scholarly journals Spontaneous rupture of pyonephrosis presenting as anterior abdominal wall abscess: a rare case report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Kamlesh Hawaldar Singh ◽  
Ankit Vyas ◽  
Tarun Rochlani ◽  
Sujata Kiran Patwardhan
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Correct Diagnosis ◽  
Rare Event ◽  
Lumbar Region ◽  
Abdominal Wall Abscess ◽  
Rare Case Report ◽  
Loin Pain ◽  
The Right ◽  
Enhanced Computed Tomography

Abstract Background A pyonephrosis caused by an obstructing calculus is typically accompanied by fever, loin pain, and other signs of urinary tract infection. Occasionally, severe thinning of the renal parenchyma in pyonephrosis allows direct forniceal rupture into the retroperitoneum and very rarely into the anterior abdominal wall, misconstruing it as an isolated abdominal wall abscess. Case presentation Diabetes-related 55-year-old diabetic male presented with abscess in his periumbilical region extending into right lumbar region. He did not exhibit any urinary symptoms, and contrast enhanced computed tomography [CECT] abdominal and pelvic examinations revealed right pelvic calculus with pyonephrosis. There is a 7.5 mm defect in the lower pole of the right kidney with 171 cc of collection adjacent to the kidney communicating with 150 cc of superficial abdominal wall collection through a 15 mm defect. Incision and drainage of abdominal and retroperitoneal abscesses were done at first. Right DJ stenting was performed. Right lateral decubitus was placed for dependent drainage. Resolution of residual collections was confirmed by subsequent ultrasonography KUB, and drain was then removed. Right DJ stenting done, and patient was discharged. Two months later, DTPA scan done and revealed GFR of 30 ml/min of right kidney. Patient underwent right percutaneous nephrolithotomy. Conclusion The sudden rupture of pyonephrosis is a rare event. Even rarer is the presentation of pyonephrosis as an abscess on the anterior abdominal wall. The correct diagnosis and search for the source of the abscess must be undertaken before intervention. An aggressive and prompt management is needed to prevent further complications from occurring. This case is being presented to add to the literature with regard to abnormal presentations of ruptured pyonephrosis and its management.

scholarly journals Anterior abdominal wall abscess secondary to spontaneous rupture of liver abscess in a resource-limited, rural, surgical setting: A case report

2021 ◽  
Vol 8 (1) ◽  
pp. 72-77
Author(s):  
Royson Dsouza ◽  
Dr. Mrudula Rao ◽  
Dr. Harshad Arvind Vanjare ◽  
Manbha Rymbai
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Liver Abscess ◽  
Spontaneous Rupture ◽  
Anterior Abdominal Wall ◽  
Care Hospital ◽  
Resource Limited ◽  
Number Of Patients ◽  
Abdominal Wall Abscess ◽  
The Right

Liver abscess continues to be a major surgical burden in low and mid-low-income countries like India. Spontaneous rupture into the anterior abdominal wall is an uncommon presentation of pyogenic liver abscess. A 53-year-old diabetic lady with a past history of laparoscopic cholecystectomy presented with acute pain in the right upper quadrant. On examination, she had an anterior abdominal wall abscess with tender hepatomegaly. On further evaluation with ultrasonography and plain computed tomography, a diagnosis of liver abscess in the right lobe with rupture into the anterior abdominal wall was made. She was treated successfully in a tribal secondary care hospital with USG guided aspiration followed by surgical drainage under local anesthesia. This case report highlights that a considerable number of patients with liver abscess and its complications can be appropriately managed in resource-limited rural surgical centers. The patient’s clinical presentation, investigations, and management have been discussed with a relevant review of the literature.  

scholarly journals Interesting case discussion of a lesion over the right abdominal wall

2019 ◽  
Vol 6 (2) ◽  
pp. 636
Author(s):  
Anand Ignatius Peter ◽  
Souvik Patra ◽  
Samreen Jaffar
Keyword(s):  
Pleural Effusion ◽  
Abdominal Wall ◽  
Malignant Lesion ◽  
Skin Surface ◽  
Liver Lesion ◽  
Interesting Case ◽  
Lumbar Region ◽  
Contrast Enhanced Ct ◽  
Surgical History ◽  
The Right

A diagnosis of hepatic actinomycosis is challenging and often overlooked because of its indiscernible nature and slow rate of progression. This is further complicated with absence of any specific clinical and radiologic manifestations. In this case, a 49 years old male, farmer, with no co-morbidities or significant past medical or surgical history, reported to the department of surgery, with complains of non-healing ulcer over right upper abdomen since five months. Examination of the ulcer led to a clinical suspicion of a malignant lesion. Sonogram of abdomen and pelvic region, which revealed heterogenous lesion with central necrosis in the right lumbar region of the abdominal wall with extension into the skin surface, a heterogenous lesion noted on the liver, and right pleural effusion with the suggestion to consider the possibility of primary skin/abdominal wall tumor with hepatic metastasis with right pleural effusion. Further investigation was performed using contrast enhanced CT scan which also favoured the diagnosis of a malignancy. However, biopsy of the skin lesion was negative for malignancy and it confirmed the diagnosis of Actinomycosis. This diagnosis was further confirmed with an ultrasound guided biopsy of the liver lesion. The patient was then started on appropriate treatment for the same and he recovered well.

Desmoid tumor of the anterior abdominal wall in a female (Clinical case)

2018 ◽  
pp. 116-118
Author(s):  
M.V. Makarenko ◽  
◽  
D.O. Govseyev ◽  
S.V. Gridchin ◽  
N.H. Isaeva ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Desmoid Tumor ◽  
Clinical Case ◽  
Anterior Abdominal Wall ◽  
Correct Diagnosis ◽  
Final Diagnosis ◽  
Histological Findings ◽  
History Of ◽  
Slow Growing ◽  
Wall Tumor

Desmoid tumors (also called desmoids fibromatosis) are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy and postoperative surgeries. Our clinical case is interesting because of the rarity of the pathology and the difficulties in setting the correct diagnosis. The patient, with a history of laparoscopic myomectomy (2012), was preparing for a routine surgery for the endometrioma of the anterior abdominal wall, according to the results of the ultrasound and computed tomography. After surgical treatment, the final diagnosis was changed, based on the histological findings. Key words: desmoid tumor, abdominal wall tumor, fibroid.

scholarly journals Anterior Abdominal Wall Abscess Secondary to Subcutaneous Gallstones

2008 ◽  
Vol 2 (2) ◽  
pp. 219-223 ◽  
Author(s):  
John A. Murphy ◽  
C.Dale Vimalachandran ◽  
Nathan Howes ◽  
Paula Ghaneh
Keyword(s):  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Abscess

scholarly journals Metastasizing Malignant Granular Cell Tumor (Abrikossoff Tumor) of the Anterior Abdominal Wall, with Prolonged Survival

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yara A. Alnashwan ◽  
Khaled A. H. Ali ◽  
Samir S. Amr
Keyword(s):  
Abdominal Wall ◽  
Poor Prognosis ◽  
Granular Cell Tumor ◽  
Anterior Abdominal Wall ◽  
Granular Cell ◽  
Cell Tumor ◽  
Prolonged Survival ◽  
Review Of The Literature ◽  
Malignant Granular Cell Tumor ◽  
The Right

Malignant granular cell tumor (MGCT) is a rare high-grade mesenchymal tumor of Schwann cell origin. MGCTs commonly affect thigh, extremity, and trunk; however, involvement of the abdominal wall is quite rare. It has poor prognosis with 39% mortality rate in 3-year interval. We report a 50-year-old female who had MGCT arising in the anterior abdominal wall and developed massive metastatic deposits in both lungs and in the right inguinal lymph nodes, with prolonged survival for 11 years. A brief review of the literature is presented.

scholarly journals 956 Retained Appendiceal Tip and Abdominal Wall Appendicolith - A Rare Combination of Post Appendicectomy Complications

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Dey ◽  
N Symons
Keyword(s):  
Abdominal Wall ◽  
Iliac Fossa ◽  
Symptomatic Relief ◽  
Radiological Investigation ◽  
Complete Excision ◽  
Rare Combination ◽  
Abdominal Wall Abscess ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Inflammatory Changes

Abstract Appendicitis involving the appendix stump is a recognised post appendicectomy complication but the same involving the appendiceal tip is rare. Similarly, abdominal wall abscess secondary to retained appendicolith is also infrequently encountered. Our case highlights a rare combination of both complications arising separately. A 29-year-old man presented with 3 days of generalised malaise and progressively worsening right iliac fossa pain some ten months after a laparoscopic appendicectomy. This had been complicated by residual right iliac fossa inflammation that was treated conservatively and serial scans demonstrated gradually resolving inflammation. He also had well controlled ulcerative colitis. On examination, he was noted to be pyrexial with a tender fluctuant mass in the right flank. An ultrasound scan demonstrated inflammatory changes in the abdominal wall with no intra-abdominal collections. A diagnostic laparoscopy found an inflamed appendix tip, attached to the residual mesoappendix and embedded in the abdominal wall behind the mid-ascending colon. A completion appendicectomy was performed. The patient recovered well but returned 4 months later with persistent pain and a fluctuant mass over the right iliac fossa. Radiological investigation revealed an abdominal wall collection containing a calcified appendicolith. The collection was refractory to ultrasound guided drainage and an exploration of the abdominal wall allowed extraction of the appendicolith followed by symptomatic relief. This case emphasizes the importance of complete excision of the appendix and extraction of debris, which can be challenging when the appendix lies in a retro-colic position.

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