Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

scholarly journals Otitis with Aspergillus niger in a patient with SARS-CoV-2 and multiple comorbidities

2021 ◽  
Vol 24 (3) ◽  
pp. 137-140
Author(s):  
Andreea Florentina Stoenescu ◽  
◽  
Geta Vancea ◽  
Dana Ispas ◽  
Nicoleta Voicu-Pârvu ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Acute Onset ◽  
Suppurative Otitis Media ◽  
Vein Thrombosis ◽  
Significant Incidence ◽  
Lower Lung ◽  
History Of ◽  
The Right

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.

scholarly journals Non-uremic Calciphylaxis: A Rare and Late Adverse Reaction of Warfarin

2019 ◽  
Vol 14 (3) ◽  
pp. 246-248 ◽  
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Akash D. Patel ◽  
Jignesh C. Kaklotar ◽  
Greshaben R. Patel ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Inflammatory Markers ◽  
Metabolic Profile ◽  
Connective Tissue Diseases ◽  
Skin Ulcer ◽  
Wound Treatment ◽  
History Of ◽  
The Right ◽  
Work Up ◽  
Late Adverse Reaction

Background:Calciphylaxis is a complex dermatological lesion of micro vascular calcification that is typically presented as panniculitis with gangrenous painful lesions having uremic and non-uremic causes.Case Report:We present a case of a 48-year old male with a history of paroxysmal atrial fibrillation and hypertension taking amlodipine 5 mg and warfarin 5 mg daily for the last 26 months. The patient had a 6- months history of painful swelling followed by necrotic skin ulcer over the right leg. His remarkable examination findings were right leg tender ulcer with surrounding erythema and secondary sepsis. His hemogram, metabolic profile and connective tissue diseases work up were unremarkable except leucocytosis and raised inflammatory markers. His local part radiological and skin biopsy findings were suggestive of calciphylaxis.Results and Conclusion:In our case, warfarin and amlodipine were culprit drugs for the lesion, but Naranjo score (warfarin 7and amlodipine 1) speculate warfarin as a probable adverse reaction of warfarin. The lesion was cured with local wound treatment after discontinuation of warfarin. The physician should be aware of this rare cutaneous disorder of systemic origin for proper management.

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) with painful erythematous nodules

2020 ◽  
Vol 13 (4) ◽  
pp. e234197
Author(s):  
Nicholas Kevin Laidler ◽  
Thomas Delaney
Keyword(s):  
Tertiary Hospital ◽  
Acute Onset ◽  
General Malaise ◽  
Metastatic Adenocarcinoma ◽  
Cutaneous Manifestations ◽  
Hands On ◽  
History Of ◽  
Recent Diagnosis ◽  
The Right ◽  
Pitting Edema

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) is an uncommon syndrome characterised by acute onset severe synovitis of the radiocarpal and small joints of the hands, with associated pitting edema. Discussed here is the case of a 69-year-old man who presented to the emergency department of a tertiary hospital with acute bilateral hand swelling. This was on a background of a recent diagnosis of metastatic adenocarcinoma of the caecum and subsequent hemicolectomy. There was a history of general malaise, fever and lethargy for 5 days prior to the swelling of the hands. On examination, the upper limbs were swollen to the elbow bilaterally. Painful erythematous nodules were noted on the dorsal and palmar aspects of the hands and violaceous periungual discolouration was observed on the right fourth and fifth fingers. Prednisolone was commenced resulting in a dramatic resolution of the articular and cutaneous manifestations within 3 weeks.

Inflammatory markers in women with a recent history of gestational diabetes mellitus

2005 ◽  
Vol 28 (3) ◽  
pp. 34-38 ◽  
Author(s):  
A. Di Benedetto ◽  
G. T. Russo ◽  
F. Corrado ◽  
E. Di Cesare ◽  
E. Alessi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Inflammatory Markers ◽  
Recent History ◽  
History Of

scholarly journals Clinical and imaging features of suspected pituitary apoplexy in a domestic rat

2020 ◽  
Vol 8 (2) ◽  
pp. e001062
Author(s):  
Stephen James Everest ◽  
Tobias Schwarz ◽  
David Walker ◽  
Kevin Eatwell ◽  
Katia Marioni-Henry
Keyword(s):  
Pituitary Apoplexy ◽  
Acute Onset ◽  
Postmortem Examination ◽  
Female Rat ◽  
Imaging Features ◽  
Gradient Echo ◽  
History Of ◽  
The Right ◽  
The Brain

A two-year-ten-month-old entire female fancy rat was evaluated for acute-onset neurological signs following a two-month history of lethargy and behavioural changes. Physical examination revealed generalised muscle atrophy. Neurological examination localised the lesion likely to the right thalamus based on suspected left unilateral hemineglect. The patient was euthanased over quality-of-life concerns, and postmortem MRI of the brain was performed, followed by postmortem examination. This showed a lesion in the region of the pituitary which was T1 hyperintense to the brain, T2 isointense to the white matter and hypointense on gradient echo sequences, suggesting subacute haemorrhage. The authors described the clinical presentation and imaging features (MRI) of suspected pituitary apoplexia secondary to a pituitary macroadenoma in an aged female rat. Of particular interest are the findings of unilateral hemineglect and blooming artefact on MRI gradient echo sequences that lead to suspicion of pituitary apoplexia confirmed on postmortem examination.

scholarly journals Juvenile Osteochondritis Dissecans of the Knee. About A Case

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0002
Author(s):  
Ignacio Astore ◽  
Juan Ignacio Agotegaray ◽  
Ignacio Comba ◽  
Luciana Bisiach
Keyword(s):  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Young Patients ◽  
Body Burden ◽  
Acute Onset ◽  
Type Iv ◽  
Juvenile Osteochondritis Dissecans ◽  
Osteosynthesis Material ◽  
History Of ◽  
The Right

Introduction: Juvenile osteochondritis dissecans is a pathology that affects the superficial articular cartilage and subchondral bone in patients with open physes. Treatment of this disease is based on patient’s age and the stage of the disease. Methods: 16-year-old patient, athlete, with a history of knee pain on the right side of acute onset, without traumatic history. A physical examination shows pain in the external compartment of the knee. MRI shows a stable lesion that involves the external femoral condyle, over a posterior area of 16 mm by 20mm. Crutches are indicate for walking without body burden. Symptoms continue for six months and there are no changes in MRI. It is decided to do a stabilization with a Herbert type screw. After the surgery, pain persists and in x-ray controls, osteointegration is not observed. Osteosynthesis material is extracted and mosaicplasty is performed. We used Guhl’s intraoperative classification. Results: In this case, for a young patient with Guhl’s lesion type III, the reduction with a Herbert type screw was indicated, as the lesion was stable, of a significant size and congruent. Lesion progressed to type IV in 6 months. Thus, mosaicplasty was performed, obtaining a good functional result according to the physical exam, with a complete range of flexion and extension. A second-look arthroscopic assessment was carried out 2 months after surgery, showing osteointegration and stability of the allogenic graft. Conclusion: The variable of stability of the fragment is very important when determining the treatment. Most of the stable lesions can be successfully treated with a conservative treatment. Also, it has been demonstrated that young patients have a higher rate of healing. Instead, unstable lesions require surgical treatment.

Unilateral Septic Arthritis of a Lumbar Facet Joint Secondary to Acupuncture Treatment - a Case Report

2004 ◽  
Vol 22 (3) ◽  
pp. 152-155 ◽  
Author(s):  
Sachin Daivajna ◽  
Alwyn Jones ◽  
Michael O’Malley ◽  
Hossein Mehdian
Keyword(s):  
Septic Arthritis ◽  
Inflammatory Markers ◽  
Acupuncture Treatment ◽  
Facet Joint ◽  
Full Range ◽  
Lumbar Facet Joint ◽  
Mri Scan ◽  
History Of ◽  
The Right ◽  
Lumbar Facet

This report describes a case of septic arthritis of the lumbar facet joint probably as a result of acupuncture treatment. A 48 year old man with a long history of back pain presented with a two week history of increasing pain following a third session of acupuncture. Examination revealed tenderness in the right lumbosacral area and laboratory investigations revealed raised inflammatory markers with negative blood cultures. A bone scan and MRI scan showed evidence of septic arthritis of the right L5/S1 facet joint. An x ray computed tomography guided biopsy was carried out which isolated staphylococcus aureus. The patient was initially treated with intravenous antibiotics. A repeat MRI scan demonstrated persistent septic arthritis with adjacent early abscess formation. Surgical debridement of the facet joint was therefore performed. The patient had resolution of his symptoms and the inflammatory markers returned to normal. He regained a full range of movement of the lumbar spine. Very few cases have been reported of lumbar facet joint septic arthritis and this condition is rare in association with acupuncture treatment. A high index of suspicion needs to be maintained and if conservative management fails then debridement can result in an acceptable outcome.

scholarly journals Remitting seronegative symmetrical synovitis with pitting oedema following BNT162b2 mRNA COVID-19 vaccination

2021 ◽  
Vol 14 (8) ◽  
pp. e244479
Author(s):  
Konstantinos Parperis ◽  
Maria Constantinou
Keyword(s):  
Older Adults ◽  
Elderly Patient ◽  
Rheumatic Disease ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Inflammatory Condition ◽  
Hand Pain ◽  
History Of

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare inflammatory condition that occurs in older adults. Here, we report a case of an 80-year-old man with no history of rheumatic disease who presented with acute onset of bilateral hand pain, pitting oedema and synovitis after the second dose of the BNT162b2 mRNA C0VID-19 vaccine. Laboratory workup revealed elevated inflammatory markers and negative autoantibodies. Significant improvement was noted with prednisolone. This is the first reported case of RS3PE in an elderly patient with no previous rheumatic disease following mRNA COVID-19 vaccination.

scholarly journals An Interesting Case of Rhino-Orbito-Cerebral Mucormycosis: A Case Report

2020 ◽  
Author(s):  
R Minnu Lekshmi ◽  
Stephen Sudhakar ◽  
S Rajasekharan
Keyword(s):  
Fungal Infections ◽  
Neurological Complications ◽  
Acute Onset ◽  
Interesting Case ◽  
Rapid Progression ◽  
Uncontrolled Diabetes ◽  
Immunocompromised Individual ◽  
Life Threatening ◽  
History Of ◽  
The Right

Fungal infections are the most challenging problems in an immunocompromised individual. Mucormycosis is a life-threatening fungal infection with rapid progression and high mortality in immunocompromised individuals. A case of 58-year-old female, with uncontrolled diabetes is with five days history of headache, fever, and acute onset drooping of the eyelid. The initial vision was normal which dropped to PL in the following days, with ophthalmoplegia and dilated nonreactive pupil in the right eye. Fundus and IOP were normal on presentation. MRI and MRV brain showed subtle ethmoidal cysts. CT-PNS showed mild ethmoidal thickening and cyst. Diagnostic nasal endoscopy showed unhealthy mucosa with no lesion suggesting eschar. A provisional diagnosis of orbital mucormycosis was made. The patient was started on antibiotics and IV Amphotericin B but she went on to further neurological complications. Despite treatment, she developed necrotising eschars in eyelid for which debridement was done. Further, exenteration was advised and patient developed septicaemia, however he died. The culture from debrided tissue showed growth of mucor. The objective of presenting this particular case is to emphasise the importance of considering mucormycosis as diagnosis despite subtle radiological and endoscopic findings in symptomatic immunocompromised patients. Early diagnosis and aggressive management improve better chances for survival.

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