scholarly journals Utility of the CT Scan in Diagnosing Midgut Volvulus in Patients with Chronic Abdominal Pain

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Ehsan Shahverdi ◽  
Mehdi Morshedi ◽  
Maryam Allahverdi Khani ◽  
Mohammad Baradaran Jamili ◽  
Fatemeh Shafizadeh Barmi
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Mesenteric Artery ◽  
Chronic Abdominal Pain ◽  
Intestinal Malrotation ◽  
Midgut Volvulus ◽  
Common Complication ◽  
Preoperative Ct

Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient. The preoperative CT findings were pathognomonic.

scholarly journals Intestinal malrotation with solitary jejunal diverticulum presenting as midgut volvulus in an adult: an unusual presentation

2021 ◽  
Vol 8 (7) ◽  
pp. 2231
Author(s):  
Debarghya Chatterjee ◽  
Subrat Kumar Raul ◽  
Elisheba Patras
Keyword(s):  
Abdominal Pain ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Intestinal Malrotation ◽  
Midgut Volvulus ◽  
Rare Entity ◽  
Intermittent Abdominal Pain ◽  
Post Operative Period ◽  
Jejunal Diverticulum ◽  
Whirlpool Sign

Intestinal malrotation with midgut volvulus presenting in adults is a rare entity, and association with jejunal diverticulum is rarer still. Herein, we report and review such a case of malrotation and volvulus, associated with intestinal band adhesions and a solitary jejunal diverticulum. This 67 years old gentleman had presented with complaints of intermittent abdominal pain for past several years. Imaging of the abdomen revealed twisting of superior mesenteric artery and vein, evidence of midgut volvulus and intestinal malrotation with “whirlpool sign”. Laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery and a jejunal diverticulum. Adhesiolysis was performed, untwisting of the bowel was done and the jejunal diverticulum was resected. Post-operative period was uneventful. This case is being reported on account of its extreme rarity.

Synchronous celiac axis and superior mesenteric artery embolism

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani
Keyword(s):  
Atrial Fibrillation ◽  
Small Intestine ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Abdominal Cavity ◽  
Celiac Axis ◽  
Contrast Administration ◽  
Artery Embolism

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.

Assessment of clinical outcomes among CT scan in the diagnosis of chronic abdominal pain

2019 ◽  
Vol 10 (3) ◽  
pp. 15-18
Author(s):  
Anant Madhukarrao Bhuibhar ◽  
◽  
Challa Anil Kumar ◽  
Lalwani Shyam Tekchand ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Clinical Outcomes ◽  
Chronic Abdominal Pain

scholarly journals A retrospective analysis and literature review of neoplastic appendiceal mucinous lesions

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Belén Matias-García ◽  
Fernando Mendoza-Moreno ◽  
Ana Blasco-Martínez ◽  
José Ignacio Busteros-Moraza ◽  
Manuel Diez-Alonso ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Surgical Technique ◽  
Clinical Status ◽  
Chronic Abdominal Pain ◽  
Tumour Type ◽  
Appendiceal Neoplasm ◽  
Appendiceal Neoplasms ◽  
Statistical Program ◽  
The Subject

Abstract Background At present, the term mucocele is outdated, and mucinous appendiceal neoplasm is preferred. Mucinous appendiceal neoplasm is an uncommon pathology that occurs predominantly in middle-aged women. Its classification and management have been the subject of debate in recent decades. The aim of this study was to analyse the incidence, clinical management and survival of these tumours diagnosed in our centre in the last 10 years. Methods This was a retrospective observational study of patients with a diagnosis of appendiceal neoplasms between 2009 and 2018 in our centre. Variables such as sex, age, tumour type, clinical status, diagnosis, treatment and survival were collected. All data were analysed using the statistical program IBM SPSS Statistic® version 25. Results Twenty-nine patients with a diagnosis of appendiceal neoplasm were identified, and 24 corresponded to neoplastic appendiceal mucinous lesions (85.7%). The average age was 59.7 ± 17.6 years. Most patients were women (15 cases; 62.5%). Most of them presented with chronic abdominal pain (37.5%), and the diagnosis was performed by computed tomography (CT) (50%). The treatment was surgical in all cases. The surgical technique depended on the findings and histology of the tumour. Conclusion Mucinous appendiceal neoplasms are an uncommon entity, and their pathological classification and management have recently changed.

Calprotectin (S100 A8/A9) and TNF-alpha in differential diagnosis of chronic abdominal pain in children

2017 ◽  
Vol 53 (1) ◽  
pp. 5-10
Author(s):  
Stanisław Pieczarkowski ◽  
Kinga Kowalska-Duplaga ◽  
Andrzej Wędrychowicz ◽  
Krzysztof Fyderek ◽  
Przemko Kwinta ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Functional Gastrointestinal Disorders ◽  
Fecal Calprotectin ◽  
Chronic Abdominal Pain ◽  
Tnf Alpha ◽  
Gastrointestinal Disorders ◽  
Control Group ◽  
Healthy Children ◽  
Inflammatory Bowel

<i>Introduction:</i> Chronic abdominal pain in children is a very frequent and sometimes challenging diagnostic issue. Differential diagnosis in that cases is difficult and often connected with numerous, time-consuming, expensive, and frequently stressful diagnostic studies. The aim of the study was to establish whether fecal calprotectin concentration (FCC) and TNF-alpha may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included patients (median age 13 years), who were assigned to functional gastrointestinal disorders group (n=33); inflammatory gastrointestinal disorders other than IBD (n=71), children with IBD (n=37) and 22 healthy children served as a control group. The concertation of FCC and TNF-alpha in stool samples was measured using ELISA. <i>Results:</i> In healthy children and in children with functional disorders FCCs were below 100 μg/g. In patients with IBD FCCs and TNF-alpha were markedly elevated as compare to children with functional gastrointestinal disorders, however using ROC discrimination of IBD patients was significantly better using FCC than TNF-alpha. <i>Conclusion:</i> FCC is better test for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders as compare to TNF-alpha concentration in stool. FCC as screening test in patients with chronic abdominal pain should allow to diminish unnecessary diagnostic in cases of functional gastrointestinal disorders.

scholarly journals The role of lumbar puncture in the diagnosis of subarachnoid hemorrhage when computed tomography is unavailable

CJEM ◽  
2002 ◽  
Vol 4 (02) ◽  
pp. 102-105 ◽  
Author(s):  
David Mann
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Subarachnoid Hemorrhage ◽  
Ct Scan ◽  
Lumbar Puncture ◽  
Uncommon Condition ◽  
Noncontrast Computed Tomography ◽  
Acute Headache ◽  
Interpretation Of Results

ABSTRACTSubarachnoid hemorrhage (SAH) is an important but uncommon condition in the differential diagnosis of acute headache. Most authorities recommend that patients with suspected SAH undergo noncontrast computed tomography (CT) as a first diagnostic intervention. If the results of the CT scan are negative, a lumbar puncture should be performed. Many nonurban Canadian hospitals do not have CT scanners and must either transfer patients or consider performing lumbar puncture prior to CT. In selected patients, performing lumbar puncture first may be an option, but timing of the procedure and the interpretation of results is important.

scholarly journals Carcinosarcoma of the Gallbladder with Chondrosarcomatous Differentiation and Intracytoplasmic Eosinophilic Hyaline Globules (Thanatosomes): A Report of a Case and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Jumana A. Alratroot ◽  
Amani A. Joudeh ◽  
Samir S. Amr
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Unusual Case ◽  
Distal Gastrectomy ◽  
Malignant Cells ◽  
Review Of The Literature ◽  
Hyaline Globules ◽  
Transverse Colectomy

A 52-year-old woman presented with abdominal pain and vomiting. Computed tomography (CT) scan of the abdomen revealed a huge exophytic gallbladder mass displacing or invading the surrounding structures. The patient underwent radical cholecystectomy, transverse colectomy, distal gastrectomy, and liver bed resection. Histologically, the tumor showed both carcinomatous and sarcomatous components, with prominent chondrosarcomatous differentiation. In addition, several malignant cells showed intracytoplasmic eosinophilic hyaline globules (Thanatosomes). The tumor showed metastatic deposits to the omentum, the liver, and the peripancreatic lymph nodes. We report this unusual case and present a review of all cases of carcinosarcoma of the gallbladder with chondrosarcomatous differentiation.

scholarly journals Small Bowel Diverticulosis Causing Pneumoperitoneum without Peritonitis: A Case Report

2018 ◽  
Vol 01 (01) ◽  
pp. 069-071
Author(s):  
Geena Benjamin ◽  
Agnes Thomas ◽  
Mathew Koshy
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Bowel Perforation ◽  
Chronic Abdominal Pain ◽  
Rare Finding ◽  
X Ray ◽  
Computed Tomography Images ◽  
Clinical Presentations ◽  
Fatal Complications

AbstractSmall bowel diverticulosis is a rare finding, with varied clinical presentations, which make the diagnosis difficult and delayed. Many cases are asymptomatic. However, it is an entity that can present with fatal complications. Here, we present a case of a 79-year-old male patient with diffuse small bowel diverticulosis, who presented with loose stools and acute exacerbation of chronic abdominal pain. Plain abdominal X-ray showed dilated bowel loops and pneumoperitoneum, which raised the possibility of bowel perforation. Computed tomography images revealed diffuse small bowel diverticulosis and pneumoperitoneum. Subsequent explorative laparotomy revealed no bowel perforation. Small bowel diverticulosis is a well-known cause of chronic/recurrent pneumoperitoneum without peritonitis or surgery.

The prognostic significance of supradiaphragmatic lymphadenopathy identified on preoperative computed tomography scan in patients undergoing primary cytoreduction for advanced stage epithelial ovarian cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16512-e16512
Author(s):  
V. Kolev ◽  
S. Mironov ◽  
O. Mironov ◽  
C. Moskowitz ◽  
N. M. Ishill ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Ct Scan ◽  
Epithelial Ovarian Cancer ◽  
Median Survival ◽  
Residual Disease ◽  
Prognostic Significance ◽  
Prognostic Impact ◽  
Preoperative Ct

e16512 Background: It has been hypothesized and shown in animal studies that the supradiaphragmatic lymph nodes serve as the principal nodes for lymphatic drainage of the entire peritoneal cavity. The purpose of this study was to determine the prognostic significance of enlarged supra-diaphragmatic nodes noted on preoperative computed tomography (CT) scan in patients with advanced epithelial ovarian cancer (EOC). Methods: We performed a retrospective chart review of all patients (pts) with FIGO stage III and IV EOC who had preoperative CT scans of the supradiaphragmatic region and primary cytoreductive surgery at our institution between 1997 and 2004. All scans were retrospectively reviewed by one board-certified radiologist (SM). To evaluate survival, Kaplan-Meier methods were used, with log rank Pvalues for comparisons. Results: A total of 212 eligible pts who underwent attempted primary cytoreduction followed by platinum-based systemic chemotherapy were identified for evaluation. With a median follow-up time of 52 mos, there were 135 deaths and a median overall survival of 48 mos (95% CI: 44–53). Of the 212 pts, 44 (21%) had supradiaphragmatic adenopathy with nodes >1 cm, while 168 (79%) did not have adenopathy in this distribution. None of the 44 pts with adenopathy had the enlarged nodes removed at primary cytoreduction. The median survival was 49 mos for pts with and 48 mos for patients without adenopathy (p = 0.46). In total, 155 (73%) patients underwent optimal cytoreduction (residual disease ≤ 1 cm). In the optimally cytoreduced pts, the median survival for the 125 pts without supradiaphragmatic adenopathy was 52 mos (95%CI: 45–59) compared to 51mos (95%CI: 41–58) for the 30 pts with supradiaphragmatic adenopathy (p = 0.33). Conclusions: Although a previous study has shown that supradiaphragmatic adenopathy was associated with poorer overall survival in EOC patients, our study did not confirm these findings. In our study, enlarged supradiaphragmatic nodes noted on preoperative CT scan did not have significant prognostic impact and therefore their clinical significance remains uncertain. No significant financial relationships to disclose.

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