scholarly journals The Best Strategy for Nasogastric Tube Removal in Patients with Acute Appendicitis Complicated with Ileus: A Case Report and Review.

2020 ◽  
Author(s):  
Yu-Ju Tseng ◽  
Pei-Yin Huang ◽  
Po-Chu Lee ◽  
Tzu-Hsin Lin ◽  
Rey-Heng Hu
Keyword(s):  
Acute Appendicitis ◽  
Nasogastric Tube ◽  
Lower Abdominal Pain ◽  
Computed Tomography Scan ◽  
Case Presentation ◽  
Nasogastric Tubes ◽  
Tube Removal ◽  
Common Causes ◽  
Periappendiceal Abscess ◽  
Tomography Scan

Abstract BackgroundAcute appendicitis is one of the most common causes of the acute abdomen. However, acute appendicitis complicated with ileus is uncommon. By presenting this case, we aim to give some suggestions on the postoperative care, especially an algorithm for the insertion and removal of nasogastric tube.Case presentation A 20-year-old man presenting with left lower abdominal pain and symptoms of ileus was diagnosed with acute appendicitis complicated with ileus by computed tomography scan. A nasogastric tube was inserted for the ileus preoperatively. He underwent laparoscopic appendectomy, during which periappendiceal abscess with local peritonitis was noted. The nasogastric tube was removed on the first postoperative day, but symptoms of ileus developed again. Urografin study revealed contrast media retaining in the small bowel, so nasogastric tube reinsertion was performed. The nasogastric tube was removed on the ninth postoperative day after the recovery from ileus. The patient was discharged on the thirteenth postoperative day.ConclusionPatients of acute appendicitis with ileus should be assessed carefully. Nasogastric tubes shouldn’t be removed until the following requirements are satisfied: Firstly, symptoms of abdominal distention and nausea relieve. Secondly, no more hypoactive bowel sounds are found. And finally, nasogastric tube drainage becomes less than 200mL per day, or the passage of flatus or stool presents.

scholarly journals Excessive dynamic airway collapse during general anesthesia: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Shunichi Murakami ◽  
Shunsuke Tsuruta ◽  
Kazuyoshi Ishida ◽  
Atsuo Yamashita ◽  
Mishiya Matsumoto
Keyword(s):  
General Anesthesia ◽  
Airway Pressure ◽  
Positive End Expiratory Pressure ◽  
Computed Tomography Scan ◽  
Case Presentation ◽  
Airway Lumen ◽  
Asthma Attack ◽  
Airway Collapse ◽  
History Of ◽  
Tomography Scan

Abstract Background Excessive dynamic airway collapse (EDAC) is an uncommon cause of high airway pressure during mechanical ventilation. However, EDAC is not widely recognized by anesthesiologists, and therefore, it is often misdiagnosed as asthma. Case presentation A 70-year-old woman with a history of asthma received anesthesia with sevoflurane for a laparotomic cholecystectomy. Under general anesthesia, she developed wheezing, high inspiratory pressure, and a shark-fin waveform on capnography, which was interpreted as an asthma attack. However, treatment with a bronchodilator was ineffective. Bronchoscopy revealed the collapse of the trachea and main bronchi upon expiration. We reviewed the preoperative computed tomography scan and saw bulging of the posterior membrane into the airway lumen, leading to a diagnosis of EDAC. Conclusions Although both EDAC and bronchospasm present as similar symptoms, the treatments are different. Bronchoscopy proved useful for distinguishing between these two entities. Positive end-expiratory pressure should be applied and bronchodilators avoided in EDAC.

scholarly journals Spontaneous Perinephric Urinoma Secondary to Drug Induced Acute Interstitial Nephritis: A Case Report

2021 ◽  
Author(s):  
Rajesh Kumar Varatharajaperumal ◽  
Rupa Renganathan ◽  
V Mangalakumar ◽  
Sriman Rajasekaran ◽  
Venkatesh Kasi Arunachalam
Keyword(s):  
Abdominal Pain ◽  
Interstitial Nephritis ◽  
Lower Abdominal Pain ◽  
Acute Interstitial Nephritis ◽  
Computed Tomography Scan ◽  
Drug Induced ◽  
Significant Deterioration ◽  
Loin Pain ◽  
Tomography Scan ◽  
Collecting System

AbstractUrinoma is defined as the extravasation of urine from any part of the urinary collecting system, which causes lipolysis of the surrounding fat, resulting in an encapsulated collection. The most common cause of urinoma is the direct obstruction of the urinary system. The other etiologies include trauma and postinstrumentation/surgery. Parenchymal cause for spontaneous urinoma is exceedingly rare. We present a case of a 30-year-old gentleman who presented with lower abdominal pain and was treated with a Diclofenac injection. The pain got better temporarily, but he presented again with right loin pain after 3 days. His computed tomography scan images revealed bilateral perinephric urinoma. As there was significant deterioration of renal function, he underwent a renal biopsy. The histopathology was reported as acute interstitial nephritis (AIN). Drug-induced AIN is very rarely presented with acute loin or abdominal pain due to spontaneous perinephric urinoma, as it was seen in our case.

scholarly journals 55 year-old Female with Hematuria

2020 ◽  
Vol 4 (2) ◽  
pp. 232-233
Author(s):  
Drew Long ◽  
Brit Long
Keyword(s):  
Computed Tomography ◽  
Renal Mass ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Flank Pain ◽  
Computed Tomography Scan ◽  
Case Presentation ◽  
Left Ureter ◽  
Tomography Scan

Case Presentation: A 55 year-old female presented to the emergency department with left sided abdominal pain and hematuria. Computed tomography scan of her abdomen and pelvis demonstrated a large left renal mass with extension into the left ureter, left renal vein, and inferior vena cava. She was admitted and treated for presumed renal cell carcinoma (RCC). Discussion: RCC may present with abdominal or flank pain and hematuria, but more commonly presents with vague symptoms. RCC should be suspected in a patient presenting with hematuria and abdominal or flank pain, especially if vague symptoms such as fatigue or anorexia are also present.

scholarly journals The Infection Returns: A Case of Pulmonary Sporotrichosis Relapse after Chemotherapy

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Samid M. Farooqui ◽  
Houssein Youness
Keyword(s):  
Fungal Infections ◽  
Left Lung ◽  
Sporothrix Schenckii ◽  
Computed Tomography Scan ◽  
Dimorphic Fungus ◽  
Carcinoma Of The Esophagus ◽  
Case Presentation ◽  
The Past ◽  
Thoracic Computed Tomography ◽  
Tomography Scan

Background. Pulmonary sporotrichosis is a rare disease caused by a dimorphic fungus, Sporothrix schenckii. It is rarely found in association with malignancy. We present a case of pulmonary sporotrichosis recurrence after chemotherapy. Case Presentation. A 44-year-old man, treated for pulmonary sporotrichosis in the past, presented with dysphagia and was found to have squamous cell carcinoma of the esophagus. After undergoing chemotherapy, extensive cavitary lesions were observed on thoracic computed tomography scan. A bronchoalveolar lavage revealed the presence of Sporothrix schenckii sensu lato. Despite treatment with itraconazole, he eventually required a left pneumonectomy for progressive destructive cavitary lesions involving the left lung. Conclusion. This case highlights the importance of considering past fungal infections, albeit cured, in patients initiating immunosuppressive therapy.

scholarly journals TP10.2.13Outcome of Acute appendicitis management during COVID-19 pandemic in a tertiary hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Su Kwan Lim
Keyword(s):  
Acute Appendicitis ◽  
Readmission Rate ◽  
Best Practice ◽  
Tertiary Hospital ◽  
Inclusion Criteria ◽  
Computed Tomography Scan ◽  
Intravenous Antibiotics ◽  
The Uk ◽  
Surgical Unit ◽  
Tomography Scan

Abstract Aim Coronavirus (COVID) has influenced the management of acute appendicitis. The Royal Colleges of Surgeons recommend best practice depending on local circumstances. The aim of this project is to assess the 30-day outcome of patients managed operatively and conservatively for acute appendicitis during the first wave of the pandemic in the UK. Method Patient data were collected prospectively at the end of March 2020, when Covid-19 became prevalent in the UK and lockdown started. Data was collected for patients admitted to the acute surgical unit for the admission dates of 20/03/2020 to 15/05/2020. At 30 days after admission, a search was done on the electronic clinical portal to check if the patient was readmitted for operation. The inclusion criteria are any patients above 16-year-old admitted through acute surgical unit with a clinical diagnosis of acute appendicitis or computed tomography scan findings of proven acute appendicitis. Result A total of 34 patients (median age, 33; range, 17-74) were identified from March 2020 to May 2020. All patients have covid-19 status as negative and were given intravenous antibiotics at point of admission. All patients received a course of seven-day of antibiotic. 17 patients underwent operation and 17 patients were managed conservatively. Only one patient who was treated conservatively for acute appendicitis, was re-admitted within 30 days of admission date. Discussion The readmission rate of patients treated conservatively for acute appendicitis after 30 days were low during the first wave of the pandemic.

scholarly journals Appendiceal diverticulitis presenting as acute appendicitis diagnosed postoperatively

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Majid Z Albeeshi ◽  
Abdullah A Alwanyan ◽  
Alaa A Salim ◽  
Ibrahim T Albabtain
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diverticular Disease ◽  
Laparoscopic Appendectomy ◽  
Rare Entity ◽  
Computed Tomography Scan ◽  
History Of ◽  
Appendiceal Diverticulitis ◽  
Tomography Scan

Abstract Appendiceal diverticular disease is a rare entity. We report a case of appendiceal diverticulitis mimicking acute appendicitis and diagnosed postoperatively on histopathology. A 28-year-old female presented with a 2-day history of shifting periumbilical pain associated with nausea and anorexia. A computed tomography scan of the abdomen demonstrated acute appendicitis. She was taken to laparoscopic appendectomy. Histopathology showed appendiceal diverticulitis, and perforation of an inflamed diverticulum with periappendicitis. Diverticulosis of the appendix is classified as congenital and acquired. Diagnosis can be made preoperatively by imaging. In this case, diverticulosis was not radiologically evident, and was interpreted as acute appendicitis. Gross appearance of the resected appendix was not suggestive of diverticulitis. Other cases reported that the gross specimen had evidence of diverticular disease. Surgeons should be aware that inflamed appendixes may harbor different pathologies warranting further management.

Treatment of upper extremity venous aneurysms with a polytetrafluoroethylene-covered stent

Vascular ◽  
2016 ◽  
Vol 25 (4) ◽  
pp. 439-441
Author(s):  
David Parizh ◽  
Jesse Victory ◽  
Syed Ali Rizvi ◽  
Anil Hingorani ◽  
Enrico Ascher
Keyword(s):  
Subclavian Vein ◽  
Covered Stent ◽  
Open Approach ◽  
Significant Morbidity ◽  
Computed Tomography Scan ◽  
Open Resection ◽  
Case Presentation ◽  
Aneurysm Resection ◽  
Viable Method ◽  
Tomography Scan

Background Venous aneurysms of the upper torso are uncommon in contrast to the abdomen and lower extremities. Mostly silent, they can cause significant morbidity. Large or symptomatic venous aneurysms are generally treated with open resection. To our knowledge, there are no documented cases of head and neck venous aneurysms treated by a hybrid endovascular and open approach. Case Presentation A 56-year-old female presented with the complaint of pain and increasing size of a supraclavicular mass. Imaging revealed a large saccular aneurysm of the subclavian vein with the presence of a large intramural thrombus on computed tomography scan with contrast. A covered stent was deployed in order to exclude the aneurysm from circulation. Three weeks later, the symptoms continued, and an aneurysmorrhaphy was performed to excise the stent and aneurysm resection. Discussion A combined endovascular and open approach to resection of symptomatic subclavian vein aneurysms is a viable method with minimal morbidity.

scholarly journals Nonspecific orbital inflammation and thyroid eye disease, a rare comorbidity: report of two cases and review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bahram Eshraghi ◽  
Amin Dehghan ◽  
Niloofar Javadi ◽  
Mohammadreza Fazel
Keyword(s):  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Review Of Literature ◽  
Computed Tomography Scan ◽  
Inflammatory Mass ◽  
Case Presentation ◽  
Orbital Inflammation ◽  
Tomography Scan ◽  
Pathological Assessment ◽  
New Onset

Abstract Background To present the very rare comorbidity of developing non-specific orbital inflammation (NSOI) in two patients with histories of definite thyroid eye disease (TED). Case presentation Both patients complained of new-onset progressive proptosis although their thyroid disease was controlled and computed tomography scan revealed an intraorbital inflammatory mass. The pathological assessment indicated that both patients had developed fibrosing NSOI. Therefore, intravenous corticosteroids were administered. The mass regressed and the amount of proptosis was decreased in both patients. Conclusions We reviewed all related cases in the literature and extracted their clinical and radiological characteristics for this paper. Ophthalmologists should consider TED and NSOI in patients with a new-onset complaint of proptosis. Despite rare comorbidity of TED and NSOI, it should be considered especially in patients with refractory proptosis, and lead to its further evaluation and prompt management.

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