scholarly journals Perforated appendicitis with peri-appendicular abscess within an incisional hernia: a report of an unusual case

2018 ◽  
Vol 6 (1) ◽  
pp. 299
Author(s):  
Tousif Kabir ◽  
Wong Kar Yong
Keyword(s):  
Incisional Hernia ◽  
Unusual Case ◽  
Abdominal Mass ◽  
Perforated Appendicitis ◽  
Right Hemicolectomy ◽  
Amyand’S Hernia ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Paramedian Incision ◽  
Hernial Appendicitis

Amyand’s hernia is a rare phenomenon referring to the presence of an appendix within an inguinal hernia. Hernial appendicitis occurs even more rarely in 0.07-0.13% of cases. Cases have been described in incisional hernias of laparoscopic port sites, nephrectomies and various other incisions. Author described an unusual case of an elderly lady who presented with nausea, fever and a tender abdominal mass over a previous paramedian incision. She was thought to have an incarcerated incisional hernia and was counselled for emergency surgical repair. Intra-operatively, she was found to have a perforated appendicitis with a large peri-appendicular abscess within an incisional hernia. The base of the appendix was unhealthy thus a limited right hemicolectomy was performed and the hernia was repaired primarily. Such cases present atypically and present a diagnostic challenge. Delays in recognition and timely intervention may lead to high morbidity and mortality. The authors hoped to raise awareness of this condition and contribute to the medical literature surrounding this unusual pathology.

scholarly journals Unusual Case of a Torted Mesenteric Fibroid

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Rawan Bajis ◽  
Gregg Eloundou
Keyword(s):  
Unusual Case ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Growth Patterns ◽  
Diagnostic Challenge ◽  
Presumptive Diagnosis ◽  
Obstetrics And Gynaecology ◽  
Colorectal Surgeon ◽  
Ileocaecal Junction ◽  
Palpable Abdominal Mass

Extrauterine leiomyomas are very rare and present a clinical and diagnostic challenge due to their unusual growth patterns and behaviours. A 47-year-old woman was transferred to our tertiary specialist obstetrics and gynaecology hospital with acute abdominal pain and a palpable abdominal mass. She was taken immediately to theatre with the presumptive diagnosis of an ovarian torsion. Intraoperatively, a large necrotic mass originating from the mesentery and attachments to the bowel at the ileocaecal junction was noted. When converted to laparotomy due to limited access and poor visualisation, the uterus, ovaries, and tubes were found to be normal. A right partial hemicolectomy was performed with the assistance of the colorectal surgeon due to suspicion of bowel malignancy. Histology revealed a benign infarcted leiomyoma with adhesions to the adjacent ileum. The diagnosis of a primary torted mesenteric fibroid was made.

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

scholarly journals Goblet Cell Carcinoids of the Appendix

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Nanna Holt ◽  
Henning Grønbæk
Keyword(s):  
Goblet Cell ◽  
Chromogranin A ◽  
Abdominal Mass ◽  
Distant Metastases ◽  
High Volume ◽  
Right Hemicolectomy ◽  
Ca 125 ◽  
Ki67 Index ◽  
Proliferation Markers ◽  
Mucinous Component

Goblet cell carcinoid (GCC) tumors are a rare subgroup of neuroendocrine tumors almost exclusively originating in the appendix. The tumor most often presents in the fifth or sixth decade with a clinical picture of appendicitis or in advanced cases an abdominal mass associated with abdominal pain. Histologically tumors are most often positive for chromogranin A and synaptophysin, however, less homogenous than for classic appendix carcinoids. The malignant potential is higher than that for the classic appendix carcinoids due to local spread and distant metastases at diagnosis and the proliferation markers (Ki67 index) may determine prognosis. Octreotide receptor scintigraphy is usually negative while CT/MRI scans may be useful. Chromogranin A is usually negative and other biomarkers related to the mucinous component or the tumor (CEA, CA-19-9, and CA-125) may be used. Surgery is the main treatment with appendectomy and right hemicolectomy while patients with disseminated disease should be treated with chemotherapy. Overall 5-year survival is approximately 75%. The diagnosis and treatment of GCC tumorss should be restricted to high volume NET centers in order to accumulate knowledge and improve survival in GCC NET patients. The aim of this paper is to update on epidemiology, clinical presentation, and diagnostic markers including Ki67 index, treatment, and survival.

Hernias in the Emergency Department

2017 ◽  
Author(s):  
Mary C. Westergaard ◽  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia. Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

Hernias in the Emergency Department

2018 ◽  
Author(s):  
Mary C. Westergaard ◽  
Daniel Berhanu ◽  
Ciara J. Barclay-Buchanan
Keyword(s):  
Risk Factors ◽  
Inguinal Hernia ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Abdominal Mass ◽  
Abdominal Wall Hernia ◽  
The United States ◽  
Abdominal Hernia ◽  
Indirect Inguinal Hernia ◽  
Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia.  Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

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

scholarly journals An Unusual Case of Rectal and Ileal Carcinoid Tumors

2017 ◽  
Vol 10 (3) ◽  
pp. 793-799
Author(s):  
Molham Abdulsamad ◽  
Naeem Abbas ◽  
Bhavna Balar
Keyword(s):  
Gastrointestinal Tract ◽  
Neuroendocrine Tumor ◽  
Carcinoid Tumor ◽  
Terminal Ileum ◽  
Incidental Findings ◽  
Unusual Case ◽  
Right Hemicolectomy ◽  
Surveillance Colonoscopy ◽  
Stage 1 ◽  
Ileal Carcinoid

Carcinoid tumor is the most common neuroendocrine tumor affecting the gastrointestinal tract. The coexistence of multifocal carcinoid lesions is a well-established phenomenon. Although intubation of the terminal ileum is not routinely attempted during colonoscopy, it can occasionally reveal the presence of some incidental findings. We present a patient with known rectal carcinoid, who was found to have another carcinoid lesion in the terminal ileum during surveillance colonoscopy. The patient underwent right hemicolectomy, and no chemotherapy was required as the patient was found to have stage 1 carcinoid tumor.

scholarly journals Actinomycosis: an unusual cause of unresectable rectal cancer

2013 ◽  
Vol 95 (6) ◽  
pp. e4-e6
Author(s):  
T Grey ◽  
K Lindsay ◽  
A Bhowmick
Keyword(s):  
Rectal Cancer ◽  
Unusual Case ◽  
Intrauterine Contraceptive Device ◽  
Current Evidence ◽  
Contraceptive Device ◽  
Diagnostic Challenge ◽  
Oncological Treatment ◽  
Intrauterine Contraceptive ◽  
Pelvic Actinomycosis ◽  
Long Course

We present a very unusual case of a woman with an intrauterine contraceptive device (IUCD) who developed pelvic actinomycosis during long course chemoradiotherapy for rectal cancer, which presented a significant diagnostic challenge and eventually rendered the cancer unresectable. IUCDs are often implicated in the development of pelvic actinomycosis but there is no current evidence or guideline to suggest that they should be removed prior to oncological treatment. Owing to the devastating consequences of this combination of disease, we suggest that it may be prudent to remove IUCDs in this setting.

scholarly journals Ileocolic intussusception as a presenting sign of primary lymphoma of the colon

2011 ◽  
Vol 139 (9-10) ◽  
pp. 673-676 ◽  
Author(s):  
Milica Nestorovic ◽  
Goran Stanojevic ◽  
Vesna Brzacki ◽  
Vesna Milojkovic ◽  
Branko Brankovic ◽  
...  
Keyword(s):  
Malignant Neoplasm ◽  
Radical Resection ◽  
Right Hemicolectomy ◽  
Primary Lymphoma ◽  
Ileocolic Intussusception ◽  
Diagnostic Challenge ◽  
Abdominal Ultrasonography ◽  
Atypical Symptoms ◽  
Colorectal Lymphoma ◽  
The Right

Introduction. Intussusception is a rare phenomenon in adults. It is caused mainly by malignant neoplasm. Primary lymphoma of the colon is a rare malignancy of the large intestine. The association of intussusception in adult and primary colorectal lymphoma is a diagnostic challenge, since they occur with a variety of atypical symptoms. Case Outline. We report a case of ileocolic intussusception in a 26-year-old man induced by primary lymphoma of the cecum. He was admitted to our hospital for incomplete intestinal obstruction. After thorough diagnostic work-up (plain abdominal radiography, abdominal ultrasonography, multi-slice computerized tomography, colonoscopy with biopsy), the patient underwent surgery. Intraoperative findings confirmed lymphoma as the cause of intussusception. The right hemicolectomy was carried out with end-to-side ileo-transverse anastomosis. Conclusion. Primary colorectal lymphomas should be considered in differential diagnosis of intussusceptions in adults. The treatment of choice is a radical resection where all oncological standards must be fulfilled.

scholarly journals CMV Colitis in Immunocompetent Patients: 2 Cases of a Diagnostic Challenge

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Maria Paparoupa ◽  
Viola Schmidt ◽  
Helgard Weckauf ◽  
Huy Ho ◽  
Frank Schuppert
Keyword(s):  
Crohn’S Disease ◽  
Unusual Case ◽  
Treatment Strategies ◽  
Diagnosis And Treatment ◽  
Diagnostic Challenge ◽  
Unsuccessful Treatment ◽  
Benign Stenosis ◽  
The Right ◽  
Cmv Colitis ◽  
Immunocompetent Patients

CMV infections are generally thought to be opportunistic by immunosuppression. Many literature cases though indicate that CMV infections can be also observed in immunocompetent patients. We present an unusual case of an extensive concentric benign stenosis due to CMV colitis and a case of coexistence with Crohn’s Disease, both observed in nonimmunosuppressed individuals. The right diagnosis was set after implementation of multiple unsuccessful treatment strategies. Our purpose is therefore to familiarize clinicians involved with the diagnosis and treatment of gastroenterological diseases with this entity.

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