scholarly journals Inflammatory Pseudotumor of Omentum Containing Gas Misdiagnosed as Perforation of Hollow Organs

2021 ◽  
Author(s):  
Shiwen Nie ◽  
Yadong He ◽  
Shuo Zhang ◽  
Fenghong Cao
Keyword(s):  
Inflammatory Pseudotumor ◽  
Epigastric Pain ◽  
Treatment Plan ◽  
Abdominal Cavity ◽  
White Blood Cells ◽  
Previous History ◽  
Clinical Manifestations ◽  
Emergency Operation ◽  
Good Prognosis ◽  
Pathological Examination

Abstract BackgroundInflammatory pseudotumors that grow on the omentum are relatively rare, and inflammatory pseudotumor most often involves the lung. As far as we know, the inflammatory pseudotumor of omentum, which is in the shape of beaded vesicles and contains gas, has never been reported in the literature. Case presentationwe report a 45-year-old Chinese woman who complained of epigastric pain with hematemesis for 9 hours, physical examination showed subxiphoid tenderness, previous history of gastric ulcer and repair of gastric perforation, laboratory examination showed slight increase of white blood cells and decrease of hemoglobin. Computed tomography showed dotted free gas in the abdominal cavity, and the perforation of the hollow organs was considered. The pathological results after emergency operation showed that histiocyte aggregation with multinucleated giant cell reaction could be seen in the omental tissue. Immunohistochemistry :ER (-), PR (-), PAX-8 (-), CK (mesothelial+), MC (mesothelial+), CR (mesothelial+), CD68 (histiocyte+), SMA (smooth muscle+). The abdominal pain was relieved after surgical resection of the tumor, and recovered well after symptomatic treatment.ConclusionInflammatory pseudotumor of omentum containing gas is easily diagnosed as perforation of hollow organs, with few clinical manifestations of acute abdomen, mostly non-specific, and a good prognosis. Understanding its clinicopathological features and pathological examination methods are helpful to diagnose the disease, so as to choose an appropriate treatment plan, and whether surgical treatment is better than conservative treatment remains to be further studied. The disease should be distinguished from perforation of hollow organs, but the source of gas is unknown. It may have something to do with past medical history.

scholarly journals Inflammatory Pseudotumor in the Nasal Cavity and Sinuses: A Case Report and Associated Literature Review

2020 ◽  
pp. 014556132092448
Author(s):  
Jing Li ◽  
Maohua Wang ◽  
Wangwei Li ◽  
Yuejin Tao ◽  
Xinyi Shi
Keyword(s):  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Inflammatory Pseudotumor ◽  
Plasma Cells ◽  
Clinical Manifestations ◽  
Good Prognosis ◽  
Benign Condition ◽  
Ocular Symptoms ◽  
Facial Swelling ◽  
The Right

Inflammatory pseudotumor (IP) is a clinically aggressive but histologically benign condition of unknown cause. It rarely appears in the nasal cavity and sinuses. Here, we describe a 24-year-old female with the main symptom of right nasal obstruction. Examinations showed dilation in the right maxillary sinus and a pale neoplasm in the nasal cavity. The neoplasm was completely excised under endoscope. Postoperative pathology showed significant proliferation of plasma cells and lymphocytes, indicating the presence of IP. No recurrence was found during 20 months of follow-up. Only 28 cases (10 males and 18 females, average 41.04 years) have been reported on Pubmed. The main clinical manifestations were nasal obstruction, epistaxis, facial swelling and pain, eyeball protrusion, diplopia, and other ocular symptoms. Inflammatory pseudotumor always erodes the surrounding bone and requires active treatments. Surgery is the optimal option with a good prognosis.

scholarly journals Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Suying Zhou ◽  
Yundan Xiao ◽  
Xin Liu ◽  
Yi Zhong ◽  
Haitao Yang
Keyword(s):  
Uric Acid ◽  
Literature Review ◽  
Previous History ◽  
Clinical Manifestations ◽  
Granulomatous Inflammation ◽  
Pathological Examination ◽  
Cervical Disc ◽  
Disc Space ◽  
Infectious Spondylodiscitis ◽  
Vertebral Endplates

Abstract Background Gout in spine is rare and commonly mimics some infectious or tumoral lesions, the differentiation of spinal gout from other diseases is not always easy. We report a case of gout involved cervical disc and adjacent vertebral endplates whose etiology was initially not determined. Compared with the previous published 10 similar cases, this case displayed a complete and continuous image data with higher image quality and resolution than before. So we give a brief literature review for concerning cervical gout, with the emphasis on the discussion of radiological findings. Case presentation A 50-year-old male with a 5-year history of neck and shoulder pain had muscle atrophy and weakness in both arms. Physical examination revealed multiple tophi were seen in left wrist, both feet and knee; bilateral superficial sensory declined below level of mastoid portion and the muscle strengths of limbs decreased. Laboratory findings showed hyperuricemia and the C-reactive protein level was very high. Imaging studies including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed abnormality of the C5–6 intervertebral disc and irregular osteolytic destruction of both adjacent C5–6 endplates, narrowing of C5–6 disc space and swelling of prevertebral soft tissue. Under the circumstance of the lesions being not determined and nerve root symptoms, surgical treatment was performed and pathological examination of the specimen revealed deposited uric acid crystals surrounded by granulomatous inflammation. After surgery combined with pharmaceutical and rehabilitation treatment, the muscle strengths of limbs, the pain of neck and shoulder and the level of serum uric acid were all improved. Conclusions Cervical spinal gout involving the disc and adjacent vertebral endplates is uncommon and may misunderstand infectious spondylodiscitis. Physician and radiologist should take the gouty spondylitis into account with a combination with previous history and clinical manifestations when encountering with such this condition.

scholarly journals Surgical therapy for herlyn-werner-wunderlich (HWW) syndrome cases

2021 ◽  
Vol 5 (5) ◽  
pp. 152-156
Author(s):  
Pangastuti N ◽  
Rahman MN ◽  
Setyawan N
Keyword(s):  
Sigmoid Colon ◽  
Surgical Therapy ◽  
Previous History ◽  
Clinical Manifestations ◽  
Good Prognosis ◽  
Menstrual Blood ◽  
Vaginal Agenesis ◽  
Main Complaint ◽  
First Case ◽  
The Right

Introduction: One of the rare forms of Mullerian congenital ducts is Herlyn-Werner-Wunderlich (HWW) syndrome. HWW syndrome is usually found at puberty with nonspecific symptoms. Pelvic pain can be found both acute and chronic, dysmenorrhoea, as well as hematometra and hematocolpos. Early detection and treatment results in a good prognosis with fertility preservation. Case presentation: Two cases of Herlyn-Werner-Wunderlich (HWW) syndrome surgically performed were reported at Dr. Sardjito Yogyakarta Indonesia Central General Hospital in 2017-2018. Both cases are still children and at the age of puberty. The chief complaint in both cases it was reported to have the same main complaint, abdominal pain, with the condition having never experienced menstruation yet. On further examination it is known that pain is caused due to hematometra and hematosalping that occur in both cases. The first case with hematometra in the right hemiuterus and right hematosalpinx, while second case with hematometra in the uterus didelphys and bilateral hematosalpinx. One case with a normal vagina, and the other case of vaginal agenesis. There was previous history of surgery in both of cases. There are abnormalities in the urinary tract that occur together with these genital abnormalities. Surgical therapy is carried out with the main goal being to drain menstrual blood from hematometra and hematosalpinx. In first case which has a vagina within the normal range (9 cm long) and the inferior area of ​​the right hemiuterus which is bulging toward the vagina, an area can be identified for the drainage incision to drain the entire hematometra and hematosalpinx. In the second case with vaginal agenesis, neovagina which is made by sigmoid colon vaginoplasty surgery can be a way of menstrual blood flow for a lifetime. Conclusion: Clinical manifestations of Herlyn-Werner-Wunderlich (HWW) syndrome cases can be classified into 2 groups, complete and incomplete. Surgical treatment is based on the condition of the uterus and vagina. In the condition of cervical agenesis but with a normal vagina, surgery can be done by making an incision in the drainage of the uterine cervical tissue. If vaginal agenesis is obtained, vaginoplasty surgery can be performed, and one of the options is sigmoid colon vaginoplasty.

Clinical Manifestations and Radiological Characteristics on Rosai-Dorfman Disease: A Retrospective Observational Study

2020 ◽  
Vol 5 (5) ◽  
Keyword(s):  
Blood Vessels ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Ct Images ◽  
High Signal ◽  
Radiological Features ◽  
Imaging Characteristics ◽  
Rosai Dorfman Disease ◽  
Heterogeneous Enhancement ◽  
The Masses

Background and Objective: Rosai-Dorfman disease (RDD) are usually misdiagnosed because of rarity and nonspecific clinical and radiological features. The aim of our study is to explore the clinical and imaging characteristics of RDD to improve diagnostic accuracy. Methods: Clinical and imaging data in 10 patients with RDD were retrospectively analyzed. 7 patients were underwent CT scanning and 3 patients were underwent MR examination. Results: 8 (8/10) patients presented with painless enlarged lymph nodes (LNs) or mass. 3 cases were involved with LNs, 5 cases were involved with extra-nodal tissues, and the remaining 2 cases were involved with LNs and extra-nodal tissue simultaneously. In enhanced CT images, enlarged LNs displayed mild or moderate enhancement, and 2 cases showed heterogeneous ring-enhancement. MR features of 3 patients with extra-nodal RDD, 2 cases showed a mass located in the subcutaneous and anterior abdominal wall respectively, and 1 case showed an intracranial mass. Besides, all lesions showed high signal foci on DWI images, and were characterized by marked heterogeneous enhancement with blurred edge. The dural/fascia tail sign and dilated blood vessels could be seen around all the lesions on enhanced MRI. Radiological features of 2 cases with LN and extranodal tissue involved, one case presented with the swelling and thickening of pharyngeal lymphoid ring and nasopharynx, meanwhile with enlarged LNs in bilateral submandibular area, neck and abdominal cavity, and also companied with osteolytic lesion in right proximal humerus. All these LNs displayed mild and moderate enhancement on CT images. Another case showed enlarged LNs in bilateral neck accompanied with soft tissue mass in the sinuses. Conclusions: RDD occurred commonly in young and middle-aged men and presented with painless enlarged LNs or mass.RDD had a huge diversity of imaging findings, which varied with different location. The radiological features, such as small patches of high signal foci in the masses on DWI images, heterogeneous enhancement and blood vessels around the masses, are helpful in diagnosis of extranodal RDD.

scholarly journals Levator palpabrae superioris myositis as an unusual cause of unilateral ptosis—case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed M. Abdrabou
Keyword(s):  
Previous History ◽  
Good Prognosis ◽  
Oculomotor Nerve Palsy ◽  
Ophthalmological Examination ◽  
Bilateral Ptosis ◽  
Mri Findings ◽  
Upper Eyelid ◽  
Unilateral Disease ◽  
The Right ◽  
Mri Study

Abstract Background Ptosis can be a manifestation of a more serious situation. Hence, the analysis of the complaint and the search for etiology are crucial in such cases. Ptosis has many causes; some of them lead to unilateral ptosis while others cause bilateral ptosis. For instance, myasthenia gravis is a cause of bilateral ptosis while oculomotor nerve palsy induces unilateral disease. Proper evaluation of the patient and identification of the cause are important to achieve accurate management and good prognosis. Case presentation A 47-year-old male patient attended the ER complaining of dropping the right eye lid of 2 days’ duration. There was no associated pain or diplopia. On examination, the extraocular muscles’ (EOM) motility was intact, normal pupil and corneal reflexes, and there was swelling of the upper eyelid. Ophthalmological examination revealed normal anterior and posterior chambers as well as the vitreous and retina. The patient had a previous history of traumatic intracranial hemorrhage that was resolved without surgical intervention. He also had diabetes mellitus and hypertension. The patient was transferred to the MRI unit to perform MRI study of the brain and orbit with MRA and IV contrast administration. MRI findings confirmed the diagnosis of LPS myositis, and the patient received medical treatment and improved. Conclusion Proper radiological diagnosis leads to accurate management and achieves rapid recovery and optimal patient care.

scholarly journals A Review of the Major Prosthetic Factors Influencing the Prognosis of Implant Prosthodontics

2021 ◽  
Vol 10 (4) ◽  
pp. 816
Author(s):  
Javier Montero
Keyword(s):  
Animal Studies ◽  
Treatment Approach ◽  
Treatment Plan ◽  
Meta Analysis ◽  
Good Prognosis ◽  
Cochrane Library ◽  
Review Of The Literature ◽  
Hand Search ◽  
Related Risk

Background: The treatment plan of prosthetic restorations supported by dental implants requires comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A comprehensive review of the literature was conducted with a PICO (Patient Intervention Comparison Outcomes) question: “For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?”. A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS * OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%), or prospective evaluations of prosthesis with various kinds of events (18%). However, narrative reviews of literature (14%) and in vitro/animal studies (16%) were also found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.

scholarly journals Autologous Graft in the Anterior Maxilla—A Case Report

2021 ◽  
Vol 5 (1) ◽  
pp. 36
Author(s):  
Rodolfo Vaz ◽  
Pedro Gameiro ◽  
Pedro Sottomayor ◽  
Bernardo Saldanha ◽  
Pedro Rodrigues
Keyword(s):  
Bone Regeneration ◽  
Gold Standard ◽  
Treatment Plan ◽  
Previous History ◽  
Guided Bone Regeneration ◽  
Bone Thickness ◽  
Anterior Maxilla ◽  
Patient Morbidity ◽  
History Of ◽  
Palatal Bone

A 44-year-old male patient was referred to the Egas Moniz Dental Clinic, with a previous history of failed bone regeneration, resulting in a reduced buccal-palatal bone thickness and aesthetic compromise of the gingival margin of the anterior maxilla. Since the use of autologous bone is considered the “gold-standard” in guided bone regeneration, the treatment plan consisted of an autologous mental graft into the maxilla, with a simultaneous guided bone regeneration with a xenograft and absorbable membrane. This allowed a predictable volumetric bone regeneration with low patient morbidity and posterior fixed rehabilitation.

scholarly journals Pyosalpinx due to Cronobacter sakazakii in an elderly woman

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Satoshi Ohira ◽  
Eri Ikeda ◽  
Kyosuke Kamijo ◽  
Tomokuni Nagai ◽  
Koji Tsunemi ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
The Elderly ◽  
Pathological Examination ◽  
Milk Formula ◽  
Adult Women ◽  
Cronobacter Sakazakii ◽  
Left Edge ◽  
Powdered Milk ◽  
First Case

Abstract Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

scholarly journals Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis

2020 ◽  
Vol 14 (3) ◽  
pp. 668-674
Author(s):  
Hiroyuki Ito ◽  
Yusuke Mishima ◽  
Tsubomi Cho ◽  
Naoki Ogiwara ◽  
Yoshimasa Shinma ◽  
...  
Keyword(s):  
Cerebral Hemorrhage ◽  
Granulomatosis With Polyangiitis ◽  
Epigastric Pain ◽  
White Blood Cells ◽  
Gallbladder Wall ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Test Results ◽  
Laboratory Investigations ◽  
Eosinophilic Granulomatosis

We report a case of eosinophilic cholecystitis associated with eosinophilic granulomatosis with polyangiitis (EGPA) complicated by cerebral hemorrhage. A 60-year-old man presented to a local hospital with a diagnosis of acute cholecystitis, with persistent fever and epigastric pain for 2 weeks. His symptoms persisted despite 3-week hospitalization; therefore, he was transferred to our hospital for further evaluation. Laboratory investigations upon admission showed white blood cells 26,300/µL and significant eosinophilia (eosinophils 61%). Abdominal computed tomography revealed no gallbladder enlargement but a circumferentially edematous gallbladder wall. Additional blood test results were negative for antineutrophil cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies; however, immunoglobulin (Ig)G and IgE levels were high at 1,953 mg/dL and 3,040/IU/mL, respectively. He improved following endoscopic transnasal gallbladder drainage for cholecystitis and was diagnosed with EGPA and received corticosteroid and immunosuppressant combination therapy. The eosinophil count decreased immediately after treatment, and abdominal pain and numbness resolved. He returned with left-sided suboccipital hemorrhage likely attributed to EGPA 6 months after discharge. EGPA is characterized by inflammation of small blood vessels and clinically manifests with an allergic presentation of bronchial asthma, as well as renal dysfunction, interstitial pneumonia, enteritis, and cerebral hemorrhage. Few reports have described cholecystitis as a presenting symptom of EGPA. We report a rare case of such a presentation with added considerations.

SECRETORY CARCINOMA OF ENDOMETRIUM: A MORPHOLOGICAL MIMICKER POSING DIAGNOSTIC DILEMMA - A RARE CASE

2021 ◽  
pp. 32-33
Author(s):  
Dharani V C ◽  
Manjunath H K ◽  
Bhargavi Mohan ◽  
Varaprasad B M ◽  
Thej M J
Keyword(s):  
Endometrial Thickness ◽  
Good Prognosis ◽  
Endometrial Biopsy ◽  
Pathological Examination ◽  
Secretory Carcinoma ◽  
Diagnostic Dilemma ◽  
Immunohistochemical Markers ◽  
Obese Female ◽  
Well Differentiated ◽  
Post Menopausal

BACKGROUND: Secretory carcinoma of the endometrium, a rare subtype of endometrioid carcinoma morphologically resembles the early secretory phase of endometrium and is almost always well differentiated and carries excellent prognosis. Very few cases of secretory carcinoma have been reported in the literature till date. Case presentation:A 58 yr old obese female presented with post-menopausal bleeding. Ultrasound revealed increased endometrial thickness and endometrial biopsy showed hyperplasia without atypia in secretory transformation. Pathological examination of the hysterectomy specimen revealed features of secretory carcinoma of the endometrium as an incidental nding. CONCLUSION: Secretory carcinoma, a rare subtype of well differentiated endometrial carcinoma carries very good prognosis and morphologically mimics various pathological conditions of endometrium. Hence, this needs to be carefully evaluated morphologically in addition with immunohistochemical markers to arrive at an accurate diagnosis.

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