scholarly journals Pediatric Multisystem Inflammatory Syndrome in Children as a Challenging Problem for Pediatric Surgeons in the COVID 19 Pandemic—A Case Report

2021 ◽  
Vol 9 ◽  
Author(s):  
Beata Jurkiewicz ◽  
Magdalena Szymanek-Szwed ◽  
Piotr Hartmann ◽  
Joanna Samotyjek ◽  
Eliza Brędowska ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Intestinal Inflammation ◽  
Ultrasound Examination ◽  
Severe Abdominal Pain ◽  
Kawasaki Syndrome ◽  
Pediatric Hospitals ◽  
Abdominal Symptoms ◽  
Post Operative Period ◽  
The World ◽  
Inflammatory Syndrome

The first cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were identified at the end of 2019 and, in the next few months, coronavirus disease (COVID-19) spread throughout the world. Initially, it was believed that this disease mainly affected elderly individuals with comorbidities, in whom respiratory failure often occurs. It was believed that children fell ill from the infection more often, although the course of infection in the vast majority of pediatric cases has been asymptomatic or mildly symptomatic. In April and May 2020, the first report of a rapidly progressing disease, similar to Kawasaki syndrome, was found in children who had been infected with SARS-CoV-2. Shortly thereafter, children with symptoms of pediatric inflammatory multisystem syndrome (PIMS-ST [temporally associated with SARS-CoV-2 infection]) began presenting to pediatric hospitals around the world. The syndrome has a mortality rate of up to 2%. Symptoms of PIMS-TS include those that may suggest the need for surgical treatment (severe abdominal pain with the presence of peritoneal symptoms, ascites, high levels of inflammatory markers, intestinal inflammation, and appendages revealed on ultrasound examination). However, there are few reports addressing surgical cases associated with this condition. The authors present a case involving an 11-year-old boy who was admitted to hospital with severe abdominal pain and underwent surgery for symptoms of peritonitis and was diagnosed with PIMS in the post-operative period. Due to the large number of illnesses caused by SARS-CoV-2 infection in recent months, the diagnosis of PIMS-TS/MISC should be considered in the differential diagnosis of acute abdominal symptoms, especially in atypical courses and interviews indicating exposure to SARS-CoV-2.

scholarly journals Acute Pancreatitis in acute viral hepatitis

2011 ◽  
Vol 51 (181) ◽  
Author(s):  
S K.C. ◽  
S Khadka ◽  
D Sharma ◽  
SP Chataut
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Viral Hepatitis ◽  
Hepatitis A ◽  
Acute Viral Hepatitis ◽  
Ultrasound Examination ◽  
Hepatitis E ◽  
Severe Abdominal Pain ◽  
Gastric Ulcers ◽  
Pancreatic Involvement

Introduction: The association of acute viral hepatitis and acute pancreatitis is well described. This study was conducted to find out the frequency of pancreatic involvement in acute viral hepatitis in the Nepalese population. Methods: Consecutive patients of acute viral hepatitis presenting with severe abdominal pain between January 2005 and April 2010 were studied. Patients with history of significant alcohol consumption and gall stones were excluded. Acute viral hepatitis was diagnosed by clinical examination, liver function test, ultrasound examination and confirmed by viral serology. Pancreatitis was diagnosed by clinical presentation, biochemistry, ultrasound examination and CT scan. Results: Severe abdominal pain was present in 38 of 382 serologically-confirmed acute viral hepatitis patients. Twenty five patients were diagnosed to have acute pancreatitis. The pancreatitis was mild in 14 and severe in 11 patients. The etiology of pancreatitis was hepatitis E virus in 18 and hepatitis A virus in 7 patients. Two patients died of complications secondary to shock. The remaining patients recovered from both pancreatitis and hepatitis on conservative treatment. Conclusions: Acute pancreatitis occurred in 6.5 % of patients with acute viral hepatitis. Cholelithiasis and gastric ulcers are the other causes of severe abdominal pain. The majority of the patients recover with conservative management. Keywords: acute viral hepatitis, acute pancreatitis, pain abdomen, hepatitis E, hepatitis A, endemic zone  

Severe abdominal pain in low dosage clofazimine

Pathology ◽  
1993 ◽  
Vol 25 (1) ◽  
pp. 24-26 ◽  
Author(s):  
Pek-Yoon Chong ◽  
Thiow-Kong Ti
Keyword(s):  
Abdominal Pain ◽  
Severe Abdominal Pain ◽  
Low Dosage

Diabetic thoracic radiculopathy: a case of a young woman with clinical improvement following immunotherapy

2020 ◽  
Vol 13 (12) ◽  
pp. e236412
Author(s):  
Alfonsa C Taiello ◽  
Vincenzo La Bella ◽  
Rossella Spataro
Keyword(s):  
Abdominal Pain ◽  
Young Woman ◽  
Clinical Improvement ◽  
Type I Diabetes ◽  
Severe Abdominal Pain ◽  
Full Recovery ◽  
Type I ◽  
Sustained Improvement ◽  
Immune Mediated ◽  
Paravertebral Muscles

Thoracic radiculopathy is a rare cause of thoracic-abdominal or abdominal pain in subjects with poorly controlled diabetes. We present a case of a young woman with type I diabetes and a severe abdominal pain in both lower quadrants. An extensive diagnostic gastroenterological and gynaecological workup did not disclose abnormalities. Electromyography revealed an initial polyneuropathy and significant neurogenic abnormalities in the T10-T12 paravertebral muscles. Following the hypothesis that the radiculopathy-related abdominal pain might have an immuno-mediated pathogenesis, the patient underwent a complex trial of immunotherapy, which was accompanied by a sustained improvement over months to full recovery. This report would support the hypothesis that immune-mediated mechanisms are still active even months after onset of symptoms.

scholarly journals Post-COVID-19 Kawasaki-Like Syndrome

2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans
Keyword(s):  
Abdominal Pain ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Hepatitis A ◽  
Clinical Presentation ◽  
Multiple Organ ◽  
Mild Form ◽  
Severe Dysphagia ◽  
History Of ◽  
Inflammatory Syndrome

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.

scholarly journals Young Man With Severe Abdominal Pain

2016 ◽  
Vol 68 (5) ◽  
pp. 544-552
Author(s):  
Aaron Lewandowski ◽  
Steven Dorsey
Keyword(s):  
Abdominal Pain ◽  
Severe Abdominal Pain

scholarly journals A case of hereditary angioedema due to C1-inhibitor deficiency with recurrent abdominal pain diagnosed 40 years after the occurrence of the initial symptom

2021 ◽  
Author(s):  
Daisuke Honda ◽  
Isao Ohsawa ◽  
Keiichi Iwanami ◽  
Hisaki Rinno ◽  
Yasuhiko Tomino ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hereditary Angioedema ◽  
Recurrent Abdominal Pain ◽  
Acute Attack ◽  
Severe Abdominal Pain ◽  
Initial Symptom ◽  
C1 Inhibitor ◽  
Self Administration ◽  
C1 Inhibitor Deficiency ◽  
Appropriate Treatment

AbstractHereditary angioedema due to C1-inhibitor deficiency (HAE-C1-INH) is a rare disease, which induces an acute attack of angioedema mediated by bradykinin. HAE-C1-INH can cause serious abdominal pain when severe edema develops in the gastrointestinal tract. However, because it takes a long time, 13.8 years on average in Japan, from the occurrence of the initial symptom to the diagnosis due to low awareness of the disease, undiagnosed HAE-C1-INH patients sometimes undergo unnecessary surgical procedures for severe abdominal pain. We herein present a 56-year-old patient with HAE-C1-INH, who underwent numerous abdominal operations. He frequently needed hospitalization with the administration of opioid due to severe abdominal pain. However, after he was accurately diagnosed with HAE-C1-INH at 55 years of age, he could start self-administration for an acute attack with icatibant, a selective bradykinin B2 receptor antagonist. Consequently, he did not need hospitalizing for ten months after the beginning of the treatment. A series of an accurate diagnosis and appropriate treatment for HAE-C1-INH improved his quality of life. Thus, HAE-C1-INH should be considered, when we meet patients with unidentified recurrent abdominal pain. This case highlights significance of an early diagnosis and appropriate treatment for HAE-C1-INH.

Huge retrovesical hydatid cyst with pelvic localization as the primary site: a case report

2007 ◽  
Vol 48 (8) ◽  
pp. 918-920 ◽  
Author(s):  
A. M. Halefoglu ◽  
A. Yasar
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Hydatid Cyst ◽  
Cystic Mass ◽  
Primary Site ◽  
Cystic Disease ◽  
The World ◽  
Indirect Hemagglutination ◽  
Indirect Hemagglutination Test

We present a patient with symptoms of abdominal pain and frequent urination due to a huge mass in the retrovesical region. All imaging modalities revealed a cystic mass containing small daughter cysts located between the urinary bladder and rectum. Its characteristics led us to suspect the presence of a hydatid cyst, and an indirect hemagglutination test for Echinococcus granulosus was found positive. No other involvement of hydatid cystic disease was detected. The primary site for the hydatid disease was therefore regarded as the pelvis, on which only a few cases have been reported previously. The patient started albendazole therapy, but refused operation. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions of the world.

620 GASTRODUODENAL EOSINOPHILIA IS UNDER-APPRECIATED IN EOSINOPHILIC ESOPHAGITIS (EOE) PATIENTS WITH FUNCTIONAL BOWEL SYMPTOMS: A REAL LIFE EXPERIENCE

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kathryn Peterson ◽  
Robert Genta ◽  
Henrik Rasmussen ◽  
Bradford Youngblood ◽  
Amol Kamboj
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Eosinophilic Esophagitis ◽  
Life Experience ◽  
Real Life ◽  
Gastrointestinal Disorder ◽  
Control Group ◽  
Abdominal Symptoms ◽  
Gi Symptoms ◽  
Initial Work

Abstract   Eosinophilic esophagitis (EoE) is currently thought to be the most common Eosinophilic Gastrointestinal Disorder. EoE patients often present with non-esophageal GI symptoms. Presence of EoE increases one’s risk of developing distal eosinophilia, including eosinophilic gastritis (EG) and duodenitis (EoD). A diagnosis of EG/EoD often takes years due to lack of provider awareness and absence of consensus diagnostic guidelines. The aim was to evaluate the prevalence of EG/EoD in patients with EoE and functional abdominal symptoms. Methods 52 EoE patients with extra-esophageal GI symptoms (i.e. abdominal pain, nausea, bloating, irritable bowel) who had stomach and small bowel biopsies interpreted as non-specific inflammation or normal were identified (‘EoE + S’). 15 EoE patients without extra-esophageal complaints who had routine screening stomach and small bowel biopsies at their initial endoscopies were included as a control group (‘EoE-S’). Biopsies taken at initial work up were identified and blocks were cut for H&E staining and assessment by an independent, blinded GI pathologist skilled in eosinophil (eos) assessment. Results 45 EoE + S and 12 EoE-S patients were evaluated (Table 1). Common symptoms were abdominal pain, bloating and nausea. All prior pathology reports were consistent with non-specific inflammation or normal tissue. Upon blinded re-assessment, 8/45 (17.8%) EoE + S patients met criteria for EG (≥30 eos/hpf in ≥5 gastric hpfs). None of the EoE-S patients met criteria for EG. 24/45 (53%) EoE + S patients met criteria for EoD (≥30 eos/hpf in ≥3 duodenal hpfs). 7 patients had concomitant EG + EoD. 3/12 EoE-S patients met criteria for EoD. Peak gastric and duodenal eos counts for the EoE + S group were higher than for the EoE-S group. Conclusion In patients with EoE and extra-esophageal GI complaints, review of gastric and duodenal biopsies previously reported as normal or ‘non-specific inflammation’ demonstrated a high discovery rate of gastroduodenal eosinophilia. These findings suggest that intentional evaluation of gastric and duodenal eos is indicated in patients with EoE and persistent non-esophageal GI symptoms. Increased awareness of EG/EoD and consensus diagnostic criteria may lead to the identification of currently undiagnosed patients with EG/EoD.

HEART INJURY IN PATIENTS WITH MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH SARS-CоV-2: A DESCRIPTION OF A SERIES OF CLINICAL CASES

2021 ◽  
Vol 100 (5) ◽  
pp. 35-45
Author(s):  
K.E. Belozerov ◽  
◽  
A.D. Kupreeva ◽  
I.S. Avrusin ◽  
V.V. Masalova ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Inflammatory Process ◽  
Scientific Data ◽  
Patient Treatment ◽  
Review Of Literature ◽  
Treatment Regimens ◽  
The World ◽  
Heart Injury ◽  
Inflammatory Syndrome ◽  
Clinical Cases

Multisystem inflammatory syndrome in children and adolescents associated with SARS-CoV-2 (MBS-D) is a new challenge for pediatricians around the world. Scientific data is updated daily and patient treatment regimens are developed. The involvement of the heart in the inflammatory process complicates the course of the disease and further rehabilitation of patients. The article describes 12 patients with heart disease in the structure of MVS-D, who underwent laboratory tests and instrumental studies, including MRI of the heart, and also provides detailed descriptions of three clinical cases and a review of literature data.

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