Enterocolic lymphocytic phlebitis: a rare pathology in children

2021 ◽  
Vol 14 (8) ◽  
pp. e243826
Author(s):  
Omar Nasher ◽  
Naved Alizai
Keyword(s):  
Surgical Resection ◽  
Preoperative Diagnosis ◽  
Diagnostic Laparoscopy ◽  
Adult Population ◽  
Lower Abdominal Pain ◽  
Paediatric Population ◽  
Rare Clinical Entity ◽  
Clinical Challenge ◽  
History Of ◽  
Venous Vasculature

Enterocolic lymphocytic phlebitis (ELP) is a rare pathology, usually seen in the adult population. The condition affects the venous vasculature of the intestine sparing the arteries and lymphatics. It is commonly identified histologically after surgical resection making the preoperative diagnosis a clinical challenge. As the condition can lead to intestinal ischaemia and necrosis, surgical resection of the affected segment is the treatment of choice. We report the case of a 9-year-old girl who presented with a 2-day history of lower abdominal pain and anorexia. The initial diagnosis of appendicitis was made clinically and the patient underwent a diagnostic laparoscopy . The appendix was macroscopically normal and there were no other obvious intra-abdominal pathologies to account for her presenting complaints . The appendix was removed, as per the preoperative discussion and consent from parents. She recovered well and was discharged home the following day. The histological examination of the appendix demonstrated ELP. We describe this rare clinical entity in a child especially in view of the scarce published literature in the paediatric population.

scholarly journals Primary Hepatic Leiomyoma in a Healthy Middle-Aged Woman: Literature Review and Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Mihajlo Djokic ◽  
Benjamin Hadzialjevic ◽  
Bostjan Luzar ◽  
Blaz Trotovsek
Keyword(s):  
Surgical Resection ◽  
Preoperative Diagnosis ◽  
Liver Tumors ◽  
Good Condition ◽  
Middle Aged ◽  
Aged Woman ◽  
Immunosuppressed Patients ◽  
Middle Aged Woman ◽  
History Of ◽  
Trucut Biopsy

Introduction: Primary hepatic leiomyoma (PHL) is a rare benign hepatic tumor with unclear pathogenesis. It more commonly occurs in immunosuppressed patients, while only 24 cases have been described among immunocompetent individuals. To date, only one successful preoperative diagnosis of PHL has been achieved.Case Presentation: Here we report a case of PHL in a middle-aged woman with no history of immunosuppression. Preoperative diagnosis of PHL was established using ultrasound-guided fine needle trucut biopsy (FNTB). Nevertheless, due to the growing nature of tumor and patient's symptoms, we proceeded with surgical resection, which confirmed the diagnosis of PHL. At 6-month follow up, the patient is in good condition with no evidence of tumor recurrence.Conclusions: PHL is an uncommon tumor that should be considered in the differential diagnosis of rare liver tumors. Image guided FNTB appears to be effective in achieving preoperative diagnosis of PHL. Surgical resection, however, remains both diagnostic and curative in the management of PHL.

scholarly journals A Case of Isolated Cecal Necrosis Preoperatively Diagnosed with Perforation of Cecum

Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 9 ◽  
Author(s):  
Atsushi Kohga ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
Kimihiro Yamashita ◽  
Jun Isogaki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Preoperative Diagnosis ◽  
Previous History ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Ileocecal Resection ◽  
Urgent Surgery ◽  
Ischemic Change ◽  
History Of ◽  
Laparoscopic Assisted

Isolated cecal necrosis (ICN) is a rare condition which is developed under decreased mesenteric perfusion. Only a few dozen cases of ICN have been reported previously. The patient was a 59-year-old male with a previous history of atrial fibrillation. He presented to our emergency room with the chief complaint of lower abdominal pain. Computed tomography imaging revealed a dilated cecum and presence of free air. With a preoperative diagnosis of perforation of the cecum; an urgent surgery was conducted. Intraoperative findings revealed an ischemic change of the cecum and a laparoscopic-assisted ileocecal resection was performed. The pathological findings showed transmural ischemic change on the anti-mesenteric side of the cecum, and the diagnosis of ICN was achieved. Preoperative diagnosis of ICN is difficult because of its non-specific radiological features. In patients with right lower abdominal pain, ICN should be considered as a differential diagnosis especially if the patient has a comorbidity causing hypotension attack.

scholarly journals Adult Colo-Colic Intussusception Induced By a Lipoma Masquerading As a Sigmoid Polyp on Colonoscopy: A Case Report

2013 ◽  
Vol 5 (1) ◽  
pp. 72-74
Author(s):  
Junaid Nabi ◽  
SM Quamrul Akhter ◽  
Mohammad Abdullah Al Mamun ◽  
Nelema Jahan ◽  
Md Mamunur Rahman
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Preoperative Diagnosis ◽  
Anal Verge ◽  
Lower Abdominal Pain ◽  
Histological Evaluation ◽  
Midline Incision ◽  
History Of ◽  
Specific Symptoms ◽  
Satisfactory Recovery

Intussusception in adults is rare, accounting for only 5% of all cases of intussusceptions and only 1% of bowel obstruction. Preoperative diagnosis is often difficult due to non specific symptoms and subacute nature. This case report was a per-operatively diagnosed adult colo-colic intussusception induced by a lipoma which mimicked a sigmoid polyp on colonoscopy. A 40-year-old Bengali woman was admitted with two weeks history of colicky lower abdominal pain. Ultrasound abdomen was unremarkable. Colonoscopy revealed a moderately enlarged sigmoid polyp at 25 cm from the anal verge. A midline incision laparotomy was performed only to reveal a colo-colic intussusception. The intussusception was reduced and the patient underwent a segmental resection of the involved bowel. Histological evaluation confirmed the diagnosis of lipoma of the colon. The patient however satisfactory recovery and remains well six months after surgery. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16226 J Shaheed Suhrawardy Med Coll, 2013;5(1):72-74

Ruptured salpingitis isthmica nodosa: a rare cause for spontaneous haemoperitoneum

2021 ◽  
Vol 14 (1) ◽  
pp. e237860
Author(s):  
Dora Huang ◽  
Sandon Lowe ◽  
Pravena Kumaran ◽  
Kay Tai Choy
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Diagnostic Laparoscopy ◽  
Lower Abdominal Pain ◽  
Atypical Presentation ◽  
Pelvic Ultrasound ◽  
Beta Human Chorionic Gonadotropin ◽  
History Of ◽  
Ectopic Pregnancies ◽  
The Right

Salpingitis isthmica nodosa (SIN) is the nodular swelling or diverticulum of the isthmus of the fallopian tube. It is most commonly identified when investigating female infertility or in association with ruptured ectopic pregnancies. We experienced a rare and atypical presentation of SIN. A 33-year-old woman presented with a 1-hour history of acute lower abdominal pain associated with nausea and vomiting. CT and pelvic ultrasound revealed haemoperitoneum with no radiological evidence for its aetiology. Initial beta-human chorionic gonadotropin excluded ectopic pregnancy. A diagnostic laparoscopy was performed following clinical deterioration of the patient. Active bleeding of the right fallopian tube was identified and managed with a right partial salpingectomy, with subsequent histopathology revealing ruptured SIN. There have been no reported cases of SIN being a primary cause for an acute abdomen or haemoperitoneum in the absence of an ectopic pregnancy, making this case a surgical novelty.

Preoperative hormonal therapy for a patient with appendiceal endometriosis

2021 ◽  
Vol 14 (11) ◽  
pp. e245667
Author(s):  
Keiko Shichiri ◽  
Kazuhiro Nishida ◽  
Alan Kawarai Lefor ◽  
Tadao Kubota
Keyword(s):  
Hormone Therapy ◽  
Hormonal Therapy ◽  
Preoperative Diagnosis ◽  
Lower Abdominal Pain ◽  
Gonadotropin Releasing Hormone ◽  
Optimal Management ◽  
Gonadotropin Releasing Hormone Agonist ◽  
Contrast Enhanced ◽  
Mucocele Of The Appendix ◽  
History Of

The optimal management of patients with appendiceal endometriosis has not been determined because of the difficulty of establishing a preoperative diagnosis. There are no reports of preoperative hormone therapy for a patient with appendiceal endometriosis. We report a patient who underwent resection of appendiceal endometriosis after hormone therapy. A 40-year-old woman with history of recurrent pelvic abscesses presented to the emergency department with lower abdominal pain. The recurrent pelvic abscesses were synchronised with her menstrual cycle. CT scan demonstrated a 25 mm contrast-enhanced luminal structure adjacent to the cecum, which was thought to be a mucocele of the appendix. Considering the recurrent symptoms during menstruation, endometriosis was suspected. Treatment with a gonadotropin-releasing hormone agonist was started for appendiceal endometriosis, which alleviated the symptoms. After 3 months, elective laparoscopic appendectomy was performed. Preoperative hormonal therapy is an option for patients with appendiceal endometriosis, especially when there is concern for dense adhesions.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

scholarly journals Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Basque Country ◽  
Adult Population ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of ◽  
Incident Cases

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.

scholarly journals Factors Associated with Clinician Adherence to USPSTF Diabetes Screening Recommendations

2021 ◽  
Vol 12 ◽  
pp. 215013272110165
Author(s):  
Elaine Seaton Banerjee ◽  
Kyle Shaak ◽  
Nicole Burgess ◽  
Melanie Johnson ◽  
Beth Careyva
Keyword(s):  
Gestational Diabetes ◽  
Adult Population ◽  
Correct Diagnosis ◽  
Retrospective Chart Review ◽  
Diabetes Screening ◽  
Factors Associated ◽  
The Us ◽  
History Of ◽  
Missed Diagnosis ◽  
Significant Health

Introduction/Objectives: Diabetes and prediabetes impact nearly half of the US adult population and are associated with significant health risks but may be underdiagnosed. Effective screening may improve diagnosis and give patients opportunity to manage their disease. The purpose of this study was to determine screening rates, identify characteristics predictive of screening, and evaluate correct diagnosis of diabetes and prediabetes. Methods: Retrospective chart review of 71 433 patients eligible for diabetes screening, defined by completing A1c test within the 3-year study period. Results: A total of 31.3% of eligible patients received diabetes screening. Factors associated with screening include older age, female sex, non-white race, Hispanic ethnicity, Medicare or Medicaid insurance, higher BMI, and having a medical comorbidity. History of prediabetes or gestational diabetes were the strongest predictors for diabetes screening, but history of gestational diabetes was under-documented. Of those screened, 10.4% had a result consistent with diabetes and 51.8% had a result consistent with prediabetes. However, 52.9% of these patients had a missed diagnosis. Conclusions: Findings of this study indicate the need for uniform coverage for diabetes screening for all insurances, increased documentation of gestational diabetes to improve screening for patients with this history, and improving accurate diagnosis after screening is completed.

scholarly journals Endometriosis Mimicking a Cecum Mass with Complete Bowel Obstruction: An Infrequent Cause of Acute Abdomen

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Gabriel A. Molina ◽  
Darwin R. Ramos ◽  
Alberto Yu ◽  
Patricio A. Paute ◽  
Paul S. Llerena ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Preoperative Diagnosis ◽  
Malignant Tumors ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Intestinal Involvement ◽  
History Of ◽  
Ovarian Abscess ◽  
Fertile Women

Endometriosis is a common entity among fertile women which unfortunately manifests through variable symptomatology. Intestinal involvement in endometriosis is quite common and can simulate several diseases such as Crohn’s disease, appendicitis, tubo-ovarian abscess, or malignant tumors. Intestinal obstruction due to endometriosis is rare, and preoperative diagnosis is difficult because the signs and symptoms are nonspecific and can be easily confused. In the case of patients without a history of endometriosis, diagnosis is further complicated. We present a case of a 41-year-old female patient. She presented to the emergency room with complete bowel obstruction and a mass in the cecum. Surgery was decided, and the patient underwent full recovery. Endometriosis was the final diagnosis for the observed condition.

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