scholarly journals Unusual Differential Diagnosis of Upper Abdominal Pain

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Lanthaler Monika ◽  
Grissmann Thomas ◽  
Schwentner Lukas ◽  
Nehoda Hermann
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Gastric Perforation ◽  
Gastric Wall ◽  
Endoscopic Removal ◽  
Quadrant Pain ◽  
Anterior Gastric Wall ◽  
Upper Abdominal

We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-old man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.

scholarly journals An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body

HPB Surgery ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Justin S. Gundara ◽  
Richard Harrison
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Liver Abscess ◽  
Foreign Bodies ◽  
High Rate ◽  
Gut Epithelium ◽  
Chicken Bone ◽  
Upper Abdominal ◽  
Distal Sigmoid ◽  
Portal Drainage

A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases.

Unusual case of hyperemesis in a pregnant patient with prior antireflux surgery

2021 ◽  
Vol 14 (8) ◽  
pp. e241935
Author(s):  
Abimbola Obisesan ◽  
Eleanor Lucy Townsend ◽  
John Lin Hieng Wong ◽  
Vinod Menon
Keyword(s):  
Decision Making ◽  
Abdominal Pain ◽  
Antireflux Surgery ◽  
Unusual Case ◽  
Nissen Fundoplication ◽  
Hyperemesis Gravidarum ◽  
Pregnant Patient ◽  
Emergency Laparotomy ◽  
Laparoscopic Nissen ◽  
Upper Abdominal

A 33-year-old, 8 weeks pregnant, presented with severe upper abdominal pain with vomiting on a background of a previous laparoscopic Nissen fundoplication for reflux disease. An urgent MRI had shown herniation of the fundoplication wrap through the diaphragmatic hiatus. The cause of her symptoms was attributed to hyperemesis gravidarum. The plan was to manage this patient conservatively until the conclusion of her pregnancy. This plan was revised when she presented for the second time and developed worsening pain and haematemesis. An emergency gastroscopy showed ischaemic changes in most of the stomach requiring the patient to undergo an emergency laparotomy. In pregnant patients, presenting with abdominal pain, vomiting as well as haematemesis, having had previous antireflux surgery, incarceration of the stomach must be considered as a differential. Prompt assessment and early senior decision-making is extremely important in avoiding a potentially catastrophic outcome for such patients.

Neuralgia-like symptoms in a patient with an airgun pellet in the ethmoid sinus: a case report

1995 ◽  
Vol 109 (7) ◽  
pp. 646-649 ◽  
Author(s):  
Paul J. Donald ◽  
Arun K. Gadre
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Surgical Management ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Ethmoid Sinus ◽  
Endoscopic Removal ◽  
Review Of The Literature ◽  
Anatomical Basis

AbstractAn unusual case of a retained airgun pellet in the ethmoid sinus is presented. The patient's only complaint was a severe neuralgic headache. Anatomical basis for this symptom, imaging and successful endoscopic removal of the foreign body are discussed. The philosophy for removal of innocuous foreign bodies, potential pitfalls in surgical management, and a review of the literature are included in the discussion.

scholarly journals Gastric Perforation Leading to The Diagnosis of Classic Ehlers Danlos syndrome: A Case Report of an Unusual Presentation.

2020 ◽  
Author(s):  
Ahad Eid Aloatibi ◽  
Ohood Hamad AlAamer ◽  
Mohammed Abdullah Bawazeer ◽  
Ali Audah Alzahrani
Keyword(s):  
Abdominal Pain ◽  
Connective Tissue ◽  
Gastric Perforation ◽  
Gastric Wall ◽  
Gastric Volvulus ◽  
Connective Tissue Diseases ◽  
Partial Gastrectomy ◽  
Type I ◽  
Ehlers Danlos Syndrome ◽  
Free Air

Abstract Background: Ehlers-Danlos syndromes (EDS) are a clinically and genetically heterogenous group of heritable connective tissue disorders caused by defective collagen synthesis or structure. Vascular subtype (EDS IV) is reported to be associated with higher incidence of gastrointestinal ruptures. The Most reported site of perforation was the colon particularly the sigmoid colon followed by small bowel. It is very rare to have stomach perforation. There were no reported cases among classic type I and II. In addition, this patient presented with Marfanoid habitus which may develop acute gastric volvulus in combined with pre-existing EDS, perforation can occur. Case presentation: We are presenting a 14-year-old girl who attended our Emergency Department (ED) with abdominal pain and vomiting. Initially diagnosed with gastroenteritis and discharged once her condition improved. 24 hours later, she developed severe abdominal pain with recurrent vomiting with peritonitis evident on clinical examination. Initial KUB failed to show any free air, however enhanced Computed Tomography (CT) revealed free air and proximal gut contrast extravasation. During exploratory laparotomy, an ischemia anterior and posterior gastric wall with gastric perforation was encountered. A free-hand partial gastrectomy was done. Her post-operative period was complicated with wound infection that managed successfully with Vacuum assisted closure (VAC) dressing. She recovered well without gastrointestinal sequalae in 4 years follow up. Conclusions: A high level of suspicion must be maintained for heritable systemic connective tissue diseases in any young patient with unusual spontaneous perforation. As these patients can develop life-threatening conditions, immediate intervention is required in addition to prepare for anticipated complications.

scholarly journals Endoscopic treatment for gastric perforation using T-tag and a plastic protection chamber: a short-term survival study

2011 ◽  
Vol 48 (2) ◽  
pp. 159-162 ◽  
Author(s):  
Kiyoshi Hashiba ◽  
Pablo R. Siqueira ◽  
Horus A. Brasil ◽  
Marco Aurélio D'Assunção ◽  
Daniel Moribe ◽  
...  
Keyword(s):  
Gastric Perforation ◽  
Gastric Wall ◽  
Short Term ◽  
Endoscopic Repair ◽  
Term Survival ◽  
Endoscopic Closure ◽  
Abdominal Organs ◽  
Real Value ◽  
Anterior Gastric Wall ◽  
Short Term Survival

CONTEXT: The endoscopic gastric perforation is a consequence of some endoscopic procedures and now a way to manage abdominal organs. This is the reason why endoscopists are studying a safe endoscopic repair. OBJECTIVE: To evaluate an endoscopic closure method for the gastric opening in natural orifice transenteric surgery DESIGN: Short-term survival animal study. METHODS: Ten White Landrace pigs underwent a gastric perforation of 1.8 cm in diameter under general anesthesia. The opening was repaired with stitch assembled in a T-tag anchor placed through the gastric wall with a needle. A plastic transparent chamber, adapted to the endoscope tip protected the abdominal organs from the needle puncture outside the stomach. Six T-tags were placed in most cases and the stitches were tied with a metallic tie-knot, forming three sutures. The animals received liquids in the same operative day. One shoot antibiotic was used. The leakage test was performed with a forceps and by air distention. RESULTS: No complication was detected in the postoperative course. One month later the endoscopy revealed a scar and some suture material was observed in all animals. The antral anterior gastric wall was clear with few adhesions in the laparotomy performed in the same time. The adhesions were intense in an animal in which a cholecystectomy was performed before the repair. CONCLUSION: The endoscopic repair using T-tag and a protector chamber is feasible, easy to perform and safe. Further studies are needed to show the real value of this kind of procedure.

scholarly journals EP.FRI.719 Gastric Perforation Leading to The Diagnosis of Classic Ehlers Danlos syndrome: A Case Report of an Unusual Presentation

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahad Alotaibi ◽  
Ohood AlAamer ◽  
Mohammed Bawazeer ◽  
Ali Alzahrani
Keyword(s):  
Abdominal Pain ◽  
Connective Tissue ◽  
Gastric Perforation ◽  
Gastric Wall ◽  
Gastric Volvulus ◽  
Connective Tissue Diseases ◽  
Partial Gastrectomy ◽  
Type I ◽  
Ehlers Danlos Syndrome ◽  
Free Air

Abstract Background Ehlers-Danlos syndromes (EDS) are clinically and genetically heterogeneous group of heritable connective tissue disorders caused by defective collagen synthesis or structure. Vascular subtype (EDS IV) is reported to be associated with a higher incidence of gastrointestinal ruptures. The Most reported site of perforation was the colon particularly the sigmoid colon followed by small bowel. It is very rare to have stomach perforation. There were no reported cases among classic type I and II. In addition, this patient presented with Marfanoid habitus which may develop acute gastric volvulus in combined with pre-existing EDS, perforation can occur. Case description A 14-year-old girl attended our Emergency Department (ED) with abdominal pain and vomiting. Initially diagnosed with gastroenteritis and discharged once her condition improved. 24 hours later, she developed severe abdominal pain with recurrent vomiting with peritonitis evident on clinical examination. Initial KUB failed to show any free air, however, enhanced Computed Tomography (CT) revealed free air and proximal gut contrast extravasation. During exploratory laparotomy, an ischemia anterior and posterior gastric wall with gastric perforation was encountered. A free-hand partial gastrectomy was done. Her post-operative period was complicated with wound infection that managed successfully with Vacuum-assisted closure (VAC) dressing. She recovered well without gastrointestinal sequelae in 4 years follow up.   Conclusions A high level of suspicion must be maintained for heritable systemic connective tissue diseases in any young patient with unusual spontaneous perforation. As these patients can develop life-threatening conditions, immediate intervention is required in addition to prepare for anticipated complications.

scholarly journals Role of Cholecystectomy in Symptomatic Hyperkinetic Gallbladder Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Jai P. Singh
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Biliary Colic ◽  
Quadrant Pain ◽  
Gallbladder Ejection Fraction ◽  
Hida Scan ◽  
Upper Abdominal ◽  
The Right ◽  
Upper Abdomen

Introduction. Biliary dyskinesia is defined by a gallbladder ejection fraction (EF) of less than 35% on HIDA scan, and these patients have shown a good response to cholecystectomy. Management of patients with biliary colic symptoms who have a hyperkinetic gallbladder ( EF > 80 % ) is not clearly defined. Herein, I report three cases of the symptomatic hyperkinetic gallbladder that were successfully managed with cholecystectomy. Case Report. Patient 1was a 56-year-old female presented with pain in the right upper abdomen for one month. Her workup was unremarkable except for the gallbladder EF of 86%. Patient 2 was a 33-year-old female with similar symptoms and workup with gallbladder EF of 97%. Patient 3 was a 20-year-old female with right upper abdominal pain and gallbladder EF of 91%. Patients 1 and 3 had the normal US, normal CT scan, and normal EGD. Patient 2 had normal US and CT but did not undergo EGD. All three patients underwent laparoscopic cholecystectomy and had complete resolution of their symptoms. Conclusion. The hyperkinetic gallbladder is a rare phenomenon, which can cause debilitating right upper quadrant pain. All three patients had an excellent response to cholecystectomy. Therefore, it is concluded that the patients with biliary colic and gallbladder EF of 80% or higher should be strongly considered for surgery.

Nutcracker Syndrome—An Unusual Case of Chronic Left Upper Abdominal Pain

2019 ◽  
Vol 12 (3) ◽  
pp. 69-72
Author(s):  
Bimal Patel ◽  
Samuel Samuel
Keyword(s):  
Abdominal Pain ◽  
Unusual Case ◽  
Nutcracker Syndrome ◽  
Upper Abdominal

scholarly journals An Unusual Case of Monolobar Caroli’s Disease

1994 ◽  
Vol 8 (3) ◽  
pp. 185-188
Author(s):  
Anthony J Gomez ◽  
Robert J Bailey
Keyword(s):  
Abdominal Pain ◽  
Unusual Case ◽  
Pathological Examination ◽  
Right Hepatectomy ◽  
Radiological Evaluation ◽  
Caroli's Disease ◽  
Caroli’S Disease ◽  
Hepatic Lobe ◽  
Upper Abdominal ◽  
The Right

A 27-year-old male with recurrent upper abdominal pain was found to have a suspicious mass in the right hepatic lobe. Right hepatectomy was performed. Pathological examination and further radiological evaluation proved this to be a focal form of Caroli’s disease.

scholarly journals Liver abscess, management strategies, and outcome

2018 ◽  
Vol 5 (9) ◽  
pp. 3093
Author(s):  
Sudhir R. Jayakar ◽  
Prabhat B. Nichkaode
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Tertiary Care ◽  
Management Strategies ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Study Population ◽  
Set Up ◽  
Upper Abdominal ◽  
Diagnosis Therapy

Background: Liver abscess, a disease troubling mankind from ancient times, has earliest documentation in the Sanskrit document. Where right upper abdominal pain, have potentially lethal consequences, if prompt diagnosis and treatment are not accomplished. However, two major types are known, amoebic and pyogenic, in medical literature. Pyogenic liver abscess constitutes major bulk of hepatic abscess in western countries. The diagnosis is confirmed by ultrasonography, reddish brown (anchovy-paste like material) aspirate from abscess. The diagnosis, treatment and prognosis, of liver abscess have evolved remarkably over past few years. Imaging has improved diagnostic competence and has altered therapeutic strategy. The study aims at early clinical and  diagnosis on imaging of liver abscess, to set up some guide lines in view of conservative or either  intervention.Methods: The present study was hospital based longitudinal study, carried out in tertiary care teaching hospital from November 2013 to November 2015.  A total of 55 patients were enrolled in the study. All patients with suspicion of having liver abscess were confirmed on Imaging and included as present study population. Authors studied mainly presentation, role of conservative treatment, Aspiration, pigtail catheter, Outcome, and post procedural complications.Results: All patients presented with Pain right or left upper abdominal pain in abdomen, any chest complaints , majority of present study group patients had fever with or without rigors, deranged liver function. Imaging is the most diagnostic method, and also helped in therapy and follow up.Conclusions: Males are affected more than females, Imaging is the best modality for diagnosis, therapy and follow up. Aspiration or pigtail drainage is the standard method of drainage. Pigtail drainage is the better method of treatment than aspiration.

Sign in / Sign up

Export Citation Format

Share Document