A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

Extramedullary haematopoiesis presenting as a periportal mass

2020 ◽  
Vol 13 (7) ◽  
pp. e235064
Author(s):  
Faranak Rafiee ◽  
Sara Haseli ◽  
Seyed Hamed Jafari ◽  
Pooya Iranpour
Keyword(s):  
Bone Marrow ◽  
Abdominal Pain ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Extramedullary Haematopoiesis ◽  
Abdominal Ct ◽  
Rare Presentation ◽  
Abdominal Ct Scan ◽  
History Of ◽  
Vague Abdominal Pain

Extramedullary haematopoiesis (EMH) is defined as haematopoiesis occurring in organs outside the bone marrow. The liver is one of the rare sites of EMH, and to the best of our knowledge, a few cases of adult EMH of the liver have been reported in the last 20 years. Here, we reported the case of a 68-year-old man with a known history of myelofibrosis presented with vague abdominal pain. An abdominal CT scan showed a hypoattenuating periportal mass encasing the portal vein. The final diagnosis of EMH was made through the histopathological examination. This is a rare presentation of EMH, which may be easily mistaken for other pathologies such as metastases. Familiarity with this type of presentation aids in correctly diagnosing it in an appropriate clinical setting.

scholarly journals Hereditary Angioedema Type II: First Presentation in Adulthood with Recurrent Severe Abdominal Pain

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Mohamed Abuzakouk ◽  
Nada AlMahmeed ◽  
Esat Memisoglu ◽  
Martine McManus ◽  
Aydamir Alrakawi
Keyword(s):  
Abdominal Pain ◽  
Family History ◽  
Hereditary Angioedema ◽  
Positive Family History ◽  
Cleveland Clinic ◽  
Severe Abdominal Pain ◽  
Type Ii ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

A 27-year-old Emirate man presented to Cleveland Clinic Abu Dhabi emergency department with a 4 year history of recurrent episodes of severe swellings affecting different parts of his body. He used to get 2 swelling episodes every week affecting either his face, hands, feet or scrotum and severe abdominal pain twice a week. Abdominal CT scan and a colonoscopy showed bowel wall oedema. There was no family history of similar complaint or of hereditary angioedema (HAE). Complement studies confirmed the diagnosis of HAE type II. He was commenced on danazol 100 mg twice daily and his symptoms resolved. This case report highlights the importance of considering HAE in patients with recurrent unexplained abdominal pain even in the absence of positive family history of HAE.

964 Prevalence of Opioid Analgesic Use Among Patients Presenting to Emergency Department With Abdominal Pain That Is Investigated With Emergent Abdominal CT Scan

2016 ◽  
Vol 150 (4) ◽  
pp. S192-S193 ◽  
Author(s):  
Disha Khemani ◽  
Ana Roldan ◽  
Alfred D. Nelson ◽  
Seon-Young Park ◽  
Andres Acosta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Opioid Analgesic ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Analgesic Use

Pancreatic microcystic serous cystadenoma: a lethal disease? Rare case of a life-threatening haemorrhage

2020 ◽  
Vol 13 (3) ◽  
pp. e233562
Author(s):  
Maria João Amaral ◽  
Marco Serôdio ◽  
Fátima Ramalhosa ◽  
José Guilherme Tralhão
Keyword(s):  
Rare Case ◽  
Serous Cystadenoma ◽  
Abdominal Ct ◽  
En Bloc ◽  
Abdominal Ct Scan ◽  
Life Threatening ◽  
History Of ◽  
Left Pancreatectomy ◽  
Life Threatening Complication ◽  
Benign Tumours

Serous pancreatic cystadenomas are benign tumours and most cases are detected incidentally. Complications are unusual. A patient with a history of a large pancreatic serous cystadenoma (SCA) presented to the emergency department with abdominal pain and haemodynamic shock. After haemodynamic stabilisation, an urgent abdominal CT scan revealed a large hemoperitoneum but the origin of the bleeding was not found. The patient was submitted to an angiography that revealed a bleeding hypervascular pancreatic mass and an embolisation was done successfully. After 3 weeks, the patient underwent a laparotomic left pancreatectomy with en bloc splenectomy. The anatomopathological results were consistent with a microcystic SCA of the pancreas. Despite the high vascularity of pancreatic SCA, haemorrhage is a very rare but life-threatening complication.

scholarly journals A case of sigmoid volvulus in an unexpected demographic

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammad Saba ◽  
Joshua Rosenberg ◽  
Gregory Wu ◽  
Gudata Hinika
Keyword(s):  
Abdominal Pain ◽  
Severe Pain ◽  
Rare Case ◽  
Young Female ◽  
Sigmoid Volvulus ◽  
Case Presentation ◽  
Operative Complications ◽  
History Of ◽  
Male Sex ◽  
Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

scholarly journals Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
T. M. Skipina ◽  
S. Macbeth ◽  
E. L. Cummer ◽  
O. L. Wells ◽  
S. Kalathoor
Keyword(s):  
Emergency Department ◽  
Metabolic Acidosis ◽  
Mental Status ◽  
Rare Case ◽  
Liver Function Tests ◽  
Altered Mental Status ◽  
Potassium Citrate ◽  
Metabolic Encephalopathy ◽  
History Of ◽  
Normal Urine

Abstract Introduction Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Case presentation Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved. Conclusion This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.

scholarly journals COVID-19 as the cause of thrombosis: recognising COVID-19 infection in apparently asymptomatic patients

2021 ◽  
Vol 14 (1) ◽  
pp. e241027
Author(s):  
Kyle B Varner ◽  
Emily J Cox
Keyword(s):  
Emergency Department ◽  
Direct Result ◽  
Abdominal Ct ◽  
Call To Action ◽  
Asymptomatic Patients ◽  
Pulmonary Manifestations ◽  
Abdominal Ct Scan ◽  
Thrombotic Complications ◽  
Work Up ◽  
Renal Thrombosis

COVID-19 has serious thrombotic complications in critically ill patients; however, thrombus is not a typical presenting symptom. This case report describes a patient with no respiratory symptoms who presented to the emergency department with abdominal pain. The pain was attributed to renal thrombosis, but the patient was found to have no risk factors for thrombotic disease and subsequent hypercoagulable work-up was unremarkable. Pulmonary manifestations of COVID-19 infection were detected incidentally on the abdominal CT scan and confirmed via PCR test. The patient was isolated and went on to develop mild respiratory failure secondary to COVID-19 infection. This case suggests that unexplained thrombus in otherwise asymptomatic patients can be a direct result of COVID-19 infection, and serves as a call to action for emergency department clinicians to treat unexplained thrombotic events as evidence of COVID-19.

scholarly journals A case of colonic gallstone ileus with a spontaneous evacuation

1970 ◽  
Vol 9 (1) ◽  
pp. 47-49 ◽  
Author(s):  
A Bajracharya ◽  
OP Pathania ◽  
S Adhikary ◽  
CS Agrawal
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Gallstone Ileus ◽  
Abdominal Distension ◽  
The Elderly ◽  
Large Bowel Obstruction ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
History Of ◽  
Spontaneous Evacuation

Colonic gallstone is an uncommon entity with a high morbidity and mortality due to various reasons. It remains a diagnostic challenge because of delayed and non-specific presentations, especially in the elderly population, often with multiple co-morbidities. We present a case of colonic gallstone ileus with spontaneous evacuation in a 67 years female who had a threeday history of intermittent bouts of colicky abdominal pain, vomiting , constipation and progressive abdominal distension, features of large bowel obstruction treated non operatively for 72 hours and passage of the stone spontaneously. Keywords: gallstone ileus; large bowel obstruction; colonic gallstone DOI: 10.3126/hren.v9i1.4363Health Renaissance, 2011: Vol.9 No.1:47-49

scholarly journals Non-painful severe variant form of eruptive lingual papillitis: A case report and literature review

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Manal Ahmed Halwani
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Oral Hygiene ◽  
Rare Case ◽  
Dorsal Surface ◽  
Variant Form ◽  
Girl Child ◽  
Rare Case Report ◽  
History Of

Eruptive lingual papillitis is a common benign disorder manifested by inflammation of fungiform papillae on the dorsolateral surface of the tongue. Several variants of lingual papillitis have been reported since 1997, most or all of them with painful erythematous papules. Here we report a case of 6 years old girl child with non-painful severe variant form of eruptive lingual papillitis presented to the emergency department. The entire dorsal surface of the tongue was surfaced by 2-3mm by multiple erythematous papules and some with a white or yellowish colour. The papules were excessively inflamed, pigmented, aggregated, and crusted. The cause was idiopathic which resolved within ten days. The parent and patient were reassured with advice to practice oral hygiene. This is a rare case report describing non-painful lingual papillitis without a history of any prior episodes.

scholarly journals No histology for diminutive duodenal neuroendocrine tumors: Is it safe?

2019 ◽  
Vol 07 (02) ◽  
pp. E308-E309
Author(s):  
Thomas Walter
Keyword(s):  
Natural History ◽  
Ct Scan ◽  
Neuroendocrine Tumors ◽  
Surgical Procedures ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
Interesting Approach ◽  
History Of ◽  
Duodenal Neuroendocrine Tumors

AbstractFor the management of diminutive duodenal neuroendocrine tumors (d-NETs), Harshit et al. have proposed – in the work accompanying this editorial – an interesting approach, the endoscopic banding without resection (BWR) technique. Given the risks associated with classic endoscopic resections and surgical procedures, and the likely favorable natural history of diminutive d-NETs, BWR may be an option for these selected patients with a very low risk of LN + and recurrence. However, a close follow-up (endoscopic, EUS and thoraco-abdominal CT scan) is then required to guarantee the safety of this policy.

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