Ectopic lumbar kidney: a rare presentation

Ectopic kidney is a rare developmental anomaly. Such kidneys may be asymptomatic or present with vague symptoms or remain unknown during the lifetime. Early detection and recognition of an ectopic kidney can prevent long-term complications. We report a 70-year-old lady with ectopic right kidney who presented with intermittent episodes of lower abdominal pain since one month 1 month. On clinical evaluation a tender lump was palpable in the right lower quadrant of the abdomen. Sonography revealed empty right renal fossa with normally present left kidney. A mass was detected in the right lower abdomen, with probability of ectopic kidney. Further, Multislice computed tomography with 3-D reconstruction demonstrated ectopic right kidney at the level of L4 to L5 lumbar vertebrae. Urine examination revealed pyuria. The patient was managed on empirical antibiotics for UTI with supportive and symptomatic therapy. On the next day, clinically the lump regressed significantly (Dietl's crises) in size, and the tenderness also reduced. The urine culture report grew Escherichia coli. Patients presenting with lower abdominal pain, and a palpable lump in the lower abdomen, one must include ectopic kidney in the differential diagnosis.

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Pyometra: An Atypical Cause of Abdominal Pain

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211022481 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110224

Author(s):

Leonidas Walthall ◽

Marc Heincelman

Keyword(s):

Abdominal Pain ◽

Vaginal Discharge ◽

Elderly Women ◽

Lower Abdominal Pain ◽

Endometrial Biopsy ◽

Laboratory Evaluation ◽

Inpatient Service ◽

Gynecologic Malignancy ◽

Intravenous Contrast ◽

Lower Quadrant

Pyometra, a purulent infection of the uterus, is a rare cause of a very common complaint—abdominal pain. Risk factors include gynecologic malignancy and postmenopausal status. The classically described presentation includes abdominal pain, fever, and vaginal discharge. In this article, we present an atypical presentation of nonperforated pyometra in an 80-year-old female who was admitted to the internal medicine inpatient service. She initially presented with nonspecific subacute right lower quadrant abdominal pain. Physical examination did not demonstrate vaginal discharge. Laboratory evaluation failed to identify an underlying etiology. Computed tomography scan of the abdomen and pelvis with oral and intravenous contrast demonstrated a 6.5 × 6.1 cm cystic containing structure within the uterine fundus, concerning for a gynecologic malignancy. Pelvis ultrasound confirmed the mass. Endometrial biopsy did not reveal underlying malignancy, but instead showed frank pus, leading to the diagnosis of pyometra. This report illustrates that pyometra should be considered in the differential diagnosis of lower abdominal pain in elderly women.

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Intestinal obstruction caused by pericecal internal herniation

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa003 ◽

2020 ◽

Vol 2020 (2) ◽

Author(s):

Floris B Poelmann ◽

Ewoud H Jutte ◽

Jean Pierre E N Pierie

Keyword(s):

Abdominal Pain ◽

Intestinal Obstruction ◽

Acute Abdominal Pain ◽

Treatment Preference ◽

Treatment Modalities ◽

Internal Herniation ◽

Lower Quadrant ◽

Surgical History ◽

The Right ◽

Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

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Appendicitis: a rare adverse event in colonoscopy

BMJ Case Reports ◽

10.1136/bcr-2021-242523 ◽

2021 ◽

Vol 14 (7) ◽

pp. e242523

Author(s):

Samer Al-Dury ◽

Mohammad Khalil ◽

Riadh Sadik ◽

Per Hedenström

Keyword(s):

Emergency Department ◽

Adverse Event ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Physical Examination ◽

De Novo ◽

Perforated Appendicitis ◽

Lower Quadrant ◽

The Right ◽

Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

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Thrombophlebitis of the Right Renal Capsular Vein during the Early Postpartum Period

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/3096468 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Koji Nakamura ◽

Kensuke Nakanishi ◽

Satoshi Kubota ◽

Ryoko Takahashi ◽

Mari Tomiie ◽

...

Keyword(s):

Abdominal Pain ◽

Postpartum Period ◽

Anticoagulation Therapy ◽

Lower Abdominal Pain ◽

Postpartum Woman ◽

Ovarian Vein ◽

Early Postpartum Period ◽

Early Postpartum ◽

The Right ◽

Contrast Ct

Venous thrombophlebitis is an uncommon cause of fever and lower abdominal pain during the early postpartum period. It mostly occurs in the right ovarian vein, and computed tomography (CT) is useful for diagnosis. We present a case of thrombophlebitis of the renal capsular vein. A 27-year-old postpartum woman presented with right lower abdominal pain and fever unresponsive to antibiotics. Contrast CT showed a ring-enhancing mass in the right retroperitoneum, which was distinct from the right ovarian vein. Exploratory laparoscopy revealed a retroperitoneal hematoma and normal appendix. Reconstruction of CT images revealed that the mass was connected to the right renal capsular vein. Anticoagulation therapy improved the patient’s symptoms. Postpartum thrombophlebitis can occur at locations other than the ovarian vein, such as the renal capsular vein. If a retroperitoneal mass is discovered during puerperium, a thorough investigation of the mass’s continuity with surrounding vessels is essential to avoid unnecessary surgery.

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LAPAROSCOPY;

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.01.1938 ◽

2012 ◽

Vol 19 (01) ◽

pp. 033-039

Author(s):

NAZIA MUSSARAT ◽

SIAMA QURESHI ◽

AWAIS SHUJA ◽

Mehnaaz Roohi

Keyword(s):

Abdominal Pain ◽

Gold Standard ◽

Open Surgery ◽

Diagnostic Laparoscopy ◽

Data Entry ◽

Lower Abdominal Pain ◽

Descriptive Study ◽

Lower Abdomen ◽

Patient Case ◽

Polycystic Ovarian Disease

Introduction: Diagnostic Laparoscopy is considered to be the gold standard for the evaluation of the pelvis and is considered asafe procedure. Diagnostic Laparoscopy is a technique in the routine investigation and treatment of infertility as well as other gynecologicalproblems. Objectives: To determine, Laparoscopic findings in different gynecological conditions, different causes of infertility andcomplications of laparoscopy Design: Retrospective, descriptive study. Material And Methods: We reviewed case records of all patients whounderwent laparoscopy for their different Gynecological problems. Data were collected from patient case records in a data entry sheet Results:In our study a total of Thirty patients under went laparoscopy for investigation of different gynecological problems. There were 17 patients whohave primary infertility and 6 have secondary infertility while 7 presented with Lower abdominal pain. In our study the leading cause of primaryinfertility was Polycystic Ovarian Disease(29%).Other causes were bilateral tubal blockade (23.53 %) ,17% has PID and fibroid uteri, While onepatients shown Endometriosis as well as one patient had no obvious pathology.(5.88 %).On laparoscopic examination of secondaryinfertility 50% shown Tubal blocked while 16.67 shown Fibroid uterus and PID.One patient had normal pelvic findings(16.67). Regardingpatients presented with pain lower abdomen 57.15% has ovarian cyst,28.58% has Ectopic pregnancy while one case(14.29%) had hetrotropicpregnancy. In 24 patients had no complication and recovery was smooth. laparoscopy had to be converted into Laparotomy due to significanthemorrhage in two patient and wound infection was observed in two patients. One patient presented with post operative fever and onepresented with abdominal pain. Conclusions: Laparoscopy is a valuable diagnostic tool for females in different gynecological problems. Thebenefit of the laparoscopy to open surgery include less pain, less scarring, less disability and quicker recovery.

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Haemorrhagic Corpus Lutem Mimic Appendicitis

Bangladesh Medical Journal ◽

10.3329/bmj.v37i2.3596 ◽

1970 ◽

Vol 37 (2) ◽

pp. 66-67

Author(s):

Hasina Afroz ◽

Rabeya Akhter ◽

Shahela Jesmin

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Corpus Luteum ◽

Ovarian Tumor ◽

Rare Complication ◽

Lower Abdominal Pain ◽

Lower Abdomen ◽

Key Word ◽

Reproductive Life ◽

Chocolate Cyst

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various types of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis. Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomem. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable. Key word: Haemoperitoneum, Appendicitis, Ruptured Corpus luteum. DOI: 10.3329/bmj.v37i2.3596 Bangladesh Medical Journal 37(2) 2008 66-67

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Ileoscopy in the Diagnosis of lleal Lymphosarcoma

PEDIATRICS ◽

10.1542/peds.56.1.127 ◽

1975 ◽

Vol 56 (1) ◽

pp. 127-129

Author(s):

Seymour Katz ◽

Irwin Katzka ◽

Keith Schneider ◽

Mervin Silverberg

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Gastrointestinal Tract ◽

Inflammatory Process ◽

Lower Abdominal Pain ◽

Recurrent Abdominal Pain ◽

Neoplastic Disease ◽

Direct Visualization ◽

Appendiceal Abscess ◽

The Right

Recent advances in flexible fiberoptic endoscopy have permitted direct visualization of segments of the gastrointestinal tract hitherto considered inaccessible. Preoperative diagnoses of diseases of these areas are subject to the vagaries of roentgen interpretation. The following case report illustrates the value of the colonoscope in distinguishing intralumenal ileal neoplastic disease from an inflammatory process (e.g., ileitis, appendiceal abscess). CASE REPORT W. M., a 15-year-old white youth, was referred for eveluation of intermittent lower abdominal pain of six weeks' duration. Prior to his admission, he experienced cramping abdominal pain, fever, cough, emesis, and diarrhea. This gradually abated, leaving a residuum of recurrent abdominal pain which was relieved partially with fiexion of the right thigh.

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Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

BMJ Case Reports ◽

10.1136/bcr-2019-232797 ◽

2021 ◽

Vol 14 (1) ◽

pp. e232797

Author(s):

Clemmie Stebbings ◽

Ahmed Latif ◽

Janakan Gnananandan

Keyword(s):

Abdominal Pain ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Sudden Onset ◽

Greater Omentum ◽

Caribbean Woman ◽

History Of ◽

Right Iliac Fossa Pain ◽

The Right ◽

Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

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The real cause of right lower abdominal pain: an analysis of ultrasonographic findings

Journal of International Medical Research ◽

10.1177/0300060520946185 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052094618

Author(s):

Xia Zhang ◽

Biaohu Liu ◽

Xiangming Zhu ◽

Guobing Hu

Keyword(s):

Abdominal Pain ◽

Histopathological Examination ◽

Splenic Vein ◽

Lower Abdominal Pain ◽

Accessory Spleen ◽

Large Mass ◽

Splenic Tissue ◽

Common Disease ◽

Ureteral Calculus ◽

The Right

A pelvic accessory spleen is uncommon and most patients with this condition are asymptomatic. Ureteral calculus is a common disease and can cause acute abdominal pain. We report a 51‐year‐old male patient who presented at our hospital with acute right lower abdominal pain and gross hematuria. A large mass on the right side of the pelvis was detected on an ultrasound examination, as well as a calculus in the lower segment of the right ureter. Computed tomography angiography showed the presence of a long vascular pedicle with an artery originating from the splenic artery and a vein that joined with the splenic vein. Laparoscopy was carried out and it showed a solid mass covered with omentum on the right lower abdomen. The mass was then removed surgically. Histopathological examination of the resected specimens confirmed splenic tissue. We speculate that the accessory spleen and ureteral calculus caused right lower abdominal pain in our case. However, the ureteral calculus might have played a much more important role in causing acute right lower abdominal pain than the accessory spleen.

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Omental infarction in an obese 10-year-old boy

Pediatric Reports ◽

10.4081/pr.2011.e22 ◽

2011 ◽

Vol 3 (3) ◽

pp. 22 ◽

Cited By ~ 1

Author(s):

Katerina Kambouri ◽

Stefanos Gardikis ◽

Alexandra Giatromanolaki ◽

Aggelos Tsalkidis ◽

Efthimios Sivridis ◽

...

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Preoperative Diagnosis ◽

Acute Abdominal Pain ◽

Accurate Diagnosis ◽

Lower Abdomen ◽

Omental Infarction ◽

Appropriate Treatment ◽

Low Incidence ◽

The Right

Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

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