Spontaneous Abdominal Bleeding from an Infundibulopelvic Ligament Tear in a Patient with Large Ovarian Fibroma

Ovarian fibromas are rare benign solid tumors of the ovary which are often difficult to differentiate from uterine leiomyomas preoperatively. The symptoms usually include abdominal discomfort and may have ascites and/or an elevation in CA-125 levels. There have been no publications of associated abdominal bleeding to date. The treatment is surgical removal via a laparoscopic or laparotomic approach. We present a case of a 19 cm unilateral ovarian fibroma with abdominal bleeding from a spontaneous right infundibulopelvic ligament (IPL) tear who underwent a laparoscopic and mini-laparotomic right salpingo-oophorectomy. Patients with large ovarian fibromas should be cautioned that abdominal bleeding and/or acute abdominal pain can occur and that a minimally invasive surgical approach is feasible.

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Segmental arterial mediolysis: a commonly overlooked aetiology of acute abdominal pain

BMJ Case Reports ◽

10.1136/bcr-2020-234576 ◽

2020 ◽

Vol 13 (6) ◽

pp. e234576

Author(s):

Moni Roy ◽

Ashish Kumar Roy ◽

Mary E McCrate

Keyword(s):

Abdominal Pain ◽

Clinical Presentation ◽

Acute Abdominal Pain ◽

Abdominal Discomfort ◽

Mesenteric Arteries ◽

Mesenteric Ischaemia ◽

Management Options ◽

Segmental Arterial Mediolysis ◽

Abdominal Bleeding ◽

Uncommon Condition

Segmental arterial mediolysis (SAM) is an uncommon condition and commonly missed diagnostic aetiology of acute abdominal pain, initially described in 1976. SAM is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries with notable asymmetric involvement of the walls of the mesenteric arteries and their branches. Clinical presentation ranges from postprandial abdominal discomfort suggestive of mesenteric ischaemia to intra-abdominal bleeding. Pathophysiological explanation and prognosis of these cases are not well understood and therefore no clear guidelines for management exist. In this case report, we emphasise the imaging modalities used to reach the diagnosis and the management options available.

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Simplified Minimally Invasive Surgical Approach for Prophylactic Laparoscopic Gastropexy in 21 Cases

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6879 ◽

2019 ◽

Vol 55 (3) ◽

pp. 152-159 ◽

Cited By ~ 4

Author(s):

Claire Deroy ◽

Harriet Hahn ◽

Camille Bismuth ◽

Guillaume Ragetly ◽

Eymeric Gomes ◽

...

Keyword(s):

Intraoperative Complications ◽

Abdominal Ultrasound ◽

Abdominal Discomfort ◽

Transversus Abdominis ◽

Barbed Suture ◽

Wound Complications ◽

Minimally Invasive Surgical ◽

Invasive Surgical Approach ◽

Seromuscular Layer ◽

Transversus Abdominis Muscle

ABSTRACT The objective of this study was to describe the operative technique and outcome of a simplified laparoscopic gastropexy approach in dogs. Twenty-one dogs undergoing prophylactic laparoscopic gastropexy with a simple continuous barbed suture without incising the seromuscular layer of the stomach and transversus abdominis muscle were reviewed. In 20 cases, additional procedures were performed (18 ovariectomies and 2 prescrotal castrations); 1 dog had two prior episodes of gastric dilation without volvulus and underwent gastropexy with a prophylactic intent. The gastropexy procedure had a median duration of 33 min (range 19–43 min). V-Loc 180 absorbable and the V-Loc PBT nonabsorbable suturing devices were used in 8 and 13 dogs, respectively. Minor intraoperative complications occurred in four cases: broken suture (1), needle dislodgement (2), and folded needle (1). Minor complications included self-limiting wound complications (3), abdominal discomfort (2), vomiting (1), and inappetence (2). Postoperative abdominal ultrasound performed after a median of 8 mo (6–36 mo) confirmed permanent adhesion at the gastropexy site in all dogs. One dog developed a fistula (1 yr postoperatively) and another a granuloma (3 mo postoperatively), both at the gastropexy site. Prophylactic laparoscopic gastropexy may be performed with knotless unidirectional barbed suture without creating an incision on the abdominal wall and stomach.

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Gastroduodenal Trichobezoar: A case report and literature review

The Journal of Medical Research ◽

10.31254/jmr.2019.5303 ◽

2019 ◽

Vol 5 (3) ◽

pp. 112-114

Author(s):

Josaphat Paluku Katswere ◽

◽

Alexis Mupepe Kumb ◽

Janvier Rugendabanga Bazibuhe ◽

Samson Todalehou ◽

...

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Case Report ◽

Blood Transfusion ◽

Literature Review ◽

Psychiatric Illness ◽

Acute Abdominal Pain ◽

Abdominal Mass ◽

Surgical Removal ◽

Upper Abdominal

Gastroduodenal trichobezoar is infrequent. Its diagnosis is easy in the presence of an evocative context. Patients with this condition often have an underlying psychiatric illness and history may not be easily forthcoming. We report a classic case of a 17 year-old patient admitted with acute abdominal pain, vomiting, an upper abdominal mass and anemia. Abdominal computed tomography (CT) scan suggested the diagnosis of bezoar. Surgical removal of trichobezoar by gastrotomy was performed without complications. Preoperative blood transfusion was admitted, the patient was referred to the department of psychiatry.

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Bayesian Diagnostic Probabilities without Assuming Independence of Symptoms

Methods of Information in Medicine ◽

10.1055/s-0038-1634813 ◽

1991 ◽

Vol 30 (01) ◽

pp. 15-22 ◽

Cited By ~ 23

Author(s):

A. Gammerman ◽

A. R. Thatcher

Keyword(s):

Abdominal Pain ◽

Acute Abdominal Pain ◽

Final Diagnosis ◽

Bayes Theorem ◽

Bayes Method ◽

Hospital Records ◽

Computer Diagnosis ◽

Bayes Model ◽

Chi Squared ◽

Past Data

The paper describes an application of Bayes’ Theorem to the problem of estimating from past data the probabilities that patients have certain diseases, given their symptoms. The data consist of hospital records of patients who suffered acute abdominal pain. For each patient the records showed a large number of symptoms and the final diagnosis, to one of nine diseases or diagnostic groups. Most current methods of computer diagnosis use the “Simple Bayes” model in which the symptoms are assumed to be independent, but the present paper does not make this assumption. Those symptoms (or lack of symptoms) which are most relevant to the diagnosis of each disease are identified by a sequence of chi-squared tests. The computer diagnoses obtained as a result of the implementation of this approach are compared with those given by the “Simple Bayes” method, by the method of classification trees (CART), and also with the preliminary and final diagnoses made by physicians.

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Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

The Heart Surgery Forum ◽

10.1532/hsf.1322 ◽

2015 ◽

Vol 18 (3) ◽

pp. 088

Author(s):

Ye-tao Li ◽

Xiao-bin Liu ◽

Tao Wang

Keyword(s):

Abdominal Pain ◽

Infective Endocarditis ◽

Aortic Valve ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Mycotic Aneurysm ◽

Acute Abdominal Pain ◽

Rare Complication ◽

Emergency Operation ◽

History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

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