scholarly journals Think beyond ascites

2019 ◽  
Vol 7 (11) ◽  
pp. 4361
Author(s):  
Prarthana Kalgaonkar ◽  
Minal Wade ◽  
Anupama Mauskar
Keyword(s):  
Surgical Intervention ◽  
Abdominal Distension ◽  
Female Child ◽  
Successful Outcome ◽  
Mesenteric Cyst ◽  
Clinical Scenario ◽  
Chylous Mesenteric Cyst ◽  
Rule Out

In children with gross, persistent ascites wherein clinical scenario is not agreeable to common conditions, one needs to revise the diagnosis and rule out the surgical cause for abdominal distension mimicking ascites. We are reporting here, a case of two year old female child who presented with abdominal distension, clinically suggestive of ascites and subsequently diagnosed to have a large chylous mesenteric cyst which was determined on biochemical investigations, imaging and confirmed on surgical intervention. She was managed surgically with successful outcome.

Management of pneumatosis intestinalis in children over the age of 6 months: a conservative approach

2017 ◽  
Vol 103 (4) ◽  
pp. 352-355 ◽  
Author(s):  
Leel Nellihela ◽  
Mohamed Mutalib ◽  
David Thompson ◽  
Kammermeier Jochen ◽  
Manasvi Upadhyaya
Keyword(s):  
Surgical Intervention ◽  
Incidental Finding ◽  
Pneumatosis Intestinalis ◽  
Abdominal Distension ◽  
Successful Outcome ◽  
Bowel Ischaemia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Peroxisomal Biogenesis ◽  
Asymptomatic Individuals

BackgroundPneumatosis intestinalis (PI) is an uncommon and poorly understood condition. Although it can be an incidental finding in asymptomatic individuals, it can also be secondary to life-threatening bowel ischaemia and sepsis. In premature infants, it is a pathognomonic sign of necrotising enterocolitis. There is no consensus regarding management and long-term outcome of children with PI.AimReview of our experience of PI in children beyond the early infantile period.MethodsRetrospective review of patient’s records and radiological images from 2013 to 2015.ResultsEighteen patients (three girls) had radiologically confirmed PI. The median age was 4.5 years (range 8 months–13 years). Background medical conditions (number): short bowel syndrome (one), congenital heart disease (two), sickle cell disease (one), epilepsy (three), cerebral palsy (six), myotonic dystrophy (four) and peroxisomal biogenesis defect (one).Six children (33%) presented with abdominal distension, four (22%) with abdominal pain, three (17%) with bilious vomiting, two (11%) with diarrhoea and one (6%) with rectal bleeding. Two (11%) were asymptomatic. One had air in portal vein and two had pneumoperitoneum.All patients with symptomatic PI were treated conservatively with successful outcome and complete resolution of PI. None required surgical intervention.ConclusionPI in children who are not on chemotherapy or immunosuppressant appears to follow a benign course and is responsive to conservative management. In contrast to adults, portal venous gas and pneumoperitoneum do not predict the need for surgical intervention.

scholarly journals Large intra-abdominal dermoid cyst presenting as small bowel volvulus

2017 ◽  
Vol 4 (9) ◽  
pp. 3188 ◽  
Author(s):  
Suneed Kumar ◽  
Gurudutt Varty
Keyword(s):  
Small Bowel ◽  
Dermoid Cyst ◽  
Surgical Intervention ◽  
Abdominal Distension ◽  
Cystic Mass ◽  
Lower Abdomen ◽  
Small Bowel Volvulus ◽  
Abdominal Emergencies ◽  
Acute Small Bowel Obstruction ◽  
Uncommon Location

Intestinal obstruction is one of the commonest abdominal emergencies requiring surgical intervention. Among its numerous causes, volvulus of the small and large bowel plays a less common aetiological role. This is a rare case of a large intra-abdominal dermoid cyst causing small bowel volvulus and presenting as obstruction. 46-year-old male presented with four-day history suggestive of acute small bowel obstruction, with gross abdominal distension on examination. With minimal investigations, he was explored to reveal a large 10×8 cm sized cystic mass in lower abdomen, with two vascular pedicles causing twisting of small bowel and resultant obstruction. Surgical intervention included unwinding of viable bowel, dividing pedicles and excision of the mass. The cyst was found to contain pultaceous material with hair and solid components. Patient tolerated the procedure well and was asymptomatic on discharge and subsequent follow-ups. This case illustrates an uncommon cause of a common presentation; an uncommon location of a relatively common cystic swelling; and the diagnostic surprise that was encountered during the management, thereby reiterating the need for keen observation and clinical acumen while dealing with such cases.

scholarly journals Surgical ventricular reconstruction and subendocardial resection for the treatment of refractory ventricular tachycardia

2014 ◽  
Vol 96 (8) ◽  
pp. e26-e27
Author(s):  
NA Ismail ◽  
J Bence ◽  
TJ Spyt
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Medical Treatment ◽  
Female Patient ◽  
Acute Heart Failure ◽  
Surgical Intervention ◽  
Clinical Scenario ◽  
Surgical Ventricular Reconstruction ◽  
Ventricular Reconstruction

We describe a case of 64-year-old female patient with ventricular tachycardia intractable to medical treatment and acute heart failure following myocardial infarction. Emergency surgical ventricular reconstruction and subendocardial resection was undertaken. We discuss the option of surgical intervention in this difficult and unusual clinical scenario.

scholarly journals Chronic osteomyelitis by Aeromons hydrophilal: A silent cause of concern

2017 ◽  
Vol 9 (04) ◽  
pp. 337-339 ◽  
Author(s):  
Sonu Agrawal ◽  
Geetika Sharma ◽  
Deepankar Srigyan ◽  
Hira L. Nag ◽  
Arti Kapil ◽  
...  
Keyword(s):  
Lower Limb ◽  
Surgical Intervention ◽  
Chronic Osteomyelitis ◽  
Successful Outcome ◽  
Management Approach ◽  
Pathogen Identification ◽  
Negative Bacillus ◽  
First Case ◽  
Delayed Complication ◽  
Antimicrobial Administration

Abstract Aeromonas is a Gram-negative bacillus, widely found in aquatic environment. Osteoarticular pathology caused by AeromonA. hydrophilal is rarely encountered. To the best of our knowledge, this is the first case of chronic osteomyelitis by A. hydrophilal reported from India. We report a case of chronic osteomyelitis of the lower limb due to A. hydrophilal, which occurred as a delayed complication following open reduction and internal fixation. Prompt medical and surgical intervention supplemented by a comprehensive microbiological workup aided in pathogen identification and specific antimicrobial administration resulting in the successful outcome of our patient. This case illustrates the utility of multidisciplinary management approach involving microbiologists and orthopedicians in investigating and appropriately managing such cases.

scholarly journals Pregnancy outcome of a patient following myomectomy performed during first trimester for red degeneration of fibroid

2016 ◽  
Vol 6 (1) ◽  
pp. 69
Author(s):  
Asma Habib ◽  
Shahla Khatun ◽  
Nafisa Khanum
Keyword(s):  
Surgical Intervention ◽  
First Trimester ◽  
Female Child ◽  
Clinical Findings ◽  
Lower Segment ◽  
Early Gestation ◽  
Lower Segment Caesarean Section ◽  
Healthy Female ◽  
The Common ◽  
Red Degeneration

Pain due to red degeneration of fibroid during pregnancy is usually associated with large myomas. Necrobiosis / red degeneration typically manifests itself about midpregnancy when Lhe leiomyoma suddenly becomes acutely painful, enlarged and tender. The common differential diagnosis of this condition are torsion of the pedicle of an ovarian cyst/a leiomyoma, abruplion placentae, acute pyelitis or any abdominal catastrophe. Ultrasound can easily delineate the presence of myomas of mixed echogenicity along with pregnancy and clinical findings usually suggest the diagnosis of pregnancy complicated by red degeneration of fibroid. The acute pain usually subsides within 3-10 days of conservative treatment. Only refractory cases (2% of patients) may demand surgical intervention in early gestation with the known risk of miscarriage. Here we report a pregnancy managed at 13 weeks by myomectomy for red degeneration. The patient ultimately delivered a healthy female child at 38 weeks by lower segment caesarean section.

scholarly journals Spontaneous heterotopic pregnancy with tubal rupture

2017 ◽  
Vol 6 (11) ◽  
pp. 5148 ◽  
Author(s):  
Spandana J. C. ◽  
Suresh S. Kanakannavar ◽  
Umashankar K. M. ◽  
Manuja N.
Keyword(s):  
Maternal Morbidity ◽  
Surgical Intervention ◽  
Heterotopic Pregnancy ◽  
Successful Outcome ◽  
Intrauterine Pregnancy ◽  
Pregnant Females ◽  
Maternal Morbidity And Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ultrasound Assessment

Heterotopic pregnancy is the coexistence of intrauterine pregnancy (IUP) and extrauterine gestation. It is a rare and dangerous life-threatening condition that is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. We report a case of a 24-year-old multigravida who was seen in the emergency department with a diagnosis of a ruptured ectopic pregnancy. A careful ultrasound assessment led to the diagnosis of a heterotopic pregnancy despite lack of any notable risk factors. Immediate surgical intervention with supportive measures resulted in a successful outcome. An obstetrician should keep in mind the occurrence of a heterotopic pregnancy while dealing with pregnant females. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

scholarly journals Laparoendoscopic Transgastric Resection of Prepyloric Gastrointestinal Stromal Tumor

2019 ◽  
Vol 14 (1) ◽  
pp. 66-68 ◽  
Author(s):  
Nandita Nettu Mahajan ◽  
Sajan Jiv Singh Nagpal ◽  
Louis M. Wong Kee Song ◽  
Shanda H. Blackmon
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Gastrointestinal Stromal Tumor ◽  
Multidisciplinary Approach ◽  
Surgical Intervention ◽  
Optimal Treatment ◽  
Stromal Tumor ◽  
Successful Outcome ◽  
Diagnostic Studies ◽  
Coffee Ground

This case report describes an 83-year-old woman with multiple comorbidities who presented with melena and coffee-ground emesis with diagnostic studies evident for a large prepyloric gastrointestinal stromal tumor. She underwent combined laparoendoscopic transgastric resection surgery for the tumor, performed by a team of gastroenterologist and thoracic surgeon with a successful outcome. The case and videos in this report provide a descriptive demonstration of the steps leading up to the surgical intervention followed by a step-by-step illustration of the combined surgical technique, thus highlighting the importance of multidisciplinary approach for optimal treatment of prepyloric gastrointestinal stromal tumor.

scholarly journals Laparoscopic Nephroureterectomy for Adult Patient with Primary Obstructive Megaureter

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Kimito Osaka ◽  
Kazuhide Makiyama ◽  
Shinji Ohtake ◽  
Hiroyuki Yamanaka ◽  
Futoshi Sano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Renal Function ◽  
Surgical Intervention ◽  
Abdominal Distension ◽  
Retrograde Pyelography ◽  
Ureteral Catheter ◽  
Large Size ◽  
History Of ◽  
Obstructive Megaureter ◽  
Laparoscopic Nephroureterectomy

A 29-year-old female with a complaint of abdominal distension was referred to our hospital. She had a history of being treated for pyelonephritis three times. By computed tomography and retrograde pyelography, she was diagnosed with adult left primary megaureter. Her left renal function was severely deteriorated. She hoped for surgical intervention before becoming pregnant. Laparoscopic nephroureterectomy for megaureters seems to be difficult due to the large size. By sucking urine from an inserted ureteral catheter and setting trocar positions, we successfully performed laparoscopic nephroureterectomy for megaureter.

scholarly journals Cystic intra-abdominal masses in children

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Luisa Ferrero ◽  
Riccardo Guanà ◽  
Giulia Carbonaro ◽  
Maria Grazia Cortese ◽  
Luca Lonati ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
Abdominal Ultrasound ◽  
Mesenteric Cyst ◽  
Diagnostic Tools ◽  
Surgical Approaches ◽  
Radical Excision ◽  
Palpable Mass ◽  
Abdominal Masses

Benign intra-abdominal cystic masses in infancy are fairly uncommon and their etiopathogenesis, histology and clinical presentation differ significantly. Our aim is to report our experience in their treatment in order to discuss the best diagnostic and treatment modality. The medical records of 5 children (2M, 3F) with cystic intraabdominal masses referred to our hospital between November 2012 and September 2016, were retrospectively reviewed. All patients underwent open surgery and subsequent histopathologic analysis. Different clinical presentations, localizations of the masses, diagnostic tools, surgical approaches, histological examinations and outcomes were reviewed. Patients mean age was 5.4 years (range: 8 months-9 years). Two patients presented recurrent abdominal pain and abdominal distension; 1 patient had a palpable mass discovered incidentally and 2 complained acute abdominal pain. Routine laboratory tests, tumor markers and abdominal ultrasound were immediately done in all patients. Three patients underwent MRI and 1 abdominal CT. At laparotomy 2 hepatic cysts, 2 mesenteric cyst and 1 retroperitoneal cyst were discovered. Histology reports described: 1 hepatobiliary cystadenoma, 1 benign hepatic hamartoma and 3 cystic lymphangiomas (1 retroperitoneal and 2 mesenteric). There were no major postoperative complications, deaths, or recurrences in our series (follow-up 3-24 months). Despite the rarity of these lesions, benign cystic abdominal masses in children are not so uncommon and should be considered as causes of acute abdominal pain. The differential diagnosis is not always possible preoperatively. In our series, radical excision of the lesions was possible in all cases, allowing reliable histological results and avoiding recurrences.

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