scholarly journals Extensive gastric necrosis in an infant

2021 ◽  
Vol 8 (9) ◽  
pp. 2816
Author(s):  
Suraj R. Gandhi ◽  
Neha S. Shenoy ◽  
Vini Joseph ◽  
Apoorva P. Makan ◽  
Syamantak Basu ◽  
...  
Keyword(s):  
Gastric Wall ◽  
Fatal Outcome ◽  
Gastric Volvulus ◽  
Rare Condition ◽  
Abdominal Distension ◽  
Feeding Tube ◽  
Gastric Necrosis ◽  
History Of ◽  
Anterior Gastric Wall ◽  
Upper Abdominal

Gastric necrosis is a rare condition, more so in children and can be potentially fatal. The sloughing of the necrosed wall results in perforations or large defects in the gastric wall.  We report a rare case of extensive gastric necrosis in a 2 months old female infant, managed successfully. Child presented with non-bilious vomiting and excessive cry. There was history of recurrent upper abdominal distension. X-ray of abdomen showed massive pneumoperitoneum. Intra operatively, posterior gastric wall was sloughed off and lower end of feeding tube was lying in the peritoneal cavity. Necrotic wall was debrided and stomach tube was created from remaining anterior gastric wall. Gastrostomy and jejunostomy was done. Post-operative period was uneventful. Dye study at three months showed good gastric capacity. Stomach being a well vascularised organ, necrosis is rare. There is varied etiology of gastric necrosis, volvulus being one of them. Gastric volvulus might be associated with other congenital anomalies like eventration, asplenia, wandering spleen. The incidence of perforation in gastric volvulus with necrosis is 5-28% and a mortality of 50% is reported with such perforations. Vigilant clinical observation in pediatric patients with upper abdominal distension and pain can point the diagnosis and prevent fatal outcome.

scholarly journals Unusual Differential Diagnosis of Upper Abdominal Pain

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Lanthaler Monika ◽  
Grissmann Thomas ◽  
Schwentner Lukas ◽  
Nehoda Hermann
Keyword(s):  
Abdominal Pain ◽  
Liver Abscess ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Gastric Perforation ◽  
Gastric Wall ◽  
Endoscopic Removal ◽  
Quadrant Pain ◽  
Anterior Gastric Wall ◽  
Upper Abdominal

We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-old man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.

scholarly journals Gastric Small-Cell Carcinoma Found on Esophagogastroduodenoscopy: A Case Report and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Natassja Frances ◽  
Simon B. Zeichner ◽  
Michael Francavilla ◽  
Mike Cusnir
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Epigastric Pain ◽  
Gastric Wall ◽  
Rare Condition ◽  
Small Cell ◽  
Japanese Male ◽  
History Of ◽  
Lesser Curvature ◽  
Hispanic Male

Introduction. Characterized as an undifferentiated, neuroendocrine tumor arising from totipotent stem cells, small-cell carcinoma (SCC) most commonly arises from the lung. Extrapulmonary small-cell carcinomas (ESCC) are rare and account for only four percent of SCC. Gastric ESCC, more commonly seen in Japanese male patients in their seventh decade of life, accounts for approximately 0.1 percent of ESCC.Case Presentation. A 75-year-old Hispanic male presented with a several week history of worsening epigastric pain with nausea and vomiting. Computer tomography (CT) of the abdomen and pelvis showed a large heterogeneous mass involving the posterior gastric wall with diffuse extension into the gastric cardia. Esophagogastroduodenoscopy (EGD) revealed a large fungating mass in the lesser curvature of the stomach. Biopsy of the mass revealed small-cell carcinoma of the stomach. The patient was diagnosed with extensive/stage 4 disease and started on chemoradiation.Discussion. Our case, of a very rare condition highlights, the importance of recognizing atypical pathologic diagnoses. More research will need to be conducted with GSCC patients in order to better characterize disease pathogenesis, genetic mutations, and optimal disease management. The hope is to identify biomarkers that will identify patients earlier in their disease course when cure is possible.

Laparoscopic Management of Phrenic Endometriosis

2011 ◽  
Vol 3 (4) ◽  
pp. 213-217
Author(s):  
Cassia Gisele Terrassani Silveira ◽  
Admir Agic ◽  
Markus Kleemann ◽  
Hartmut Merz ◽  
Daniela Hornung
Keyword(s):  
Rare Case ◽  
Bowel Resection ◽  
Rare Condition ◽  
Pulmonary Complications ◽  
Reproductive Age ◽  
Surgical Interventions ◽  
History Of ◽  
Laparoscopic Bowel Resection ◽  
Upper Abdominal ◽  
Extrapelvic Endometriosis

Introduction Extrapelvic endometriosis is a rare condition typically associated with variable symptomatology and complex diagnosis. Case report: Here, we report a rare case of phrenic endometriosis manifested insidiously in a woman of reproductive age after a prolonged history of endometriosis with several surgical interventions, including laparoscopic bowel resection a few months ago. The patient presented with menstrual-related, cyclical, right upper abdominal pain. Results Accurate surgical inspection during the laparoscopic procedure enabled the identification and full resection of a deep infiltrating endometriotic lesion growing from the peritoneum into the phrenic tissue, which was suspected by symptomatology. No pulmonary complications were detected before or after surgery except for a small right-sided pneumothorax, which did not require drainage and disappeared spontaneously after five days. Conclusions The rare case reported here emphasizes the importance of a very exact conversation with the patient before surgery, a systematic and accurate surgical exploration for the diagnosis, and the successful laparoscopic treatment of a symptomatic phrenic disease in a woman with a longstanding history of endometriosis.

scholarly journals Acute Gastric Necrosis in a Teenager

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Joseph Yorke ◽  
Frank Enoch Gyamfi ◽  
Ronald Awoonor-Williams ◽  
Ebenezer Osei-Akoto ◽  
Emmanuel Acheampong ◽  
...  
Keyword(s):  
High Mortality ◽  
Digital Rectal Examination ◽  
Rare Condition ◽  
Abdominal Distension ◽  
Gastric Necrosis ◽  
Biochemical Tests ◽  
Delay In Diagnosis ◽  
Rebound Tenderness ◽  
Rare Site ◽  
High Index Of Suspicion

Gastric infarction is a rare condition often associated with high mortality due to a delay in diagnosis. The stomach which has a rich supply of blood is a rare site for such a condition. Gastric infarction has a long list of etiological factors. We report a case of a patient who was managed successfully following gastric infarction from gastric dilatation. An 18-year-old female student presented with a three-day history of abdominal pain associated with abdominal distension of two days. The abdomen was distended with generalized tenderness, rebound tenderness, and guarding. Bowel sounds were absent. Digital rectal examination was unremarkable, and a pregnancy test was negative. Biochemical tests were all normal. Intraoperatively, two litres of serosanguinous fluid was suctioned from the abdomen. About 300 mL of pus was suctioned from the pelvis. The gangrenous portion was resected, and repair was done in two layers using Conell and Lambert suture techniques. Acute gastric necrosis is a rare surgical condition that requires a high index of suspicion and prompts aggressive resuscitation and surgical intervention to obviate the high mortality rate associated with the condition.

scholarly journals Chronic Elevation of Liver Enzymes in Acute Intermittent Porphyria Initially Misdiagnosed as Autoimmune Hepatitis

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
A. González Estrada ◽  
S. García-Morillo ◽  
L. Gómez Morales ◽  
P. Stiefel García-Junco
Keyword(s):  
Autoimmune Hepatitis ◽  
Liver Enzymes ◽  
Correct Diagnosis ◽  
Fatal Outcome ◽  
Rare Condition ◽  
Acute Intermittent Porphyria ◽  
Biopsy Result ◽  
Prompt Treatment ◽  
History Of ◽  
Elevated Transaminases

Autoimmune hepatitis is a disease characterized by an elevation of liver enzymes, as well as specific autoantibodies. It is more common in women than men. We describe a 32-year-old woman with elevated transaminases, autoantibodies, and a liver biopsy result suggestive of autoimmune hepatitis. The indicated treatment was administered without showing a satisfactory response. The patient had a family history of acute intermittent porphyria (AIP) so we decided to begin treatment with hematin, achieving a complete remission of the symptoms. Acute intermittent porphyria is a rare condition characterized by neurovisceral symptoms, abdominal pain being the most common of them. The disease has a higher prevalence among young women and certain European countries such as Sweden, Great Britain, and Spain. A correct diagnosis and prompt treatment are essential because patients affected by AIP must have a strict followup due to the fatal outcome of the outbreaks.

scholarly journals Necrosis and perforation of the stomach in newborn babies and infants

2021 ◽  
Vol 179 (5) ◽  
pp. 36-40
Author(s):  
S. A. Karavaeva ◽  
A. V. Podkamenev ◽  
A. A. Skopetc
Keyword(s):  
Gastric Wall ◽  
Fatal Outcome ◽  
Multiple Organ ◽  
Diagnostic Methods ◽  
Gastric Necrosis ◽  
Extensive Resection ◽  
Organ Volume ◽  
Results Of Treatment ◽  
Atypical Resection ◽  
Extensive Necrosis

The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis.Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect.Results. Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life.Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach. 

scholarly journals P-EGS15 Gastric pneumatosis in an elderly patient with recurrence of gastric volvulus

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Virginia Ledda ◽  
Rajesh Yagati Satchidanand
Keyword(s):  
Mortality Rate ◽  
High Mortality ◽  
Hiatus Hernia ◽  
Gastric Wall ◽  
Gastric Volvulus ◽  
Rare Event ◽  
Diagnostic Process ◽  
Porta Hepatis ◽  
Benign Condition ◽  
History Of

Abstract Background Gastric pneumatosis (GP), defined as the presence of air in the gastric wall, is a rare CT finding. It is associated with a spectrum of conditions which can range from benign and self-limiting to severe with high mortality rate. A gastric volvulus occurs with a rotation of 180 degrees or more of the stomach around its longitudinal or transverse axis. It is a rare event, and can culminate in obstruction, strangulation, ischaemia and necrosis. We present a case of gastric pneumatosis in a patient suffering with hiatus hernia and a history of recurrent gastric volvuli. Methods An 83-year-old man presented with a history of vomiting and abdominal pain. His background included a known hiatus hernia with previous episodes of gastric volvulus. A computer tomography (CT) showed a gastric volvulus with air in the gastric wall, in the intrahepatic biliary tree and porta hepatis. Conservative management was pursued with IV PPI and antibiotics, keeping the patient nil by mouth. He improved clinically and a repeat CT scan showed regression of the gastric pneumatosis, with resorption of gas in the porta hepatis and regression of the pneumobilia. He was discharged home 12 days after his initial presentation. Results Gastric pneumatosis (GP) is described as a rare finding that can occur in conditions such as gastric emphysema (GE) and emphysematous gastritis (EG). GE is described as a more benign condition, usually self-limiting which can be managed conservatively in most cases and rarely requires surgical interventions. EG is a more severe condition with a high mortality rate, and more aggressive treatment is advocated. The diagnostic process can be challenging but literature shows lactate, the presence of metabolic acidosis and peritonitis can help differentiating between the two clinical entities and choosing the appropriate management plan. Conclusions This case described a patient presenting with a gastric volvulus with the presence of gastric pneumatosis, pneumobilia and portal venous gas. These findings were diagnosed as gastric ischaemia secondary to volvulus. In this case the patient made a good recovery after being managed conservatively. GP is a rare CT entity which can be found in the presence of GE or EG. Differentiating between the two can be a challenging process, aided by clinical examination as well as blood test results. Achieving the right diagnosis is key as radical surgical intervention is not always needed to guarantee a good outcome.

scholarly journals Necrotizing gastritis: a case report

2017 ◽  
Vol 4 (10) ◽  
pp. 3535
Author(s):  
Tejas A. P. ◽  
S. Rajagopalan ◽  
Rohit K.
Keyword(s):  
Case Reports ◽  
Gastric Wall ◽  
Gastric Volvulus ◽  
Tube Placement ◽  
Gelatin Sponge ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Necrosis ◽  
Fatal Disease ◽  
Gastric Gangrene ◽  
Upper Gastrointestinal

Gangrene of the stomach is a rare and often fatal disease. It occurs when there is vascular anomalies, gastric volvulus or herniation and in infectious gastritis. A 65-year-old man was wheeled into the Emergency Department with complaints of abdominal pain for 8 hours. The pain was in the epigastric region which was severe in nature continuous and associated with nausea. There was no history of hematemesis or vomiting. The past medical history was not significant. He was HIV negative. On examination, he was in agonizing pain and tachypneic. The vital signs were temperature 98.6°F, pulse 118/minut, respiratory rate 28/minutes, BP 90/60 mmHg. Abdominal examination found diffuse tenderness with voluntary guarding and rigidity. Bowel sounds were sluggish. Rectal examination was normal. The Ryle’s tube showed hemorrhagic aspirate. Erect X-ray abdomen showed large gastric air fluid level and no evidence of pneumoperitoneum. Routine hemogram showed leukocytosis. Blood sugar level and serum urea, creatinine levels were within normal limits. After initial resuscitation with intravenous fluids and antibiotics, decision was taken to proceed for an emergency exploratory laparotomy. Gastric necrosis is a rare and fatal condition. Etiology includes thromboembolism and occlusion of major arterial supply, ingestion of corrosive agents, volvulus of the stomach, herniation of the stomach through the diaphragm, bulimia nervosa, iatrogenic gelfoam embolism, endoscopic hemostatic injections and infectious gastritis. So, the most probable cause of the gastric necrosis was infectious gastritis. It begins as phlegmonous (suppurative) gastritis (PG), and then it progresses to the lethal severe form: acute necrotizing gastritis. The few case reports of gastric gangrene are there in literature with the underlying etiological factors. Harvey et al, reported a rare case of multifocal infarction of stomach secondary to atheromatous emboli originating in a thoracic aortic aneurysm. Bradly et al, reported a case of extensive gastric necrosis in a patient with recurrent massive upper gastrointestinal hemorrhage. They found massive gastric gangrene secondary to therapeutic transcatheter embolization of the left gastric artery with fragments of gelatin sponge. Ovnat et al, reported three cases of acute obstruction of the celiac trunk. In all the three patients, the mucosa along the lesser curvature of the stomach was necrotic but the gross appearance of the stomach was only mildly ischemic. Organisms isolated from the gastric wall include hemolytic streptococci, proteus, E. coli and clostridium welchi. PG can be diagnosed by upper gastrointestinal endoscopy, CT scan, or endoscopic ultrasound. Its endoscopic findings can show purple colored gastric mucosa covered with dirty necrotic materials. Absolute diagnosis is made, most frequently at laparotomy. Gastric gangrene due to necrotizing gastritis is a rare and fatal disease. The diagnosis is usually made at laparotomy. Treatment consists of resection and feeding tube placement followed by intravenous antibiotics. Increased awareness of this rare entity may lead to more prompt diagnosis and an increased chance for patient survival.

Adenoid Cystic Carcinoma of Lacrimal Gland

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 76-77
Author(s):  
Mohd Athar ◽  
K S Sodhi ◽  
S Kala ◽  
R K Maurya ◽  
S Chauhan ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Natural History ◽  
Adenoid Cystic Carcinoma ◽  
Salivary Glands ◽  
Hard Palate ◽  
Clinical Course ◽  
Fatal Outcome ◽  
Minor Salivary Glands ◽  
Adenoid Cystic ◽  
History Of

Adenoid cystic carcinoma is a relatively uncommon tumour of salivary, glands and is characterised by a prolonged clinical course and a fatal outcome. It was first described as `cylindroma' by Billroth in 1859. Half of these tumors occur in glandular tissues other than the major salivary glands; principally in the hard palate, but they can also arise in the tongue and minor salivary glands. Unusual locations include the external auditory canal, nasopharynx, lacrimal glands, breast, vulva, esophagus, cervix and Cowper glands. The long natural history of this tumor and its tendency for local recurrence are well known. JMS 2012;15(1):76-77.

THERAPEUTIC MANAGEMENT OF ASCITES IN SPITZ DOG IN BANGLADESH WITH A BRIEF REVIEW ON CANINE ASCITES

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
M. A. Samad
Keyword(s):  
Ascitic Fluid ◽  
Clinical Examination ◽  
Clinical Case ◽  
Abdominal Distension ◽  
Multiple Organ ◽  
Therapeutic Management ◽  
Vitamin Supplement ◽  
Case Record ◽  
Successful Recovery ◽  
History Of

Background: Ascites is one of the most important clinical syndromes, caused by multiple organ disorders, characterized by abdominal distension with accumulation of fluid of various colors and consistencies depending on the etiology that are encountered commonly in canine practice worldwide. Although it has been reported from different countries including India but it has not yet been documented from Bangladesh. Objectives: To evaluate the successful therapeutic management of a clinical case of ascites in dog supported with its brief review for its appropriate application Materials and Methods: A female Spitz dog two and half years old brought for treatment with the history of abdominal distension on 1st November 2009. Clinical examination, abdominocentesis and laboratory examination of ascitic fluid were used for the diagnosis of ascites in dog. Results: Clinical examination revealed dyspnea, discomfort, lethargy, weakness, pale mucous membrane, normal rectal temperature 103.2 0F and distended abdomen with fluid thrill on palpation. Examination of ascitic fluid revealed clear white fluid (pure transudate) which is mainly hepatic origin resulting portal hypertension and hypoproteinaemia. Treatment with restricted sodium diet, antibiotic (amoxicillin), diuretic (furosemide; Lasix, Sanofi Aventis) and vitamin B-complex and C- vitamin supplement with regular monitoring assisted in successful recovery. The recovered dog survived for next five years up to 2014 and then died due to other reasons. Conclusions: This clinical case record on canine ascites with successful treatment along with review especially on the methods of diagnosis and cause-wise treatment would certainly help the clinician for proper management of the clinical cases of canine ascites. Keywords: Ascites, Spitz dog, Diagnosis, SAAG, Therapeutic management, Brief review

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