scholarly journals Case Report: Adult Right-Sided Bochdalek Hernia Complicated by Intrathoracic Bowel Perforation

2021 ◽  
Vol 8 ◽  
Author(s):  
Jan Philipp Ramspott ◽  
Stephan Regenbogen ◽  
Tarkan Jäger ◽  
Michael Lechner ◽  
Franz Mayer ◽  
...  
Keyword(s):  
Intestinal Ischemia ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Bowel Perforation ◽  
Pleural Empyema ◽  
Emergency Laparotomy ◽  
Bochdalek Hernia ◽  
Congenital Condition ◽  
One Year ◽  
The Right

Right-sided Bochdalek hernia is a mostly congenital condition of the diaphragm caused by a persistence of the pleuroperitoneal cavity and a rare disease in adults. As it often presents as an emergent situation, urgent diagnostics and surgical intervention are essential to reduce morbidity and mortality rates. Choosing the right surgical approach (abdominal, thoracic, or a combination of both) can be very challenging for clinicians. Here, we report a case of a 40-year-old woman, who presented with severe abdominal pain and tachypnoea. Imaging revealed a right-sided Bochdalek hernia. Emergency laparotomy was performed followed by reduction of hernia content, right-sided hemicolectomy, and side-to-side anastomosis from the ileum to the transverse colon due to intestinal ischemia and intrathoracic bowel perforation. The post-operative course was complicated by a pleural empyema. Therefore, the patient underwent thoracotomy. One year after surgical repair the patient had no recurrence. Here, we discuss feasible approaches for the surgical management of complicated Bochdalek hernias.

scholarly journals A very persistent chicken bone: two separate perforations from the same foreign object 2 months apart

2019 ◽  
Vol 12 (5) ◽  
pp. e228050
Author(s):  
Andrew James Brown ◽  
Thomas Whitehead-Clarke ◽  
Vera Tudyka
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Linear Structure ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Small Bowel Perforation ◽  
Chicken Bone ◽  
Abdomen Ct ◽  
Distal Migration ◽  
The Right

A 56-year-old man presented acutely with abdominal pain and raised inflammatory markers. Initial CT images demonstrated acute inflammation in the right upper quadrant surrounding a high-density linear structure. The appearance was of a chicken bone causing a contained small bowel perforation. This was managed conservatively with intravenous antibiotics and the patient was discharged 10 days later. The same patient returned to the hospital 2 months later, once again with an acute abdomen. CT imaging on this occasion showed distal migration of the chicken bone as well as free gas and fluid indicative of a new small bowel perforation. The patient underwent an emergency laparotomy, washout and small bowel resection. No foreign body was found at laparotomy or in the histopathology specimen. The postoperative course was complicated by an anastomotic leak. A further CT on that admission demonstrated that the chicken bone had migrated to the rectum!

Use of an optical surface scanner in assessment of outcome following rhinoplasty surgery

2008 ◽  
Vol 122 (9) ◽  
pp. 972-977 ◽  
Author(s):  
H Chau ◽  
R Dasgupta ◽  
V Sauret ◽  
G Kenyon
Keyword(s):  
Surgical Intervention ◽  
University Hospital ◽  
Facial Features ◽  
Optical Surface ◽  
Case Study Analysis ◽  
The Future ◽  
University College London ◽  
One Year ◽  
The Right

AbstractObjective:To demonstrate the use of an optical surface scanner, with associated software, in the assessment of rhinoplasty patients, and to discuss the possible clinical applications of this technology in the future.Design:Case study analysis of pre- and post-operative scans of a patient undergoing septorhinoplasty at Whipps Cross University Hospital, London, UK.Subject:A 21-year-old man undergoing septorhinoplasty underwent pre-operative optical surface scanning of his face. The scans were repeated at one week and one year post-operatively. Software developed at University College London was then used to analyse the scans.Results:The scans clearly showed that the man's dorsal hump had been well reduced and the nose straightened, with a resulting 1600 mm3 gain on the right side and a 1000 mm3 loss on the left side of the nose. Tip projection had also been achieved.Conclusion:This technique allowed objective quantification of facial features and analysis of change. It may well prove useful in the future in predicting change following surgical intervention.

scholarly journals Acute presentation of ruptured ovarian cyst secondary to torsion with ipsislateral concomitant ectopic pregnancy: A case report

2014 ◽  
Vol 3 (2) ◽  
pp. 54-56
Author(s):  
Mahendra R Pandey ◽  
Neeva Ojha
Keyword(s):  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Emergency Laparotomy ◽  
Hospital Emergency ◽  
Obstetrics And Gynaecology ◽  
History Of ◽  
Gestational Sac ◽  
One Year ◽  
The Right ◽  
Urine Pregnancy Test

Twenty-one year unmarried regularly menstruating lady without history of amenorrhea presented with acute abdomen in TU Teaching Hospital –Emergency Department. On evaluation urine pregnancy test was positive. Urgent ultrasound revealed multiloculated cystic lesion measuring 8.5 x 8 x 6.7 cms in the right adnexa anterolateral to the uterus with no intrauterine gestational sac. She underwent emergency laparotomy with right salpingo-oophorectomy. On laparotomy there was twisted and ruptured right ovarian cyst with unruptured ampullary pregnancy on the same side. There was coexistence of these two conditions which presented as acute abdomen. DOI: http://dx.doi.org/10.3126/njog.v3i2.10834 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 54-56

Strangulated Morgagni hernia masquerading as an acute coronary syndrome

2021 ◽  
Vol 14 (7) ◽  
pp. e244045
Author(s):  
May Honey Ohn ◽  
Jun Rong Ng ◽  
Theviga Neela Mehan ◽  
Ng Pey Luen
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Surgical Repair ◽  
Bleeding Risk ◽  
Emergency Laparotomy ◽  
Morgagni Hernia ◽  
X Ray ◽  
Coronary Syndrome ◽  
The Right ◽  
Rule Out

Morgagni hernia is the rarest type of congenital diaphragmatic hernia, which can present late in adulthood. Here, we report a case of Morgagni hernia in an elderly woman who presented as an acute coronary syndrome with raised troponin level. X-ray of the chest (CXR) showed air–fluid level in the right lower hemithorax with loss of right diaphragmatic outline and subsequently confirmed strangulated Morgagni hernia with CT. She was treated with emergency laparotomy to reduce the hernia content and surgical repair with mesh done. In conclusion, Troponin can be falsely positive in Morgagni hernia patients, possibly due to strain on the heart by herniated bowel contents. Basic imaging such as a (CXR) is useful in the case of chest pain to rule out the non-cardiac causes. Although ‘time is the myocardium’ in the setting of all cases of chest pain with raised troponin, CXR should be done before treatment that poses bleeding risk and unnecessary delay in laparotomy.

scholarly journals Brain Abscess Due to Neglected Tetralogy of Fallot: A Case Report

2021 ◽  
Vol 9 (T3) ◽  
pp. 285-287
Author(s):  
Ririe F. Malisie ◽  
Hafaz Abdillah ◽  
Hariadi E. Saputra ◽  
Bayu Dewanto ◽  
Josephine Gloriana
Keyword(s):  
Tetralogy Of Fallot ◽  
Brain Abscess ◽  
Oxygen Deficiency ◽  
Pulmonary Stenosis ◽  
Emergency Laparotomy ◽  
High Grade Fever ◽  
Cardiac Manifestation ◽  
One Year ◽  
The Right ◽  
First Year Of Life

Backgroiund: Tetralogy of Fallot (TOF) is a type of congenital heart disease accounts for about 10% of all congenital cardiac deformities, and is the most common cyanotic lesion after the first year of life. The ideal age for correction of tetralogy of Fallot is still under discussion. Non-cardiac manifestation due to oxygen deficiency has to be aware of in cyanotic patient is brain abscess, because of the right-left shunt in long standing TOF. Objectives: To report a case of neglected TOF. Case And Discussion: A one-year-old male presented to Murni Teguh Memorial Hospital with the chief complaint of stiffed neck for the past 3 days and got fever for 10 days before admitted, with nausea and vomiting. He was diagnosed with Tetralogy of Fallot through an echocardiography examination when he was 2 months old, but never go through any medical nor surgical treatment. The boy responded to verbal, no eye contact, high grade fever, stiffed neck, Kernig sign and Brudzinski sign was found, and the right extremities were spastic, clubbing finger. On cardiac examination, there was systolic murmur grade ¾ in the left second intercostal space. Echocardiography evaluation revealed dilated RA-RV, no PDA shunt, large mal alignment ventricular septal defect, overriding aorta > 50%, right ventricular hypertrophy, and severe infundibular pulmonary stenosis, consistent with Tetralogy of Fallot. During hospitalization, there were several episodes of seizure and decreased of consciousness, brain CT investigation was done. The abscess was evacuated and a ventriculoperitoneal shunt was performed. One week after the operation, the patient developed abdominal distention, green bile like vomiting, decreased bowel movement and soon muscular defense. From the plain abdominal x-ray and CT revealed peritonitis and intestinal obstruction. An emergency laparotomy was performed, followed by adhesiolysis and jejunostomy due to jejunal perforation. The boy passed away after several episodes of septic shock. Conclusions: We would like to emphasis the consequence of the neglected treatment in infant with TOF.

scholarly journals Actinomycosis: A Rare Disease

1970 ◽  
Vol 11 (1) ◽  
pp. 74-77
Author(s):  
ABM Moniruddin ◽  
Hamida Begum ◽  
Khairun Nahar ◽  
Tanveer Ahmed ◽  
Maliha Alam Simi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Rare Disease ◽  
Surgical Intervention ◽  
Gluteal Region ◽  
Affected Area ◽  
One Year ◽  
The Right

A 35 year old male presented with multiple discharging sinuses in the right gluteal region & multiple nodular soft tissue swellings in the right side of face for one year. FNAC from lesions of both sites showed it as a case of actinomycosis. He was successfully treated by antibiotics & local care of the affected area. No surgical intervention was required. Here we like to present our experience of diagnosing & treating this rare disease. Keywords: Actinomycosis, Actinomyces israeli, cervicofacial actinomycosis DOI:10.3329/jom.v11i1.4279 J Medicine 2010: 11: 74-77

scholarly journals Ingested Magnets: A health hazard and the Role of laparoscopy

2021 ◽  
Vol 1 (1) ◽  
pp. 37-41
Author(s):  
Ahmed H. Al-Salem ◽  
Moustafa Hamchou ◽  
Hillal Matta ◽  
Adnan Swid ◽  
Bahjat Sahari ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Bowel Perforation ◽  
Health Hazard ◽  
Intestinal Resection ◽  
Emergency Laparotomy ◽  
Pressure Necrosis ◽  
Magnet Ingestion ◽  
The Subject ◽  
Early Surgical Intervention

Ingestion of magnets is becoming a common problem among children and teens and are known to be associated with serious complications that result from pressure necrosis and bowel perforation. We report a series of eight children with multiple magnets ingestion that resulted in complications including small bowel perforation and intestinal obstruction necessitating an emergency laparotomy and intestinal resection. The aim of this report is to raise awareness of the complications associated with magnet ingestion in children. The literature on the subject is also reviewed and early surgical intervention is recommended for multiple swallowed magnets. The role of laparoscopy in this regard is also stressed.

Successful treatment of conversion chemotherapy for initially unresectable synchronous colorectal liver metastasis

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Surgical Intervention ◽  
Liver Volume ◽  
Sigmoid Colon Cancer ◽  
Remnant Liver ◽  
Future Remnant Liver ◽  
The Right ◽  
Synchronous Colorectal Liver Metastasis ◽  
Right Hepatic Vein

A 72-year-old woman with a sigmoid colon cancer anda synchronous colorectal liver metastasis (CRLM), whichinvolved the right hepatic vein (RHV) and the inferiorvena cava (IVC), was referred to our hospital. Themetastatic lesion was diagnosed as initially unresectablebecause of its invasion into the confluence of theRHV and IVC. After she had undergone laparoscopicsigmoidectomy for the original tumor, she consequentlyhad 3 courses of modified 5-fluorouracil, leucovorin,and oxaliplatin (mFOLFOX6) plus cetuximab. Computedtomography revealed a partial response, and theconfluence of the RHV and IVC got free from cancerinvasion. After 3 additional courses of mFOLFOX6 pluscetuximab, preoperative percutaneous transhepaticportal vein embolization (PTPE) was performed tosecure the future remnant liver volume. Finally, a righthemihepatectomy was performed. The postoperativecourse was uneventful. The patient was dischargedfrom the hospital on postoperative day 13. She hadneither local recurrence nor distant metastasis 18 moafter the last surgical intervention. This multidisciplinarystrategy, consisting of conversion chemotherapy usingFOLFOX plus cetuximab and PTPE, could contributein facilitating curative hepatic resection for initiallyunresectable CRLM.Key words: Initially unresectable; Colorectal liver metastasis;Conversion chemotherapy; Cetuximab; Percutaneoustranshepatic portal vein embolization

Late Presentation of Penetrating Ulcers at the Ascending Aorta Associated With Intra-Mural Haematoma

2020 ◽  
Vol 3 (2) ◽  
pp. 01-05
Author(s):  
Ayman Kenawy
Keyword(s):  
High Risk ◽  
Disease Progression ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Late Presentation ◽  
Ascending Aorta ◽  
Chronic Type ◽  
Penetrating Aortic Ulcer ◽  
Good Outcome ◽  
Pseudo Aneurysm

The combined pathology of intra-mural haematoma (IMH) and penetrating aortic ulcer (PAU) represents disease progression of the PAU with high risk for further progression to either rupture or pseudo-aneurysm formation, and hence surgical intervention should be offered once diagnosis is made regardless of the presentation. We present a 70-year-old fit lady with chronic type A IMH associated with multiple PAUs, diagnosed incidentally, the patient underwent urgent surgical repair with good outcome.

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