scholarly journals SPONTANEOUS RUPTURE OF THE RIGHT CONGENITAL DIAPHRAGMATIC EVENTRATION ON THE RIGHT SUBJECTED TO SURGICAL CORRECTION IN A CHILD WITH MEGADOLICOCOLON

2021 ◽  
Vol 11 (3(41)) ◽  
pp. 55-61
Author(s):  
S. Babuci ◽  
O. Gorbatyuk ◽  
V. Eremia ◽  
V. Petrovici
Keyword(s):  
Spontaneous Rupture ◽  
Rare Complication ◽  
Abdominal Distension ◽  
Clinical Situation ◽  
Suture Line ◽  
Surgical Correction ◽  
Fibrin Adhesive ◽  
Diaphragmatic Eventration ◽  
Thoracic Approach ◽  
The Right

Спонтанний розрив гемідіафрагми у випадках вродженої діафрагмальної евентрації зустрічається вкрай рідко, у літературі повідомляють про унікальні випадки.In this context, the authors present the case of an 8-year-old child who was hospitalized in the coloproctology service for abdominal pain, lack of stool for more than 7 days, pronounced abdominal distension. The child suffers from Down's disease. In 2017, he was occasionally diagnosed with right diaphragmatic eventration and underwent surgical correction by thoracic approach. After a thorough evaluation, with signs suggestive of diaphragmatic hernia on the right, the child underwent surgery, intraoperatively the rupture of the right hemidiaphragm was found with intrathoracic ascension of the malrotated intestinal loops, transverse colon and omentum. The repair of the diaphragmatic eventration complicated by rupture was used using the “overcoat” folding procedure, on the suture line being carefully applied a collagen foil covered with components of the fibrin adhesive. The postoperative period passed without complications.Conclusion. Spontaneous rupture of the diaphragm is a rare complication in children with diaphragmatic eventration, especially on the right side, in this case obstruction of the malformative colon ascended intrathoracically with progressive dilation of the intestinal loops being responsible for distension with gradual thinning of the hemidiaphragm sac resulting malformation in diaphragmatic rupture with herniation and progressive obliteration of the pleural space. The case of rupture of the diaphragmatic eventration associated with megadolicocolon confirms that the respiratory symptoms characteristic of this clinical situation may be overshadowed by the predominance of signs of intestinal obstruction, without leading to sudden progressive clinical deterioration, which proved to be a misleading moment in diagnosis. certainty of this serious complication rarity.

scholarly journals Spontaneous Rupture of an Ovarian Dermoid Cyst Associated with Intra- Abdominal Chemical Peritonitis: Characteristic CT Findings

2019 ◽  
Vol 9 (2) ◽  
pp. 52-54
Author(s):  
Sapana Koirala ◽  
Kapil Adhikari ◽  
Sujan Khadka
Keyword(s):  
Spontaneous Rupture ◽  
Rare Complication ◽  
Cystic Teratoma ◽  
Abdominal Distension ◽  
Abdominal Ct ◽  
Pain Abdomen ◽  
Contrast Enhanced ◽  
Abdominal Ct Scan ◽  
Chemical Peritonitis ◽  
Ovarian Dermoid Cyst

Spontaneous rupture of mature cystic teratoma is a rare complication which results in leakage of the liquefied sebaceous contents into the peritoneum leading to acute or chronic peritonitis. We report a case of a 23-year-old female who presented with pain abdomen, abdominal distension and fever. Contrast enhanced abdominal CT scan showed right adnexal complex cystic lesion with discontinuity in its wall along with features of peritonitis.

scholarly journals Intraperitoneal Rupture of Ectopic Varices—a Rare Complication of Portal Hypertension

HPB Surgery ◽  
1994 ◽  
Vol 7 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Alastair N. J. Graham ◽  
Paul Mcaleese ◽  
R. John Moorehead
Keyword(s):  
Rare Complication ◽  
Abdominal Distension ◽  
Emergency Laparotomy ◽  
High Dose ◽  
Rare Occurrence ◽  
Ectopic Varices ◽  
Intraperitoneal Rupture ◽  
High Dose Aprotinin ◽  
The Right ◽  
Intraperitoneal Haemorrhage

A 50 year old man presented with sudden abdominal pain, abdominal distension and shock. At emergency laparotomy a large amount of blood was found in the peritoneal cavity. There was micronodular cirrhosis of the liver and the spleen was enlarged. The bleeding was traced to distended veins in the right paracolic gutter which were oversewn and the abdomen closed. A coagulopathy was diagnosed and treatment including high dose aprotinin commenced. However, he continued to bleed and at a second laparotomy the area of previous haemorrhage was packed. Further deterioration continued until death 12 hours later. Intraperitoneal haemorrhage from ectopic varices is a rare occurrence. There is a high mortality rate usually due to an advanced coagulopathy. This is the first report of aprotinin being used in an attempt to treat this. On the basis of this report aprotinin would not seem to be of benefit for this condition.

scholarly journals Obstruction of the Hepatic Venous Flow Caused by Intravenous Leiomyomatosis

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 696
Author(s):  
Sin-Youl Park ◽  
In Hwan Yeo ◽  
Yun Jeong Kim ◽  
Jong Kun Kim
Keyword(s):  
Early Recognition ◽  
Rare Complication ◽  
Vena Cava ◽  
Pelvic Mass ◽  
Abdominal Distension ◽  
Hepatic Veins ◽  
Intravenous Leiomyomatosis ◽  
Venous Flow ◽  
Bedside Ultrasonography ◽  
The Right

Budd–Chiari syndrome (BCS) is a rare intrahepatic vascular disease that is characterized by a hepatic venous outflow obstruction. Intravenous leiomyomatosis (ILs) is a rare complication of a myoma. Here, we report a case of BCS that was caused by intracaval ILs. A woman presented to the emergency department (ED) with abdominal distension that had gradually progressed over a period of 3 years. Bedside ultrasonography and contrast-enhanced computed tomography (CECT) showed a large ascites and pelvic mass. The mass continued to the inferior vena cava and the right atrium. The intracaval mass was obstructing the left and middle hepatic veins. We established a tentative diagnosis of BCS caused by intracaval ILs and attempted surgical resection. Complete resection of the intracaval mass failed because of adhesion; however, she was discharged from the hospital without any postoperative complications. After 3 months, a pelvic ultrasonography showed a recurrence of a 4 × 3 cm pelvic mass. The mass size increased to 6 cm after 30 months. ILs can cause secondary BCS and can lead to life-threatening conditions. Owing to its extreme rarity, early detection in the ED is challenging. Bedside ultrasonography and CECT can enable the early recognition of BCS by ILs.

scholarly journals Management of Bleed from Percutaneous Portal Puncture Site (post-BRTO) by Trans-jugular-Trans-Hepatic Embolization

2021 ◽  
Author(s):  
Raghav Seth ◽  
Arun Gupta ◽  
Ajit Yadav
Keyword(s):  
Portal Vein ◽  
Abdominal Distension ◽  
Clinical Situation ◽  
Elderly Male ◽  
Puncture Site ◽  
Endovascular Interventions ◽  
History Of ◽  
Upper Gi Endoscopy ◽  
The Right ◽  
Parenchymal Disease

AbstractWe report the case of an elderly male, who was a known case of chronic liver parenchymal disease. He presented with a history of melena for 2 weeks and upper-GI endoscopy revealed fundal varices. He was planned for BRTO. Along with BRTO, a percutaneous trans-hepatic puncture of a branch of the right portal vein was also performed for proper embolization of the varices. The trans-hepatic puncture-tract was embolized after the procedure. However, after 24 hours of the procedure, the patient developed hypotension and abdominal distension due to hemorrhage from the portal puncture site. Portal-venography was performed via the trans-jugular-trans-hepatic route to confirm the source of hemorrhage and embolization of the culprit portal venous branch was performed via the same route. The patient was stable after the procedure.Various interventional procedures via the trans-jugular route have been routinely described in the literature, including trans-jugular liver biopsies, placement of TIPSS shunts and endovascular interventions for haemodialysis. However, the literature on trans-jugular embolization of portal vein is scarce. This case describes the unexpected clinical situation, in the form of bleeding from the portal puncture site, despite embolization of the trans-hepatic tract after BRTO. Finally, a creative solution was thought of and trans-jugular embolization of the portal vein was performed, which succeeded in terminating the ongoing bleeding from the portal vein.

scholarly journals Spontaneous Rupture of Uterine Vein in Twin Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Emek Doger ◽  
Yigit Cakiroglu ◽  
Sule Yildirim Kopuk ◽  
Bertan Akar ◽  
Eray Caliskan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Spontaneous Rupture ◽  
Laboratory Tests ◽  
Twin Pregnancy ◽  
Acute Abdominal Pain ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Hypovolemic Shock ◽  
Third Trimester ◽  
The Right

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester.Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear.Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

scholarly journals Ovarian epithelioid angiosarcoma complicating pregnancy: a case report and review of the literature

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110196
Author(s):  
Xiaotong Peng ◽  
Zhi Duan ◽  
Hongling Yin ◽  
Furong Dai ◽  
Huining Liu
Keyword(s):  
Adverse Events ◽  
Soft Tissues ◽  
Malignant Tumors ◽  
Cystic Teratoma ◽  
Abdominal Distension ◽  
Epithelioid Angiosarcoma ◽  
History Of ◽  
New Ideas ◽  
The Right ◽  
Clinical Awareness

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.

scholarly journals Marginal and internal fit and intaglio surface trueness of interim crowns fabricated from tooth preparation of four finish line locations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keunbada Son ◽  
Young-Tak Son ◽  
Ji-Min Lee ◽  
Kyu-Bok Lee
Keyword(s):  
Three Dimensional ◽  
Clinical Situation ◽  
Intraoral Scanner ◽  
Replica Technique ◽  
Finish Line ◽  
Marginal Fit ◽  
Tooth Preparation ◽  
The Right ◽  
Internal Fit ◽  
Marginal Region

AbstractThis study evaluated the marginal and internal fit and intaglio surface trueness of interim crowns fabricated from tooth preparation scanned at four finish line locations. The right maxillary first molar tooth preparation model was fabricated using a ceramic material and placed in four finish line locations (supragingival, equigingival, subgingival, and subgingival with a cord). Intraoral scanning was performed. Crowns were designed based on the scanned area. Interim crowns were fabricated using a stereolithography three-dimensional (3D) printer (N = 16 per location). Marginal and internal fit were evaluated with a silicone replica technique. Intaglio surface trueness was evaluated using a 3D inspection software. One-way analysis of variance and Tukey HSD test were performed for comparisons (α = 0.05). The marginal and internal fit showed significant differences according to locations (P < 0.05); the marginal fit showed the best results in the supragingival finish line (P < 0.05). Intaglio surface trueness was significantly different in the marginal region, with the highest value in the subgingival location (P < 0.05). Crowns fabricated on the subgingival finish line caused inaccurate marginal fit due to poor fabrication reproducibility of the marginal region. The use of an intraoral scanner should be decided on the clinical situation and needs.

scholarly journals Multiple hepatic aneurysms and dry gangrene of fingertips in eosinophilic granulomatosis with polyangiitis: a case report

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Eunsil Koh ◽  
Noeul Kang ◽  
Jin-Young Lee ◽  
Duk-Kyung Kim ◽  
Young Soo Do ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Granulomatosis With Polyangiitis ◽  
Stable State ◽  
Clinical Situation ◽  
High Dose ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Case Presentation ◽  
The Right ◽  
Small Aneurysms ◽  
Eosinophilic Granulomatosis

Abstract Background Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis mainly affecting small-sized arteries. Involvement of medium-sized vessels is very rare in EGPA. Here we present the case of a patient with EGPA who showed multiple hepatic aneurysms and distal gangrene. Case presentation A known EGPA patient visited to the emergency room (ER) with abrupt squeezing abdominal pain. She had suffered from gangrene in the fingertips of both hands for 1 year because of arterial thrombosis associated with hypereosinophilia. However, her absolute eosinophil count in the ER was 1120 cells/µL. An abdomen-pelvis CT demonstrated subcapsular hematoma in the right hepatic lobe. A celiac angiogram demonstrated multiple sized aneurysms in both hepatic lobes and some aneurysms in S7 and S8 were huge, more than 1 cm in size. The shape of the small aneurysms resembled a string of beads, as in polyarteritis nodosa. Given the clinical situation, emergency embolization was performed. Before this patient visited to the ER, she had been treated with a high dose of systemic corticosteroid, azathioprine, and cyclophosphamide. After addition of mepolizumab, the eosinophil count remained stable state with a near zero percentage of total white blood cell count. Conclusions Aneurysm and gangrene resulting from the involvement of medium-sized vessels can occur in EGPA. Destruction of vessels might occur even if eosinophil count is below 1500 cells/µL. If involvement of medium-sized arteries is suspected, thorough investigation to identify the involved organs and prompt management are needed to prevent fatal complications.

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