Bilateral iliopsoas abscess presenting with abdominal wall cellulitis and left-sided empyema thoracis: a rare presentation

2021 ◽  
Vol 14 (10) ◽  
pp. e244697
Author(s):  
Chilaka Suresh ◽  
Oseen Hajilal Shaikh ◽  
Mude Naveen Naik ◽  
Uday Shamrao Kumbhar
Keyword(s):  
Abdominal Wall ◽  
Pleural Empyema ◽  
Facial Dysmorphism ◽  
Empyema Thoracis ◽  
Open Drainage ◽  
Rare Presentation ◽  
Iliopsoas Abscess ◽  
Contrast Enhanced Ct ◽  
Left Pleural Effusion ◽  
History Of

Iliopsoas abscess is common in immunocompromised patients and rarely presents with empyema thoracis. We present a 26-year-old male with no comorbidities who presented with a 3-day history of abdominal pain, fever and dyspnoea. There was no history of tuberculosis or recent contact with a tuberculous patient. On examination, the patient had facial dysmorphism and abdominal wall cellulitis extending bilaterally from flank to the inguinoscrotal region. Chest X-ray showed a left pleural effusion. Ultrasonography and contrast-enhanced CT also showed bilateral iliopsoas abscess with a left massive pleural empyema. The patient underwent bilateral abscess open drainage, thoracostomy for left empyema thoracis and intravenous antibiotic therapy. The patient had an uneventful course postoperatively and was discharged.

scholarly journals Melioidosis: A Rare Cause of Liver Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Peter Franz M. San Martin ◽  
Catherine S. C. Teh ◽  
Ma. Amornetta J. Casupang
Keyword(s):  
Liver Abscess ◽  
Burkholderia Pseudomallei ◽  
Abdominal Ultrasound ◽  
Open Drainage ◽  
High Grade Fever ◽  
Rare Presentation ◽  
Culture Studies ◽  
Moderate Growth ◽  
Male Farmer ◽  
History Of

Case Presentation. This is a case of a 44-year-old male, farmer, known to be diabetic, presenting with two-week history of vague abdominal pain associated with high grade fever. Abdominal CT scan showed localized liver abscess at segment 8 measuring 7.5 × 6.8 × 6.1 cm. Patient subsequently underwent laparoscopic ultrasound guided pigtail insertion for drainage of abscess. Culture studies showed moderate growth ofBurkholderia pseudomalleiin which the patient completed seven days of IV Meropenem. On follow-up after 12 weeks of oral Sulfamethoxazole/Trimethoprim, taken twice a day, the patient remained asymptomatic with no residual findings based on the abdominal ultrasound.Discussion. Diagnosis of melioidosis, a known “great masquerader,” relies heavily on culture studies. Consensus with regard to the management of liver abscess caused byBurkholderia pseudomalleihas not yet been established due to the rarity of cases. Surgical intervention through either a percutaneous or open drainage has shown good outcomes compared to IV antibiotics alone. In Philippines, the possibility of underreporting is highly plausible. This write-up serves not only to report a rare presentation of melioidosis but also to add to the number of cases reported in the country, possibly indicative of disease emergence.

Mistaken identity: an unexpected case of spontaneous cholecystocutaneous fistula formation

2021 ◽  
Vol 14 (2) ◽  
pp. e234191
Author(s):  
Isla Shariatmadari ◽  
Chiara Rossi ◽  
Kandaswamy Krishna
Keyword(s):  
Abdominal Wall ◽  
Fistula Formation ◽  
Rare Presentation ◽  
Incision And Drainage ◽  
Skin Changes ◽  
Diagnostic Uncertainty ◽  
Mistaken Identity ◽  
History Of ◽  
Erythematous Skin ◽  
Gallbladder Fossa

We describe the case of a 78-year-old woman who presented to the emergency department with a 2-week history of a superficially developing mass in the lower right abdominal wall, fluctuant and non-tender with overlaying erythematous skin changes. Though resembling an abdominal wall abscess and initially listed for a simple incision and drainage, diagnostic uncertainty encouraged further investigation. CT and ultrasound confirmed the mass appeared to be in continuity with the gallbladder fossa, with the lumen also containing small bowel medially. While awaiting a multidisciplinary team discussion, the patient re-presented with concern over discharge appearing at the site of the mass. On inspection, we noted black flecks and small stones. This case describes the unusual and rare presentation of a cholecystocutaneous fistula. The patient was managed conservatively and remains clinically well.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden
Keyword(s):  
Airway Obstruction ◽  
Nasal Polyp ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Rare Presentation ◽  
First Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Sinonasal Symptoms ◽  
Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

scholarly journals A Case of a Laryngeal MALT Lymphoma in a Patient with a History of Gastric MALT

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mark Ashamalla ◽  
Marita S. Teng ◽  
Joshua Brody ◽  
Elizabeth Demicco ◽  
Rahul Parikh ◽  
...  
Keyword(s):  
African American ◽  
Malt Lymphoma ◽  
African American Woman ◽  
American Woman ◽  
Complete Response ◽  
Gastric Malt Lymphoma ◽  
Rare Presentation ◽  
Original Diagnosis ◽  
History Of ◽  
Previously Treated

We are reporting a case of a 62-year-old African American woman with a history of gastric MALT lymphoma successfully treated with radiation who presented with a laryngeal MALT lymphoma 4 years after her original diagnosis. She received definitive radiation with a complete response. The case presented is unique for the rare presentation of a MALT lymphoma in the larynx, especially in light of the patient’s previously treated gastric MALT lymphoma years ago.

scholarly journals Sarcoidosis Causing Complete Nasal Obstruction

2021 ◽  
pp. 014556132110038
Author(s):  
Margaret K. Mills ◽  
M. Melinda Sanders ◽  
Todd E. Falcone
Keyword(s):  
Nasal Obstruction ◽  
Pulmonary Sarcoidosis ◽  
Prior History ◽  
Rare Presentation ◽  
History Of ◽  
Sinonasal Involvement

Our case demonstrates the rare presentation of sinonasal sarcoidosis causing severe nasal obstruction. While the patient had a remote history of pulmonary sarcoidosis, she was in remission and had no prior history of sinonasal involvement. Sarcoidosis should be considered in a patient with nasal obstruction especially when there is a history of systemic sarcoid disease.

BILATERAL PROPTOSIS - INITIAL AND RARE PRESENTATION: AML

2021 ◽  
pp. 17-18
Author(s):  
Tejasvini Chandra ◽  
Perwez Khan ◽  
Lubna Khan ◽  
Anshika Gupta
Keyword(s):  
Myeloid Leukemia ◽  
Blood Count ◽  
Complete Blood Count ◽  
Rare Condition ◽  
Metastatic Tumour ◽  
Blood Picture ◽  
Rare Presentation ◽  
Radiological Investigation ◽  
Presumptive Diagnosis ◽  
History Of

We report bilateral proptosis as the initial presentation of Acute Myeloid Leukemia (AML) in a child. An Eight year child presented with a history of painless proptosis in the both eyes within 10 days. Radiological investigation (CT scan) showed inltration of orbit with the metastatic tumour cell. AML was diagnosed with complete blood count, General Blood Picture (GBP) and bone marrow biopsy. The presumptive diagnosis of leukemic inltration of the orbit is made. We report this case as AML can rarely present in child as a bilateral proptosis due to leukemic inltration. Urgent treatment modality for this rare condition is radiation.

ANTERIOR ABDOMINAL WALL ABSCESS A RARE PRESENTATION OF LEFT SIDED COLONIC CARCINOMA: A DIAGNOSTIC CHALLENGE FOR A GENERAL SURGEON

2021 ◽  
pp. 26-28
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Subhabrata Das ◽  
Dibyendu Chatterjee
Keyword(s):  
Abscess Formation ◽  
Colonic Carcinoma ◽  
Uneventful Recovery ◽  
General Surgeon ◽  
Bowel Habit ◽  
Abdominal Abscess ◽  
Diagnostic Challenge ◽  
Rare Presentation ◽  
Carcinoma Of The Colon ◽  
History Of

Background: The various presentations of carcinoma of the colon are well known. Abscess formation occurs in 0.3 to 0.4% and is the second most common complication of perforated lesions. Perforation and penetration of adjacent organs with intra-abdominal abscess formation as the initial presentation is uncommon. It is difcult to make an accurate diagnosis of abscess formation as the rst evidence of colonic carcinoma preoperatively. A 68 yrs old female who presented to the ED with acute onset of left lower abdominal f Case presentation: ullness, pain and local redness for 15 days. She denied any history of vomiting, fever, anorexia but history of altered bowel habit. Clinically she had a palpable lump (20 x15) cm in left lumber region .The lump was parietal with local raise of temperature , redness and tenderness can be elicited . So our initial impression was parietal wall abscess and we underwent emergency drainage of abscess. She had uneventful recovery and discharged after 2 weeks. She was admitted with similar presentation in previous location 30 days after discharge. Now we investigate thoroughly, a CECT scan of whole abdomen which conrms radio-logically as carcinoma of descending colon with abscess extending into the parietal wall .We underwent an exploratory laparotomy and HPE proven as adenocarcinoma of the colon. Post op she developed SSI which was managed with regular dressing and she was discharged in post-op day 20. We report this case because of an unusual Conclusion: presentation of left sided colonic Ca. The accurate preoperative diagnosis of these conditions extremely complicated because of the fuzzy clinical presentation. The CT scan can diagnose malignancy pre-operatively, even if the denitive diagnosis of colonic perforated neoplasia may be evident only during surgery. So early diagnosis and prompted intervention can save the patient to developed sepsis and to reduce signicantly the morbidity and mortality. The importance is to focus on the differential diagnosis and keep in mind that a colon carcinoma can present with abdominal abscess. Surgeons should be aware of this differential because it is easily ignored pre-operatively.

scholarly journals Overt Lower Gastrointestinal Bleeding and Pseudotumor: A Rare Presentation of Cytomegalovirus Infection

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Akanksha Agrawal ◽  
Deepanshu Jain ◽  
Sameer Siddique
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
The Body ◽  
Cmv Infection ◽  
Rare Presentation ◽  
Multiple Organs ◽  
Highly Active ◽  
History Of ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Cytomegalovirus (CMV) is a ubiquitous organism which can infect multiple organs of the body. In an immunocompromised patient, it can have a myriad of gastrointestinal manifestations. We report a case of recurrent hematochezia and concomitant pseudotumor in an AIDS (acquired immunodeficiency syndrome) patient attributable to CMV infection. A 62-year-old man with a history of AIDS, noncompliant with highly active antiretroviral therapy (HAART), presented with bright red blood per rectum. Index colonoscopy showed presence of multiple ulcers, colonic stenosis, and mass-like appearing lesion. Biopsy confirmed CMV infection and ruled out malignancy. Cessation of dual antiplatelet therapy and compliance with HAART lead to clinical cessation of bleeding and endoscopic healing of ulcers with complete resolution of colon mass on follow-up colonoscopy.

scholarly journals Managing a Colonoscopic Perforation in a Patient with No Abdominal Wall

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Jayan George ◽  
Michael Peirson ◽  
Samuel Birks ◽  
Paul Skinner
Keyword(s):  
Abdominal Pain ◽  
Incisional Hernia ◽  
Plastic Surgery ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Colonic Perforation ◽  
Conservative Approach ◽  
Wall Defect ◽  
Surgical History ◽  
History Of

We describe the case of a 37-year-old gentleman with Crohn’s disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted. The patient improved significantly and is currently awaiting plastic surgery input for the management of his abdominal wall defect.

Sign in / Sign up

Export Citation Format

Share Document