scholarly journals Subacute infective endocarditis presenting as upper abdominal pain

2020 ◽  
Vol 7 (10) ◽  
pp. 1588
Author(s):  
Bobithamol K. Benny ◽  
Stephen Daimei ◽  
Thouseef Mohammed ◽  
Prity Ering ◽  
Tatagata Dutta
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Acute Abdominal Pain ◽  
Splenic Abscess ◽  
Quadrant Pain ◽  
Septic Embolization ◽  
Incorrect Diagnosis ◽  
Splenic Embolization ◽  
Upper Abdominal ◽  
Symptoms And Signs

Splenic abscess develops in 3-5% of patients with infective endocarditis. In more protracted subacute cases of infective endocarditis, symptoms and signs such as anorexia, weight loss, weakness, arthralgia and abdominal pain may occur in 5-30% of patients and thereby misleading the clinician to pursue incorrect diagnosis such as malignancy, connective tissue disease, or other chronic infection or systemic inflammatory disorders. Left upper quadrant pain can be a presenting symptom in a patient with IE, if it is complicated by septic embolization to spleen. Here reported a case of subacute infective endocarditis complicated with splenic embolization in a 34-year-old male with diabetic nephropathy and ischemic dilated cardiomyopathy, presented as acute abdominal pain.

scholarly journals Massive splenic infarction in a patient with acute calculous cholecystitis: a case report and literature review

2019 ◽  
Vol 6 (8) ◽  
pp. 2976
Author(s):  
Alaa Sedik ◽  
Ahmed Fathi ◽  
Mufid Maali ◽  
Salwa Elhoushy ◽  
Shima Morsy
Keyword(s):  
Acute Abdominal Pain ◽  
Open Cholecystectomy ◽  
Good Condition ◽  
Splenic Abscess ◽  
Splenic Infarction ◽  
Uneventful Recovery ◽  
Quadrant Pain ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Symptoms And Signs

Massive splenic infarction (MSI) is a rare cause of acute abdominal pain and is attributed to compromised blood flow to more than half of the spleen. It may be due to hematological, non-hematological, or rarely spontaneous. Symptoms and signs are non-specific. Diagnosis is based mainly on radiological investigations. The treatment is splenectomy if complications occur. We reported a case of a 50-year-Saudi lady, who was presented with a picture of acute calculous cholecystitis that was treated conservatively. Then 48 hours later, pain improved significantly, then shortly she suddenly developed a left upper quadrant pain. Computerized tomography of the abdomen diagnosed the situation as MSI. She underwent open cholecystectomy and splenectomy as conservative treatment failed and she developed a splenic abscess. She made uneventful recovery and discharged in a good condition. Hematological, cardiology, and rheumatology services diagnosed the situation as a spontaneous MSI. She was seen in surgery outpatient free of complaints.

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

scholarly journals Acute Pancreatitis: An Atypical Presentation

2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Reports ◽  
Case Series ◽  
Normal Serum ◽  
Intravenous Fluids ◽  
Serum Enzyme ◽  
Serum Lipase ◽  
Upper Abdominal ◽  
Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

scholarly journals New viral hepatitis caused by covid-19 virus- A case report

2021 ◽  
Vol 7 (2) ◽  
pp. 98-102
Author(s):  
R H Gobbur ◽  
Ranjima M ◽  
Aravind S Akki
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Respiratory Failure ◽  
Liver Injury ◽  
Viral Hepatitis ◽  
Pediatric Patients ◽  
Acute Abdominal Pain ◽  
Diffuse Alveolar Damage ◽  
Gastrointestinal Symptoms ◽  
Symptoms And Signs

During the current COVID-19 pandemic, the assessment, and management of patients are challenging. The clinical features of COVID-19 are heterogeneous and subtle in many cases. Although diffuse alveolar damage and acute respiratory failure are the main features of COVID-19, the impairment of other organs are also seen. Gastrointestinal symptoms are common in pediatric patients with COVID-19 as SARS-CoV-2 is able to enter gastrointestinal epithelial cells. However, these complaints can also be caused by a COVID-19-independent concomitant abdominal pathology. Therefore, patients with fever with acute abdominal pain, anorexia, nausea, vomiting and diarrhea need to be assessed very thoroughly. Previous studies reported that COVID-19 was likely to result in liver injury. Based on clinical cases, we present our approach of management of children with symptoms and signs of viral hepatitis and concomitant suspicion of ­COVID-19.

Chronic and acute abdominal pain

2016 ◽  
Author(s):  
Stergios K. Doumouchtsis ◽  
S. Arulkumaran ◽  
Stergios K. Doumouchtsis
Keyword(s):  
Abdominal Pain ◽  
Outpatient Clinic ◽  
Acute Abdominal Pain ◽  
Chronic Abdominal Pain ◽  
Diagnosis And Treatment ◽  
The Common ◽  
Symptoms And Signs

This chapter discusses chronic and acute abdominal pain. Chronic abdominal pain is one of the common presenting complaints, accounting for about 10% of referrals to the gynaecology outpatient clinic. This chapter discusses the potential causes, symptoms and signs, investigations, and treatments of chronic abdominal pain. Acute abdominal pain, defined as pain that is sudden in onset (less than 24 hours) usually associated with signs of peritonism (guarding, rebound, rigidity), is also discussed, including causes, history, examination, investigations, diagnosis, and treatment.

Treatment: abdomen

2018 ◽  
Author(s):  
Chris Imray ◽  
Sarah R. Anderson ◽  
Tim Campbell-Smith ◽  
Jane Wilson-Howarth
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Acute Abdominal Pain ◽  
Lower Abdominal Pain ◽  
Scrotal Pain ◽  
Acute Scrotal Pain ◽  
Gastrointestinal Problems ◽  
Upper Abdominal

Acute abdominal pain - Upper abdominal pain - Lower abdominal pain - Gastrointestinal bleeding - Diarrhoea and vomiting - Other gastrointestinal problems - Urological problems - Acute scrotal pain - Gynaecological problems

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 Splenic abscess leading to spontaneous splenic rupture

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Annum A. Bhullar ◽  
Caleb P. Canders ◽  
Amir Rouhani ◽  
Steven Lai
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Splenic Abscess ◽  
Spontaneous Splenic Rupture ◽  
Surgical History ◽  
Missed Diagnosis ◽  
Ruptured Spleen ◽  
Upper Abdominal ◽  
Rupture Of The Spleen ◽  
Dental Work

Spontaneous, atraumatic rupture of the spleen is an uncommon but potentially fatal cause of acute abdominal pain. Splenic abscesses are equally rare and can be a risk factor for spontaneous splenic rupture. We present a 45-year-old man with no past medical or surgical history who presented with acute worsening of left upper abdominal pain that had been present for months, who was discovered to have a ruptured spleen. Splenic abscess was discovered intra-operatively and was thought to have developed after dental work. Recognizing presenting features of spontaneous splenic rupture and understanding its potential causes, such as splenic abscesses, may prevent delayed or missed diagnosis and guide treatment, which typically includes emergent splenectomy.

scholarly journals Role of Cholecystectomy in Symptomatic Hyperkinetic Gallbladder Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Jai P. Singh
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Biliary Colic ◽  
Quadrant Pain ◽  
Gallbladder Ejection Fraction ◽  
Hida Scan ◽  
Upper Abdominal ◽  
The Right ◽  
Upper Abdomen

Introduction. Biliary dyskinesia is defined by a gallbladder ejection fraction (EF) of less than 35% on HIDA scan, and these patients have shown a good response to cholecystectomy. Management of patients with biliary colic symptoms who have a hyperkinetic gallbladder ( EF > 80 % ) is not clearly defined. Herein, I report three cases of the symptomatic hyperkinetic gallbladder that were successfully managed with cholecystectomy. Case Report. Patient 1was a 56-year-old female presented with pain in the right upper abdomen for one month. Her workup was unremarkable except for the gallbladder EF of 86%. Patient 2 was a 33-year-old female with similar symptoms and workup with gallbladder EF of 97%. Patient 3 was a 20-year-old female with right upper abdominal pain and gallbladder EF of 91%. Patients 1 and 3 had the normal US, normal CT scan, and normal EGD. Patient 2 had normal US and CT but did not undergo EGD. All three patients underwent laparoscopic cholecystectomy and had complete resolution of their symptoms. Conclusion. The hyperkinetic gallbladder is a rare phenomenon, which can cause debilitating right upper quadrant pain. All three patients had an excellent response to cholecystectomy. Therefore, it is concluded that the patients with biliary colic and gallbladder EF of 80% or higher should be strongly considered for surgery.

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