scholarly journals Sonographic Evaluation of Acute Appendicitis

2012 ◽  
Vol 28 (6) ◽  
pp. 320-323 ◽  
Author(s):  
Colleen Ryan

Appendicitis is a surgical emergency that can mimic many other abnormalities. Early diagnosis is critical to reduce the risk of perforation and potentially life-threatening complications. The use of sonography has proven to aid in accurately diagnosing an inflamed appendix without adversely affecting the rate of perforation. However, the accuracy of sonography is highly operator dependent. This case demonstrates the classic clinical presentation of appendicitis with the incorporation of sonographic findings to support the diagnosis.

2018 ◽  
Vol 132 (9) ◽  
pp. 827-831 ◽  
Author(s):  
K Mahawerawat ◽  
P Kasemsiri

AbstractBackgroundAlthough melioidosis in the head and neck region is uncommon, it is a potentially life-threatening infection. Thus, early diagnosis and proper management are very important.ObjectivesTo report the clinical presentation and management of melioidosis in the head and neck.MethodA retrospective study was conducted from 1 January 2013 to 31 October 2016 in Mukdahan Hospital, Thailand. Case records of patients who had presented with culture-positive melioidosis were analysed.ResultsMedical records of 49 patients (23 males and 26 females) were analysed. Patients ranged in age from 1 to 75 years. Clinical presentations included 22 parotid abscesses, 16 neck abscesses and 11 suppurative lymphadenitis cases. Only 35 patients (71 per cent) had high indirect haemagglutination assay titres of ≥ 1:160 (95 per cent confidence interval = 45.35–88.28). Almost half of the patients received intravenous ceftazidime and subsequently oral co-trimoxazole. Oral antibiotic regimens were prescribed for mild localised melioidosis. Overall, 95.65 per cent of patients were in remission and no relapses were observed (95 per cent confidence interval = 85.47–98.80).ConclusionCareful clinical correlation and proper investigation are required to establish an early diagnosis of melioidosis and to initiate appropriate treatment.


2020 ◽  
Vol 2 (3(September-December)) ◽  
pp. e622020
Author(s):  
Alick Durão Moreira ◽  
Antonio Bellas ◽  
Marcelo Sampaio Poousa ◽  
Rafaeldos Santos Mitraud Mitraud ◽  
Tatiana Protzenko

Introduction:Congenital Dermal Sinuses (CDS) are rare closed dysraphisms that can present throughout the extent of the neuroaxis. They occur due to a failure of the disjunction of the neuroectoderm and cutaneous ectoderm in a focal point during 3-4 week of embryogenic development. The prevalence of CDS of all types has been estimated to be 1 in 2,500 live births, most commonly localized in the lumbar region. More than half of the cases are associated with dermoid or epidermoid tumors. Clinical presentation of CDS usually consists in cutaneous stigmas like dimples, which has the potential to be diagnosed at birth. However, the majority of patients are diagnosed older and after complications such as meningitis, abscess, osteomyelitis, rupture of an associated epi/dermoid cyst. Once suspected the patient should be submitted to an image study with CT scan and/or MRI, and surgical consultation. Complete exeresis is the definitive treatment. Case report: we present 3 cases of CDS, including an extremely rare case of frontonasal location, to illustrate the extent of the disease and the importance of early diagnosis and treatment. All of the 3 cases presented with complications, requiring surgical treatment and long term antibiotic therapy. Conclusion: Although well reported in the literature, CDS are usually diagnosed after complications. The knowledge of clinical presentation, early diagnosis and treatment are essential to prevent its life threatening complications. 


2017 ◽  
Vol 8 (1) ◽  
pp. 73-75
Author(s):  
Md Tahminur Rahman ◽  
Abdus Salam Arif ◽  
Md Abdul Wohab Khan ◽  
Mumtahina Setu ◽  
Md Imam Shafique ◽  
...  

Most patients with acute appendicitis can be easily diagnosed, but there are many in whom the signs and symptoms are quite variable, and a firm clinical diagnosis is often very difficult to establish. Difficulties in the early diagnosis of appendicitis, particularly in children, often lead to life threatening complications, such as gangrene or perforation of the appendix. Here we report a case where a nine-year-old boy presented to the Paediatric Department at Anwer Khan Modern Medical College Hospital in Dhaka in April 2016 with a history of abdominal pain, vomiting & fever that began nine days before admission.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 73-75


2021 ◽  
Vol 10 (39) ◽  
pp. 3505-3507
Author(s):  
Srinivas Naik ◽  
Sourya Acharya ◽  
Gajendra Agrawal ◽  
Chetan Rathi ◽  
Sunil Kumar

Congenital heart disease (CHD) often poses a great diagnostic challenge for physicians. Despite antenatal diagnostic tests advancing to a great level, accurate diagnosis and treatment of congenital heart diseases is mandatory. These diseases range from mild to severe life-threatening scenarios sometimes having vague presentations making diagnosis even more difficult. Early diagnosis and treatment are usually lifesaving.1 Congenital heart diseases can often be classified as cyanotic and acyanotic based on clinical presentation. After birth, fetal structures like foramen ovale, ductus venosus and ductus arteriosus are no longer required for survival and they begin to close.2 Persistence of such structures after birth is a sign of congenital heart diseases. High mortality contributing diseases which require prompt intervention include hypoplastic left heart syndrome (HLHS), coarctation of aorta (COA), interrupted aortic arch (IAA), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), critical aortic stenosis (AS) pulmonary atresia (PA) and tricuspid atresia (TA).3 They contribute to significant mortality amongst neonatal age groups. Recognition of congenital heart diseases based on clinical fractures like cyanosis, tachycardia, tachypnoea, irritability, refusal to feed stabilisation and prompt referral to tertiary cardiac centre are critical to improve outcomes in neonates with CHDs, seizures, murmur etc is diagnostically challenging but lifesaving. Life-threatening CHDs may perhaps present with cyanosis, respiratory distress, shock or collapse; all of these are also frequent clinical presentation of various respiratory problems or sepsis in newborn. Early diagnosis and prompt treatment are the only life saving measures.


Author(s):  
Subha Ranjan Samantaray ◽  
Ipsita Mohapatra ◽  
Achanta Vivekanada

Background: Ectopic pregnancy (EP) is a life-threatening obstetrics emergency in early trimester, associated with a high morbidity and mortality if not timely intervened.  High index of clinical suspicion is required for early diagnosis, specifically in women presenting with amenorrhoea, pain abdomen and vaginal bleeding. Aim of this study is to determine the incidence, risk factors, clinical presentation, management and outcome of ectopic pregnancy.Methods: This retrospective observational study was conducted in the department of obstetrics and gynaecology, at Prathima institute of medical sciences, Telangana from July 2012 to June 2019, for a period of 7 years. A total of 53 cases of ectopic pregnancy were analyzed for parameters like age, gravidity, gestational age, risk factors, clinical presentation, management and morbidity.Results: Incidence of ectopic pregnancy was 5.3 per thousand deliveries. Majority of cases were in age group of 20 to 25 years (52.8%) and were gravida 3 and above (68%). The commonest risk factors identified were history of previous pelvic surgeries (37.7%) followed by history of abortion (18.8%). Commonest symptoms were abdominal pain (90.6%), amenorrhoea (75.5%) and vaginal bleeding (47.2%). Only 41.5 % of cases had triad of symptoms. Fallopian tube (92.4%), specifically ampulla (62.3%) was the most frequent site affected. About 73.6% cases presented with ruptured tube. Surgery (94.3%) was the mainstay of therapy.Conclusions: ectopic pregnancy is a life-threatening emergency, early diagnosis and treatment will improve the prognosis.


2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.


Author(s):  
Gabriel Guízar Sahagún

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.


2020 ◽  
Vol 16 ◽  
Author(s):  
Molla Imaduddin Ahmed ◽  
Rosalind V Saunders ◽  
Srini Bandi

: We reviewed the clinical presentation and management of children with Invasive group A streptococcal infections admitted to our tertiary Children’s Hospital in the last eight years. Our study highlighted the varied symptomatology and management practices in children with iGAS and showed that early diagnosis and prompt initiation of appropriate antibiotics for iGAS can help in resolution of symptoms and good outcome.


2017 ◽  
Vol 26 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Anisha M. Fernandes ◽  
Maheshkumar M. Lakhe ◽  
Sanjay A. Pai

Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were reactive lymphoid follicles with histiocytes in the submucosa and tachyzoites in the muscularis propria. Immunohistochemistry confirmed the diagnosis of toxoplasma appendicitis. Serological evaluation yielded negative results. Retrospective review of the history revealed that the patient was on long-term immunosuppressive therapy with methotrexate. The patient was treated with sulfamethoxazole-trimethoprim and is asymptomatic at 7-month follow-up. Toxoplasma appendicitis must be considered in the differential diagnosis of appendicitis in immunosuppressed patients.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Santiago Fabián Moscoso Martínez ◽  
Evelyn Carolina Polanco Jácome ◽  
Elizabeth Guevara ◽  
Vijay Mattoo

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.


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