scholarly journals Generalized Peritonitis Secondary to Spontaneous Perforation of Pyometra in a 63-Year-Old Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ahmed Abu-Zaid ◽  
Osama AlOmar ◽  
Ahmed Nazer ◽  
Ayman Azzam ◽  
Zainab Abudan ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Abdominal Cavity ◽  
Uneventful Recovery ◽  
Diffuse Peritonitis ◽  
Spontaneous Perforation ◽  
High Grade Fever ◽  
Diffuse Abdominal Pain ◽  
Generalized Peritonitis ◽  
Plain Chest Radiograph ◽  
Free Air

Spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. Herein, we report the case of a 63-year-old woman who presented to emergency department with a 2-day history of severe diffuse abdominal pain, high-grade fever, nausea, and vomiting. Acute abdomen series was done, and upright plain chest radiograph showed free air under diaphragm. A noncontrast-enhanced computed tomography scan showed a significantly distended fluid-filled uterus measuring 10 × 7.8 × 10 cm, in addition to a single focus of perforation involving the uterine fundus and associated with presence of free air within the nondependant area. No evidence of ascites or pelvi-abdominal lymphadenopathy was identified. A preoperative diagnosis of generalized peritonitis secondary to spontaneous perforation of uterus was established. Subsequently, patient underwent urgent exploratory laparotomy which revealed pus-filled uterus with perforated fundus. Diagnosis of generalized peritonitis secondary to spontaneous perforation of pyometra was established. Consequently, patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, as well as thorough drainage and irrigation of pelvi-abdominal cavity. Postoperatively, patient was admitted to intensive care unit. Histopathological examination of uterus was negative for malignancy, and surgical culture grewStreptococcus constellatus. Patient had an uneventful recovery. Moreover, a brief literature review on pyometra is presented.

scholarly journals Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Toshihiro Kitai ◽  
Kentaro Okuno ◽  
Hiromi Ugaki ◽  
Yoshiko Komoto ◽  
Satoshi Fujimi ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Uterine Cavity ◽  
Severe Infection ◽  
Wound Dehiscence ◽  
Multiple Organ ◽  
Uterine Perforation ◽  
Diffuse Peritonitis ◽  
Spontaneous Perforation ◽  
Diffuse Abdominal Pain ◽  
Generalized Peritonitis

Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts.

scholarly journals Spontaneous Rupture of Pyometra

2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
Author(s):  
Fatemeh Mallah ◽  
Tahere Eftekhar ◽  
Mohammad Naghavi-Behzad
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Rare Complication ◽  
Abdominal Cavity ◽  
Clinical Findings ◽  
Diffuse Peritonitis ◽  
Spontaneous Perforation ◽  
Definite Diagnosis ◽  
Incarcerated Hernia ◽  
First Case

Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. In most cases, a correct and definite diagnosis can be made only by laparotomy. We report two cases of diffuse peritonitis caused by spontaneous perforated pyometra. The first case is a 78-year-old woman with abdominal pain for which laparotomy was performed because of suspected incarcerated hernia. The second case is a 61-year-old woman with abdominal pain for which laparotomy was performed because of symptoms of peritonitis. At laparotomy of both cases, 1 liter of pus with the source of uterine was found in the abdominal cavity. The ruptured uterine is also detected. More investigations revealed no malignancy as the reason of the pyometra.

scholarly journals Subdiaphragmatic abscess due to penetration of a duodenal ulcer successfully treated with endoscopic transgastric drainage: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tomoya Takami ◽  
Hiroshi Takihara ◽  
Koji Yasuda ◽  
Nozomi Kasyu ◽  
Hiroyuki Yoshitake ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Inflammatory Response ◽  
Endoscopic Ultrasound ◽  
Abdominal Cavity ◽  
Treatment Method ◽  
Ultrasound Guided ◽  
Invasive Treatment ◽  
Case Presentation ◽  
Generalized Peritonitis ◽  
Free Air

Abstract Background Subdiaphragmatic abscesses are sometimes caused by intraabdominal infections. We report a case of endoscopic ultrasound-guided transgastric drainage. Case presentation A 75-year-old Asian man was referred to our hospital for treatment for upper gastrointestinal bleeding. On admission, blood tests showed a marked inflammatory response, and abdominal computed tomography showed free air in the abdominal cavity and a left subdiaphragmatic abscess. Therefore, the patient was diagnosed with an intraabdominal abscess associated with a perforated duodenal ulcer. Because he did not have generalized peritonitis, fasting and antibiotic treatment were the first therapies. However, because of the strong pressure on the stomach associated with the abscess and difficulty eating, we performed endoscopic ultrasound-guided transgastric drainage. After treatment, the inflammatory response resolved, and food intake was possible. The patient’s condition remains stable. Conclusions Drainage is the basic treatment for subdiaphragmatic abscesses; however, percutaneous drainage is often anatomically difficult, and surgical drainage is common. We suggest that our success with endoscopic ultrasound-guided transgastric drainage in this patient indicates that this approach can be considered in similar cases and that it can be selected as a minimally invasive treatment method.

scholarly journals Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takeshi Ueda ◽  
Tetsuya Tanaka ◽  
Takashi Yokoyama ◽  
Tomomi Sadamitsu ◽  
Suzuka Harada ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Abdominal Cavity ◽  
Vital Signs ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Case Presentation ◽  
Free Air ◽  
Spontaneous Pneumoperitoneum ◽  
Upper Abdominal ◽  
Emergent Laparotomy

Abstract Background Pneumoperitoneum commonly occurs as a result of a viscus perforation and usually presents with peritoneal signs requiring emergent laparotomy. Spontaneous pneumoperitoneum is a rare condition characterized by intraperitoneal gas with no clear etiology. Case presentation We herein report a case in which conservative treatment was achieved for an 83-year-old male patient with spontaneous pneumoperitoneum that probably occurred due to duodenal diverticulosis. He had stable vital signs and slight epigastric discomfort without any other signs of peritonitis. A chest radiograph and computed tomography showed that a large amount of free gas extended into the upper abdominal cavity. Esophagogastroduodenoscopy showed duodenal diverticulosis but no perforation of the upper gastrointestinal tract. He was diagnosed with spontaneous pneumoperitoneum, and conservative treatment was selected. His medical course was uneventful, and pneumoperitoneum disappeared after 6 months. Conclusion In the management of spontaneous pneumoperitoneum, recognition of this rare condition and an accurate diagnosis based on symptoms and clinical imaging might contribute to reducing the performance of unnecessary laparotomy. However, in uncertain cases with peritoneal signs, spontaneous pneumoperitoneum is difficult to differentiate from free air resulting from gastrointestinal perforation and emergency exploratory laparotomy should be considered for these patients.

A SCROTAL ABDOMEN IN AN ELDERLY PATIENT MANAGED BY HERNIOPLASTY WITHOUT DEBULKING OF THE HERNIA CONTENTS: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
pp. 15-17
Author(s):  
Sukanta Sikdar ◽  
Mala Mistri ◽  
Piyas Sengupta ◽  
Tuhinsubhra Manda
Keyword(s):  
Elderly Patient ◽  
Abdominal Cavity ◽  
Wound Dehiscence ◽  
Uneventful Recovery ◽  
General Surgeon ◽  
Respiratory Compromise ◽  
Hernia Sac ◽  
Long Duration ◽  
Giant Inguinoscrotal Hernia ◽  
Mesh Hernioplasty

Background: Scrotal abdomen is not a common today, but most challenging case even in experienced general surgeon, as there is no standard surgical procedure. They present as a huge inguinoscrotal swelling for a longstanding, neglected to treatment, because fear of operative intervention and remote places where medical service is inadequate. The morbidity and mortality also high because of forced reduction of the herniated viscera to the abdominal cavity, which is accustomed to being relatively empty for long duration, may cause alteration in the intra-abdominal and intra-thoracic pressures, leading to complications such as ACS, precipitation of cardiovascular or respiratory compromise, hernia recurrence and wound dehiscence . We present this ca Case presentation: se of giant inguinoscrotal hernia of a 72 years old male who had difculty in performing his daily activities. Patient underwent emergency mesh repair after reduction of content through inguinal approach. Giant inguinal hernia containing almost whole abdomen with terminal 50 cm ileum, caecum, appendix, ascending colon, hepatic exure of colon and transverse colon with omentum in the hernia sac and the patient had an uneventful recovery with eventual discharge on postoperative day 8. The giant inguinal hernias are uncommon in today's surgical Conclusion: practice. Management of which is challenging with grave complications but early intervention and postoperative monitoring to raised IAP and its complications which can save the patient. We report this case of an elderly patient with an acute presentation of scrotal abdomen with contents as both direct and indirect component which has been managed successfully with tension free open mesh hernioplasty and biological repair without debulking of the hernia contents and this case supported by a review of the literature.

Treatment of purulent diffuse peritonitis

1927 ◽  
Vol 23 (3) ◽  
pp. 351-352
Author(s):  
A. Timofeev
Keyword(s):  
Abdominal Cavity ◽  
Harmful Effect ◽  
Diffuse Peritonitis ◽  
Infectious Focus ◽  
Perforative Peritonitis

The author reports that in Petrivalskis' clinic in the treatment of diffuse perforative peritonitis drainage is not used if the infectious focus is removed; abscesses are drained; antiseptics are also not used due to their harmful effect on the vital properties of the peritoneal endothelium, but it is recommended to infuse 50-100 cc into the abdominal cavity. 3% solution of hydrogenii superoxydati, and the resulting foam mechanically cleans the abdominal cavity, and the released oxygen produces oxidation of toxins.

scholarly journals The first experience of stapled intestinal anastomoses application in children in Ukraine

2020 ◽  
pp. 15-20
Author(s):  
O. Sliepov ◽  
◽  
M. Migur ◽  
O. Ponomarenko ◽  
O. Gladyshko ◽  
...  
Keyword(s):  
Body Weight ◽  
Necrotizing Enterocolitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Developed Countries ◽  
Premature Baby ◽  
Diffuse Peritonitis ◽  
Level Of Evidence ◽  
Intestinal Anastomoses

Introduction. Conducting reconstructive surgery in children, especially those with low body weight, associated with an increase in the operation time and a worsening of the postoperative period. Therefore, to reduce the operation time, surgical clinics in developed countries of the world use linear staplers for anastomoses in children, especially young children. Case report. A premature newborn, with a birth weight of 1420 g, was diagnosed with necrotizing enterocolitis, with ileal perforation and diffuse peritonitis. According to vital indications, the operation was performed: laparotomy, revision of the abdominal cavity, Mikulich enterostomy. After complete stabilization of the general condition of the child, upon reaching 2550 g of body weight, at the age of 2 months, enterostomy closure was performed with the imposition of a stapled side-to-side functional end-to-end ileoileostomy. In 14 days after the operation, the child achieved full enteral autonomy. There were no postoperative surgical complications. In the late postoperative period, the child gains weight well, grows and develops according to age. Conclusion. The use of linear staplers in time of enteroanastomoses creation can significantly reduce operation time in children, in particular, premature babies with low body weight. Level of evidence. Level V. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution.The informed consent of the child’s parents was obtained from the studies. No conflict of interest was declared by the authors. Key words: linear staplers, enteroanastomosis, necrotizing enterocolitis, perforation of the small intestine, newborn premature baby.

scholarly journals Fulminant Wegener's granulomatosis: A case report

2013 ◽  
Vol 70 (9) ◽  
pp. 887-890 ◽  
Author(s):  
Miroslav Dinic ◽  
Lidija Kandolf-Sekulovic ◽  
Lidija Zolotarevski ◽  
Rados Zecevic
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Systemic Vasculitis ◽  
Bowel Perforation ◽  
Exploratory Laparotomy ◽  
Unknown Etiology ◽  
Diffuse Peritonitis ◽  
Skin Sample ◽  
Skin Ulcers ◽  
Hemorrhagic Bullae

Introduction. Granulomatosis Wegener is anti-neutrophil cytoplasmic antibodies (ANCAs)-associated systemic vasculitis of unknown etiology. It is manifested as granulomatous necrotizing inflammation of the upper and lower parts of the respiratory tract, glomerulonephritis and systemic vasculitis involving most frequently the skin and oral mucous membrane. Sera markers of this disease are c-ANCA and p-ANCA. Case report. We presented a female patient aged 52 years with purpuric spots that had appeared on the lower legs ten months before admission to our hospital. The disease ran an aggressive course, and a month before admission hemorrhagic bullae, skin ulcers, hoarseness, dyspnea, generalized arthralgia, fatigue and fever had rapidly developed. Histopathological examination of a skin sample revealed necrotizing vasculitis, so that sera markers concentrations were elevated (c-ANCA, p-ANCA). There was a perforation of the nasal septum found on rhinoscopy. During hospitalization acute abdominal pain occurred, a possible tumor in the small intestine and possible granulomas in the liver were seen by multislice computed tomography (MSCT) examination, with normal findings on the lungs and kidneys. The treatment started with methylprednisolone: 500 mg/d i.v. infusion for consecutive 3 days, then 60 mg/d. On exploratory laparotomy small bowel perforation and diffuse peritonitis were found. Unstable in the postoperative period, the patient died on the day 12 of hospitalization. Conclusion. The reported patient was with fulminant Wegener?s granulomatosis, dominantly with skin changes and with gastrointestinal manifestation. This case accents the need for rapid systemic clinical evaluation in a severely ill patient with unclear diagnosis.

scholarly journals Pulmonary adenocarcinoma in cattle

2014 ◽  
pp. 4358-4363 ◽  
Author(s):  
Diogo Sousa Z ◽  
Luis Rivera C ◽  
Didier Quevedo C ◽  
Ana Claudia Gorino ◽  
Simone Biagio C ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Tumor Cells ◽  
Adult Female ◽  
Histopathological Examination ◽  
Abdominal Cavity ◽  
Pulmonary Adenocarcinoma ◽  
Immunohistochemical Examination ◽  
Histopathological Findings ◽  
Hematoxylin Eosin ◽  
Neoplastic Epithelial Cells

ABSTRACTThe Macroscopic, histological and immunohistochemical aspects of lung acinar adenocarcinoma and the presence of nodules in the abdominal cavity of an adult female bovine are reported. In the necropsy analysis samples were collected from the: lung, heart, spleen, liver, pancreas, kidney, uterus, intestine, brain, and from nodules found in the lung and abdominal cavity, which were routinely processed to be stained by hematoxylin-eosin and for an immunohistochemistry exam with the antibodies: cytokeratin (dilution 1:200 μL) and vimentin (dilution 1:1000 μL). The histopathological examination revealed neoplastic epithelial cells with acini formation. The immunohistochemical examination of the tumor cells showed positive marking for cytokeratin and the absence of marking for vimentin. According to anatomical, morphological, and histopathological findings, as well as the result of the immunohistochemical examination, the tumor was characterized as lung acinar adenocarcinoma.

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