scholarly journals Incidentally detected pancake kidney:case report of an extremely rare congenital anomaly.

2020 ◽  
Author(s):  
Sabyasachi Bakshi
Keyword(s):  
Kidney Function ◽  
Lower Abdominal Pain ◽  
Pelvic Cavity ◽  
Abdominal Organs ◽  
Urine Examination ◽  
Medial Surfaces ◽  
Calculus Formation ◽  
History Of ◽  
Malignant Changes ◽  
Patient Department

Abstract Background:Congenital anomalies of urinary system are very common and have extremely varied presentation. Among them most rarely found structural anomaly is the pancake kidney. When both kidneys are fused along their medial surfaces to form a round shaped single renal mass is termed as Pancake kidney. In this case report, a pancake kidney was incidentally detected in a girl. The majority of subjects who have pancake kidney are usually symptom less but surgeons should be aware of coexisting malformation of other organs and its potential risk of developing malignancy.Case presentation:A 12-year-old young lady attended out-patient department with mild dull aching lower abdominal pain and dysuria. She had no history of fever, haematuria, menstrual abnormality, pelvic inflammatory disease or trauma. Urine examination showed traces of albumin and 10-12 pus cells/ HPF. She had normal kidney function test and digital X-ray of KUB region. A USG of the whole abdomen showed normal intra-abdominal organs except empty bilateral renal fossa. The Multi-Detector Computed Tomography(MDCT) scan of the whole abdomen revealed one round shaped mass measuring approximately 9 cm(vertical) X 10 cm(horizontal), in the pelvic cavity. That mass was finally identified as a pancake kidney. She was prescribed antibiotics based on urine culture, and sensitivity test that cured her symptoms. She was advised to follow-up regularly in Out-Patient Department to evaluate her kidney function and to rule out any neoplastic change.Conclusions: This condition can be managed conservatively, if the subject remains symptom less, by regular monitoring of renal function. Surgeon should remain alert for the development of infections, any obstructive manifestations leading to calculus formation and any malignant changes. The person should be careful in avoiding trauma to low-lying pelvic kidney. Extensive surgeries should be avoided and only selective procedures should be done so that the patient may lead a normal lifestyle.

Congenital Intercostal Hernia: A Rare Entity

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 48
Author(s):  
Syed Muzamil Andrabi ◽  
Mohd Yousuf Dar ◽  
Javid Ahmad Bhat
Keyword(s):  
Male Patient ◽  
General Surgery ◽  
Rare Entity ◽  
Intercostal Hernia ◽  
History Of ◽  
Lateral Chest ◽  
Patient Department

A 35-year-old male patient presented to the General Surgery Out Patient Department with a history of swelling on the left lateral chest since birth. The swelling appeared during inspiration and disappeared during expiration. JMS 2018;21(1):48 

Hypercalcaemia due to ovarian small cell carcinoma of the hypercalcaemic type

2021 ◽  
Vol 14 (7) ◽  
pp. e243571
Author(s):  
Annalisa Montebello ◽  
Mark Gruppetta
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Incidental Finding ◽  
Lower Abdominal Pain ◽  
Ovarian Tumour ◽  
Small Cell ◽  
Pelvic Radiotherapy ◽  
Wide Range ◽  
History Of ◽  
Parathyroid Hormone Related Peptide

A 37-year-old woman presented with a few days’ history of lower abdominal pain and an incidental finding of hypercalcaemia. A thorough workup ensued, and the cause was found to be an exceptionally rare ovarian tumour—ovarian small cell carcinoma of the hypercalcaemic type. Acute treatment of hypercalcaemia consisted of aggressive intravenous fluids and bisphosphonates. She underwent surgery to remove the tumour and is currently receiving systemic platinum/etoposide chemotherapy combination to be followed by pelvic radiotherapy. This case highlights the wide range of differential diagnosis for hypercalcaemia and the importance of a stepwise and thorough approach during investigations. We discuss the pathophysiology of malignancy-related hypercalcaemia, focusing especially on parathyroid hormone-related peptide-associated hypercalcaemia.

scholarly journals Prostatic Adenocarcinoma Metastatic to Pleomorphic Liposarcoma, a “Collision Phenomenon”: Report of a Case with Review of Pelvic Collision Tumors

2011 ◽  
Vol 2011 ◽  
pp. 1-7
Author(s):  
Somak Roy ◽  
Ronald L. Hrebinko ◽  
Kathleen M. Cieply ◽  
Anil V. Parwani ◽  
Uma N. M. Rao
Keyword(s):  
Pelvic Mass ◽  
Collision Tumor ◽  
The Body ◽  
Pathological Examination ◽  
Prior History ◽  
Pelvic Cavity ◽  
Collision Tumors ◽  
History Of ◽  
Conclusive Diagnosis

“Collision tumor” is an uncommon phenomenon characterized by coexistence of two completely distinct and independent tumors at the same site. Collision tumors have been reported in different sites in the body; however, these are particularly uncommon in the pelvic cavity. A 70-year-old man, with prior history of urothelial and prostate cancer, presented with a large pelvic mass detected on imaging studies. Pathological examination revealed a large liposarcoma with prostatic carcinoma embedded in it. Immunohistochemistry and florescence in situ hybridization studies were performed to reach to a conclusive diagnosis. To the best of our knowledge, this is the second case reported till date. We present the challenges encountered in the diagnosis of this case and review of pelvic collision tumors.

scholarly journals Superior Mesenteric Vein Thrombosis Associated with Hormonal Contraceptive Use

2016 ◽  
Vol 10 (2) ◽  
pp. 264-268 ◽  
Author(s):  
Nobuatsu Koyama
Keyword(s):  
Superior Mesenteric Vein ◽  
Ethinyl Estradiol ◽  
Lower Abdominal Pain ◽  
Hormonal Contraceptive ◽  
Laboratory Evaluation ◽  
Mesenteric Vein Thrombosis ◽  
Mesenteric Vein ◽  
Vein Thrombosis ◽  
Superior Mesenteric Vein Thrombosis ◽  
History Of

A 44-year-old woman was admitted with a 7-day history of lower abdominal pain and nausea. Physical examination demonstrated tenderness in the lower abdomen without signs of peritonitis. There were no specific findings in the laboratory evaluation. She had a history of dysmenorrhea for 15 years and was taking a combined hormonal contraceptive containing 0.02 mg ethinyl estradiol and 3 mg drospirenone for 19 months. Contrast-enhanced computed tomography showed superior mesenteric vein thrombosis (SMVT). Systemic anticoagulant infusion was immediately administered and the symptoms disappeared within 2 days. The thrombus disappeared after 3 months. This case report suggests that early diagnosis of SMVT and immediate systemic anticoagulant therapy may reduce the rate of intestinal infarction.

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

Enterocolic lymphocytic phlebitis: a rare pathology in children

2021 ◽  
Vol 14 (8) ◽  
pp. e243826
Author(s):  
Omar Nasher ◽  
Naved Alizai
Keyword(s):  
Surgical Resection ◽  
Preoperative Diagnosis ◽  
Diagnostic Laparoscopy ◽  
Adult Population ◽  
Lower Abdominal Pain ◽  
Paediatric Population ◽  
Rare Clinical Entity ◽  
Clinical Challenge ◽  
History Of ◽  
Venous Vasculature

Enterocolic lymphocytic phlebitis (ELP) is a rare pathology, usually seen in the adult population. The condition affects the venous vasculature of the intestine sparing the arteries and lymphatics. It is commonly identified histologically after surgical resection making the preoperative diagnosis a clinical challenge. As the condition can lead to intestinal ischaemia and necrosis, surgical resection of the affected segment is the treatment of choice. We report the case of a 9-year-old girl who presented with a 2-day history of lower abdominal pain and anorexia. The initial diagnosis of appendicitis was made clinically and the patient underwent a diagnostic laparoscopy . The appendix was macroscopically normal and there were no other obvious intra-abdominal pathologies to account for her presenting complaints . The appendix was removed, as per the preoperative discussion and consent from parents. She recovered well and was discharged home the following day. The histological examination of the appendix demonstrated ELP. We describe this rare clinical entity in a child especially in view of the scarce published literature in the paediatric population.

MO292MALIGNANT DISEASE IS MORE COMMON WITH DETERIORATING KIDNEY FUNCTION IN PATIENTS WITH MEMBRANOUS NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ivana Vukovic Brinar ◽  
Karlo Kurtov ◽  
Mario Laganovic ◽  
Zivka Dika ◽  
Marijana Ćorić ◽  
...  
Keyword(s):  
Kidney Function ◽  
Membranous Nephropathy ◽  
Malignant Disease ◽  
Initial Therapy ◽  
University Hospital ◽  
Long Term Follow Up ◽  
History Of ◽  
Kdigo Guidelines ◽  
Informatic System

Abstract Background and Aims Membranous nephropathy (MN) can be associated with tumor and present a paraneoplastic condition. Recently, development of tumors during the course of follow up is more in focus. It is especially interested whether patient with MN are prone to tumors, or tumors are condition indipendent of membranous nephropathy or consequence of imunosupressive therapy (IS). Method Retrospective data of all adult patients diagnosed with MN from 1987 to 2017 at the Department of Nephrology of University Hospital Centre Zagreb were analysed. Medical data regarding antropometric measeures and preexsisting comorbid disease at presentation and during follow up were derived from medical records and hospital informatic system. Furthermore, data regarding kidney function were used, namely serum creatinine (SCr), proteinuria. Renal function was assessed using CKD-EPI equation. CKD stages, partial and complete remission were defined according to KDIGO guidelines. Results From 1987 till 2017 a total of 122 patients were diagnosed with MN. Eighty nine (72.9%) were treated with imunosupressive therapy. Most commonly prescribed initial therapy was combination of corticosteroids and cyclophosphamide (N=66; 74%). Three (0,02%) patients had history of tumor with median of 3y (min – max 1-4 y) before glomerular disease presentation, two solid tumor, adenocarcinoma pulmonum and carcinoma prostatae, and one condition after allogenic haematopoetic transplantation due to acute myeloid leukemia. There was no difference in clinical presentation between those with positive history of malignant disease and others (proteinura 11.7 g/du (25-75C 3.4-15.7) vs. 5.8 g/dU (25-75C 3.4 – 8.5); p=0.232 and eGFR 57 ml/min/1,73m2 (25C-75C 14 – 59) vs. 81 ml/min/1.73m2 (25-75C 54 – 100); p=0.066). During follow up 11 (9%) patients developed tumor, median age of pts 67 y (min – max 59 – 71); nine solid tumors most comonly of gastrointestinal origin (pancreas, colon N=5 (45%)), then pulmonum (N=2(18%)) and urogenithal origin (ca renis and prostate N=2 18%). Also two hematological malignancies (B-ALL, B-NHL) occurred. Median time till confirmed malignant disease was 9 y (min – max 5 -24). At the time of detecting the tumor six (54%) patients were in complete and partial remission (4 and 2) and 2 (18%) patients had nephrotic syndrome. No difference was observed in proteinuria between those with malignant condition and other MN patients (1,4 g/dU (25 – 75C 0.2 – 5.6) vs. 0,29 g/dU (25 – 75C 0.13 – 0.74); P=0.154). MN patients with malignant disease during follow up had lower estimated glomerular filtration rate (eGFR 45 ml/min/1,73m2 (25 – 75C 22 – 70) vs. 77 (25 – 75C 58 – 92); p=0.010). There was no difference in cummulative dose of cyclophosphamide between those who developed tumor with others (24 g(25 – 75C13.5 – 30) vs. 27 g(25 – 75C 15 – 38)p=0.592). Conclusion Our data emphasize the need for long term follow up of patients with membranous nephropathy despite accomplishing remission of MN and period screening for malignant disease, especially in those with deteriorating kidney function.

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 Epiploic Appendagitis: An Often Misdiagnosed Cause of Acute Abdomen

2019 ◽  
Vol 13 (3) ◽  
pp. 364-368
Author(s):  
Vishnu Charan Suresh Kumar ◽  
Kishore Kumar Mani ◽  
Hisham Alwakkaa ◽  
James Shina
Keyword(s):  
Abdominal Pain ◽  
Bowel Wall ◽  
Acute Diverticulitis ◽  
Lower Abdominal Pain ◽  
Wall Thickening ◽  
Antibiotic Administration ◽  
Epiploic Appendagitis ◽  
High Attenuation ◽  
History Of ◽  
Bowel Wall Thickening

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.

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