An Uncommon Cause of Massive Intraperitoneal Bleeding: Leiomyoblastoma of the Stomach

1988 ◽  
Vol 74 (3) ◽  
pp. 365-367
Author(s):  
Alessandro Zerbi ◽  
Marco Braga ◽  
Alessandro Sironi ◽  
Agostino Faravelli ◽  
Valerio Di Carlo
Keyword(s):  
Abdominal Mass ◽  
Abdominal Ultrasound ◽  
Cystic Mass ◽  
Emergency Laparotomy ◽  
Intraperitoneal Rupture ◽  
Abdominal Masses ◽  
Liver And Pancreas ◽  
Intraperitoneal Bleeding ◽  
Upper Abdominal ◽  
Diagnostic Investigations

A large exogastric leiomyoblastoma in a 48-year-old male revealed by asymptomatic upper abdominal mass is reported. Abdominal ultrasound, computerized tomography scan and magnetic resonance showed a 20 cm cystic lesion apart from liver and pancreas of undetermined origin. During hospitalization, massive intraperitoneal bleeding due to rupture of the mass was observed. An emergency laparotomy was carried out, and excision of a large, ruptured, cystic mass involving the greater gastric curvature was performed. Microscopy revealed a gastric leiomyoblastoma. Even if infrequent, massive intraperitoneal bleeding is a very serious complication of gastric leiomyoblastoma. Considering the difficulty of an accurate preoperative diagnosis and the risk of intraperitoneal rupture, the authors suggest that similar abdominal masses should be managed by quick diagnostic investigations and early surgical procedures.

scholarly journals Case Report of Three Immature Cystic Teratomas in Northern Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
E. M. Der ◽  
S. Seidu
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Germ Cell Tumour ◽  
Cystic Teratoma ◽  
Abdominal Ultrasound ◽  
Northern Ghana ◽  
Ovarian Teratoma ◽  
Emergency Laparotomy ◽  
Abdominal Masses ◽  
High Sense

Background. Preoperative diagnosis of immature cystic teratoma can be challenging for clinicians. In this report, we present three cases.Methods. We describe three women aged 10, 20, and 23 years, respectively, who presented with abdominal masses which were diagnosed by abdominal ultrasound as mature cystic teratomas. All women had emergency laparotomy and oophorectomy.Results. Histopathological examination reported these ovarian tumours to be immature cystic teratomas. This case report also provided a brief summary of the clinicopathological features of all ovarian teratomas diagnosed in two centres during the period of review.Conclusion. Immature ovarian teratoma affects primarily younger patients; it is important for clinicians to have a high sense of suspicion whenever the diagnosis of a germ cell tumour is entertained.

Supernumerary Kidney with Ipsilateral Cryptorchidism in a Cat

2013 ◽  
Vol 49 (5) ◽  
pp. 338-341 ◽  
Author(s):  
Danielle Paradise ◽  
David Clark
Keyword(s):  
Abdominal Mass ◽  
Left Kidney ◽  
Cystic Mass ◽  
Differential Diagnoses ◽  
Pathologic Examination ◽  
First Report ◽  
Abdominal Masses ◽  
Cryptorchid Testis ◽  
The Right

An 8 wk old male domestic longhair was presented with an abdominal mass and cryptorchidism. A 2 cm mass was palpable in the midabdomen. Ultrasonography confirmed a complex, septated, cystic mass adjacent and caudal to the right kidney. A normally appearing left kidney was present. Pathologic examination of the excised abdominal mass revealed it to be a kidney with an attached, normal caliber ureter. At surgery, this kidney was separate from the parenchyma of the second, cranial, right kidney. Subsequently, the second right kidney became hydronephrotic and was removed together with the cryptorchid testis and an apparently hypoplastic ureter. This is the first report of a supernumerary kidney in a cat, adding it to the differential diagnoses of abdominal masses.

scholarly journals Gossypiboma: a ghastly find

2018 ◽  
pp. bcr-2017-221537
Author(s):  
Aitor de Gea Rico ◽  
Priya Krishna ◽  
Hannah Louise Devlin ◽  
Ashish Rohatgi
Keyword(s):  
Traffic Accident ◽  
Road Traffic ◽  
Epigastric Pain ◽  
Abdominal Ultrasound ◽  
Cystic Mass ◽  
Emergency Laparotomy ◽  
Complete Excision ◽  
Left Hypochondrium ◽  
Surgical History

A gossypiboma is a mass within a patient’s body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass with some solid areas occupying the left hypochondrium. Conservative management with insertion of a percutaneous drain proved to be inefficient. A laparotomy was performed; intraoperatively, the cyst was found to be ruptured and within it, a large surgical gauze was found. This was removed but required a distal pancreatectomy and gastrectomy for complete excision. He was discharged on day 74 of admission with outpatient follow-up.

Congenital hepatic cyst: Prenatal and postnatal imaging findings

Ultrasound ◽  
2020 ◽  
pp. 1742271X2097060
Author(s):  
Waldo Sepulveda ◽  
Francisco Sepulveda ◽  
Gloria Gonzalez ◽  
Claudio Arce ◽  
Elisa Alcalde
Keyword(s):  
Late Pregnancy ◽  
Abdominal Ultrasound ◽  
Hepatic Cyst ◽  
Cystic Mass ◽  
Pathological Examination ◽  
Simple Cyst ◽  
Radiologic Imaging ◽  
Laparoscopic Excision ◽  
Upper Abdominal ◽  
Selection Of

Introduction Congenital hepatic cyst is a rare hepatobiliary malformation that can present as an asymptomatic, unilocular, upper abdominal cystic mass in the fetus. Cases We report two cases of congenital hepatic cyst in which the diagnosis was made by prenatal ultrasound at 25 and 33 weeks’ gestation. The diagnosis was confirmed postnatally by abdominal ultrasound and radiologic imaging studies. Although the infants remained asymptomatic, laparoscopic excision was performed due to the increasing size of the cyst in both cases. Pathological examination of the resected specimens confirmed a simple cyst in one case and an epidermoid cyst in the other. Conclusions Our cases and those described in the literature demonstrate the usefulness of incidental prenatal detection of congenital hepatic cyst, especially during late pregnancy. Such a diagnosis can allow for proper perinatal surveillance, selection of the route of delivery, and timely postnatal surgical intervention if required.

scholarly journals Ultrasound of the adrenal gland in children

Ultrasound ◽  
2020 ◽  
pp. 1742271X2095191
Author(s):  
Tobi SM Aderotimi ◽  
Jeannette K Kraft
Keyword(s):  
Adrenal Gland ◽  
Multimodality Imaging ◽  
Imaging Modality ◽  
Abdominal Mass ◽  
Imaging Features ◽  
Adrenal Hyperplasia ◽  
Abdominal Masses ◽  
Adrenal Masses ◽  
Initial Imaging ◽  
Upper Abdominal

Introduction Ultrasound is the modality of choice in the evaluation of neonates and young children with suspected adrenal lesions including adrenal haemorrhage and congenital adrenal hyperplasia. It is also the initial imaging modality in children presenting with an upper abdominal mass, which may be adrenal in origin. Topic discussion: This paper shows adrenal anatomy and demonstrates how the sonographic features change with age. It reviews the imaging features of congenital adrenal lesions, as well as benign and malignant conditions affecting the adrenal gland in childhood. Discussion and Conclusion: Ultrasound is a useful primary imaging modality in the assessment of the adrenal gland in children. Knowledge of the changes of the adrenal gland with age is important when assessing the adrenal gland. Ultrasound is also useful for assessing abdominal masses. However, it cannot differentiate adrenal masses, therefore correlation with biochemical findings, multimodality imaging, and histology is usually required.

scholarly journals A Massive Arteriovenous Malformation arising from the Aorta causing Severe Pulmonary Hypertension

2018 ◽  
Vol 1 (1) ◽  
pp. 31-34
Author(s):  
Patrick John Kennelly ◽  
David Rea ◽  
Suzanne Crowe
Keyword(s):  
Pulmonary Hypertension ◽  
Interventional Radiology ◽  
Arteriovenous Malformation ◽  
Abdominal Mass ◽  
Vena Cava ◽  
Abdominal Ultrasound ◽  
Vascular Lesion ◽  
Cystic Mass ◽  
Severe Pulmonary Hypertension ◽  
Unsuccessful Attempt

            Aortic arteriovenous malformations (AVMs) are rare vascular anomalies where the aorta communicates with adjacent venous structures, bypassing the capillary system. We report a case of a neonate born at 34 weeks gestation who presented at 3 weeks of life in respiratory distress. Echocardiography demonstrated severe pulmonary hypertension with right ventricular dilatation but an otherwise structurally normal heart. Clinical examination revealed a pulsatile abdominal mass with an audible bruit. Abdominal ultrasound was performed and it demonstrated a large cystic mass arising from the inferior vena cava (IVC) with both arterial and venous vascular flow within it. Further evaluation with magnetic resonance angiography (MRA) showed a massive arteriovenous malformation from both left and right iliac arteries, and lumbar arteries communicating with the IVC. A decision was made with interventional radiology to attempt coiling of the vascular lesion. Following this procedure his pulmonary hypertension worsened in severity, culminating in acute heart failure and multi-organ dysfunction. A subsequent interventional radiology procedure found that there was no blood flow to his bowel or abdominal viscera. Cardiac arrest followed with an unsuccessful attempt at resuscitation. This case describes a presentation of severe pulmonary hypertension initially considered to be secondary to either congenital heart disease or intrinsic pulmonary disease, but which was found to be as a result of a very rarely occurring massive aortic AVM. 

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.

scholarly journals Mature Cystic Teratoma of the Fallopian Tube in a Postmenopausal Woman: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Mustafa Erkan Sari ◽  
Ozhan Ozdemir ◽  
Pinar Kadirogullari ◽  
Funda Arpaci Ertugrul ◽  
Cemal Resat Atalay
Keyword(s):  
Postmenopausal Woman ◽  
Fallopian Tube ◽  
Frozen Section ◽  
Operative Procedure ◽  
Cystic Teratoma ◽  
Cystic Mass ◽  
Hair Follicles ◽  
Mature Cystic Teratoma ◽  
Abdominal Masses ◽  
The Right

Background. Mature cystic teratomas of the fallopian tube are extremely rare and only 54 cases have been reported in the literature. In this paper, we report a mature cystic teratoma of the fallopian tube in a postmenopausal woman and we report the review of literature of tubal cystic teratomas.Case. A 62-year-old, gravida 4 postmenopausal woman presented with pain in the right lower abdominal region for a long time. An 88 × 72 × 95 mm heterogeneous mass which contained calcifications and lipoid components was detected in the right adnexal region by transvaginal ultrasonogram (TV-USG). Serum tumour markers, namely, CA125, CA15-3, and CA19-9, were within normal range. A laparotomy revealed a 9 × 10 cm cystic mass within the fimbrial region in the right fallopian tube, and right salpingoopherectomy was performed consequently. Microscopic examination revealed squamous epithelium with sebaceous glands and hair follicles, and pseudostratified ciliated respiratory epithelium with cartilage and mucous glands. Because the frozen section resulted in a benign dermoid cyst, no further operative procedure was performed. The postoperative follow-up was uneventful and the patient was discharged on the second postoperative day.Conclusion. In cases of undetermined pelvic or abdominal masses, a teratoma of the fallopian tube should be considered.

scholarly journals Solid Pseudopapillary Neoplasm (SPN) of the Pancreas: A 7-year Study in A Tertiary Level Teaching Hospital in Bangladesh

2021 ◽  
Vol 9 (2) ◽  
pp. 34-38
Author(s):  
Mehdi Ashik Chowdhury ◽  
- Asaduzzaman
Keyword(s):  
Clinical Symptoms ◽  
Tumour Size ◽  
Abdominal Mass ◽  
Cross Sectional Study ◽  
Cystic Mass ◽  
Preoperative Imaging ◽  
Cystic Degeneration ◽  
Solid Pseudopapillary Neoplasm ◽  
Rare Tumour ◽  
Cross Sectional

Solid pseudopapillary neoplasm (SPN) of the pancreas, also referred to as Frantz's tumour, is a rare tumour and represents 1-3% of all pancreatic tumours, which typically affects young women without significant clinical symptoms. This cross-sectional study was done in the Department of Pathology, Bangabandhu Sheikh Mujib Medical Un iversity (BSMMU) between January 2009 and December 2015. A total of nineteen cases of solid pseudopapillary neoplasm (SPN) of pancreas were detected in patients and included in this study. In all the patients the diagnosis was confirmed by histopathology after the surgery. Tumours were nodular, cystic or solid-cystic, often encapsulated. Some of them were received as irregular fragmented pieces, as intact removal was not possible. Cut surfaces were partly grey-white and partly tan-brown with cystic degeneration. Areas of necrosis and hemorrhage were present in all the specimens.The age range was of 14-45 years (mean age 26.9±3.7 years) (Table-I). Among the tumours, 18 were found in female patients, while only 1 was from male patient. In all the cases, preoperative imaging contributed to diagnosis of an abdominal mass in the patients. 11 of these were reported as pancreatic mass, while 3 as pancreatic cystic mass, 2 as retroperitoneal mass, 2 as mesenteric mass and only 1 as adrenal mass. Tumour-size ranged from 6 to 19 cm (mean size 9.3±1.5 cm). 7 tumours were solid and cystic in nature, while 8 were solid and 4 were only cystic. Complete capsule was found in 17 specimens. Calcifications were found in only 5 specimens. Surgical resection was found generally curative. In our study, absence of metastasis suggests that these tumours hardly show aggressive clinical behaviour. However, follow-up is important to observe potential local recurrence and metastasis. CBMJ 2020 July: Vol. 09 No. 02 P: 34-38

scholarly journals Hepatic hydatid cyst: a masquerader

2020 ◽  
Vol 7 (5) ◽  
pp. 1688
Author(s):  
Krishan Kumar Kanhaiya ◽  
Bhimsi Kandoriya ◽  
Vineet Pandey ◽  
Viresh Kumar ◽  
Sushanto Neogi
Keyword(s):  
Differential Diagnosis ◽  
Hydatid Cyst ◽  
Surgical Excision ◽  
Hepatic Cyst ◽  
Cystic Mass ◽  
Hepatic Hydatid Cyst ◽  
Adrenal Cyst ◽  
Upper Abdominal ◽  
Hepatic Hydatid

Liver is the most common organ involved in echinococcosis. Organs affected by E granulosus are the liver (63%), lungs (25%) and muscles (5%). Rest of the organs are rarely affected.  Adrenal cysts are uncommon. Their size may range widely and the origin of large adrenal cysts is often difficult to distinguish from other organs, including the kidney, pancreas, spleen, and liver. A large right-sided adrenal cystic mass can rarely be mistaken for a hepatic cyst by imaging. In this report, authors have described an adrenal cyst in a 28 year old lady, who was diagnosed preoperatively to have a hepatic hydatid cyst but intraoperatively it was found to be of adrenal origin. The size of the adrenal cyst can vary from a few millimetres up to 50 cm in diameter. Majority of the adrenal cysts are unilateral, while 8-10% of those cysts have been noted to be present bilaterally. The majority of cases are diagnosed between the 3rd and 6th decades. Although uncommon, Adrenal cyst should be considered as one of the differential diagnosis of upper abdominal cysts. Surgical excision is advisable when the cysts are symptomatic, greater than 5 cm in diameter and in the case of suspecting malignancy. 

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