scholarly journals Wandering Spleen - A Rare Entity

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdomen ◽  
High Index ◽  
Wandering Spleen ◽  
Rare Entity ◽  
Rare Differential Diagnosis ◽  
High Index Of Suspicion ◽  
Very High

Wandering spleen is a rare differential diagnosis of an acute abdomen and must be suspected if a patient presents with abdominal pain along with a palpable lump and displacement of bowel to left upper quadrant and should be confirmed by CT scan. As the condition is very rarely diagnosed pre-operatively, it requires a very high index of suspicion.

scholarly journals Acute Ischaemic Colitis- A Case Report

2012 ◽  
Vol 52 (185) ◽  
Author(s):  
M Basra ◽  
B M Shrestha
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Acute Abdomen ◽  
Management Strategies ◽  
Review Literature ◽  
High Index ◽  
Ischaemic Colitis ◽  
Bleeding Per Rectum ◽  
High Index Of Suspicion

Acute ischaemic colitis (AIC) is being increasingly recognised as an uncommon cause of abdominal pain associated with fresh bleeding per rectum. It is paramount to maintain a high index of suspicion and adopt appropriate management strategies to avoid complications and inappropriate interventions. In this paper, we describe a case of AIC and review literature pertinent to the management of this condition. Keywords: Ischaemic colitis, acute abdomen, management.

scholarly journals Bilateral Charcot hip Arthropathy Due to Tabes Dorsalis: A Case Report

2018 ◽  
Vol 25 (1) ◽  
pp. 21-23
Author(s):  
Ip Hoi Yeung ◽  
Yeung Yip Kan ◽  
Luk Kristine Shik ◽  
Lam Polly Wy ◽  
Wong Kwok Ho
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Clinical Course ◽  
High Index ◽  
Tabes Dorsalis ◽  
High Index Of Suspicion

This article illustrates the clinical course of a patient diagnosed to have bilateral Charcot hip arthropathy secondary to tabes dorsalis from delayed untreated syphilitic infection. This differential diagnosis of rapid bilateral hip destruction was a near-extinct entity, and a high index of suspicion is needed to prevent untoward sequelae.

scholarly journals Solid Pseudopapillary Neoplasm of Pancreas In A 35 Year Old Lady

2018 ◽  
Vol 9 (1) ◽  
pp. 31-34
Author(s):  
Sadia Imdad ◽  
Pankaj Kumar Saha ◽  
Md Mustafizur Rahman ◽  
Md Mozammal Hoque ◽  
Krishna Pada Saha ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Young Female ◽  
Clinical Suspicion ◽  
High Index ◽  
Rare Entity ◽  
Solid Pseudopapillary Neoplasm ◽  
Treatment Protocols ◽  
Female Patients ◽  
Proper Diagnosis

Solid pseudopapillary neoplasm of pancreas (SPN) is a rare entity; therefore proper diagnosis, evaluation and formulation of treatment protocols is difficult. The commonest presenting symptom is abdominal pain. This article presents a case of solid pseudopapillary neoplasm of pancreas in a 35 years old lady. A high index of clinical suspicion is necessary to suspect and diagnose SPN. This diagnosis should be borne in mind when young female patients present with a pancreatic mass.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 31-34

Use of CT Scans for Abdominal Pain in the ED: Factors in Choice

2020 ◽  
Vol 86 (4) ◽  
pp. 324-333 ◽  
Author(s):  
Aubrey A. Mwinyogle ◽  
Astha Bhatt ◽  
Onyebuchi U. Ogbuagu ◽  
Neer Dhillon ◽  
Anne Sill ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Primary Diagnosis ◽  
Socioeconomic Disparities ◽  
Ct Scans ◽  
Utilization Rate ◽  
Rebound Tenderness ◽  
High Index Of Suspicion ◽  
Ct Finding

Overutilization of healthcare resources is a threat to long-term healthcare sustainability and patient outcomes. CTis a costly but efficient means of assessing abdominal pain; however, 97 per cent of ED physicians acknowledge its overutilization. This study sought to understand factors that influence ED providers’ decision regarding CT use in the evaluation of abdominal pain. After evaluating a patient for acute abdominal pain, ED providers filled in a form in which the primary diagnosis and index of suspicion were recorded. Bivariate and multivariate analyses were used to identify predictors of outcomes. The CT scan utilization rate was 54.82 per cent. Whereas 34.11 per cent of CT scans were normal, 30 per cent yielded an acute abdominal pathology. Tenderness and rebound tenderness were positive predictors of high index of suspicion [odds ratio (OR) 2.09 and 2.54, respectively]. These variables were also predictive of obtaining a CT scan [OR 2.64 and 3.41, respectively]. Compared with whites, the index of suspicion was 26 per cent and 56 per cent less likely to be high when patients were black [OR 0.73] or Hispanic [OR 0.44] respectively. Blacks and Hispanics were less likely to have CT scans performed than whites [OR 0.58 and 0.48, respectively]. Leukocytosis significantly affected the index of suspicion for acute abdominal pathology, obtaining a CTscan and the acuity of CTscan diagnosis on multivariate analysis. Patients aged ≥60 years had 2.03 odds of acute CT finding compared with those aged <60 years. There is a need for committed efforts to optimize CT scan utilization and eliminate socioeconomic disparities in health care.

Cyriax syndrome: a misdiagnosed condition of the chest wall

2019 ◽  
Vol 27 (7) ◽  
pp. 609-611
Author(s):  
Sarra Zairi ◽  
Mariem Hadj Dahmane ◽  
Monia Attia ◽  
Amira Dridi ◽  
Taher Mestiri ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Young People ◽  
Physical Examination ◽  
Chest Wall ◽  
Rare Entity ◽  
Hypochondriac Region ◽  
The Right

Cyriax syndrome is a rare entity of the chest wall, which mainly affects young people. It can manifest as abdominal pain in the right or left hypochondriac region, which may be very intense, and often causes problems in the differential diagnosis. We report the case of a 36-year-old man who presented with intense left hypochondrial pain, worsening on exercise. After multiple specialized consultations and several unnecessary and expensive investigations, a diagnosis of Cyriax syndrome was obtained. A thorough physical examination might have been sufficient to evoke the diagnosis.

Caecal-diverticulitis: A rare differential diagnosis for right-sided lower abdominal pain

2003 ◽  
Vol 5 (3) ◽  
pp. 241-245 ◽  
Author(s):  
K. Junge ◽  
A. Marx ◽  
Ch. Peiper ◽  
B. Klosterhalfen ◽  
V. Schumpelick
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Lower Abdominal Pain ◽  
Rare Differential Diagnosis

Recurrent meningitis due to a congenital fistula of the stapedial footplate

1993 ◽  
Vol 107 (10) ◽  
pp. 931-932 ◽  
Author(s):  
H. S. Kaddour
Keyword(s):  
High Resolution ◽  
Ct Scan ◽  
Rare Case ◽  
High Index ◽  
Definite Diagnosis ◽  
Recurrent Meningitis ◽  
Stapes Footplate ◽  
Temporal Bones ◽  
High Index Of Suspicion ◽  
Congenital Fistula

AbstractA rare case of a congenital fistula of the stapes footplate, in a 10-year-old girl, resulting in recurrent meningitis, is reported. A full ENT examination and a high index of suspicion, is essential if the diagnosis is to be made.Exploratory tympanotomy should be considered on clinical grounds, even if a high resolution CT scan of the temporal bones does not show any anomalies, in order to ascertain the definite diagnosis of a fistula and to seal it permanently.

scholarly journals Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

2019 ◽  
Vol 4 (1) ◽  
pp. 33-36
Author(s):  
Cédric Kwizera ◽  
Benedikt Wagner ◽  
Johannes B. Wagner ◽  
Călin Molnar
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Fragile X ◽  
Pleural Empyema ◽  
Blind Ending ◽  
Rare Differential Diagnosis ◽  
Mentally Impaired ◽  
The Right ◽  
Tract Infections

Abstract The appendix is a worm-like, blind-ending tube, with its base on the caecum and its tip in multiple locations. Against all odds, it plays a key role in the digestive immune system and appendectomy should therefore be cautiously considered and indicated. We report the case of a 45-year-old male with a known history of Fragile-X syndrome who presented to the emergency department with intense abdominal pain and was suspected of acute appendicitis, after a positive Dieulafoy’s triad was confirmed. The laparoscopic exploration showed no signs of inflammation of the appendix; nonetheless, its removal was carried out. Rising inflammatory laboratory parameters led to a focused identification of a pleural empyema due to a tooth inlay aspiration. Our objective is to emphasize the importance of a thorough anamnesis, even in cases of mentally impaired patients, as well as to highlight a rare differential diagnosis for appendicitis. Acute appendicitis is an emergency condition that requires a thorough assessment and appropriate therapy. Clinical examinations are important, but in this particular case, imaging methods had a much more important role in establishing the right treatment approach. Furthermore, the signs of acute appendicitis are mimicked by several medical conditions including respiratory tract infections.

Case 5

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Differential Diagnosis ◽  
Young Woman ◽  
Mechanism Of Action ◽  
Rare Entity ◽  
Lumbosacral Plexus ◽  
Retroperitoneal Hemorrhage ◽  
Lumbosacral Plexopathy ◽  
Common Causes ◽  
Main Component ◽  
High Index Of Suspicion

Lumbosacral plexopathy is a relatively rare entity with a variety of etiology and pathophysiology. The diagnosis of lumbosacral plexopathy requires high index of suspicion and knowledge of the detailed anatomy of the lumbosacral plexus is a prerequisite to the accurate conclusion. This case describes a young woman with injury to the lumbosacral trunk (cord), a main component of the lumbosacral plexus, occurring during the delivery of her newborn and outlines its mechanism of action, pathophysiology and risks. The case highlights also the differential diagnosis of lumbosacral plexopathy and discusses the most common causes including retroperitoneal hemorrhage, lumbosacral plexitis, and intrapartum maternal lumbosacral plexopathy.

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