scholarly journals Computed tomography film quiz: A woman with severe epigastric pain and vomiting

2017 ◽  
Vol 24 (5) ◽  
pp. 255-256
Author(s):  
Kin Hoi Wong ◽  
Sai Chung Ho
Keyword(s):  
Computed Tomography ◽  
Epigastric Pain ◽  
Severe Epigastric Pain

scholarly journals Usefulness of Plain Computed Tomography with Swallowing of GastrografinTM for the Diagnosis of a Late-Onset Iatrogenic Diaphragmatic Hernia following Biopsy of a Diaphragmatic Tumor: Report of a Case

2018 ◽  
Vol 12 (2) ◽  
pp. 271-276
Author(s):  
Yoh Asahi ◽  
Shohei Honda ◽  
Tadao Okada ◽  
Hisayuki Miyagi ◽  
Makoto Kaneda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Late Onset ◽  
Epigastric Pain ◽  
Contrast Study ◽  
Mixed Germ Cell Tumor ◽  
Left Diaphragm ◽  
Granulomatous Lesions ◽  
Chest X Ray ◽  
Diaphragmatic Tumor

Although diaphragmatic hernia (DH) may be congenital, posttraumatic, or iatrogenic, DHs after diaphragmatic surgery are rarely reported in the literature. This report describes the rare case of a 14-year-old girl complicated by iatrogenic DH following the biopsy of granulomatous lesions of the left diaphragm, when a mediastinal mixed germ cell tumor was extirpated. Plain computed tomography (CT) with swallowing of GastrografinTM was useful for the diagnosis of this disorder. The patient presented to our hospital with frequent epigastric pain and vomiting 11 months after the original surgery. Chest X-ray, a gastrointestinal contrast study, and plain CT with swallowing of GastrografinTM revealed the left DH with gastric content. At laparotomy, the diaphragmatic defect, 3 × 3 cm in diameter, was repaired using nonabsorbable sutures after hernia reduction. The patient showed a rapid recovery with complete resolution of symptoms. We should consider the presence of iatrogenic DH in patients who develop epigastralgia after procedures involving the diaphragm, even at 11 months after the original surgery. Furthermore, plain CT with swallowing of GastrografinTM is useful for the diagnosis of this disorder.

scholarly journals Delayed diaphragmatic rupture presenting with acute gastric volvulus

2014 ◽  
Vol 96 (7) ◽  
pp. e17-e19 ◽  
Author(s):  
JML Williamson ◽  
R Macleod ◽  
A Hollowood
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Gastric Volvulus ◽  
Diaphragmatic Rupture ◽  
Motorcycle Accident ◽  
Thoracic Computed Tomography ◽  
Acute Gastric Volvulus ◽  
Hospital Cardiac Arrest

Gastric volvulus is a rare complication of diaphragmatic rupture. We report the case of an 82-year-old man who presented following an out-of-hospital cardiac arrest. Chest radiography and thoracic computed tomography revealed an acute gastric volvulus and a chronic diaphragmatic hernia containing transverse colon and abdominal viscera. He had complained of retching and associated epigastric pain prior to collapse, and had sustained a motorcycle accident approximately 60 years earlier. Insertion of a nasogastric tube was unsuccessful (completing Borchardt’s diagnostic triad) and his condition prevented both operative and endoscopic reduction of his volvulus. He died soon afterwards.

scholarly journals Postpartum Spontaneous Subcapsular Hepatic Hematoma Related to Preeclampsia

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Dimitrios Anyfantakis ◽  
Miltiades Kastanakis ◽  
Georgios Fragiadakis ◽  
Paraskevi Karona ◽  
Nikolaos Katsougris ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Emergency Caesarean Section ◽  
Maternity Ward ◽  
Hepatic Hematoma ◽  
Pregnancy And Postpartum ◽  
Life Threatening ◽  
Clinical Phenomenon ◽  
Diagnostic Work ◽  
Work Up ◽  
Severe Epigastric Pain

Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

scholarly journals Dermoid Cyst of the Pancreas: A Report of an Unusual Case and a Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Aynur Albayrak ◽  
Umran Yildirim ◽  
Metin Aydin
Keyword(s):  
Computed Tomography ◽  
Dermoid Cyst ◽  
Preoperative Diagnosis ◽  
Unusual Case ◽  
Epigastric Pain ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Histopathologic Evaluation ◽  
Cystic Pancreatic Lesions ◽  
Rare Diagnosis

Pancreatic dermoid cysts are a rare entity. Preoperative diagnosis is difficult. The diagnosis is generally taking intraoperative. A 20-year-old female presented with epigastric pain without nausea, vomiting, diarrhea, fever, jaundice, and weight loss of one-month duration. Ultrasonography and computed tomography showed a smooth borders, solid, hyperechoic tumor within midline abdomen, without any connection to the stomach or spleen. At surgery, the entire mass was excised off of the head and inferior part of pancreas. Histopathologic evaluation revealed the rare diagnosis of a dermoid cyst. The diagnosis is difficult preoperatively in evaluating cystic pancreatic lesions by imaging. Therefore, we want to summarize the literature on this rare entity knowledge.

scholarly journals Hiatal Hernia as a Total Gastrectomy Complication

2016 ◽  
Vol 9 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Bruna do Nascimento Santos ◽  
Marcos Belotto de Oliveira ◽  
Renata D'Alpino Peixoto
Keyword(s):  
Hiatal Hernia ◽  
Gastric Adenocarcinoma ◽  
Epigastric Pain ◽  
Abdominal Cavity ◽  
Esophageal Hiatus ◽  
The Third ◽  
Esophageal Anastomosis ◽  
Folfox Chemotherapy ◽  
Laparoscopic Assisted ◽  
Severe Epigastric Pain

Introduction: According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy. Case Report: A 76-year-old man was diagnosed with intestinal-type gastric adenocarcinoma. He underwent a total laparoscopic-assisted gastrectomy and D2 lymphadenectomy on May 19, 2015. The pathology revealed a pT4pN3 gastric adenocarcinoma. The patient became clinically stable and was discharged 10 days after surgery. He was subsequently started on adjuvant FOLFOX chemotherapy; however, 9 days after the second cycle, he was brought to the emergency room with nausea and severe epigastric pain. A CT scan revealed a hiatal hernia with signs of strangulation. The patient underwent emergent repair of the hernia and suffered no postoperative complications. He was discharged from the hospital 9 days after surgery. Conclusion: Hiatal hernia is not well documented, and its occurrence in the context of gastrectomy is an infrequent complication.

scholarly journals Severe Epigastric Pain with Nausea and Vomiting

Surgery ◽  
2019 ◽  
pp. 227-237
Author(s):  
Areg Grigorian ◽  
Matthew Y. C. Lin ◽  
Christian de Virgilio
Keyword(s):  
Epigastric Pain ◽  
Nausea And Vomiting ◽  
Severe Epigastric Pain

scholarly journals A rare case of COVID-19 related stomach gangrene after an abortion: a case report

2021 ◽  
Vol 8 (4) ◽  
pp. 1360
Author(s):  
Komal Gupta ◽  
Gopal Puri ◽  
Jnaneshwari Jayaram ◽  
Muhammed Huzaifa ◽  
Kamal Kataria
Keyword(s):  
Epigastric Pain ◽  
Subtotal Gastrectomy ◽  
Abdominal Distension ◽  
Posterior Wall ◽  
Emergency Laparotomy ◽  
Rt Pcr ◽  
Missed Abortion ◽  
Medical Termination ◽  
Arterial Thrombus ◽  
Severe Epigastric Pain

A 25 year old female had presented with complaints of severe epigastric pain with abdominal distension and vomiting for 4 days. She had undergone medical termination of pregnancy for a missed abortion of 5 weeks of gestation 5 days prior. The patient's COVID-19 RT PCR was found to be positive. Her CECT showed covid related changes in bilateral lungs and pneumoperitoneum. Stomach was distended. Other small bowels appeared normal. Patient underwent emergency laparotomy. Two third of stomach appeared gangrenous with a perforation in the posterior wall of stomach so she underwent a subtotal gastrectomy. She had features of covid associated coagulopathy (CAC) with high D-dimer (520 ng/ml), thrombocytosis (up to 705,000/mcl), high activated partial thromboplastin time (aPTT) (up to 55.6 sec) and high prothrombin time (PT) (up to 27.9 sec and INR 2.11) for which low molecular heparin was given. Stomach is a highly vascular organ. Gangrene of the stomach has been very rarely reported. CAC is known to lead to both arterial thrombus and venous thromboembolism. COVID-19 related abortions have also been reported though the exact mechanism not certain but CAC could be one of them.

scholarly journals Gastric Outlet Obstruction Due to Malposition of Replacement Gastrostomy Tube

2019 ◽  
Vol 3 (4) ◽  
pp. 442-443
Author(s):  
Brent Becker ◽  
Travis Walker
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Small Bowel ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Gastrostomy Tube ◽  
Abdominal Radiography ◽  
Radiographic Findings ◽  
Proximal Small Bowel

A 78-year old male presented to the emergency department after accidental dislodgement of his chronic gastrostomy tube. A replacement gastrostomy tube was passed easily through the existing stoma and flushed without difficulty. Confirmatory abdominal radiography demonstrated contrast in the proximal small bowel, but the patient subsequently developed epigastric pain and refractory vomiting. Computed tomography revealed the tip of the gastrostomy tube terminating in the pylorus or proximal duodenum. This case highlights gastric outlet obstruction complicating the replacement of a gastrostomy tube and the associated radiographic findings.

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