scholarly journals Tension pneumoperitoneum: a very rare complication of acute gangrenous appendicitis

2016 ◽  
Vol 98 (8) ◽  
pp. e197-e199 ◽  
Author(s):  
P Das ◽  
R Mukherjee ◽  
D Pathak ◽  
A Gangopadhyay ◽  
S Halder ◽  
...  
Keyword(s):  
Rare Complication ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Hemodynamic Instability ◽  
Gangrenous Appendicitis ◽  
Free Air ◽  
Tension Pneumoperitoneum ◽  
Emergency Measure ◽  
Intraperitoneal Free Air ◽  
Needle Decompression

Tension pneumoperitoneum is a very rare consequence of acute gangrenous appendicitis. We report a case of a 32-year-old woman who presented with abdominal pain, progressively increasing abdominal distension, profound hemodynamic instability and ventilatory compromise. The diagnosis of tension pneumoperitoneum was confirmed by computed tomography, which showed compression of the intra-abdominal viscera and liver (saddlebag sign) by a large volume of intraperitoneal free air. Urgent needle decompression was done as an emergency measure. Exploratory laparotomy, planned due to persistent peritonitis, revealed gangrenous appendicitis with perforation near its base. Appendicectomy with excision of gangrenous portion of caecum was performed. The purpose of the reporting this case is to highlight that the tension pneumoperitoneum can be, very rarely, associated with gangrenous appendicitis and timely diagnosis is very important for the emergency management of this deadly condition.

scholarly journals Postpolypectomy Electrocoagulation Syndrome: A Mimicker of Colonic Perforation

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Brian C. Benson ◽  
Jonathan J. Myers ◽  
Jeffrey T. Laczek
Keyword(s):  
Abdominal Pain ◽  
Transverse Colon ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Ct Imaging ◽  
Colonic Perforation ◽  
Colon Wall ◽  
Free Air

Postpolypectomy electrocoagulation syndrome is a rare complication of polypectomy with electrocautery and is characterized by a transmural burn of the colon wall. Patients typically present within 12 hours after the procedure with symptoms mimicking colonic perforation. Presented is the case of a 56-year-old man who developed abdominal pain six hours after colonoscopy during which polypectomy was performed using snare cautery. CT imaging of the abdomen revealed circumferential thickening of the wall of the transverse colon without evidence of free air. The patient was treated conservatively as an outpatient and had resolution of his pain over the following four days. Recognition of the diagnosis and understanding of the treatment are important to avoid unnecessary exploratory laparotomy or hospitalization.

scholarly journals Isolated tension pneumoperitoneum following endobronchial ultrasound-guided transbronchial needle aspiration complicated by cardiac peri-arrest: A case report

2018 ◽  
Vol 88 (3) ◽  
Author(s):  
Piergiorgio Muriana ◽  
Angelo Carretta ◽  
Paola Ciriaco ◽  
Francesca Rossetti ◽  
Giampiero Negri
Keyword(s):  
Lung Cancer ◽  
Abdominal Distension ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Contrast Study ◽  
Transbronchial Needle Aspiration ◽  
Free Air ◽  
Tension Pneumoperitoneum ◽  
Hemodynamic Improvement ◽  
Total Body

Transbronchial needle aspiration under endobronchial ultrasound guidance (EBUS-TBNA) is recommended for the diagnosis and staging of lung cancer. Major complications following EBUS-TBNA are uncommon. We report a case of isolated tension pneumoperitoneum following EBUS-TBNA under deep sedation in an 80-year-old male patient affected by a right hilar mass suspicious for lung cancer. At the end of the procedure, the patient suddenly manifested desaturation, severe bradycardia and hypotension, and abdominal distension. After resuscitation, in the suspect of intraperitoneal free air, needle decompression led to respiratory and hemodynamic improvement. A total body CT-scan showed isolated pneumoperitoneum without signs of gastrointestinal perforation, confirmed by a subsequent upper digestive contrast study. The patient recovered well without the need of surgical exploration. Isolated tension pneumoperitoneum can be an exceptional complication of EBUS-TBNA; a conservative treatment can avoid unnecessary surgery in the absence of peritonism.

Rare complication of adenomyosis: acute purulent peritonitis and septicaemia in a young nulligravida

2021 ◽  
Vol 14 (11) ◽  
pp. e238374
Author(s):  
Kameshwarachari Pushpalatha ◽  
Ruchi Kalra ◽  
Bharti Singh ◽  
Anusha Devalla
Keyword(s):  
Indian Subcontinent ◽  
Rare Complication ◽  
Ventilatory Support ◽  
Stable Condition ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Purulent Peritonitis ◽  
Multiparous Women ◽  
Life Threatening ◽  
Upper Gastrointestinal Tract Endoscopy

Adenomyosis is a benign gynaecological condition in multiparous women during their middle age commonly presenting as pelvic pain and menorrhagia. We report a case of a 27-year-old nulligravida of Asian origin from the Indian subcontinent who presented with a huge adenomyotic uterus with mild splenomegaly, and portal cavernoma having gross ascites that developed life-threatening peritonitis and septicaemia. Endometrial aspiration done showed no atypia or malignancy and upper gastrointestinal tract endoscopy done showed no dilated varices. With increasing abdominal distension, she developed tachycardia, tachypnoea, septicaemia and oliguria. Exploratory laparotomy done revealed purulent loculi, omentum and bowel adhesion around the uterus. Adnexa was not distinctly identifiable. Hysterectomy with left salpingo-oopherectomy was performed. She required ventilatory support and intensive unit care postoperatively. Histopathology examination showed adenomyosis with suppuration, right ovary endometriotic cyst and left ovary non-specific inflammation. The patient was discharged in stable condition on day 21. Adenomyosis may rarely occur in young nulligravida women as life-threatening manifestations with purulent peritonitis and septicaemia. Early exploration is crucial for diagnosis and recovery.

Tension Pneumoperitoneum Following Attempted Pneumatic Reduction of Intussusception

2020 ◽  
pp. 000313482097336
Author(s):  
Rajavi S. Parikh ◽  
Timothy Weiner ◽  
Jeffrey Dehmer
Keyword(s):  
Surgical Management ◽  
Rare Complication ◽  
Hemodynamic Instability ◽  
Positive Outcome ◽  
Pneumatic Reduction ◽  
Tension Pneumoperitoneum ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
High Index Of Suspicion ◽  
Emergent Laparotomy

Tension pneumoperitoneum is a life-threatening complication of pneumatic reduction for intussusception if not immediately recognized and treated. We describe a 3-month-old woman who presented with intussusception, underwent attempted pneumatic reduction, and subsequently developed tension pneumoperitoneum with associated hemodynamic instability requiring emergent laparotomy. This is a known, rare complication of pneumatic reduction which highlights the need to have a high index of suspicion for early surgical management to obtain a positive outcome.

scholarly journals Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 73-75
Author(s):  
R Hamid ◽  
AH Shera ◽  
NA Bhat ◽  
A Baba ◽  
A Rashid
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Transverse Colon ◽  
Late Onset ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Colonic Stenosis ◽  
Colonic Atresia ◽  
Mucous Fistula

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446   J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75  

scholarly journals Spontaneous pneumoperitoneum with duodenal diverticulosis in an elderly patient: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takeshi Ueda ◽  
Tetsuya Tanaka ◽  
Takashi Yokoyama ◽  
Tomomi Sadamitsu ◽  
Suzuka Harada ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Abdominal Cavity ◽  
Vital Signs ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Case Presentation ◽  
Free Air ◽  
Spontaneous Pneumoperitoneum ◽  
Upper Abdominal ◽  
Emergent Laparotomy

Abstract Background Pneumoperitoneum commonly occurs as a result of a viscus perforation and usually presents with peritoneal signs requiring emergent laparotomy. Spontaneous pneumoperitoneum is a rare condition characterized by intraperitoneal gas with no clear etiology. Case presentation We herein report a case in which conservative treatment was achieved for an 83-year-old male patient with spontaneous pneumoperitoneum that probably occurred due to duodenal diverticulosis. He had stable vital signs and slight epigastric discomfort without any other signs of peritonitis. A chest radiograph and computed tomography showed that a large amount of free gas extended into the upper abdominal cavity. Esophagogastroduodenoscopy showed duodenal diverticulosis but no perforation of the upper gastrointestinal tract. He was diagnosed with spontaneous pneumoperitoneum, and conservative treatment was selected. His medical course was uneventful, and pneumoperitoneum disappeared after 6 months. Conclusion In the management of spontaneous pneumoperitoneum, recognition of this rare condition and an accurate diagnosis based on symptoms and clinical imaging might contribute to reducing the performance of unnecessary laparotomy. However, in uncertain cases with peritoneal signs, spontaneous pneumoperitoneum is difficult to differentiate from free air resulting from gastrointestinal perforation and emergency exploratory laparotomy should be considered for these patients.

scholarly journals ADENEXAL CYSTS

2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami
Keyword(s):  
Demographic Data ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Risk Of Malignancy ◽  
Histopathologic Evaluation ◽  
Operative Findings

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.

scholarly journals Bilateral ovarian dysgerminoma with metastasis in female dog's mesenteric lymph node: a case report

2021 ◽  
Vol 1 (2) ◽  
pp. 32-41
Author(s):  
Edgar Tavares de Assis-Neto ◽  
Daniel de Araújo Viana ◽  
Márcio César Vasconcelos Silva
Keyword(s):  
Lymph Node ◽  
Histopathological Examination ◽  
Present Report ◽  
Malignant Neoplasm ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Incisional Biopsy ◽  
Mesenteric Lymph ◽  
Chemotherapy Protocol ◽  
Ovarian Dysgerminoma

Dysgerminoma is a rare malignant neoplasm, associated with hormonal dysfunctions, which occurs in canine and feline females from middle age to elderly, without racial predisposition. In the present report, we described a case of ovarian dysgerminoma in a dog, only abdominal distension, persistent vulvar bloody discharge and apathy. The animal in question underwent exploratory laparotomy, where general neoformations were detected in the ovaries, and a lymph node with abnormal characteristics was also found. Therefore, surgery for ovariosalpingoisterectomy and puncture of a fragment of the lymph node altered for incisional biopsy was performed. The diagnosis was made through histopathological examination of the ovaries of the fragment derived from the lymph node, the result of which indicated the presence of dysgerminoma in both ovaries and in the lymph node, characterizing a metastasis. In view of this result, the chemotherapy protocol with the association of carboplatin and vinblastine was instituted, which proved to be effective and not very toxic to the animal, with no clinical sign of metastasis being identified after its use.

scholarly journals Mysterious Gelly Belly: a Case Report of Pseudomyxoma Peritonei and Literature Review

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Pseudomyxoma Peritonei ◽  
Clinical Condition ◽  
Imaging Techniques ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Primary Site ◽  
Diffuse Abdominal Pain

Pseudomyxoma peritonei (PMP) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumors. Although appendix has usually been implicated as the primary site, some reports found no cause. This case also describes a PMP with no identifiable primary site. A 52-year-old male presented with an abdominal distension evolving for 3 months associated with diffuse abdominal pain, imaging techniques objective intra peritoneal mucoid materials with septated ascites but it failed to identify the primary site. Exploratory laparotomy with Biopsy confirmed PMP but also failed to found the original site.

scholarly journals Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mahendra Singh ◽  
Lovekesh Kumar ◽  
Rajkumar Chejara ◽  
Om Prakash Prasad ◽  
Yuvraj Kolhe ◽  
...  
Keyword(s):  
Low Frequency ◽  
Surgical Excision ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Complete Surgical Excision ◽  
Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

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