scholarly journals PSEUDOTUMOR TUBERKULOSIS HATI DIAGNOSIS MELALUI BIOPSI ASPIRASI JARUM HALUS

2013 ◽  
Vol 2 (2) ◽  
Author(s):  
Poppy M. Lintong
Keyword(s):  
Ct Scan ◽  
Metastatic Cancer ◽  
Abdominal Cavity ◽  
Needle Aspiration ◽  
Diagnostic Tools ◽  
Focal Lesions ◽  
Normal Limits ◽  
Cell Aggregations ◽  
Upper Abdominal ◽  
The Right

Abstract: Nowadays, the role of Fine Needle Aspiration Biopsy (FNAB) in the evaluation of focal lesions in the liver, especially nodular hepatocellular carcinoma, is well developed. As one of the diagnostic tools, FNAB is very important in making a preoperative diagnosis to prevent unneeded hepatectomy. Although a CT scan or USG can detect a tubercular lesion in the abdo-minal cavity, this imaging is not always specific, and still needs microbiologic and histo-pathologic examinations for further confirmation. We reported a case of a 45-year-old female with a tumor in the right upper abdominal cavity. She had undergone a USG twice with two different results: the first one was a hepatoma, and the second one was a benign nodule of the liver. The AFP test was within normal limits (2.6 mg/ul). FNAB showed a tubercular granuloma consisting of epitheloid cell aggregations and Langhans datia cells, with a background of necrotic tissues, connective tissue fibrils, and normal hepatocytes. Localized tuberculosis as a clinical entity producing large nodules is exceedingly rare, even in endemic areas. These pseudotumors often resemble metastatic cancer, clinically and radiographically. By using FNAB we can detect liver tuberculosis that clinically manifests as a tumor. Key words: FNAB, liver tuberculosis, pseudotumor.     Abstrak: Saat ini peranan biopsi  aspirasi jarum halus  dalam        hal menilai kelainan-kelainan fo-kal pada hati sudah berkembang, terutama pada nodul karsinoma hepatoseluler. Biopsi aspirasi jarum halus pada hati  sebagai salah satu sarana diagnostik  sangat berguna untuk menegakkan diagnosis preoperatif sehingga dapat  menghindari tindakan hepatektomi yang tidak perlu. Meskipun pemeriksaan computerized tomography scan (CT-scan) dan ultrasonography (USG) pada hati dapat mendeteksi lesi tuberkulosis dalam rongga perut, namun  pencitraannya tidak selalu spesifik sehingga membutuhkan konfirmasi pemeriksaan mikrobiologi dan histopatologi. Dilaporkan kasus  seorang wanita berusia 45 tahun dengan tumor pada perut kanan atas. Telah dilakukan dua kali pemeriksaan USG: yang pertama hasilnya suatu hepatoma dan yang kedua suatu nodul jinak pada hati. Pemeriksaan alpha-feto protein (AFP) dalam batas normal (2,6 mg/ul). Kemudian dilakukan pemeriksaan biopsi aspirasi jarum halus dengan hasil menunjukkan granuloma tuberkulosis dari agregat sel-sel epiteloid yang tersusun dalam granuloma dan sel-sel datia Langhans dengan latar belakang fokus-fokus nekrosis, fibril jaringan ikat serta sel-sel hati normal. Tuberkulosis terlokalisir pada hati  yang secara klinik menimbulkan nodul besar, sangat jarang terjadi, sekalipun pada daerah endemik. Pseudotumor seperti ini sering menyerupai  metastatik kanker secara klinik dan radiologik. Melalui pemeriksaan biopsi aspirasi jarum halus dapat dikonfirmasi suatu tuberkulosis hati yang klinisnya memberi manifestasi seperti tumor. Kata kunci: biopsi  aspirasi jarum halus, tuberkulosis hati, pseudotumor.

EP.TU.439Falciform ligament torsion – a rare cause of the acute abdomen

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shariq Sabri ◽  
Adam O'Connor ◽  
Maseera Solkar ◽  
Amalia Ramzan ◽  
Mamoon Solkar
Keyword(s):  
Ct Scan ◽  
Vascular Occlusion ◽  
Normal Liver ◽  
Abdominal Ultrasound ◽  
Liver Function Tests ◽  
Falciform Ligament ◽  
Inferior Aspect ◽  
Successful Recovery ◽  
Upper Abdominal ◽  
The Right

Abstract The falciform ligament attaches the liver to the anterior abdominal wall and diaphragm. Acute falciform ligament related pathology is rare. In this case report we present a case of acute fat necrosis related to the falciform ligament. A 53 year old women presented with acute upper abdominal pain localised to the right hypochondrium. He was tender to palpation in the same region with a positive Murphy’s sign. A provisional diagnosis of acute cholecystitis was made. Blood work revealed raised inflammatory markers but normal liver function tests. Abdominal ultrasound revealed no gallbladder pathology nor gallstones. Thus computed tomogram (CT) scan of the abdomen was performed, showing hyper-attenuation rim signal present within the inferior aspect of the falciform ligament consistent with local vascular occlusion. The patient was managed with intravenous antibiotics with liberal analgesia and went on to make a successful recovery. Only 10 cases have been reported in the literature related to falciform ligament necrosis. We present this unusual pathology encountered on our acute surgical take, to alert surgeons to this rare diagnosis and provide a review of the literature and provide detail of how such a pathology manifests on CT scan.

Abdominal actinomycosis after reparative surgery for cholecystogastric fistula in an immunosuppressed patient

2021 ◽  
Vol 14 (7) ◽  
pp. e243445
Author(s):  
Maria Carolina Fra ◽  
Massimo Brenna ◽  
Caroline Di Benedetto ◽  
Marco De Monti
Keyword(s):  
Ct Scan ◽  
Laboratory Tests ◽  
Needle Aspiration ◽  
Immunosuppressed Patient ◽  
Ct Guided ◽  
Abdominal Actinomycosis ◽  
Patient Reported ◽  
Daily Dose ◽  
The Right ◽  
Ultrasound Features

A male patient, aged over 75 years, was referred to the emergency room for pain in his right hypochondrium. This pain, which persisted for approximately 3 days, radiated to his right flank and right iliac quadrant and worsened after meals. The patient reported no nausea, vomiting, diarrhoea, fever or recent traumatic events. Blood laboratory tests, ultrasonography, an MRI and a CT scan were performed, leading to the diagnosis of a mass in the Morrison’s pouch with ultrasound features of adipose tissue compatible with a liposarcoma, infiltrating the liver and the right kidney. Subsequent CT-guided needle aspiration and a histological examination led to the diagnosis of actinomycosis. The patient was initially treated with a daily dose of 18 million IU of benzylpenicillin for 4 weeks and subsequently prescribed the oral administration of 3 g/day of amoxicillin for 11 months. A monitoring CT scan was performed after 1, 5, 8 and 12 months, and a CT scan re-evaluation confirmed that the mass had completely healed.

scholarly journals ABSES HATI PIOGENIK

2012 ◽  
Vol 36 (1) ◽  
pp. 106
Author(s):  
Yusri Dianne Jurnalis ◽  
Delfican Delfican ◽  
Yorva Sayoeti
Keyword(s):  
Liver Abscess ◽  
Clinical Symptoms ◽  
Pyogenic Liver Abscess ◽  
Needle Aspiration ◽  
Surgical Drainage ◽  
Percutaneous Aspiration ◽  
High Grade Fever ◽  
Threatening Condition ◽  
Upper Abdominal ◽  
The Right

AbstrakAbses hati piogenik merupakan suatu kondisi yang berat dan mengancam kehidupan dengan angka mortalitas yang tinggi sehingga membutuhkan diagnostik dan terapi yang akurat. Gejala yang paling sering ditemukan adalah nyeri perut bagian atas, hepatomegali, demam tinggi, mual dan muntah. Gejala ini bervariasi sesuai ukuran abses, keadaan umum pasien, adanya penyakit dasar dan komplikasi. Pada sebagian besar kasus, penyakit dasarnya tidak diketahui. Abses biasanya soliter dan terletak di lobus kanan hati. USG dan CT scan abdomen merupakan sarana diagnostik utama. Abses hati piogenik diterapi dengan aspirasi perkutaneus bersamaan dengan antibiotik. Jika gagal, drainase dengan pembedahan dibutuhkan. Dengan adanya terapi invasif yang minimal seperti aspirasi jarum perkutaneus atau drainase kateter yang dipandu secara radiologis serta ketersediaan antibiotik berspektrum luas, pasien jarang membutuhkan tindakan pembedahan saat ini.Kata kunci : abses hati piogenik, aspirasi perkutaneus, drainase bedahAbstractPyogenic liver abscess (PLA) is a serious, life threatening condition with a high mortality rate that represents a diagnostic and therapeutic challenge. The most common presenting clinical symptoms are upper abdominal pain, tenderness, hepatomegaly, high-grade fever, nausea and vomiting. These features are variable depending upon the size of the abscess, general health of the patient, associated diseases and complications. In majority of the cases, the underlying cause could not be identified. Majority of abscesses are solitary and are noted in the right lobe of liver. USG and CT of the abdomen are the main tools of diagnosis. PLAs are mainly treated by percutaneous aspiration under antibiotic cover. If fails, surgical drainage becomes necessary. However, with the advent of minimally invasive therapy such as image-guided percutaneous needle aspiration or catheter drainage and the availability of broadspectrum antibiotics, patients with PLA nowadays seldom require open surgery for treatment.Key word : pyogenic liver abscess, percutaneous aspiration, surgical drainage

scholarly journals ISOLATED OCULOMOTOR NERVE PALSY

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Melissa T. E. Ratag ◽  
Ralf R Pangalila
Keyword(s):  
Ct Scan ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Uncontrolled Hypertension ◽  
Oculomotor Nerve Palsy ◽  
Relative Afferent Pupillary Defect ◽  
Primary Position ◽  
Normal Limits ◽  
The Right ◽  
Per Oral

Abstract: We reported a case of a 59-year-old male who came to the hospital with the chief complaint of a droopy upper right eyelid originating a month before, accompanied by diplopia. This patient was also suffering from uncontrolled hypertension. The ophthalmologic examination of the right eye showed a best corrected visual acuity (BCVA) of 1.0. In the primary position there was a deviation to the temporal side; limitations on elevation, adduction, and depression; and an endorotation on nasal down gaze. The aberrant regenerative trigeminal nerve was noticed, but the relative afferent pupillary defect (RAPD) was not found. The anterior and posterior segments of the right eye were normal. Laboratory tests were within normal limits and the CT-scan did not show any abnormality. Conclusion: Based on all the tests performed, the diagnosis of the patient was an isolated oculomotor nerve palsy of the right eye. The patient was treated with a non-steroid anti inflammatory drug and a neurotropic vitamine, and had to be observed for three months. Keywords: palsy, oculomotor nerve, right eye.   Abstrak: Kami melaporkan kasus seorang laki-laki berusia 59 tahun dengan keluhan utama kelopak mata atas kanan tertutup sejak satu bulan lalu, disertai diplopia. Dalam anamnesis ditemukan adanya riwayat hipertensi sedangkan riwayat trauma tidak ada. Pemeriksaan oftalmologi mata kanan didapatkan tajam penglihatan 6/6, pergerakan bola mata kanan tampak sedikit deviasi ke temporal pada posisi primer, serta keterbatasan dalam elevasi, aduksi, dan depresi. Mata kanan tampak endorotasi saat melirik ke nasal bawah dan terdapat aberrant regenerative; relative afferent pupillary defect (RAPD) tidak ditemukan. Segmen anterior dan posterior dalam batas normal. Pemeriksaan laboratorium dan CT scan kepala dalam batas normal. Simpulan: Berdasarkan hasil pemeriksaan oftalmologik dan pemeriksaan penunjang ditegakkan diagnosis isolated oculomotor nerve palsy mata kanan yang ditangani dengan pemberian anti inflamasi non steroid dan neurotropik per oral sambil diobservasi selama tiga bulan. Kata kunci: kelumpuhan, saraf okulomotor, mata kanan.

scholarly journals Pyogenic liver abscess caused by Gemella morbillorum

2014 ◽  
pp. 81-84 ◽  
Author(s):  
Paolo Borro ◽  
Alessandro Sumberaz ◽  
Gianni Testino
Keyword(s):  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Pleural Empyema ◽  
Abdominal Ultrasound ◽  
Needle Aspiration ◽  
Focal Lesions ◽  
Simple Cyst ◽  
Systemic Antibiotic Therapy ◽  
The Right

Even though Gemella morbillorum infection (GMI) is rare in humans, it may, nevertheless, cause endocarditis, meningitis, brain abscess, pleural empyema, nephritis, mediastinitis, and – occasionally – liver abscess. We are describing the case of a 64-year-old Caucasian male admitted with fever and abdominal pain. Laboratory parameters revealed inflammation signs, and instrumental examinations showed the presence of diverticula in the ascending colon. Abdominal ultrasound (US) and computer tomography (CT) showed two focal lesions in the right liver lobe. One had the characteristics of a simple cyst; the second was hypoechoic with a low density area, possibly containing necrotic material. US-guided needle biopsy was found negative for neoplastic cells, showing purulent infiltrate. Pus culture was found positive for GMI. Systemic antibiotic therapy, coupled with repeated US-guided needle aspiration, induced the resolution of the hepatic abscess. Few cases have been reported of hepatic abscess caused by GMI in immunocompetent non-cirrhotic subjects.

scholarly journals Concha Bullosa in Paradoxical Middle Turbinate: A New Variation

2016 ◽  
Vol 9 (3) ◽  
pp. 141-142 ◽  
Author(s):  
Mohammad W El-Anwar ◽  
Ahmed I Ali
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Laboratory Tests ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Normal Limits ◽  
Osteomeatal Complex ◽  
The Right

ABSTRACT Introduction Concha bullosa is the most common anatomic variation of osteomeatal complex region that is generally seen in the middle turbinate (MT). Materials and methods A 25-year-old male presented with headache and nasal obstruction. Computed tomography (CT) scan documented right paradoxical MT. The right MT also showed aerated concha bullosa with narrow right osteomeatal area. Routine preoperative laboratory tests were within normal limits. Results This case of concha bullosa in paradoxically bent MT was reported, described, and could be safely managed endoscopically. Patient was symptom free up to date without any complication, recurrence, or other pathology. Conclusion Computed tomography may easily identify such uncommon anatomic variations of the osteomeatal region. This directs the surgeon attention to these variations as a cause of headache and osteomeatal area obstruction. How to cite this article El-Anwar MW, Ali AI. Concha Bullosa in Paradoxical Middle Turbinate: A New Variation. Clin Rhinol An Int J 2016;9(3):141-142.

scholarly journals Intrahepatic Pregnancy - A Rare Form Of Abdominal Pregnancy At Lira Regional Referral Hospital, Northern Uganda; A Case Report And Literature Review

2020 ◽  
Vol 7 (08) ◽  
pp. 4895-4899
Author(s):  
Andrew Odur ◽  
Tom Richard Okello ◽  
Richard Okii ◽  
John Stephen Obbo Olwenyi ◽  
Irene Pecorella
Keyword(s):  
Abdominal Cavity ◽  
Rare Condition ◽  
Rare Form ◽  
Regional Referral Hospital ◽  
Female Baby ◽  
Upper Abdominal ◽  
The Right ◽  
Hepatic Pregnancy

Primary intra-hepatic pregnancy is an extremely rare condition. The purpose of this study was to report a case of 24-year-old Gravida 2 para 1+0 who presented at 35 weeks of amenorrhea, vaginal bleeding and mild right upper abdominal tenderness. Ultrasonography revealed a non-viable extra-uterine fetus located around the right upper part of the abdomen with a bulky uterus. At laparotomy was preferred and on finding a fetus free abdominal cavity and uterus, a macerated female baby was delivered from inside the liver with birth weight of 2.7kilogram. Placenta was left in situ and methotrexate given to hasten its resorption. Maternal outcome during the 18 days of intense follow up was uneventful. This case is a rare occurrence in our setting and it has diagnostic challenges in low resource settings like ours, however intra-hepatic pregnancy can grow to considerable size and weight.

Synchronous carcinoma of the thyroid and hypopharynx; a diagnostic and management challenge

2020 ◽  
Vol 1 (1) ◽  
pp. 24-28
Author(s):  
Louise McMurran ◽  
◽  
Usman Rasul ◽  
Seok Jun Jeong ◽  
Vamsidhar Vallamkondu ◽  
...  
Keyword(s):  
Ct Scan ◽  
Thyroid Cartilage ◽  
Needle Aspiration ◽  
Neck Swelling ◽  
Pyriform Fossa ◽  
Synchronous Carcinoma ◽  
Chinese Origin ◽  
Thyroid Mass ◽  
Synchronous Cancers ◽  
The Right

A 73-year-old Chinese origin woman presented with a right neck swelling associated with recent swallowing issues and hoarseness. She had an apparent goitre and a right posterior neck swelling. An ultrasound guided fine needle aspiration demonstrated papillary thyroid carcinoma in both thyroid lobes and right neck lymphadenopathy. While awaiting total thyroidectomy and neck dissection she presented with haemoptysis. She was found to have an exophytic mass in right pyriform fossa. The CT scan confirmed an intralaryngeal extension of the thyroid mass via thyroid cartilage and metastatic disease in the lung. Unexpectedly histology showed that the tissue from the right pyriform fossa was squamous cell carcinoma and papillary carcinoma in the thyroid was confirmed. She had synchronous cancers in the thyroid and hypopharynx. Synchronous tumours are a big challenge to diagnose and to treat. In her case the CT scan was misleading. We discuss this unusual presentation of synchronous head and neck cancers and difficulty in managing them.

scholarly journals Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kamel A. Gharaibeh ◽  
Arnaldo Lopez-Ruiz ◽  
Tauqeer Yousuf
Keyword(s):  
Ct Scan ◽  
Psoas Abscess ◽  
Psoas Muscle ◽  
Needle Aspiration ◽  
Imaging Studies ◽  
Lower Quadrant ◽  
History Of ◽  
Undifferentiated Adenocarcinoma ◽  
Poorly Differentiated ◽  
The Right

Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations.

scholarly journals Handlebar sign: a bruise with underlying visceral injury

2019 ◽  
Vol 12 (11) ◽  
pp. e231835 ◽  
Author(s):  
Vijay Waman Dhakre ◽  
Sarvesh B Kadam ◽  
Akhilesh Gowda ◽  
Sandhya Iyer
Keyword(s):  
Ct Scan ◽  
Abdominal Cavity ◽  
Transversus Abdominis ◽  
Oblique Muscle ◽  
Solid Organ ◽  
Delayed Presentation ◽  
Visceral Injury ◽  
Contrast Enhanced Ct ◽  
Handlebar Hernia ◽  
The Right

A 14-year-old boy presented with a painful swelling topped by a bruise overlying the skin of the right inguinal region without peritonitis. This was the area of impact of bicycle handlebar while riding 6 days ago. On contrast-enhanced CT scan, we found a traumatic abdominal wall hernia (handlebar hernia) near the right deep ring without any solid organ, bowel or urinary bladder injury. Inguinal exploration revealed a defect in transversus abdominis and internal oblique muscle which was repaired and meshplasty was done.Delayed presentation and ignorance towards ‘handlebar sign’ is associated with visceral injury (haematoma/perforation) will incur the risk of rising morbidity and mortality. With CT scan we can assess the abdominal cavity to rule out associated visceral or vascular injury. Surgical repair for restoring disrupted anatomy with or without meshplasty is the preferred approach.

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