scholarly journals Abdominal Pain Relieved By A Warm Hot Water Bottle: An Atypical Presentation Of Eosinophilic Gastroenteritis

Author(s):  
Ahmad Reza Shirazi-Nejad ◽  
John M Hebden

A 26-year-old woman presented with a 3-month history of worsening episodic abdominal pain, which was associated with frequent passage of watery stools, nausea and dyspepsia. Her peripheral eosinophil count was markedly elevated. This responded well to a reducing regimen of corticosteroids. Her symptoms completely resolved with a corresponding fall in eosinophil count. The patient was diagnosed with eosinophilic gastroenteritis. We have not considered steroid-sparing agents at this point, but should she have future exacerbations then this will be considered.

2021 ◽  
Vol 39 (4) ◽  
pp. 261-265
Author(s):  
ABM Moniruddin ◽  
Salma Chowdhury ◽  
Tanvirul Hasan ◽  
Kazi Muhammad Mahmudul Hasan ◽  
- RounakJahan ◽  
...  

Acute appendicitis is a very common surgical emergency. It has got diverse presentations and various complications. Here, we report case history of a young male patient with a 2- year history of recurrent abdominal pain, who presented to our center with a 4-day history of increasing abdominal pain, constipation and vomiting. Clinical and radiological evaluation revealed it as a case of acute intestinal obstruction preoperatively. Per-operative findings suggested acute appendicitis without perforation, small gut obstruction by adhesions, appendicular lump or internal herniation. Appendicectomy was done along with other necessary procedures. His post-operative period was uneventful. This case is reported here to highlight that acute appendicitis may present with atypical features like acute small gut obstruction. J Bangladesh Coll Phys Surg 2021; 39: 261-265


2017 ◽  
Vol 10 (1) ◽  
pp. 27
Author(s):  
Md. Abdul Aziz ◽  
Surozit Kumar Sarkar ◽  
Farzana Rahman ◽  
Showrab Biswas ◽  
Saqi Md. Abdul Baqi ◽  
...  

<p>A 20 year old female presented with a history of frequent syncopal attack since her childhood. Each episode persisted 5-10 min without having any aggravating factor or prodrome. She had persistent generalized bodyache aggravating during the winter. She had jaundice and episodic abdominal pain. She received 1 unit of blood transfusion 4 months back and improved sympto-matically. Patient was mildly anemic, moderately icteric and had mild splenomegaly. Over these long periods of her illness she was thoroughly evaluated several times. Her biochemical and neurological evaluation revealed no abnormalities. But she was treated with anticonvulsant for long time empirically without significant improvement. Her CBC showed microcytic hypochromic anemia. She was negative for Wilson’s disease. Reticulocyte count was high. Coomb’s test was negative. Osmotic fragility test was positive. Hemoglobin electrophoresis revealed Hb-S 60%. Sickling test was found positive. Finally it was diagnosed as a case of HbS/β+.</p>


2021 ◽  
Vol 14 (2) ◽  
pp. e238532
Author(s):  
Carol Stephanie C Tan-Lim ◽  
Juan Miguel L Murillo ◽  
Marysia Stella T Recto ◽  
Mary Anne R Castor

Eosinophilic gastroenteritis is a rare inflammatory disorder of the gastrointestinal tract. Although commonly associated with allergic diseases, it is also rarely associated with autoimmune disorders. This case report describes a 17-year-old Filipino male with eosinophilic gastroenteritis, manifesting as abdominal pain, vomiting and diarrhoea. He had no allergic diseases, but he was previously diagnosed with chronic bullous disease. His symptoms improved with the initiation of corticosteroids. To date, this is the first case report of a patient with eosinophilic gastroenteritis and chronic bullous disease.


Author(s):  
Shamrao Ramji Wakode ◽  
Roshni Vinod Lodha

Leiomyomas or fibroids are the most common benign pelvic tumors in females that grow mono-clonally from the smooth muscle cells of the uterus. Most common tumors of the uterus are fibroids but cervical fibroid is rare during pregnancy with different management difficulties but cervical leiomyomas are less than 5% of all leiomyomas. A middle-aged female patient came to the obstetric opd with complaints of amenorrea for 2 months, per vaginal spotting and abdominal pain for 5 days. Her obstetric score is gravida 2 para 1 living 1. She has no h/o of urinary retention, urgency, constipation or mass per vagina. There is no history of bleeding during coitus. This case is of great importance not only because of its atypical presentation, but because we are dealing with rare pathology that can have consequences as serious as a total uterine inversion or a complete uterovaginal prolapse. Decision of myomectomy SOS hysterectomy may be considered intra operatively based on 1. Age, 2. Parity, 3. Severity of symptoms and 4. Experience of surgeon


2019 ◽  
pp. 1-2
Author(s):  
NG Bertrand RJ ◽  
Subramanian Pradeep

Acute appendicitis is one of the most common emergency surgical procedure, yet atypical presentation sometimes can be challenging for clinician. I present a case of 19-year-old gentleman that initially presented with 1day history of bilateral testicular pain and lower abdominal pain. His past history includes a positive sexual history. Initial ultrasound of the testis showed bilateral orchitis and an equivocal appendix. With a significantly raised inflammatory marker and highly suspicious for appendicitis, a CT scan was obtained which showed perforated appendicitis and the patient underwent laparoscopic appendicectomy with resolution of symptoms after that. We encourage clinician to be aware of this clinical pitfall as patient can sometimes be managed in other department to minimise any delayed diagnosis or any unnecessary procedure.


Author(s):  
Ryan Faderani ◽  
Stephen R Ali ◽  
Jeremy Yarrow

Abstract We report a case of a 34-year old female with systemic lupus erythematosus (SLE) and lupus nephritis who was referred to the regional burns service with a suspected contact burn to the left flank and hypogastrium from a hot water bottle. The patient had been applying a hot-water bottle to the area at night for pain relief and after 3-days she noticed a localised area of erythema which became larger and began to blister over a period of 5-days. The blistered areas were erythematous and wet, however the capillary refill time was sluggish. The lesion was initially diagnosed and treated as a superficial partial thickness burn that had developed secondary to prolonged contact with a hot water bottle. However, due to the history of immunosuppression as well as elements of the lesion being unusual for a burn, we consequently diagnosed this as herpes zoster infection. This case highlights the importance of always thinking of alternative diagnoses. There are several cases in the literature where shingles has been dangerously misdiagnosed, furthermore leading to patients being mistakenly treated and even operated on. In the early stages, abdominal shingles may present very similarly to superficial partial thickness burns, both with neuropathic pain, erythema and blistering. It is important for the burns surgeon to be aware of this diagnosis as a differential in atypical presentations, and to pay particular attention to the timeline of events is the key to diagnosis.


1970 ◽  
Vol 29 (6) ◽  
Author(s):  
Kirubel Abebe ◽  
Abebe Megersa ◽  
Engida Abebe

Background-Schistosomiasis is a trematode infestation causing a chronic granulomatous disease in various organs. Both S. mansoni & S. haematobium are endemic in Ethiopia. Most infected individuals are asymptomatic. Ectopic schistosomiasis can affect the lungs, genitalia, CNS, skin, peritoneum, Lymph nodes & other organs. Schistosomiasis as a cause of acute abdomen is seldom reported.Case Detail-A 51years -old male Ethiopian farmer presented with a two weeks history of abdominal pain with recent onset bilious vomiting and abdominal distention. Emergency laparotomy done & the finding was multiple tiny whitish nodule over the peritoneum & small bowel with multiple mesenteric lymphadenopathy. The diagnosis was confirmed with histopathology study.Conclusions- Schistosomal peritonitis is a very uncommon form of schistosomiasis. Physicians should be aware of such atypical presentation in patients from endemic areas of schistosomiasis. And biopsy should be considered in unsettled forms of peritonitis during laparotomy. The pathogenesis is not well known which warrants further study.


2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.


2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang

<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>


2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.


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