock. The patient was successfully managed by suturing the rupture of the hepatic caudate lobe and clearing part of the hematoma. The postoperative course was uneventful, and the patient was discharged after two weeks of hospitalization.

Primary Cutaneous Follicle Center Lymphoma (PCFCL) with Parotid Gland Involvement

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S84-S85
Author(s):  
S Ayub ◽  
Z Al-Duwal ◽  
D Sellers ◽  
A Rosenberg
Keyword(s):  
Parotid Gland ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphoma Cells ◽  
Diffuse Infiltration ◽  
First Case ◽  
History Of ◽  
The Right

Abstract Introduction/Objective Primary cutaneous follicle center lymphoma (PCFCL) is the most common primary cutaneous B-cell lymphoma. It arises from mature germinal center B lymphocytes. Here we report two cases of PCFCL with parotid gland involvement. Methods First case is a 66-year-old male with an enlarging forehead mass for nine months and a painless nodule on the right pre-auricular skin. Second is a 39-year-old male with a history of a recurring scalp spindle cell B-cell lymphoma now presenting with an enlarging lesion on the scalp and “fullness” in the right neck. There was no nodal or other extranodal involvement found in either case. Skin and parotid gland biopsies were obtained in both cases. Results Case one: The skin and parotid gland demonstrated sheets of predominantly medium sized infiltrating lymphoma cells, positive for CD20, Bcl-6, CD5 (dim) and Bcl-2 (dim), and negative for CD10, Bcl-1, and MUM-1. The epidermis was spared. Case two demonstrated medium sized, spindle shaped lymphoma cells. The skin showed a vague follicular growth pattern, sparing the epidermis. The parotid gland showed diffuse infiltration by lymphoma cells, positive for CD20 and Bcl-6, Bcl-2 (dim) and no definite positivity for CD10. Fluorescent in situ hybridization for t(14;18) translocation was absent in both cases. Conclusion Dissemination of PCFCL to extracutaneous sites is uncommon (~10% of cases) and to our knowledge, has not been reported in the parotid gland. Here we present two unique cases, which in the absence of nodal disease, prove the diagnosis of PCFCL with parotid gland involvement.

scholarly journals To Amputate or Not to Amputate: Management of Iatrogenic LASIK Flap Dehiscence and Epithelial Ingrowth with Overlying Pseudopterygium

2021 ◽  
pp. 967-974
Author(s):  
Dean Ouano ◽  
Rachel Huynh ◽  
Alyson Nicole Tukan ◽  
Nour Bundogji ◽  
Majid Moshirfar
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Surgical Trauma ◽  
Corneal Epithelial ◽  
Epithelial Ingrowth ◽  
History Of ◽  
Pars Plana ◽  
Contralateral Eye ◽  
The Right

A 73-year-old male with a history of myopic laser-assisted in situ keratomileusis (LASIK) 20 years earlier presented with a late LASIK flap dehiscence, epithelial ingrowth, conjunctivalization, and the development of a pseudopterygium in the right eye. The findings were consistent with surgical trauma, likely occurring after corneal epithelial debridement to improve visualization during pars plana vitrectomy for retinal detachment repair 3 months earlier. The patient underwent epithelial ingrowth debridement, LASIK flap reapproximation and suturing, and a conjunctival limbal autograft from the contralateral eye. The surgery was completed successfully without the need for flap amputation. Postoperatively, the patient had an uneventful course with a well-healing conjunctival graft and no interface opacity or evidence of recurrent pseudopterygium of the right eye. The graft and corneal topography remained stable after subsequent cataract surgery.

scholarly journals Clinical patterns and causes of post-cholecystectomy syndrome

2021 ◽  
Author(s):  
Muhammed Ihsan Muhammad ◽  
Abdullah Hasem Alhassan ◽  
Abdulmohsen Yaseer Alkhars ◽  
Rayan Abdulkhaliq Alzahrani ◽  
Mohammed Hamad Al Mansour ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Symptoms ◽  
Physiological Changes ◽  
Postcholecystectomy Syndrome ◽  
The Common ◽  
Clinical Patterns ◽  
Irritable Bowel ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

Post-cholecystectomy syndrome is suspected when the patients complain about the persistent presence of pain in the right upper abdominal quadrant. Other symptoms might appear which are related to the gastrointestinal tract. These symptoms appear after performing cholecystectomy. The manifestations are usually similar to those experienced before the procedure. In this study, the aim to conduct a literature review to increase the knowledge and to explore facts related to the clinical patterns and causes of post-cholecystectomy syndrome. The most commonly reported cause of this syndrome is the prior development of an extra-biliary disorder, which includes many modalities as peptic ulcer, reflux esophagitis, chronic pancreatitis, irritable bowel syndrome, and biliary-related disorders. However, the etiology of postcholecystectomy is hugely variable across the different studies in the literature. Patients that develop postcholecystectomy syndrome usually present with non-specific gastrointestinal symptoms that may or may not be similar to the symptoms that were exhibited before conducting the surgery. Some of the common physiological changes that have been reported with postcholecystectomy syndrome include the disruption of cholecysto-antral reflex, the cholecystosphincter of oddi reflex, and the cholecysto-esophageal related reflexes. In addition, the development of other changes that can significantly affect the normal physiology of the gastrointestinal tract leads to the development of significant symptoms and clinical patterns.

Interface fluid syndrome secondary to endothelial failure due to toxic anterior segment syndrome after cataract surgery

2018 ◽  
Vol 29 (3) ◽  
pp. NP1-NP4
Author(s):  
Burcu Kasım ◽  
Yusuf Koçluk ◽  
Ayşe Burcu
Keyword(s):  
Cataract Surgery ◽  
Cell Function ◽  
Anterior Segment ◽  
Laser In Situ Keratomileusis ◽  
Blurred Vision ◽  
Endothelial Cell Function ◽  
History Of ◽  
Toxic Anterior Segment Syndrome ◽  
The Right

Purpose: To present a case of previous laser in situ keratomileusis with interface fluid syndrome secondary to toxic anterior segment syndrome following cataract surgery. Case report: A 52-year-old woman, complaining blurred vision in her right eye for 18 months after cataract surgery, was referred to our clinic. She was diagnosed with toxic anterior segment syndrome, postoperatively, which resolved in 3 days. She had a history of laser in situ keratomileusis surgery 15 years ago. Slit-lamp examination of the right eye showed corneal haze, limited to laser in situ keratomileusis flap. The patient was diagnosed with interface fluid syndrome secondary to endothelial decompensation due to toxic anterior segment syndrome. Descemet’s membrane endothelial keratoplasy was performed along with full thickness fenestrations in the laser in situ keratomileusis flap to the right eye of the patient. The fluid was resolved in 1 week and visual acuity was improved rapidly. Conclusion: This case shows the importance of considering the diagnosis and determining the specific etiology of interface fluid syndrome, even years after the laser in situ keratomileusis surgery, when endothelial cell function has been compromised with any factor, such as intraocular surgery and its complications.

scholarly journals Intrahepatic Pregnancy - A Rare Form Of Abdominal Pregnancy At Lira Regional Referral Hospital, Northern Uganda; A Case Report And Literature Review

2020 ◽  
Vol 7 (08) ◽  
pp. 4895-4899
Author(s):  
Andrew Odur ◽  
Tom Richard Okello ◽  
Richard Okii ◽  
John Stephen Obbo Olwenyi ◽  
Irene Pecorella
Keyword(s):  
Abdominal Cavity ◽  
Rare Condition ◽  
Rare Form ◽  
Regional Referral Hospital ◽  
Female Baby ◽  
Upper Abdominal ◽  
The Right ◽  
Hepatic Pregnancy

Primary intra-hepatic pregnancy is an extremely rare condition. The purpose of this study was to report a case of 24-year-old Gravida 2 para 1+0 who presented at 35 weeks of amenorrhea, vaginal bleeding and mild right upper abdominal tenderness. Ultrasonography revealed a non-viable extra-uterine fetus located around the right upper part of the abdomen with a bulky uterus. At laparotomy was preferred and on finding a fetus free abdominal cavity and uterus, a macerated female baby was delivered from inside the liver with birth weight of 2.7kilogram. Placenta was left in situ and methotrexate given to hasten its resorption. Maternal outcome during the 18 days of intense follow up was uneventful. This case is a rare occurrence in our setting and it has diagnostic challenges in low resource settings like ours, however intra-hepatic pregnancy can grow to considerable size and weight.

scholarly journals An Unusual Cause of Abdominal Pain: Three Lead Pellets within the Appendix Vermiformis

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Orhan Veli Ozkan ◽  
Vecdi Muderris ◽  
Fatih Altintoprak ◽  
Orhan Yagmurkaya ◽  
Omer Yalkin ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
High Risk ◽  
Foreign Bodies ◽  
Fluoroscopic Guidance ◽  
Appendix Vermiformis ◽  
Lower Abdominal Quadrant ◽  
History Of ◽  
Rabbit Meat ◽  
The Right ◽  
Abdominal Quadrant

Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as intestinal perforation and bleeding usually occur with sharp, thin, stiff, long, and pointed objects. This case describes the management of three lead pellets within the appendix vermiformis. A 45-year-old male visited our clinic complaining of a 4-month history of abdominal pain. The patient inquiry revealed that he had eaten hunted rabbit meat on numerous occasions and had unintentionally ingested three lead pellets. Plain abdominal films and a barium enema showed foreign bodies in the right lower abdominal quadrant. Since the lead pellets were thought to have migrated extraluminally, they were removed through laparotomy under fluoroscopic guidance. An appendectomy was performed. Pathologically, three lead pellets were embedded in the appendix, which showed signs of intramucosal inflammation. Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects enter the appendicular lumen, there is a high risk of appendicitis, perforation, or abdominal pain. An appendectomy was required to remove the ingested lead pellets in the appendix.

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