scholarly journals Atypical Manifestation of Crohn’s Disease in a Teenage Girl

2021 ◽  
Vol 10 (1) ◽  
pp. 187-195
Author(s):  
E. V. Donskaya ◽  
V. P. Gavrilyuk ◽  
S. V. Kostin ◽  
D. A. Severinov ◽  
L. Y. Zakutayeva
Keyword(s):  
Crohn’S Disease ◽  
Body Temperature ◽  
Crohn's Disease ◽  
Abdominal Wall ◽  
Transverse Colon ◽  
Anterior Abdominal Wall ◽  
Abdominal Cavity ◽  
The Body ◽  
Greater Omentum ◽  
Teenage Girl

Crohn’s disease (CD) is nonspecific granulomatous inflammatory disease of all layers of the intestinal wall, characterized by a variety of clinical forms, heterogeneity of age groups of children and extraintestinal manifestations.  The diagnosis of the disease is difficult due to the presence of many  symptoms specific to a number of other surgical diseases of the abdominal cavity organs. This diagnosis is often made intraoperatively. In this study we report a case of treatment of a teenage girl who was admitted with complaints of a mass in the right iliac region extruding above the skin surface, instability of body weight, an increase in body temperature to 37.2° C for one month. As a result of laboratory and instrumental examination, the etiology was not established. Laparoscopy revealed abdominal infiltrate, consisting of the cecum, the distal ileum and a part of the greater omentum, tightly fixed to the anterior abdominal wall, which led to the destruction ofthe peritoneum, muscle tissue and aponeurosis with further infiltration into the sub-cutaneous fat. Appendectomy and separation of the infiltrate were performed. After that, the girl was discharged due to the categorical refusal of the parents of the further treatment.Twelve days later the patient had abdominal pain again, the dynamics of the pain syndrome intensified, the body temperature was febrile. After examination and detection of signs of peritonitis, emergency laparotomy, subtotal resection of the greater omentum, separation of the abdominal infiltrate (repeated), sanitation and drainage of the abdominal cavity were performed. During the surgery, the access to the abdominal cavity was performed with technical difficulties due to the fact that a conglomerate of intestinal loops and omentum was fixed to the anterior abdominal wall from the interior. The conglomerate was separated from the anterior abdominal wall by blunt dissection. The size of the conglomerate was up to 12–15 cm, formed by the transverse colon, the ileum and the greater omentum. The walls of the transverse colon and ileum in the area of the conglomerate had the cartilaginous density. For the purpose of further examination and determination of tactics for further treatment, the child was transferred to the Gastroenterology Department with a diagnosis of “Terminal ileitis. Purulent omentitis. Serous peritonitis. Mild normochromic anemia of mixed origin. Crohn’s disease?” After the additional examination in a specialized hospital, the diagnosis of CD was confirmed.

scholarly journals RARE COMPLICATION OF CROHN’S DISEASE WITH LOCALIZATION IN THE INFLAMMATORY INTESTINE IN THE F0ORM OF THE SPREAD OF INFLAMMATORY OF THE PROCESS ON THE ANTERIOR ABDOMINAL WALL WITH FORMATION ABSCESS AND ITS DISCLOSURE IN THE NAVEL

2021 ◽  
pp. 66-70
Author(s):  
O. A. Povch ◽  
S. O. Rebenkov ◽  
A. V. Kovalchuk ◽  
A. B. Bilyakov-Belskiy ◽  
V. M. Sidorenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rare Complication ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Right Hemicolectomy ◽  
Complicated Course

The purpose of the study. Show a rare variant of the clinical course of complications of Crohn’s disease (СD). To analyze the anamnestic data, symptoms, clinical manifestations, preoperative diagnosis, features of surgery, postoperative period and the results of histological examination in a patient with CD who had complications in the form of transition of inflammation from the ileal wall to the anterior abdominal wall with abscess formation, opening it in the navel and the formation of a fistula. Material and methods. An analysis of the case of a complicated course of CD, manifested by the transition of inflammation from the ileum to the anterior abdominal wall, the formation of an abscess, its breakthrough into the navel and the formation of a fistula in the umbilical region. This complication was detected only after urgent computed tomography of the abdominal cavity and small pelvis (CTACSP). Results. The patient, despite the history of complaints, performed appendectomy, in which the removed appendix did not fully correspond to the clinical manifestations and data of CTACSP, in which CD was suspected, did not complete the examination, was not consulted by gastroenterologists and proctologists. He was urgently hospitalized with a clinic similar to acute purulent omphalitis. Only careful collection of the anamnesis and performance of urgent CTACSP allowed to suspect existence at the patient of the complicated course of CD. This allowed us to predict the course of surgery, perform a right hemicolectomy with excision of the altered tissues of the anterior abdominal wall and suturing the wound in the form of a laparostomy. The patient’s condition improved, he was discharged from the hospital. Conclusions. Patients with suspected CD should be monitored and treated by gastroenterologists and proctologists. Careful collection of anamnesis in patients of this group and the implementation of emergency CTACSP allowed to establish a correct diagnosis in the preoperative period.

The reaction of the soft tissues of the anterior abdominal wall to various suture material

1982 ◽  
Vol 63 (4) ◽  
pp. 72-74
Author(s):  
V. P. Nefedov ◽  
R. M. Ramazanov
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Soft Tissues ◽  
Suture Material ◽  
Anterior Abdominal Wall ◽  
The Body ◽  
Reactive Changes ◽  
Healing Processes

The healing processes of sutured wounds of soft tissues in most cases depend on the type and quality of the suture material. Any kind of suture material in the tissues of the body is a foreign body that causes various reactive changes from the tissues. The nature of these changes, all other things being equal, is mainly determined by the type of suture material, its thickness and the method of sterilization of the tissues on which the sutures are applied, the trauma of surgery, the infection of the wound and the irritating effect of the threads on the tissues.

Surgical Anatomy of the Retroperitoneal Spaces Part II: The Architecture of the Retroperitoneal Space

2010 ◽  
Vol 76 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Petros Mirilas ◽  
John E. Skandalakis
Keyword(s):  
Urinary Bladder ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Anterior Part ◽  
Abdominal Cavity ◽  
Surgical Anatomy ◽  
Preperitoneal Space ◽  
Renal Fascia ◽  
Pelvic Wall ◽  
Prevesical Space

The extraperitoneal space extends between peritoneum and investing fascia of muscles of anterior, lateral and posterior abdominal and pelvic walls, and circumferentially surrounds the abdominal cavity. The retroperitoneum, which is confined to the posterior and lateral abdominal and pelvic wall, may be divided into three surgicoanatomic zones: centromedial, lateral (right and left), and pelvic. The preperitoneal space is confined to the anterior abdominal wall and the subperitoneal extraperitoneal space to the pelvis. In the extraperitoneal tissue, condensation fascias delineate peri- and parasplanchnic spaces. The former are between organs and condensation fasciae, the latter between this fascia and investing fascia of neighboring muscles of the wall. Thus, perirenal space is encircled by renal fascia, and pararenal is exterior to renal fascia. Similarly for the urinary bladder, paravesical space is between the umbilical prevesical fascia and fascia of the pelvic wall muscles—the prevesical space is its anterior part, between transversalis and umbilical prevesical fascia. For the rectum, the “mesorectum” describes the extraperitoneal tissue bound by the mesorectal condensation fascia, and the pararectal space is between the latter and the muscles of the pelvic wall. Perisplanchnic spaces are closed, except for neurovascular pedicles. Prevesical and pararectal (presacral) and posterior pararenal spaces are in the same anatomical level and communicate. Anterior to the anterior layer of the renal fascia, the anterior interfascial plane (superimposed and fused mesenteries of pancreas, duodenum, and colon) permits communication across the midline. Thus parasplanchnic extraperitoneal spaces of abdomen and pelvis communicate with each other and across the midline.

scholarly journals Rare case of synovial sarcoma of anterior abdominal wall in a young Indian male

2017 ◽  
Vol 4 (7) ◽  
pp. 2358
Author(s):  
Abhishek Katyal ◽  
Yash Patel
Keyword(s):  
Abdominal Wall ◽  
Synovial Sarcoma ◽  
Rare Case ◽  
Anterior Abdominal Wall ◽  
Close Association ◽  
Abdominal Cavity ◽  
Typically Develop ◽  
Synovial Sarcomas ◽  
Upper Abdominal ◽  
Malignant Soft Tissue

Synovial Sarcomas (synoviomas) are the fourth most common malignant soft-tissue tumours, and typically develop in para-articular locations of the extremities in close association with joint capsules, tendon sheaths, bursae and fascial structures. Other less common sites include the head and neck, abdominal wall, intra-abdominal cavity, and mediastinum. In this article, an interesting and rare case of a 25-year-old man with left upper abdominal lump is reported which was subsequently diagnosed as biphasic synovial sarcoma (spindle cell variety) of anterior abdominal wall. 

scholarly journals Crohn's Disease with a Left Psoas Muscle Abscess and an Abdominal Wall Abscess : a Case Report

2003 ◽  
Vol 15 (4) ◽  
pp. 351-356 ◽  
Author(s):  
Naokuni YASUDA ◽  
Makoto WATANABE ◽  
Tomokazu KUSANO ◽  
Akira TSUNODA ◽  
Mitsuo KUSANO
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Abdominal Wall ◽  
Psoas Muscle ◽  
Abdominal Wall Abscess ◽  
Left Psoas Muscle

scholarly journals Mirrored Appearance of Complete Common Mesentery Discovered on CT Scan for Crohn's Disease

2021 ◽  
Author(s):  
Odette Ndikumana ◽  
Fatima Zahra Badi ◽  
Oumar Djidda ◽  
Mouna Sabiri ◽  
Samia Elmanjra ◽  
...  
Keyword(s):  
Small Intestine ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Mirror Image ◽  
Wall Thickening ◽  
Rectosigmoid Junction ◽  
History Of ◽  
The Right

Incomplete 90° intestinal rotation in a clockwise direction results in complete common mesentery being placed in a mirror image to and with a similar appearance to complete common mesentery. This rotation places the colon in the right half of the abdominal cavity and the small intestine in the left half of the abdominal cavity. We report the case of a 19-year-old patient with a history of cerebral palsy secondary to meningitis who presented with melaena and inflammatory anaemia. CT enterography was performed which showed regular, non-stenosing circumferential wall thickening of the sigmoid colon and rectosigmoid junction compatible with Crohn's disease, which was confirmed by pathophysiology. It also revealed transposition of the colon to the right hemi-abdomen and the small intestine to the left hemi-abdomen, the caecum to the right iliac fossa, and the third portion of the duodenum to the left of the mesenteric vessels.

scholarly journals CRITICAL ANALYSIS OF EXPERIMENTAL MODEL FOR STUDY OF ADHESIONS AFTER INCISIONAL HERNIAS INDUCED IN RATS’ AND REPAIR OF ABDOMINAL WALL WITH DIFFERENT BIOMATERIALS

2015 ◽  
Vol 28 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Leonardo Carvalho SERIGIOLLE ◽  
Renato Lamounier BARBIERI ◽  
Helbert Minuncio Pereira GOMES ◽  
Daren Athiê Boy RODRIGUES ◽  
Sarah do Valle STUDART ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Experimental Model ◽  
Primary Repair ◽  
Statistical Significance ◽  
Abdominal Cavity ◽  
Incisional Hernia Repair ◽  
Greater Omentum ◽  
Abdominal Wall Defects ◽  
Hernia Sac ◽  
Incisional Hernias

Background: Adhesions induced by biomaterials experimentally implanted in the abdominal cavity are basically studied by primary repair of different abdominal wall defects or by the correction of incisional hernias previously performed with no precise definition of the most appropriate model. Aim: To describe the adhesions which occur after the development of incisional hernias, before the prosthesis implantation, in an experimental model to study the changes induced by different meshes. Methods: Incisional hernias were performed in 10 rats with hernia orifices of standardized dimensions, obtained by the median incision of the abdominal wall and eversion of the defect edges. Ten days after the procedure adhesions of abdominal structures were found when hernias were repaired with different meshes. Results: The results showed hernia sac well defined in all rats ten days after the initial procedure. Adhesions of the greater omentum occurred in five animals of which two also showed adhesions of small bowel loops besides the omentum, and another two showed liver adhesions as well as the greater omentum, numbers with statistical significance by Student's t test (p<0.05). Conclusion: Although it reproduces the real clinical situation, the choice of experimental model of incisional hernia repair previously induced implies important adhesions, with possible repercussions in the evaluation of the second operation, when different implants of synthetic materials are used.

scholarly journals Hormonal Contraception and the Development of Autoimmunity: A Review of the Literature

2017 ◽  
Vol 84 (3) ◽  
pp. 275-295 ◽  
Author(s):  
William V. Williams
Keyword(s):  
Crohn’S Disease ◽  
Immune System ◽  
Crohn's Disease ◽  
Autoimmune Diseases ◽  
Interstitial Cystitis ◽  
White Blood Cells ◽  
The Body ◽  
Hormonal Contraceptives ◽  
Chemical Components ◽  
Increased Risk

Estrogens and progestins are known to have profound effects on the immune system and may modulate the susceptibility to autoimmune diseases. A comprehensive literature search was carried out using PubMed for any of 153 autoimmune disease terms and the terms contraception, contraceptive, or their chemical components with limits of Humans + Title or Abstract. Over 1,800 titles were returned and scanned, 352 papers retrieved and reviewed in depth and an additional 70 papers retrieved from the bibliographies. Based on this review, substantial evidence exists linking the use of combined oral contraceptives to a lower incidence of hyperthyroidism, an increase in multiple sclerosis, ulcerative colitis, Crohn's disease, Systemic Lupus Erythematosus, and interstitial cystitis. Progesterone only contraceptives are linked to progesterone dermatitis and in one large developing world concurrent cohort study are associated with increases in arthropathies and related disorders, eczema and contact dermatitis, pruritis and related conditions, alopecia, acne, and urticaria. Hormonal contraceptives modulate the immune system and may influence the susceptibility to autoimmune diseases with significant increases in risk for several autoimmune diseases. Summary Hormonal contraceptives (HCs), such as the “pill,” Norplant, and vaginal rings, are very potent hormones that have effects on the immune system, which is made up of white blood cells and lymph nodes and normally defends the body against invading bacteria, viruses and parasites. This review looked at the association of HC use to the development of autoimmune diseases, where the immune system turns against the body and causes damage to organs. There is good evidence that HC use is associated with an increased risk of several serious autoimmune diseases such as Crohn's disease (which causes inflammation of the bowels), Lupus (which causes inflammation in many organs), and interstitial cystitis (which causes inflammation in the bladder). Several other rarer autoimmune diseases are also linked to HC use. People contemplating the use of HCs should be informed of these risks.

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