scholarly journals Percutaneous internal suturing procedure for a posttraumatic abdominal wall “handlebar hernia”

2021 ◽  
Vol 70 (1) ◽  
pp. 80-83
Author(s):  
Maria Popescu ◽  
◽  
Gabriel Dragan ◽  
Keyword(s):  
Abdominal Wall ◽  
Pediatric Population ◽  
Traumatic Injury ◽  
Internal Ring ◽  
Lower Quadrant ◽  
Handlebar Hernia ◽  
Suturing Technique ◽  
The Right ◽  
Right Lower Quadrant

Posttraumatic abdominal wall hernias are extremely rare and are the result of the wall impact with an object that does not break the skin but has enough energy to disrupt the underlying muscular and fascia layers. One of the most frequent mechanisms for the pediatric population is the handle bar traumatic injury. We present the case of a 13-year-old male patient that was diagnosed with posttraumatic handlebar hernia in the right lower quadrant after performing a CT scan examination. The chosen surgical procedure was to repair the abdominal defect using an adaptation of the PIRS (percutaneous internal ring suturing) suturing technique assisted laparoscopically. The follow up of the case was uneventful.

The Management of Terminal Ileum Diverticulitis

2009 ◽  
Vol 75 (12) ◽  
pp. 1199-1202 ◽  
Author(s):  
Hyoung-Chul Park ◽  
Bong Hwa Lee
Keyword(s):  
Clinical Features ◽  
Terminal Ileum ◽  
Nonoperative Management ◽  
Perforated Diverticulitis ◽  
Radiographic Evaluation ◽  
Lower Quadrant ◽  
Average Hospital ◽  
The Right ◽  
Right Lower Quadrant

Terminal ileum diverticulitis is a very rare disease that may lead to an acute abdomen mimicking appendicitis. Because of its rarity, an optimal treatment for this disease has not been established yet. In this study, we evaluated the clinical features and outcomes of nonoperative management of terminal ileum diverticulitis, including suspected perforation. From 2000 to 2007, 346 patients were treated for acute symptomatic right-sided diverticulitis. Radiographic evaluation revealed that nine patients (2.6%) had terminal ileum diverticulitis. All patients presented with pain in the right lower quadrant. The clinical features and outcomes, including recurrence, were evaluated from a collected database and by phone interview. The average age of the patients was 43.7 years. Radiographic imaging was used to diagnose diverticulitis in all patients. Two of nine patients had suspected perforated diverticulitis, and three patients had multiple diverticula. Nonoperative management was successfully carried out on these patients. The average hospital stay was 8 days and the duration of antibiotic treatment was 6.4 days. The median follow-up was 36 months, and patients showed no recurrence within this interval. Nonoperative management may be feasible to treat terminal ileum diverticulitis.

scholarly journals A Case Giving Proof of Pathogenesis of Abdominoscrotal Hydrocele: A Case Report

2021 ◽  
Vol 27 (2) ◽  
pp. 91-94
Author(s):  
Hee Jo Yang ◽  
Myoung Won Son ◽  
Doo Sang Kim
Keyword(s):  
Abdominal Cavity ◽  
Surgical Excision ◽  
Cystic Mass ◽  
Palpable Mass ◽  
Lower Quadrant ◽  
Uncommon Condition ◽  
Abdominoscrotal Hydrocele ◽  
The Right ◽  
Right Lower Quadrant

An abdominoscrotal hydrocele (ASH) is an uncommon condition characterized by cystic mass that occupies the scrotum and abdomen. The characteristic aspect is the presence of two hydrocele sacs in the abdominal cavity and the scrotum, and compression of one side causes enlargement of the other side, thereby connecting the two sacs. There are several hypotheses regarding the occurrence of ASH. However, the evidence of the hypotheses is lacking. The patient was a 52-year-old male. During observation of the right inguinoscrotal hydrocele, the patient complained of a palpable mass lesion on the right lower quadrant of the abdomen. Physical examination revealed ASH that occurred with the growth of the inguinoscrotal hydrocele. This was further confirmed by sequential imaging test thereby proposing the verification of cephalad extension of hydrocele. The surgical excision was recommended and inguinal exploration was performed under general anesthesia. No evidence of relapse was observed during the 2-year follow-up period after surgery. The present case proves the cephalad extension of hydrocele among other hypotheses on the etiology of ASH.

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

Correlating Abdominal Wall Thickness and Body Mass Index to Predict Usefulness of Right Lower Quadrant Ultrasound for Evaluation of Pediatric Appendicitis

2017 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jeannie K. Kwon ◽  
Nowice Trexler ◽  
Joan Reisch ◽  
Cory M. Pfeifer ◽  
Jason Ginos ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Abdominal Wall ◽  
Body Mass ◽  
Wall Thickness ◽  
Lower Quadrant ◽  
Right Lower Quadrant

Appendicitis

2016 ◽  
Author(s):  
David Scordino
Keyword(s):  
Antibiotic Therapy ◽  
Acute Inflammation ◽  
Surgical Intervention ◽  
Significant Risk ◽  
Disease Course ◽  
Lower Quadrant ◽  
Nonoperative Therapy ◽  
Atypical Presentations ◽  
The Right ◽  
Right Lower Quadrant

Appendicitis is caused by acute inflammation of the appendix (usually secondary to obstruction) and can result in perforation, leading to peritonitis, sepsis, and/or abscess formation. Symptomatology includes anorexia, nausea, vomiting, and periumbilical pain (later localizing to the right lower quadrant). Patients at the extremes of age and pregnant women may have atypical presentations and higher rates of perforation and complications. Most patients suspected of having appendicitis receive prompt surgical intervention (usually laparoscopic). Antibiotic therapy, initiated preoperatively, varies for perforated vs nonperforated appendicitis. In patients with evidence of a contained abscess, nonoperative therapy is considered, as abscess is evidence of a prolonged disease course (more than 5 days) prior to presentation. On imaging, patients may have a well-circumscribed abscess or phlegmon; if immediate surgical intervention is attempted, there is significant risk of morbidity due to adhesions to adjacent tissues.

scholarly journals Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Michelle J. Hong ◽  
Lauren M. Porter ◽  
Debra D. Esernio-Jenssen ◽  
Andrew C. Miller ◽  
Marna Rayl Greenberg
Keyword(s):  
Partner Violence ◽  
Pediatric Population ◽  
Lower Quadrant ◽  
System A ◽  
Complete Transection ◽  
Pancreatic Injuries ◽  
History Of ◽  
Low Threshold ◽  
Preservation Of The Spleen ◽  
Right Lower Quadrant

Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen. On further inquiry specific to trauma, the child disclosed that his older brother had punched him in his abdomen the night before. The child’s parents were separated due to intimate partner violence, and this older sibling recently had been very stressed. The sibling was referred for mental health evaluation and counseling, and the case reported to the county children and youth investigative services system. A low threshold for considering trauma and child abuse in the pediatric population is recommended when significant intra-abdominal injury is diagnosed.

scholarly journals Isolated intestinal Ganglioneuromatosis: case report and literature review

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Angela Mauro ◽  
Letizia Zenzeri ◽  
Francesco Esposito ◽  
Giovanni Gaglione ◽  
Caterina Strisciuglio ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Polypoid Lesion ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Ileal Loop ◽  
Lower Quadrant ◽  
Blood Tests ◽  
Fecal Occult ◽  
The Right ◽  
Right Lower Quadrant

Abstract Background Intestinal Ganglioneuromatosis (IG) is a rare disorder of the enteric nervous system. In pediatric age it is often associated with genetic syndromes such as Neurofibromatosis 1 (NF1), multiple endocrine neoplasia type 2B (MEN2B) and Cowden syndrome (PTEN mutation), and ganglioneuromas (GNs) may be sometimes the first sign of the disease. Isolated GNs are rare and sporadic. Clinical symptom vary and depend on the size and on the location of the GNs. This disorder affects intestinal motility and it, consequently, causes changes in bowel habits, abdominal pain, occlusive symptoms and rarely lower gastrointestinal bleeding secondary to ulceration of the intestinal mucosa. On the other hand, patients can remain asymptomatic for many years. Case presentation We describe a 9-year-old boy referred to our emergency department for right lower quadrant abdominal pain. No familial history for gastrointestinal disorders. No history of fever or weight loss. At physical examination, he had diffused abdominal pain. Abdominal ultrasonography showed a hypoechoic formation measuring 41.8 mm by 35 mm in the right lower quadrant of the abdomen. Routine blood tests were normal, but fecal occult blood test was positive. Abdominal TC confirmed the hypodense formation, of about 5 cm in transverse diameter, in the right hypochondrium that apparently invaginated in the caecum-last ileal loop. Colonoscopy showed in the cecum an invaginated polypoid lesion of the terminal ileal loop. Laparoscopic resection of the polypoid lesion was performed. Histological diagnosis of the large neoplasm observed in the terminal ileum was diffuse ganglioneuromatosis. NF1, RET and PTEN gene tests resulted negative for specific mutations. At the 1 year follow-up, the patient presented good general condition and blood tests, fecal occult blood test, esophagogastroduodenoscopy, colonoscopy and MR-enterography were negative. Conclusions Only few cases are reported in literature of IG in pediatric age. Although rare, the present case suggests that this disorder must be taken in consideration in every patient with GI symptoms such as abdominal pain, constipation, lower intestinal bleeding, in order to avoid a delayed diagnosis.

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