scholarly journals Pneumoperitoneum due to perforated appendicitis: a rare anatomo-radiologic correlation

2008 ◽  
Vol 21 (3) ◽  
pp. 142-143
Author(s):  
André Luiz Santos Rodrigues ◽  
Marcelino Ferreira Lobato ◽  
Augusto César Santana ◽  
Lucas Crociati Meguins ◽  
Daniel Felgueiras Rolo
Keyword(s):  
Peptic Ulcer ◽  
Severe Sepsis ◽  
Abdominal Pain ◽  
Case Report ◽  
Medical Literature ◽  
Perforated Appendicitis ◽  
Perforated Peptic Ulcer ◽  
Exploratory Laparotomy ◽  
Diffuse Peritonitis ◽  
Diffuse Abdominal Pain

BACKGROUND: Pneumoperitoneum is usually associated with a perforated peptic ulcer. However, perforated appendicits may be evolved on it. In the medical literature, the anatomo-radiologic correlation between them is an uncommon event. CASE REPORT: Man with 56-year-old look for assistance with diffuse abdominal pain and distension associated with fever, vomit and absence of flatus and evacuation for about 14 days. The chest radiography revealed a pneumoperitoneum. Diffuse peritonitis was found during the exploratory laparotomy. Appendectomy, peritoneal cavity cleaning and drainage with tubular drains were carried out. However, severe sepsis occurred and the patient died on the 16th post-operative day with multiple systemic organ failure. CONCLUSION: Although rare as pneumoperitoneum ethiology, acute appendicitis may be thought as it's cause.

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 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 Síndrome de Valentino: una causa no común de abdomen agudo. Reporte de un caso

2020 ◽  
Vol 12 (3) ◽  
pp. 231-235
Author(s):  
Jaime Lenin Veintimilla Hurtado ◽  
Ana Belén Rivas Ullaguari ◽  
Alonso Xavier Quito Becerra ◽  
Viviana Gisela Patiño Cuenca ◽  
Yessica Gabriela Castillo Andrade
Keyword(s):  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Case Reports ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Exploratory Laparotomy ◽  
Peptic Ulcer Perforation ◽  
Successful Recovery

BACKGROUND: Valentino’s syndrome is secondary to a perforated peptic ulcer, which could be located in the stomach or the duodenum, patients present with clinical features that suggest acute appendicitis, with localized peritonitis. There are few case reports about this syndrome worldwide and no one submitted in Ecuador. It is essential to transmit this clinical case for the knowledge of the medical- scientific community. CASE REPORT: A 63-year-old male patient came to the emergency department with abdominal pain, located in the right iliac fossa, that began 12 hours ago, associated to peritoneal irritation signs and hemodynamic decompensation; suggestive of peritonitis. An exploratory laparotomy was performed. EVOLUTION: During exploratory laparotomy, no inflammatory changes were identified in the appendix. After abdominal cavity exploration, a perforated gastric ulcer was found. Primary raffia was stitched in two planes, incidental appendectomy and lavage of the abdominal cavity were performed. The patient had a successful recovery; and was discharged after 7 days at hospitalization. CONCLUSION: The perforation of a peptic ulcer can generate right iliac fossa pain, simulating acute appendicitis due to its clinical similarity. The medical team should consider Valentino’s Syndrome as an important differential diagnosis during the evaluation of a patient that arrives to the emergency room with abdominal pain, suggestive of appendicitis. KEYWORDS: ABDOMINAL PAIN, ILIUM, APPENDICITIS, PEPTIC ULCER PERFORATION, ABDOMEN ACU-TE, PERITONITIS

scholarly journals Hydatid Disease Simulating Acute Abdomen: A Case Report and Brief Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Georgios Lianos ◽  
Georgios Baltogiannis ◽  
Avrilios Lazaros ◽  
Konstantinos Vlachos
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Hydatid Disease ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
The Body ◽  
Parasitic Disease ◽  
Review Of The Literature ◽  
Diffuse Abdominal Pain ◽  
Operating Surgeon

Introduction. Hydatid disease is caused by the tapewormEchinococcus granulosusand is still a matter of public health in many regions of the world, where it is an endemic parasitic disease. Although the liver is the most involved organ, hydatidosis can be found anywhere in the human body. Rare forms of location may lead to diagnostic and therapeutic dilemmas.Case Report. Herein we report a rare case of acute abdominal pain and progressively increasing abdominal distension due to abdominal and multiple splenic echinococcosis in a 72-year-old Caucasian male. We also provide a brief review of the literature.Conclusion. Although hydatid disease is found most often in the liver and lungs, rarely any organ of the body can be involved by this zoonosis. Though rare, the possibility of unusual location of echinococcosis must always be considered by the operating surgeon, when dealing with diffuse abdominal pain in endemic areas, because any misinterpretation may result in unfavorable outcomes.

scholarly journals An unusual case of pediatric abdominal pain

CJEM ◽  
2011 ◽  
Vol 13 (02) ◽  
pp. 133-138 ◽  
Author(s):  
Lars P. Bjoernsen ◽  
M. Bruce Lindsay
Keyword(s):  
Abdominal Pain ◽  
Colonic Obstruction ◽  
Exploratory Laparotomy ◽  
Symptomatic Treatment ◽  
Systematic Evaluation ◽  
White Female ◽  
Symptomatic Therapy ◽  
Regional Lymph Nodes ◽  
Diffuse Abdominal Pain ◽  
Gastrografin Enema

ABSTRACTChronic and recurrent abdominal pains are common complaints in children and adolescents, but the evaluation in the emergency department (ED) can be challenging. We present a rare yet serious case of a 17-year-old white female who presented to the ED with a 2-day history of diffuse abdominal pain, nausea, and intractable vomiting. Abdominal examination and imaging, including computed tomography (CT), were negative during an episode 6 weeks previously. This was her fifth similar episode in a 2-month period, and she had been seen at three different hospitals and admitted on each occasion. Three days prior to presentation to our ED, she was seen at a gastroenterology clinic and diagnosed with irritable bowel syndrome and an ovarian cyst. Symptomatic therapy during the current presentation, with intravenous fluids, antiemetics, and parenteral narcotics, failed to alleviate her abdominal pain and vomiting. Emergent CT evaluation revealed a high-grade colonic obstruction with focal circumferential narrowing in the transverse colon and a lower gastrointestinal follow-through radiograph with Gastrografin enema showed a classic “apple-core” lesion. Colonic adenocarcinoma with positive regional lymph nodes was found during emergent exploratory laparotomy. Pediatric patients with recurrent, episodic abdominal pain should undergo systematic evaluation and symptomatic treatment. A previous negative workup should not dissuade emergency physicians from proceeding with a systematic and thorough evaluation of the pediatric patient presenting with abdominal pain and vomiting.

scholarly journals Emergency surgical management of sub-hepatic appendicular perforation with abscess; rare presentation of a common disease: a case report

2021 ◽  
Vol 9 (11) ◽  
pp. 3478
Author(s):  
S. K. Sekendar Ali ◽  
Narendra Nath Mukhopadhyay
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Clinical Suspicion ◽  
Common Disease ◽  
Emergency Setting ◽  
Atypical Presentation ◽  
Rare Presentation ◽  
High Level

Subhepatic appendicitis is a very rare presentation that has been rarely reported, accounting for 0.01% of acute appendicitis case. It is difficult to diagnose and prime to be aware of variants, manage such challenging case in emergency setting. We present a case of 29 years male patient with subhepatic perforated appendicitis and its sequelae-abscess and peritonitis who underwent an exploratory laparotomy and appendectomy. The initial diagnosis and surgical management of such patients is challenging due to very rare and atypical presentation in emergency setting. A high level of clinical suspicion, promote decision to operate and skillful surgical approach is discussed with briefly.

scholarly journals Small Intestine Obstruction in Patients due to Phytobezoar: Case Report of Four Patients

2016 ◽  
Vol 02 (01) ◽  
pp. 040-043
Author(s):  
V Kumar ◽  
Anupama Pujar ◽  
Ashwini Kudari ◽  
Kush Luthra
Keyword(s):  
Peptic Ulcer ◽  
Case Report ◽  
Perforated Peptic Ulcer ◽  
Definitive Treatment ◽  
Ulcer Disease ◽  
High Fiber ◽  
Fiber Diet ◽  
Barium Examination ◽  
Carcinoma Esophagus ◽  
High Fiber Diet

ABSTRACT Introduction: Bezoars are rare cause of small-bowel obstruction and lead to intraluminal obstruction. The other causes are foreign bodies, gall stones, and enteroliths. Phytobezoars are collection of non-digestible materials, usually of vegetable origin, and are most commonly found in patients with impaired gastric emptying, on high-fiber diet and with abnormal food habits.We present a case report of four patients who presented with acute intestinal obstruction, and the etiology in all these four cases was found to be a phytobezoar. The complaints of diffuse pain abdomen, vomiting, and constipation were common in all four cases. One patient had undergone a gastric pull-up surgery for carcinoma esophagus and one female had undergone bilroth1 for peptic ulcer disease. One patient was a known case of diabetes mellitus and had undergone surgery for perforated peptic ulcer few years back. Conclusion: Diagnosis of bezoars is usually confirmed by barium examination or endoscopy, and definitive treatment is surgery in case of obstruction with the removal of bezoar.

scholarly journals Fulminant Wegener's granulomatosis: A case report

2013 ◽  
Vol 70 (9) ◽  
pp. 887-890 ◽  
Author(s):  
Miroslav Dinic ◽  
Lidija Kandolf-Sekulovic ◽  
Lidija Zolotarevski ◽  
Rados Zecevic
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Systemic Vasculitis ◽  
Bowel Perforation ◽  
Exploratory Laparotomy ◽  
Unknown Etiology ◽  
Diffuse Peritonitis ◽  
Skin Sample ◽  
Skin Ulcers ◽  
Hemorrhagic Bullae

Introduction. Granulomatosis Wegener is anti-neutrophil cytoplasmic antibodies (ANCAs)-associated systemic vasculitis of unknown etiology. It is manifested as granulomatous necrotizing inflammation of the upper and lower parts of the respiratory tract, glomerulonephritis and systemic vasculitis involving most frequently the skin and oral mucous membrane. Sera markers of this disease are c-ANCA and p-ANCA. Case report. We presented a female patient aged 52 years with purpuric spots that had appeared on the lower legs ten months before admission to our hospital. The disease ran an aggressive course, and a month before admission hemorrhagic bullae, skin ulcers, hoarseness, dyspnea, generalized arthralgia, fatigue and fever had rapidly developed. Histopathological examination of a skin sample revealed necrotizing vasculitis, so that sera markers concentrations were elevated (c-ANCA, p-ANCA). There was a perforation of the nasal septum found on rhinoscopy. During hospitalization acute abdominal pain occurred, a possible tumor in the small intestine and possible granulomas in the liver were seen by multislice computed tomography (MSCT) examination, with normal findings on the lungs and kidneys. The treatment started with methylprednisolone: 500 mg/d i.v. infusion for consecutive 3 days, then 60 mg/d. On exploratory laparotomy small bowel perforation and diffuse peritonitis were found. Unstable in the postoperative period, the patient died on the day 12 of hospitalization. Conclusion. The reported patient was with fulminant Wegener?s granulomatosis, dominantly with skin changes and with gastrointestinal manifestation. This case accents the need for rapid systemic clinical evaluation in a severely ill patient with unclear diagnosis.

A Case Report on the Surgical Management of Subhepatic Perforated Appendicitis: A Rare Presentation

2020 ◽  
Author(s):  
Mumin Hakim ◽  
Rania Mostafa ◽  
Mohammed Al Shehri ◽  
Sherif Sharawy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Female Patient ◽  
Surgical Management ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Atypical Presentation ◽  
Review Of Literature ◽  
Rare Presentation ◽  
Case Presentation

Abstract Background: Subhepatic appendicitis is an exceedingly rare presentation accounting for 0.01% of Acute appendicitis. It is of prime importance to be aware of various variants and thereby managing such challenging cases accordingly.Case presentation: We present a middle-aged female patient with subhepatic perforated appendicitis and peritonitis who underwent an exploratory laparotomy and appendectomy.Conclusions: Surgical management of such patients is challenging due to an atypical presentation. The surgical management of such patients is discussed with a brief review of literature.

Acute pancreatitis

2010 ◽  
pp. 2557-2567
Author(s):  
R. Carter ◽  
C.J. McKay
Keyword(s):  
Acute Pancreatitis ◽  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Abdominal Pain ◽  
Serum Amylase ◽  
Perforated Peptic Ulcer ◽  
Upper Limit ◽  
Abdominal Emergencies ◽  
Idiopathic Acute Pancreatitis ◽  
Upper Abdominal

Acute pancreatitis affects 300 to 600 new patients per million population per year and is most commonly caused by gallstones or alcohol, but there are many other causes and associations. Careful imaging reveals that most so-called idiopathic acute pancreatitis is due to small (1–3 mm diameter) gallstones. Diagnosis is made by a combination of a typical presentation (upper abdominal pain and vomiting) in conjunction with raised serum amylase (> × 3 upper limit of normal) and/or lipase (> × 2 upper limit of normal). Several acute abdominal emergencies can mimic acute pancreatitis and may be associated with a raised serum amylase. These include perforated peptic ulcer (particularly perforated posterior gastric ulcer) and acute mesenteric ischaemia. In equivocal cases, a CT scan is indicated in order to exclude other causes and confirm the diagnosis....

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