scholarly journals Intrathoracic Acute Cholecystitis

2020 ◽  
Author(s):  
Giovana Ennis ◽  
Gabriela Venade ◽  
Joana Silva Marques ◽  
Paulo Batista ◽  
Ana Abreu Nunes ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diaphragmatic Hernia ◽  
Traumatic Injury ◽  
Traumatic Diaphragmatic Hernia ◽  
Reactive Protein ◽  
Dark Urine ◽  
History Of ◽  
Slight Elevation ◽  
Loss Of Appetite ◽  
Work Up

The authors present the case of a 51-year-old woman with no history of surgical or traumatic injury or accident, who presented with right hypochondrium and epigastric discomfort, malaise, nausea, loss of appetite and episodes of dark urine and greenish stools. Initial laboratory work-up revealed elevated inflammatory markers including leucocytosis with left shift and C-reactive protein, and a slight elevation of gamma-glutamyltransferase and alkaline phosphatase, with no other significant alterations. Computed tomography (CT) showed intrathoracic acute cholecystitis with a large diaphragmatic hernia. A literature search revealed only one other case of acute cholecystitis complicated by intrathoracic gallbladder due to a non-traumatic diaphragmatic hernia. Symptoms are uncharacteristic and the absence of pain or fever, explained by the altered location of the gallbladder, makes the diagnosis a challenge.

scholarly journals Delayed Traumatic Diaphragmatic Hernia With Bacterial Pleuritis

2016 ◽  
Vol 101 (5-6) ◽  
pp. 270-274
Author(s):  
Yu Ohkura ◽  
Shusuke Haruta ◽  
Yusuke Maeda ◽  
Hisashi Shinohara ◽  
Masaki Ueno ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diaphragmatic Hernia ◽  
Diaphragmatic Rupture ◽  
Traumatic Diaphragmatic Hernia ◽  
Hernia Mesh ◽  
Reactive Protein ◽  
Traumatic Diaphragmatic Rupture ◽  
Absorbable Sutures ◽  
Abdominal Blunt Trauma ◽  
Traumatic Pneumothorax

Thoraco-abdominal blunt trauma may cause traumatic diaphragmatic hernia. Here, we report a case of delayed traumatic diaphragmatic rupture with herniation of multiple viscera along with bacterial pleuritis without perforation or necrosis. A 72-year-old man presented with severe left-sided chest pain and dyspnea following a fall in the bathroom on the previous day; he had hit the left side and back of the chest against a faucet. Computed tomography (CT) revealed pneumoderma, mediastinal emphysema, pneumothorax, and fractures of the 8th–11th left ribs. We diagnosed traumatic pneumothorax, which was treated by a thoracostomy tube inserted into the pleural space. Approximately 6 months later, he presented again with fever (39.2°C), dyspnea, and coughing. The white blood cell count and C-reactive protein were elevated at 20.3 × 103/μL and 28.7 mg/dL, respectively. A CT scan revealed left-sided pleural effusion and diaphragmatic hernia. Thoracocentesis was performed for the pleural effusion, and bacterial cultivation tests revealed Bacteroides fragilis; therefore, antibiotics were administered for 3 weeks. Subsequently, diaphragmatic hernia repair was performed. Laparotomy via a left subcostal incision revealed a defect measuring 60 × 60 mm; this was repaired with uninterrupted absorbable sutures without using a hernia mesh to avoid infection. The postoperative course was uneventful, and no recurrence was noted at the 1-year follow-up. We repaired delayed traumatic diaphragmatic rupture with herniation of multiple viscera by simple suturing without using a hernia mesh following the treatment of associated bacterial pleuritis.

scholarly journals Right-sided strangulating diaphragmatic hernia in an adult without history of trauma: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Konstantinos G. Spiridakis ◽  
Mathaios E. Flamourakis ◽  
Ioannis G. Gkionis ◽  
Eleni I. Kaloeidi ◽  
Anthoula I. Fachouridi ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Clinical Status ◽  
Traumatic Injury ◽  
Postoperative Recovery ◽  
Case Presentation ◽  
Uneventful Postoperative Recovery ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
Diaphragmatic Hernias

Abstract Background Diaphragmatic hernia involves protrusion of abdominal contents into the thorax through a defect in the diaphragm. This defect can be caused either by developmental failure of the posterolateral foramina to fuse properly, or by traumatic injury of the diaphragm. Left-sided diaphragmatic hernias are more common (80–90%) because the right pleuroperitoneal canal closes earlier and the liver protects the right diaphragm. Diaphragmatic hernias in adults are relatively asymptomatic, but in some cases may lead to incarcerated bowel, intraabdominal organ dysfunction, or severe pulmonary disease. The aim of this report is to enlighten clinical doctors about this rare entity that can have fatal consequences for the patient. Case presentation We present a rare case of a right-sided strangulating diaphragmatic hernia in an adult Caucasian patient without history of trauma. Clinical examination revealed bowel sounds in the right hemithorax, which were confirmed by the presence of loops of small intestine into the right part of the thorax through the right diaphragm, as was shown on chest X-ray and computerized tomography. Deterioration of the clinical status of the patient led to an operation, which revealed strangulated necrotic small bowel. Approximately 1 m of bowel was removed, and laterolateral anastomosis was performed. The patient had an uneventful postoperative recovery and was discharged 8 days later. Conclusions Surgery is required to replace emerged organs into the abdomen and to repair diaphragmatic lesion. A delayed approach can have catastrophic complications for a patient.

scholarly journals Secondary cluster headache and numb chin syndrome as initial manifestation of high-grade B-lymphoma: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Joe Munoz-Cerón ◽  
Felipe Díaz-Forero ◽  
Adriana Buitrago ◽  
Sandra Chinchilla
Keyword(s):  
Cluster Headache ◽  
Vascular System ◽  
Clinical Manifestations ◽  
High Grade ◽  
Initial Manifestation ◽  
Numb Chin Syndrome ◽  
History Of ◽  
Loss Of Appetite ◽  
The Right ◽  
Work Up

Abstract Background Cluster headache is a primary condition characterized by severe headache accompanied by trigeminal autonomic signs. By definition, it is not attributed to underlying etiologies; however, under certain clinical characteristics, secondary etiologies must be ruled out. Case presentation We present the case of a 48-year-old Hispanic man with a history of episodic right orbital pain, lasting 30 minutes, associated with ipsilateral tearing, who prior to the onset of his symptoms reported loss of appetite, weight loss, and paresthesias in the right chin region. After work-up studies, high-grade lymphoma with infiltration to the right submental nerve was diagnosed, in which numb chin syndrome was the initial presentation. Despite initiation of treatment, the patient died 3 weeks after the diagnosis. Conclusions In the study of cluster headache, underlying etiologies must be considered when there are atypical clinical manifestations. Within these etiologies, metastases to pericranial nerves must be included, which, besides generating localized symptoms, can activate the trigeminal vascular system simulating headaches of primary etiology.

scholarly journals Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia

2020 ◽  
Vol 15 (1) ◽  
pp. 119-120
Author(s):  
Md Mahboob Hasan ◽  
MA Baqui ◽  
Farzana Rahman ◽  
Merajul Hasan
Keyword(s):  
Diaphragmatic Hernia ◽  
Transverse Colon ◽  
Proper Time ◽  
Past History ◽  
Armed Forces ◽  
Military Hospital ◽  
Diagnostic Dilemma ◽  
Left Chest ◽  
Traumatic Diaphragmatic Hernia ◽  
History Of

A 33 years old patient was admitted in a Military Hospital with the features of acute large gut obstruction. Exploratory laparotomy was done and peroperatively the obstruction was seen in the transverse colon and obstruction seemed to be carcinoma of transverse colon with involvement of left hemidiaphragm which was not negotiable. Transverse loop colostomy with decompression of bowel was done. Subsequently the patient was transferred to tertiary level hospital in Dhaka. In the tertiary hospital, the patient developed left sided massive pleural effusion. With relevant investigation the condition was diagnosed as left sided diaphragmatic hernia. Thoracotomy was done and herniorrhophy was performed after reduction of the content. Post-operative management was stormy and eventful but the condition improved gradually and the patient was discharged in proper time. The patient had history of chest trauma due to RTA he met 4 years back and he received hospital indoor management for 3½ months. The patient was asymptomatic and leading normal active military life before 2nd time admission for acute intestinal obstruction. The patient had past history of trauma to left chest wall 4 years back, presented with acute large gut obstruction and there was diagnostic dilemma. There were management difficulties and post operative events were stormy. The aim of this reporting is to highlight all of these. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 119-120

scholarly journals A case of colon necrosis resulting from a delayed traumatic diaphragmatic hernia

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Héloïse Tessely ◽  
Stéphane Journé ◽  
Alexis Therasse ◽  
Didier Hossey ◽  
Jean Lemaitre
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Diaphragmatic Hernia ◽  
Emergency Surgery ◽  
Past History ◽  
Traumatic Diaphragmatic Hernia ◽  
Abdominal Symptoms ◽  
History Of ◽  
Diaphragmatic Hernias

Abstract We present the case of a 71 years old woman who came at the emergency room for abdominal pain and symptoms of occlusion. The scanner demonstrated a colonic occlusion resulting from an incarceration, diagnosed as a hernia of Bochdalek. But two old rib fractures and a past history of a fall directed us to the diagnostic of delayed diaphragmatic rupture. The patient was operated in emergency and post-operative follow-up was simple. Traumatic diaphragmatic hernias are rarely diagnosed directly after trauma. Complications such as pneumonia, occlusion, enteric ischemia, visceral perforation and twisting of splenic hilium can occur many years after the trauma. This is why, for patients with intestinal obstruction or association of pulmonary abdominal symptoms and history of thoraco-abdominal injury, the diagnostic of diaphragmatic hernia should be considered. When patients present complications, there is a higher rate of morbidity and mortality (31%) reason why, emergency surgery is mandatory.

Multiple subluxations and comminuted fracture of the cervical spine in a sheep

2015 ◽  
Vol 43 (01) ◽  
pp. 44-38
Author(s):  
C.-C. Lin ◽  
K.-S. Chen ◽  
Y.-L. Lin ◽  
J. P.-W. Chan
Keyword(s):  
Cervical Spine ◽  
Pain Perception ◽  
Cervical Vertebrae ◽  
Traumatic Injury ◽  
Spinal Reflexes ◽  
Spine Trauma ◽  
Blunt Force Trauma ◽  
Comminuted Fracture ◽  
History Of ◽  
The Right

SummaryA 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1–C2 and C2–C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

Renal Impairment in Young Patients with Unilateral Ureteral Lithiasis Obstruction: What Factors can be Responsible?

2018 ◽  
Vol 69 (2) ◽  
pp. 375-378
Author(s):  
Catalin Pricop ◽  
Ileana Adela Vacaroiu ◽  
Daniela Radulescu ◽  
Daniel Andone ◽  
Dragos Puia
Keyword(s):  
Renal Impairment ◽  
Serum Creatinine ◽  
Young Patients ◽  
Kidney Injury ◽  
Contralateral Kidney ◽  
Reactive Protein ◽  
Ureteral Lithiasis ◽  
Unilateral Hydronephrosis ◽  
Duration Of Hospitalization ◽  
History Of

In the literature, occurrence of acute kidney injury (AKI) in young patients with unilateral ureteral lithiasic obstruction and without previous renal impairment is not very often reported, and the underlined pathophysiological mechanisms are poorly known; according to some studies, it is a false kidney failure, the increase in serum creatinine being due to absorbtion of obstructed urine in the affected kidney. We have conducted a retro and prospective study in order to identify the possible risk factors that can cause renal function impairment in young patients (18-40 years) with unilateral ureteral lithiasis obstruction and a normal contralateral kidney. Results. From 402 patients included in the study, 20.64% (83 cases) presented with serum creatinine ] 1.3 mg/dL. In patients with renal impairment, prevalence of male gender and history of NSAIDS use before admission were significantly higher than in non-AKI group. Serum urea/creatinine ratio, and estimated glomerular filtration rate (MDRD formula) were significantly higher, and respectively lower in AKI group. We found no significant differences between the two groups regarding age, prevalence of urinary tract infection after relief of obstruction, C-reactive protein value, and the duration of hospitalization. Conclusions. AKI in young patients with unilateral ureteral lithiasis obstruction and normal contralateral kidney is not quite a rare finding in our region. NSAIDs use can influence development of AKI, and should be used cautiously even in young patients with renal colic. In our opinion, the presence of AKI in patients with unilateral hydronephrosis demands urgent endourological intervention. Choosing conservative therapy in these patients, especially treatment with NSAIDS may aggravate the renal dysfunction.

scholarly journals Faecopneumothorax due to missing diaphragmatic hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder
Keyword(s):  
Computed Tomography ◽  
Diaphragmatic Hernia ◽  
Colon Resection ◽  
Emergency Laparotomy ◽  
Hernia Sac ◽  
Case Presentation ◽  
Abdominal Tenderness ◽  
History Of ◽  
Diaphragmatic Hernias ◽  
Tomography Scan

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

Post-traumatic diaphragmatic hernia

2020 ◽  
Author(s):  
Lorena Cambeiro Cabré ◽  
Eduard M. Targarona Soler ◽  
Carlos Rodríguez-Otero Luppi ◽  
Joan Borràs Marcet
Keyword(s):  
Diaphragmatic Hernia ◽  
Traumatic Diaphragmatic Hernia ◽  
Post Traumatic
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