scholarly journals Perforation of a Retrocecal Appendix Resulting in Retroperitoneal Air: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Behrang Litkouhi ◽  
Alicia S. Huang ◽  
David J. Lundy ◽  
Maria Solis
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Acute Appendicitis ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Abscess Formation ◽  
Retroperitoneal Abscess ◽  
Retroperitoneal Perforation ◽  
Retroperitoneal Air

There have been several case reports documenting acute appendicitis complicated by perforation presenting with retroperitoneal abscess formation. To date, there are no case reports of acute appendicitis in which the only sign for retroperitoneal perforation is the presence of retroperitoneal air as detected by computed tomography (CT). In the case presented, an 18-year-old male presented to the emergency department with clinical symptoms of acute appendicitis. CT exam demonstrated an inflamed appendix with multiple collections of air in the retroperitoneum, without abscess. Laparotomy revealed perforation of a retrocecal appendix into the retroperitoneum.

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

scholarly journals Asymptomatic Presentation of Aggressive Ossifying Fibroma:A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Roopashri Rajesh Kashyap ◽  
Gopakumar R. Nair ◽  
Subhas Babu Gogineni
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Head And Neck ◽  
Clinical Symptoms ◽  
Neck Region ◽  
Ethmoid Sinus ◽  
Ossifying Fibroma ◽  
Head And Neck Region ◽  
Aggressive Form ◽  
Aggressive Tumors

Ossifying fibromas form a part of the spectrum of fibro-osseous lesions of the jaws. They are rare, benign, nonaggressive tumors that are commonly seen in head and neck region. This paper presents the case of a 40-year-old female patient presented with minimal clinical symptoms, diagnosed to be suffering from aggressive form of ossifying fibroma of maxilla involving the maxillary sinus and ethmoid sinus. This paper emphasizes the importance of computed tomography in diagnosing such unapparent aggressive tumors.

Cardiac metastasis of osteosarcoma

Open Medicine ◽  
2010 ◽  
Vol 5 (5) ◽  
pp. 551-555
Author(s):  
Hilal Sahin ◽  
Naim Ceylan ◽  
Selen Bayraktaroglu ◽  
Recep Savas
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Case Reports ◽  
Primary Tumour ◽  
Cardiac Metastasis ◽  
Imaging Findings ◽  
Cardiac Metastases ◽  
Enhanced Computed Tomography ◽  
Demographic Features

AbstractCardiac osteosarcoma metastasis is extremely rare and is documented in several case reports in the literature. The behaviour of osteosarcoma metastases is similar to the primary tumour. Thoracic non-enhanced computed tomography (CT) examination is beneficial in the detection of calcific cardiac metastases. In this case report, we describe a 29-year-old woman with cardiac osteosarcoma metastasis after 7 years of follow-up, compare the demographic features with previous cases and discuss the imaging findings.

scholarly journals Chilaiditi Syndrome: A Case Report Highlighting the Intermittent Nature of the Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Esha M. Kapania ◽  
Christina Link ◽  
Joshua M. Eberhardt
Keyword(s):  
Case Report ◽  
Complete Resolution ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Delayed Diagnosis ◽  
Spontaneous Resolution ◽  
Radiographic Evidence ◽  
Case Presentation ◽  
Chilaiditi Syndrome

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.

scholarly journals The clicking chest: what exactly did Hamman hear? A case report of a left-sided pneumothorax

2020 ◽  
Author(s):  
Nadeem Jimidar ◽  
Patrick Lauwers ◽  
Emmanuela Govaerts ◽  
Marc Claeys
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Case Report ◽  
Case Reports ◽  
Gunshot Wounds ◽  
Computed Tomography Scan ◽  
Imaging Studies ◽  
Left Chest ◽  
Case Summary ◽  
Tomography Scan

Abstract Background Hamman’s sign is a rare phenomenon. Louis Hamman described this pathognomonic clicking chest noise in association with pneumomediastinum in 1937. This typical noise can also be present in left-sided pneumothorax. Clinical cases already mention this pericardial knock in 1918 in gunshot wounds of the left chest and in 1928 in cases of spontaneous left-sided pneumothorax. However, the sound itself has only rarely been recorded. Case summary We describe a case of a young man with no significant medical history who was referred to the hospital with chest pain and audible clicks, documented with his smartphone. Imaging studies including chest radiograph and computed tomography scan revealed a left-sided pneumothorax. The patient underwent semi-urgent insertion of a thorax drain. His clinical outcome was excellent. Discussion In recent years only a few case reports describe Hamman’s sign, as it is rare and happens only transiently. This case report includes the audible clicks recorded by the patient with his smartphone. We stress the importance of thoracic clicking sounds as key symptom in the differential diagnosis of left-sided pneumothorax, pneumomediastinum, and valvular pathology such as mitral valve prolapse.

scholarly journals The Foot That Broke Both Hips: A Case Report and Literature Review of Tumor-Induced Osteomalacia

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Sara Beygi ◽  
Alfred Denio ◽  
Tarun S. Sharma
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Paraneoplastic Syndrome ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Limited Knowledge

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by hypophosphatemia and clinical symptoms of osteomalacia. Only discussed as case reports, there is still limited knowledge of this condition as a potentially curable cause of osteomalacia among clinicians and pathologists. In this article, we present a case of tumor-induced osteomalacia in a 59-year-old gentleman followed by an up-to-date review of the existing literature on TIO.

scholarly journals Accuracy of Alvarado Scoring System and Selective Computed Tomography in Diagnosis of Suspected Cases of Acute Appendicitis

2020 ◽  
Vol 1 (2) ◽  
pp. 01-11
Author(s):  
Abbas AR Mohamed ◽  
Safaa A Mobarki ◽  
Ashwag H Al Qabasani ◽  
Nusiba A Al Shingiti ◽  
Alaa A El Sayed
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Scoring System ◽  
Oral Contrast ◽  
Middle Group ◽  
Group A ◽  
Group B

Objective: To evaluate the diagnostic accuracy of combined Alvarado scoring system and selective computed tomography (CT) in the diagnosis of suspected cases of acute appendicitis. Material and methods: This study was conducted during the period March 2018 to January 2020 at Prince Mohammed bin Abdul-Aziz hospital (NGHA) in Al Madinah, KSA. It is a prospective study involving 100 consecutive patients attending the emergency department with right iliac fossa pain, excluding children below the age of 14 years and pregnant women. All patients were initially assessed by the Alvarado scoring system, and the result of each patient was recorded in a separate predesigned data sheath. Based on the patient's calculated Alvarado scores, patients were stratified into three groups: Group A (score ≤ 4), Group B (score 5-6), and group C (score ≥ 7). All patients in group A were discharged from the emergency department with instruction to return if their symptoms persist or get worse while all patients in group B had an abdominal multidetector CT scan (MDCT) with IV contrast and no oral contrast to help the diagnosis. Group C patients had surgery without further investigation. Alvarado scores were compared to intraoperative findings and histopathological examination of the removed appendix in those who were operated. The sensitivity, specificity, positive and negative predictive values of the scoring system in each group were calculated with special reference to the role of CT scan in improving the diagnostic accuracy of the scoring system in the middle group (group B). Result: 58 patients were male and 42 were female. Age range between 14 and 43 years with median age 24 years. Out of the 100 patients, 14 (8 males, 6 females) belonged to Group A, 23 (11 males, 12 females) to Group B and 63 (39 males, 24 females) to group C. Two patients from group A (one male and one female) were returned with worsening symptoms and subsequently operated for acute appendicitis. CT scan established the diagnosis of acute appendicitis in 16 out of the patients of group B with subsequent histological confirmation of acute appendicitis in 15 of them. Histopathology confirmed the diagnosis of acute appendicitis in 32 out of 63 patients of group C. Conclusion: Alvarado score has a high accuracy of ruling in and out acute appendicitis at the extremes of the score (≤7 and ≥4), however, the accuracy of the score to confirm or rule out acute appendicitis in the middle group (5 -6) is significantly low. Selective utilization of CT scan in patients in the middle of the score improves the diagnostic accuracy of the score and limits overutilization of CT scan in the other patients at the extremes of the score saving patients unnecessary exposure to radiation and health authorities’ time and cost without increasing the rate of negative appendectomy.

scholarly journals Bilateral Blindness Due to Acute Isolated Sphenoid Sinusitis- Is It Reversible? A Case Report

2014 ◽  
Vol 15 (2) ◽  
pp. 146-148
Author(s):  
Roshan Kumar Verma ◽  
Naresh K Panda
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Differential Diagnosis ◽  
Case Report ◽  
Early Diagnosis ◽  
Paranasal Sinuses ◽  
Sphenoid Sinus ◽  
Vision Loss ◽  
Clinical Presentation ◽  
Sphenoid Sinusitis

Acute isolated sphenoid sinusitis is a rare and is seen in only 3% of all cases of all sinusitis. It is frequently misdiagnosed because of its vague clinical presentation. We report a case of 35year old female who presented to our emergency department with complaints of painless rapidly developing bilateral vision loss. Non contrast computed tomography of paranasal sinuses showed only mild opacification of sphenoid sinus. Endoscopic sphenoidectomy was performed within 4 hrs of presentation. After 48 hrs of surgery the patient vision returned to 6/6 bilaterally. Acute sphenoid sinusitis should be considered in the differential diagnosis of acute vision loss. Awareness, early diagnosis, astute clinical sense and emergent intervention can prevent permanent complication.DOI: http://dx.doi.org/10.3329/jom.v15i2.20700 J MEDICINE 2014; 15 : 146-148

scholarly journals Mimickers of Acute Appendicitis

2021 ◽  
Author(s):  
Esam Amer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Imaging Modality ◽  
Correct Diagnosis ◽  
Emergency Setting ◽  
Magnetic Resonance Imaging Mri ◽  
Clinical Conditions

Acute appendicitis (AA) is a common surgical diagnosis in patients presenting to the Emergency Department with acute abdominal pain. A wide variety of other clinical conditions can present with a very similar presentation to acute appendicitis and therefore it can be occasionally challenging to make the correct diagnosis. In this review paper, the focus is to shed some light on the differential diagnosis of acute appendicitis which includes a variety of gastrointestinal, vascular, urological, and gynaecological conditions. In the emergency setting there are three main imaging modalities to evaluate patients presenting with abdominal pain, this includes computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI). The choice of imaging modality for each clinical condition is variable and as such being familiar with those differential diagnoses is vital in deciding what is the best imaging modality for every patient presenting with abdominal pain.

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