scholarly journals Very rare giant adrenal myelolipoma: a tumor mimic

2020 ◽  
Vol 7 (2) ◽  
pp. 586
Author(s):  
Aditya Prasad Padhy ◽  
Abinash Kanungo ◽  
Deepak Kumar Das ◽  
Sunny .
Keyword(s):  
Abdominal Pain ◽  
Unusual Case ◽  
Benign Neoplasm ◽  
Chronic Abdominal Pain ◽  
Histopathological Study ◽  
Main Role ◽  
Adrenal Myelolipoma ◽  
Invasive Approach ◽  
Life Threatening ◽  
History Of

Adrenal myelolipoma is a very rare benign neoplasm usually unilateral, and nonsecreting, occurring in the adrenal gland which consist of fatty tissues and hematopoietic elements. Some cases of this type may cause symptoms like chronic abdominal pain however usually these tumors are small and asymptomatic. Surgery is the modality of treatment where there are severe symptoms with life threatening progression with size of tumor reaching more than 6 cm. Here we report an unusual case of a 59-year-old male with history of chronic abdominal pain from a growing right-sided large adrenal mass. With all possible hematological, histo-pathological as well as imaging investigations warranted a high suspicion for tumor mass, hence decided for surgically excision, which was both diagnostic as well as curative. The histopathological study of the excised mass confirmed the initial diagnosis of adrenal myelolipoma. Surgery is the diagnostic and curative modality of treatment for adrenal myelolipoma after all possible investigations to reach for a clinical diagnosis as well for proper planning for surgery. By this we can prevent complications like spontaneous rupture and hemorrhage of the mass, and subsequent cardiovascular shock. Management varies from individual to individual. Open radical adrenalectomy is the standard treatment for giant myelolipomas (size >10 cm), while the minimally invasive approach has been used in only few cases of small sized tumors. Although it is a benign tumor, surgery plays main role for symptomatic cases and high suspicion of malignancy.

scholarly journals Unusual case of Giardia lamblia causing eosinophilic ascites along with Plesiomonasshigelloides gastroenteritis

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 321-323
Author(s):  
Ballal Mamatha ◽  
Shetty Vignesh ◽  
Agarwal Manali ◽  
Nayal Bhavna ◽  
Umakanth Shashikiran
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Giardia Lamblia ◽  
Complete Resolution ◽  
Unusual Case ◽  
Peripheral Eosinophilia ◽  
Short Trip ◽  
Eosinophilic Ascites ◽  
History Of

A case report of a healthy, immunocompetent male,an international traveller from Germany who had visited India for a short trip,presented at our OPD with a history of loose stools, fever and abdominal pain,for two months. After thorough investigations, he was diagnosed to have an infection withGiardia lambliaacute gastroenteritis (AGE) along witheosinophilic ascites with peripheral eosinophilia, withassociatedPlesiomonasshigelloidesdiarrhoea. He was then treated with metronidazole and cotrimoxazole, which resulted in complete resolution of the symptoms.

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals A rare cause of neutropenic enterocolitis: Propylthiouracil-induced agranulocytosis

2018 ◽  
Vol 25 (5) ◽  
pp. 286-289 ◽  
Author(s):  
Vermi Degerli ◽  
Fulya Yilmaz Duran ◽  
Mustafa Kucuk ◽  
Ibrahim Atasoy
Keyword(s):  
Abdominal Pain ◽  
Complete Blood Count ◽  
Multiple Organ ◽  
Antithyroid Drugs ◽  
Gastrointestinal Complication ◽  
Emergency Physicians ◽  
Neutropenic Enterocolitis ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
History Of

Introduction: Neutropenic enterocolitis is a life-threatening gastrointestinal complication of neutropenia that is rarely seen in adults. Neutropenic enterocolitis is more common in oncology patients, especially in those with leukemia. Antithyroid drugs are widely used to treat hyperthyroidism, but they can rarely cause agranulocytosis. Although the pathophysiology is not well understood, high clinical suspicion and immediate and appropriate treatment responses are essential to reduce the mortality rate of neutropenic enterocolitis. Case presentation: We present a case of a 57-year-old male patient who developed neutropenic enterocolitis as a result of agranulocytosis caused by the use of propylthiouracil. He had history of hyperthyroidism and was on propylthiouracil. He presented to the emergency department with abdominal pain but eventually died due to rapid deterioration of sepsis and multiple organ failure despite medical and surgical treatment. Discussion: Thioamides can cause agranulocytosis which can result in serious complication including neutropenic enterocolitis. Complete blood count must be monitored in patients receiving thioamides, and these patients should be educated on symptoms of agranulocytosis. Conclusion: Since patients with neutropenic enterocolitis are often evaluated first by emergency physicians, emergency physicians must be vigilant for neutropenic enterocolitis in patients with neutropenia and abdominal pain.

scholarly journals PICA LEADING TO LITHOBEZOAR AND TRICHOBEZOAR IN ADULT MALE: A CASE REPORT

2020 ◽  
pp. 1-3
Author(s):  
Bhuvana Lakshmi Sundararajan ◽  
Siddartha Gowthaman ◽  
Arul Kumar ◽  
Ramanathan M
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Developmental Disabilities ◽  
Adult Male ◽  
Conservative Management ◽  
Foreign Bodies ◽  
Exploratory Laparotomy ◽  
Life Threatening ◽  
History Of

INTRODUCTION: Pica is common in patients with developmental disabilities and can be life-threatening. It is important to identify pica and manage it appropriately. CASE REPORT:A 19-year-old male presented with history of abdominal pain and vomiting for two days.On imaging he was found to have multiple foreign bodies within the small and large bowel.After trial of conservative management,he was taken up for exploratory laparotomy. He was found to have trichobezoar and lithobezoar obstructing the bowel at terminal ileum.Bezoars when removed via enterotomy. DISCUSSION: Bezoars are conglomerates of non-absorbable food or fibre formed in the alimentary tract.Trichobezoar forms following ingestion of hair and usually leads to gastric outlet obstruction.Lithobezoar refers to the accumulation of stones in the GIT. Reports of colonic lithobezoar are rare. Pica is the persistent ingestion of non-nutritive substances beyond a developmentally inappropriate age. Patients should be referred to a psychologist/behaviour analyst and caregivers should also be educated

scholarly journals Use of methylene blue in the prevention of recurrent intra-abdominal postoperative adhesions

2017 ◽  
Vol 46 (1) ◽  
pp. 504-510 ◽  
Author(s):  
Octavian C. Neagoe ◽  
Mihaela Ionica ◽  
Octavian Mazilu
Keyword(s):  
Methylene Blue ◽  
Abdominal Pain ◽  
Abdominal Surgery ◽  
Beneficial Effect ◽  
Adhesion Formation ◽  
Chronic Abdominal Pain ◽  
Postoperative Adhesions ◽  
Similar Time ◽  
History Of

Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign. However, the recurrence of adhesions after a previous adhesiolysis surgery had a similar time onset regardless of the initial disease. Following adhesiolysis surgery with methylene blue, the majority of patients did not present with symptoms associated with adhesion complications (i.e., chronic abdominal pain, bowel obstruction) for the length of the follow-up period. Conclusions The use of methylene blue during adhesiolysis surgery appears to reduce the recurrence of adhesion-related symptoms, suggesting a beneficial effect in the prevention of adhesion formation.

scholarly journals Migrated Tubal Ligation (Filshie) Clip as an Uncommon Cause of Chronic Abdominal Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Sahil Sharma ◽  
Radek Martyniak ◽  
Vladislav Khokhotva
Keyword(s):  
Abdominal Pain ◽  
Fertility Control ◽  
Left Lobe ◽  
Tubal Ligation ◽  
Chronic Abdominal Pain ◽  
Pathology Report ◽  
Patient Reported ◽  
Surgical History ◽  
History Of ◽  
Gastrohepatic Omentum

Tubal ligation (TL) is an effective and common method of fertility control. In the year 2009, over 24,000 were performed in Canada alone. Migration of Filshie clips used during TL is estimated to occur in 25% of all patients; 0.1-0.6% of these patients subsequently experience symptoms or extrusion of the clip from anatomical sites such as the anus, vagina, urethra, or abdominal wall. Migrated clips may present as chronic groin sinus, perianal sepsis, or chronic abdominal pain. These symptoms can occur as early as 6 weeks or as late as 21 years after application. We present the case of a 49-year-old female with a 3.5-year history of intermittent dull nonradiating left upper quadrant (LUQ) pain lasting on average 2-3 days. There were no other associated symptoms, and the longest pain-free period was 4 days. Her past medical history includes COPD, GERD, IBS, and depression. Current medications are only remarkable for Symbicort. Pertinent past surgical history includes laparoscopic tubal ligation with Filshie clips in 1999, followed by a vaginal hysterectomy in 2013. Migrated tubal ligation clip was noted on an abdominal X-ray. The patient was then referred for surgical management. Subsequent CT scan confirmed a solitary clip present adjacent to the left lobe of the liver. No other abnormalities were reported. Patient underwent laparoscopy for removal of the clip, which was identified to be underneath the left lobe of the liver embedded in the gastrohepatic omentum. Please see the video link provided. Postoperative pathology report confirmed the presence of a Filshie clip. Patient reported complete resolution of her LUQ pain at a 5-week and 3.5-month follow-up. This case shows that although symptomatic clip migration is a rare phenomenon, it should be given special consideration in women with unexplained chronic abdominal pain and a history of TL. Additionally, removal of clip can provide resolution of symptoms.

scholarly journals Simultaneous Huge Splenic and Mesenteric Hydatid Cyst

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Mostafa M. Abdelmaksoud ◽  
Alaa Jamjoom ◽  
Mohamed T. Hafez
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Chronic Abdominal Pain ◽  
The Body ◽  
Mesenteric Cyst ◽  
Imaging Studies ◽  
The World ◽  
Typical History ◽  
Animal Contact ◽  
History Of

Hydatid disease (HD) is caused by Echinococcus granulosus and is endemic in many parts of the world. This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. The spleen and mesentery are unusual locations. We report a case of simultaneous huge splenic and mesenteric hydatid cyst in a 91-year-old male patient. The patient was presented with chronic abdominal pain, increased frequency of defecation, and typical history of animal contact (cattle, sheep, and dogs). After performing imaging studies, he was diagnosed with a simultaneous huge spleen and pelvic mesentery hydatid cyst that was managed surgically by splenectomy, pelvic mesenteric cyst deroofing, and partial cystectomy.

scholarly journals Implantation of an intercostal nerve stimulator for chronic abdominal pain

2010 ◽  
Vol 92 (3) ◽  
pp. e1-e3 ◽  
Author(s):  
RD Johnson ◽  
AL Green ◽  
TZ Aziz
Keyword(s):  
Abdominal Pain ◽  
Abdominal Surgery ◽  
Intercostal Nerve ◽  
Chronic Abdominal Pain ◽  
Laparoscopic Appendicectomy ◽  
Nerve Stimulator ◽  
First Report ◽  
History Of

Chronic abdominal pain is not uncommon and can be difficult to manage. We present the case of a 17-year-old man with a 4-year history of chronic abdominal pain. The patient had previously undergone abdominal surgery by way of laparoscopic appendicectomy and right nephrectomy for a mal-rotated kidney. The patient continued to suffer right-sided abdominal pain which was not controlled by analgesia. We report the successful implantation of a right D11 intercostal nerve stimulator to control the patient’s pain. This is the first report of an implantable intercostal nerve stimulator to control intractable chronic abdominal pain.

scholarly journals Acute and Massive Aortic Thrombosis and Embolic Occlusion in a Patient with COVID-19: A Case Report

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyedjavad Davarisani ◽  
Javad Koushki ◽  
Saeed Moghaddamzade ◽  
Hamzeh Sherafati ◽  
Mehdi Jamalinik ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Artery ◽  
Distal Part ◽  
Gastrointestinal Symptoms ◽  
High Resolution Computed Tomography ◽  
Aortic Thrombosis ◽  
Reactive Protein ◽  
Risk Patients ◽  
Life Threatening ◽  
History Of

: A 73-year-old man with a history of COVID-19 infection from two weeks ago was referred to the Emergency Department with a complaint of colicky and generalized abdominal pain in addition to prior respiratory symptoms. High-resolution Computed Tomography (HRCT) displayed the typical signs of COVID-19 pneumonia. Initially, laboratory tests showed increased C-reactive protein and severe leukocytosis. Because of generalized abdominal pain, spiral abdominal and pelvic CT scans were done, which showed massive irregular and free-floating aortic thrombosis from the carina site to the Superior Mesenteric Artery (SMA) detachment, indicative of acute and life-threatening thrombosis. Filling defects were seen in the middle and distal part of the splenic artery, indicating the embolic occlusion of the splenic artery. The patient was admitted to the Intensive Care Unit (ICU), and he became a candidate for conservative treatment because of the wide extension of thrombosis. Therefore, we should pay more attention to the indirect signs of thrombosis in patients with COVID-19 infection with gastrointestinal symptoms and consider anticoagulant therapy for high-risk patients with COVID-19. The unique feature of our case was acute and extensive arterial thrombosis.

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