scholarly journals Abdominal hereditary angio-oedema caught on magnetic resonance imaging

2021 ◽  
Vol 14 (12) ◽  
pp. e246339
Author(s):  
Mayven Tien Li Siow ◽  
Alexander Myles Robertson ◽  
Rohit R Ghurye ◽  
Paul A Blaker
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Recurrent Abdominal Pain ◽  
Acute Attack ◽  
Free Fluid ◽  
Resonance Imaging ◽  
Mr Images ◽  
First Case ◽  
Moderate Volume ◽  
History Of

A 17-year-old woman presented with a 3-year history of recurrent, severe abdominal pain with spontaneous resolution within a few days. An ultrasound revealed nothing more than free fluid within the pelvis. An MRI of the small bowel was done within 24 hours of abdominal pain onset, which revealed extensive submucosal oedema associated with moderate volume ascites. A repeat MRI of the small bowel after 72 hours showed near-complete resolution of these changes. Checking C1 inhibitor levels confirmed a diagnosis of hereditary angio-oedema with an abdominal presentation. This is a rare cause of recurrent abdominal pain and, to our knowledge, the first case in which MR images have been obtained during and after an acute attack.

scholarly journals Lupus causing small bowel obstruction

2018 ◽  
pp. bcr-2018-225886 ◽  
Author(s):  
Yunfei Yang ◽  
Anne-Marie Bartsch ◽  
Eve Fryer ◽  
Daniel Hancu
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Renal Involvement ◽  
Emergency Admission ◽  
Recurrent Abdominal Pain ◽  
Systemic Lupus Erythematous ◽  
Systemic Lupus ◽  
Short Gut Syndrome ◽  
Bowel Involvement ◽  
History Of

A 20-year-old female patient was admitted to hospital in 2015 with 1 year history of recurrent abdominal pain, distension, borborygmi and nausea. The patient had a background of systemic lupus erythematous (SLE) diagnosed 4 years before, with skin, joint and renal involvement. The initial investigations have shown a long segment of ileal inflammation with upstream obstruction. Differential diagnoses were mainly SLE enteritis or concomitant Crohn’s. Patient failed the initial conservative management and had a laparotomy with small bowel (SB) resection and ileostomy. The histology was suggestive of autoimmune enteritis. Although bowel involvement is a frequent feature of SLE, surgery for obstruction is extremely rare. Postoperatively, she had an emergency admission and was diagnosed with SB volvulus with perforation. She underwent further resection and stoma refashioning in 2016. As a consequence, she developed short gut syndrome. Eventually, the stoma was reversed and parenteral nutrition was stopped and weight became stable.

scholarly journals A case of iatrogenic intussusception in adults: a rare case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiang Hu ◽  
Yuanshui Sun ◽  
Jianfeng Shi
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Color Change ◽  
Abdominal Distension ◽  
Recurrent Abdominal Pain ◽  
Abdominal Ct ◽  
Surgical Exploration ◽  
Intestinal Tube ◽  
First Case

Abstract Background Intussusception has a low incidence rate in adults. Many cases in adults are caused by tumors. Intussusception results from conditions other than tumors are uncommon. This is the first case report about intussusception that occurred after removing a long intestinal tube (LT). Case presentation A 69-year-old female complained of “recurrent abdominal pain with reduced flatus passage and frequency of bowel movement for 10 days” was admitted to the hospital. Plain abdominal radiography and abdominal CT upon admission showed intestinal obstruction. The patient’s abdominal pain was not relieved after symptomatic treatments, which involved fluid and electrolyte replacement, LT placement, spasmolytic agents, and analgesics. Hence, surgical exploration was carried out. The patient had a good recovery postoperatively. No abdominal pain or bloating developed after food intake. The patient passed flatus and had bowel movements later. On postoperative day 9, the LT was removed. On the 10th day, the patient suddenly developed abdominal distension and acute abdominal pain. Emergency abdominal CT showed small bowel intussusception. Surgical exploration was then performed. Severe small bowel dilatation located at 1.5 m from the ligament of Treitz was found during the procedure. Intussusception at the site was observed. No color change of the intestinal wall was detected, suggesting that no necrosis was present. So, a manual reduction was done. The patient was discharged on postoperative day 6. Conclusions This case serves as a warning that the simple action of pulling out the LT might also cause serious complications, which should be given more attention.

scholarly journals Pharmacoresistant Abdominal Seizures in Symptomatic Localization-Related Epilepsy

2021 ◽  
Vol 11 (1) ◽  
pp. 106-109
Author(s):  
Vadakke Puthanveetil Tushar ◽  
Sachin Sureshbabu ◽  
Kunnath Gopalakrishnan Sruthi ◽  
Smilu Mohanlal
Keyword(s):  
Abdominal Pain ◽  
Focal Epilepsy ◽  
Obstructive Hydrocephalus ◽  
Recurrent Abdominal Pain ◽  
Resonance Imaging ◽  
Present Case Report ◽  
Ventriculoperitoneal Shunting ◽  
Positron Emission ◽  
History Of ◽  
The Right

Abdominal epilepsy is an uncommon cause of recurrent abdominal pain with or without other complaints seen in children and adults which often goes unnoticed. Here we are presenting a case of abdominal epilepsy in a 7-year boy who had recurrent abdominal pain since many years. He had a history of ventriculoperitoneal shunting which was performed for obstructive hydrocephalus at 1 month and left hemiparesis. He was evaluated at multiple centers for abdominal complaints before being referred here. The video electroencephalogram done showed inter ictal and ictal abnormalities which correlated with magnetic resonance imaging and positron emission tomography abnormalities on the right side. He was started on antiepileptics with a partial response and continued to get events even with four antiepileptics but the frequency and severity reduced significantly. The present case report is to highlight the drug refractoriness of abdominal seizures in a patient with symptomatic focal epilepsy.

Lockdown dilemma: ingestion of magnetic beads presenting as right iliac fossa pain and subacute small bowel obstruction

2020 ◽  
Vol 13 (11) ◽  
pp. e236429
Author(s):  
Bankole Oyewole ◽  
Anu Sandhya ◽  
Ian Maheswaran ◽  
Timothy Campbell-Smith
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Magnetic Beads ◽  
Iliac Fossa ◽  
Serous Fluid ◽  
Magnetic Resonance Scan ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
Multiple Episodes ◽  
Safety Netting

A 13-year-old girl presented with a 3-day history of migratory right iliac fossa pain. Observations and inflammatory markers were normal, and an ultrasound scan was inconclusive. A provisional diagnosis of non-specific abdominal pain or early appendicitis was made, and she was discharged with safety netting advice. She presented again 6 days later with ongoing abdominal pain now associated with multiple episodes of vomiting; hence, the decision was made to proceed to diagnostic laparoscopy rather than a magnetic resonance scan for further assessment. Intraoperative findings revealed 200 mL of serous fluid in the pelvis, normal-looking appendix, dilated stomach and a tangle of small bowel loops. Blunt and careful dissection revealed fistulous tracts that magnetised the laparoscopic instruments. A minilaparotomy was performed with the extraction of 14 magnetic beads and the repair of nine enterotomies. This case highlights the importance of careful history taking in children presenting with acute abdominal pain of doubtful aetiology.

scholarly journals Laparoscopic reduction and repair of a left paraduodenal hernia

2019 ◽  
Vol 12 (12) ◽  
pp. e232098 ◽  
Author(s):  
Takashi Sakamoto ◽  
Alan Kawarai Lefor
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Repair ◽  
Recurrent Abdominal Pain ◽  
Paraduodenal Hernia ◽  
Enhanced Ct ◽  
History Of ◽  
Congenital Internal Hernia ◽  
Continuous Closure ◽  
Hernia Orifice ◽  
Similar Episode

Left paraduodenal hernias are the most common type of congenital internal hernia, but they are difficult to diagnose without appropriate imaging. A 79-year-old man with a history of recurrent abdominal pain had another similar episode of abdominal pain, which prompted him to seek evaluation. The pain resolved spontaneously on arrival to the hospital. Enhanced CT scan showed the characteristic findings of a left paraduodenal hernia and laparoscopic repair was undertaken. The small intestine was reduced successfully, and the hernia orifice was approximated with a continuous closure. He was discharged uneventfully 4 days after admission. The characteristic clinical and imaging findings of paraduodenal hernias are reviewed. Laparoscopic repair is reasonable in patients who have a paraduodenal hernia without intestinal ischemia.

scholarly journals A case of hereditary angioedema due to C1-inhibitor deficiency with recurrent abdominal pain diagnosed 40 years after the occurrence of the initial symptom

2021 ◽  
Author(s):  
Daisuke Honda ◽  
Isao Ohsawa ◽  
Keiichi Iwanami ◽  
Hisaki Rinno ◽  
Yasuhiko Tomino ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hereditary Angioedema ◽  
Recurrent Abdominal Pain ◽  
Acute Attack ◽  
Severe Abdominal Pain ◽  
Initial Symptom ◽  
C1 Inhibitor ◽  
Self Administration ◽  
C1 Inhibitor Deficiency ◽  
Appropriate Treatment

AbstractHereditary angioedema due to C1-inhibitor deficiency (HAE-C1-INH) is a rare disease, which induces an acute attack of angioedema mediated by bradykinin. HAE-C1-INH can cause serious abdominal pain when severe edema develops in the gastrointestinal tract. However, because it takes a long time, 13.8 years on average in Japan, from the occurrence of the initial symptom to the diagnosis due to low awareness of the disease, undiagnosed HAE-C1-INH patients sometimes undergo unnecessary surgical procedures for severe abdominal pain. We herein present a 56-year-old patient with HAE-C1-INH, who underwent numerous abdominal operations. He frequently needed hospitalization with the administration of opioid due to severe abdominal pain. However, after he was accurately diagnosed with HAE-C1-INH at 55 years of age, he could start self-administration for an acute attack with icatibant, a selective bradykinin B2 receptor antagonist. Consequently, he did not need hospitalizing for ten months after the beginning of the treatment. A series of an accurate diagnosis and appropriate treatment for HAE-C1-INH improved his quality of life. Thus, HAE-C1-INH should be considered, when we meet patients with unidentified recurrent abdominal pain. This case highlights significance of an early diagnosis and appropriate treatment for HAE-C1-INH.

scholarly journals Trichobezoars in the practice of a pediatric surgeon

2021 ◽  
Vol 25 (2) ◽  
pp. 135-139
Author(s):  
R. V. Bocharov ◽  
Ya. V. Shikunova ◽  
G. V. Slyzovsky ◽  
V. G. Pogorelko ◽  
M. A. Zykova ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Medical Records ◽  
Foreign Bodies ◽  
Psychological Trauma ◽  
Postoperative Course ◽  
X Ray ◽  
First Case ◽  
History Of ◽  
Dense Hair ◽  
Hair Formation

Material and methods. A retrospective analysis of medical records of two children. Anamnestic, clinical, diagnostic and intraoperative findings were analyzed.Purpose. To describe cases of trichobezoars in children : occurrence, diagnostics and treatment.Results. In the first case, a girl, aged 5, often swallowed her own hair after a psychological trauma; and at the age of 15 she complained of hair loss and anemia. In the second case, a boy was chewing and swallowing his own hair for 6 months under the emotional stress. Two weeks before hospitalization he complained of abdominal pain. In both cases, there were no history of intestinal obstruction. At the fibroesophagogastroduodenoscopy, foreign bodies were visualized which were diagnosed as trichobezoars. X-ray diagnostics confirmed foreign bodies in both patients. Those bodies had the shape of the stomach and had an inhomogeneous porous structure. The patients were operated: laparotomy, gastrotomy with removal of dense hair formation. Postoperative course was uneventful.Conclusion. Psychological situations provoked in children the obsessive trichotillomania and trichophagia due to which large trichobezoars were formed in the stomach.

scholarly journals Abdominal intussusception associated with coeliac disease: case report and literature review

2021 ◽  
Author(s):  
Rashid Hameed ◽  
Noshine Irrum ◽  
Subodhini P. Arachchige ◽  
Edwin Tan ◽  
Jacinta Tobin
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Coeliac Disease ◽  
Recurrent Abdominal Pain ◽  
Immune Infiltration ◽  
Disease Case ◽  
Classical Pattern ◽  
History Of

In genetically susceptible individuals, gluten ingestion triggers and immune infiltration and bowel damage in the classical pattern of coeliac disease, with variable symptoms. Intussusception is a condition where one segment of intestine ‘telescopes’ inside of another portion of intestine, which may cause symptoms of abdominal pain due to obstruction. Intussusception has been associated with coeliac disease. We report a 4-year-old girl presented with recurrent abdominal pain of variable severity and found to have intussusception on two occasions, which on both occasions reduced spontaneously during ultrasound examinations. She was later diagnosed with coeliac disease. This case highlights the importance of considering coeliac screening in patients with a history of recurrent abdominal pain and intussusception.

Case 5.1

2014 ◽  
pp. 245-246
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Diabetes Mellitus ◽  
Abdominal Pain ◽  
Signal Intensity ◽  
Recurrent Abdominal Pain ◽  
Iron Deposition ◽  
History Of ◽  
T2 Weighted Images

35-year-old man with a long history of diabetes mellitus and recent episode of peritonitis now presents with recurrent abdominal pain and fever Axial fat-suppressed FSE T2-weighted images (Figure 5.1.1) show multiple hyperintense lesions in the spleen. The diffuse, decreased signal intensity throughout the remainder of the spleen is due to hemosiderosis and iron deposition. Gadolinium-enhanced axial 3D SPGR images (...

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