scholarly journals Intestinal endometriosis: a diagnostic dilemma

2019 ◽  
Vol 8 (3) ◽  
pp. 1139
Author(s):  
Sunil Kumar Juneja ◽  
Satpal Singh Virk ◽  
Saurabh Singla ◽  
Kamal Sachdeva ◽  
Harpreet Kaur ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Gastrointestinal Symptoms ◽  
Integrated Approach ◽  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Intestinal Endometriosis ◽  
True Incidence ◽  
Intestinal Involvement ◽  
Menstruating Women

Background: Endometriosis is a benign gynaecological condition that causes significant morbidity to women of reproductive age group. It uncommonly affects the gastrointestinal tract and acute bowel obstruction is a rare manifestation.Methods: A retrospective observational study was conducted on eight patients.Results: In three patients (37.5%), small intestinal involvement was seen, and colon was involved in five patients (62.5%). One (12.5%) patient presented with complete bowel obstruction while in others partial obstruction of the intestine was seen.Conclusions: Intestinal endometriosis is a diagnostic challenge and should be considered in young menstruating women with gastrointestinal symptoms. Intestinal endometriosis is the most common extra-pelvic site and it is found in 12% of women with endometriosis. The true incidence of endometriosis causing bowel obstruction is unknown. Pre or intraoperative sigmoidoscopy may prove helpful in ruling out malignancy. The gold standard for diagnosis is laparoscopy and biopsy, which allows a full assessment of the pelvis as well as surgical resection if required. The management of endometriosis is an integrated approach of both medical and surgical therapy. Bowel resection is usually undertaken if there are features of obstruction or bleeding, and if there is suspicion of malignancy.

scholarly journals Uterine Epithelioid Trophoblastic Tumor in a 44-Year-Old Woman: A Diagnostic Dilemma

2021 ◽  
Vol 11 (3) ◽  
pp. 631-639
Author(s):  
Maria-Gabriela Aniţei ◽  
Diana-Elena Lazăr ◽  
Raluca Alina Pleşca ◽  
Cristina Terinte ◽  
Radu Iulian ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Natural Childbirth ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor ◽  
Uterine Curettage ◽  
Normal Human ◽  
Poorly Differentiated ◽  
Β Hcg

Background: Epithelioid trophoblastic tumor (ETT) is a rare and newly defined disease, which most commonly occurs in women of reproductive age and can be a sequela of any gestational event. ETT can be present in both intrauterine and extrauterine sites. Case report: A woman of reproductive age, without specific comorbidities and with a single pregnancy and natural childbirth eight years ago, was diagnosed initially with poorly differentiated pleomorphic leiomyosarcoma on the hemostatic uterine curettage. Conclusion: Our case highlights that ETT presents a diagnostic challenge due to its rarity and histologic resemblance to other pathologies. Misdiagnosis delays effective treatment and affects survival. To date, only 8 cases of ETT of the uterus without previous gestational event and normal human chorionic gonadotropin (β-HCG) levels in a 60-year literature survey have been reported.

Endometrioma Causing Near-Complete Obstruction of the Sigmoid Colon

2021 ◽  
pp. 000313482199506
Author(s):  
Kaitlyn Stevens ◽  
Tarik Wasfie ◽  
Carolyn Haus
Keyword(s):  
Sigmoid Colon ◽  
Transvaginal Ultrasound ◽  
Colonic Obstruction ◽  
Gastrointestinal Symptoms ◽  
Rectal Stump ◽  
Muscularis Propria ◽  
Reproductive Age ◽  
Ca 125 ◽  
En Bloc ◽  
Intestinal Endometriosis

Endometriosis is characterized by extra-uterine endometrial gland and stroma implantation. Intestinal endometriosis is believed to affect about one-third of patients with endometriosis 4 ; 72-95% of patients experience recto-sigmoid involvement. 2 , 3 Occasionally, endometriotic lesions precipitate mass effect or infiltrate the bowel wall, mimicking a neoplasm. In the index case, we evaluated a G0P0 41-year-old perimenopausal female with near obstructing sigmoid endometrioma, clinically presented, investigated, and managed in the lines of sigmoid colon carcinoma. Computed Tomography revealed marked distention of the distal descending and proximal sigmoid colon to the level of a [possible] intraluminal mass. CA-125 was 247.4. Transvaginal ultrasound revealed a heterogeneous irregularity adjacent the left adnexa. Flexible sigmoidoscopy to 12-15 cm was unable to pass liquid or visualize the lumen secondary to extrinsic colonic obstruction. She underwent exploratory laparotomy with sigmoidectomy, oversew of rectal stump, and descending colostomy. Left fallopian tube and ovary were adherent to sigmoid mass, therefore, removed en-bloc. Histopathological report revealed extensive endometriosis involving the muscularis propria and serosal surface of colon and ovary, with fibrinous serosal adhesions of the sigmoid colon. While inconsistent clinical presentation, similar radiographic features, and colonoscopy with other inflammatory or malignant lesions of the bowel makes the preoperative diagnosis challenging, colonic endometriosis is to always be considered as one of the differential diagnoses in reproductive age women with patterned, cyclic gastrointestinal symptoms, and intestinal masses of uncertain etiology or diagnosis.

scholarly journals Distal ileal endometriosis as a cause of ileus: A case report

2012 ◽  
Vol 140 (3-4) ◽  
pp. 225-228 ◽  
Author(s):  
Pavle Gregoric ◽  
Krstina Doklestic ◽  
Milena Pandurovic ◽  
Dejan Radenkovic ◽  
Borivoje Karadzic ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Small Bowel Resection ◽  
Reproductive Age ◽  
Intestinal Endometriosis ◽  
Benign Condition ◽  
Acute Small Bowel Obstruction ◽  
Symptoms And Signs

Introduction. Endometriosis is a benign condition affecting females of reproductive age. Although intestinal endometriosis is common, it is rarely manifested as an acute bowel obstruction secondary to ileal endometriosis. Enteric endometriosis should be considered as a differential diagnosis when assessing females of reproductive age with acute small bowel obstruction. Case Outline. A 41-year-old woman presented with symptoms and signs of an acute small bowel obstruction requiring emergency surgery. A small bowel resection was performed with end-to-end anastomosis. Histological examination demonstrated endometriosis with fibrosis and stricture of the ileal segment. This case is important to report as it highlights the diagnostic difficulty this particular condition presents to an emergency surgeon. Conclusion. In the differential diagnosis, endometriosis should be taken into consideration when assessing females of reproductive age who present with abdominal pain and small bowel obstruction.

scholarly journals Submucosal Lesions Presenting With Rectal Bleeding-Endometriosis in the GI Tract

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Fahd Jowhari MD ◽  
Pearl Behl, MD, PhD ◽  
Sean Pritchett, MD, FRCPC
Keyword(s):  
Rectal Bleeding ◽  
Inguinal Canal ◽  
Interesting Case ◽  
Gi Tract ◽  
Diagnostic Challenge ◽  
Intestinal Endometriosis ◽  
Intestinal Involvement ◽  
Submucosal Lesions ◽  
Endometrial Cavity ◽  
Bowel Movements

Endometriosis is typically marked by the implantation and proliferation of foci of endometrial stroma and glands outside the endometrial cavity and uterine musculature. Extra-gonadal seeding has been observed in sites like the small and large bowel, peritoneum, appendix, pleura, umbilicus, old wound scars, subarachnoid space, inguinal canal, heart and lungs.14,7 The gastrointestinal tract is the third most common localization of endometriosis after the ovaries and the peritoneum, with intestinal involvement being reported in about 12 to 37% of individuals.1,2,5-7 Establishing a diagnosis of intestinal endometriosis can often be a diagnostic challenge. We present an interesting case of sigmoidal endometriosis in a 46-year-old female, whose initial presentation was irregular bowel movements with rectal bleeding.

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

scholarly journals Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 387-396
Author(s):  
Sing-Ting Wang ◽  
Chieh-Lung Chen ◽  
Shih-Hsin Liang ◽  
Shih-Peng Yeh ◽  
Wen-Chien Cheng
Keyword(s):  
Acute Myeloid Leukemia ◽  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Myeloid Leukemia ◽  
Diagnostic Yield ◽  
Leukemic Cells ◽  
Pleural Effusions ◽  
Diagnostic Dilemma ◽  
True Incidence ◽  
Acute Myeloid

Abstract Pleural effusions are rarely observed in association with acute myeloid leukemia (AML), and their true incidence remains unknown. Given the low diagnostic yield from cytopathologic analysis of malignant pleural effusions and the fact that patients with leukemia are often thrombocytopenic and unable to tolerate invasive procedures, the incidence of leukemic effusions may be underestimated. Here, we report a rare case of pleural effusion in a patient with newly diagnosed AML. Initial analysis revealed an exudative, lymphocyte-predominant effusion. High levels of adenosine deaminase (ADA) were detected in pleural fluid, consistent with a diagnosis of tuberculosis. However, the analysis of pleural cytology revealed leukemic cells, permitting the diagnosis of leukemic effusion to be made. The patient underwent induction chemotherapy and pleural effusion resolved without recurrence. This case emphasizes the diagnostic dilemma presented by high levels of ADA in a leukemic pleural effusion, as this association has not been previously considered in the literature.

scholarly journals Ovarian Dysgerminoma in Pregnant Women with Viable Fetus: A Rare Case Report

2021 ◽  
pp. 141-146
Author(s):  
Reda Youssef ◽  
Gamal Sayed Ahmed ◽  
Samir Alhyassat ◽  
Sanaa Badr ◽  
Ahmed Sabry ◽  
...  
Keyword(s):  
Gestational Age ◽  
Ovarian Neoplasms ◽  
Imaging Modality ◽  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Short Period ◽  
Ovarian Dysgerminoma ◽  
The Impact ◽  
In Pregnancy

Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2–1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.

scholarly journals Endometriosis Mimicking a Cecum Mass with Complete Bowel Obstruction: An Infrequent Cause of Acute Abdomen

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Gabriel A. Molina ◽  
Darwin R. Ramos ◽  
Alberto Yu ◽  
Patricio A. Paute ◽  
Paul S. Llerena ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Preoperative Diagnosis ◽  
Malignant Tumors ◽  
Signs And Symptoms ◽  
Final Diagnosis ◽  
Intestinal Involvement ◽  
History Of ◽  
Ovarian Abscess ◽  
Fertile Women

Endometriosis is a common entity among fertile women which unfortunately manifests through variable symptomatology. Intestinal involvement in endometriosis is quite common and can simulate several diseases such as Crohn’s disease, appendicitis, tubo-ovarian abscess, or malignant tumors. Intestinal obstruction due to endometriosis is rare, and preoperative diagnosis is difficult because the signs and symptoms are nonspecific and can be easily confused. In the case of patients without a history of endometriosis, diagnosis is further complicated. We present a case of a 41-year-old female patient. She presented to the emergency room with complete bowel obstruction and a mass in the cecum. Surgery was decided, and the patient underwent full recovery. Endometriosis was the final diagnosis for the observed condition.

scholarly journals Benign Osteoblastoma Involving Maxilla: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
K. Bokhari ◽  
M. S. Hameed ◽  
M. Ajmal ◽  
Rafi A. Togoo
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Long Term Follow Up ◽  
Rare Benign Tumor ◽  
Benign Osteoblastoma ◽  
Maxilla And Mandible

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma.Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free.Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

scholarly journals A case of colonic gallstone ileus with a spontaneous evacuation

1970 ◽  
Vol 9 (1) ◽  
pp. 47-49 ◽  
Author(s):  
A Bajracharya ◽  
OP Pathania ◽  
S Adhikary ◽  
CS Agrawal
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Gallstone Ileus ◽  
Abdominal Distension ◽  
The Elderly ◽  
Large Bowel Obstruction ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
History Of ◽  
Spontaneous Evacuation

Colonic gallstone is an uncommon entity with a high morbidity and mortality due to various reasons. It remains a diagnostic challenge because of delayed and non-specific presentations, especially in the elderly population, often with multiple co-morbidities. We present a case of colonic gallstone ileus with spontaneous evacuation in a 67 years female who had a threeday history of intermittent bouts of colicky abdominal pain, vomiting , constipation and progressive abdominal distension, features of large bowel obstruction treated non operatively for 72 hours and passage of the stone spontaneously. Keywords: gallstone ileus; large bowel obstruction; colonic gallstone DOI: 10.3126/hren.v9i1.4363Health Renaissance, 2011: Vol.9 No.1:47-49

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