scholarly journals Volvulus of ileum: A rare case of small bowel obstruction and the effectiveness of abdominal ultrasound imaging for the diagnosis

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Bajhat Barakat ◽  
Raffaele Pezzilli
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Imaging Modality ◽  
Abdominal Ultrasound ◽  
Computed Tomography Scan ◽  
Mesenteric Lymph Nodes ◽  
Abdominal Ultrasonography ◽  
Primary Type ◽  
Tomography Scan ◽  
Secondary Type

Primary type small bowel volvulus is observed mainly in children and young adults, whereas the secondary type is usually found between the ages of 40 and 90 years and is mainly due to adhesions after previous surgery: tumors and mesenteric lymph nodes can also be responsible for the secondary type. Diagnosis is difficult and the computed tomography scan is the most relevant imaging modality. For this reason we believe that the case presented in which diagnosis was primary made by abdominal ultrasonography and then confirmed first by computed tomography scan and definitively by surgical exploration is worth reporting.

Hepatitis following Treatments with Famotidine and Then CimetIDINE

1994 ◽  
Vol 28 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Fred Hashimoto ◽  
Robin L. Davis ◽  
Douglas Egli
Keyword(s):  
Computed Tomography ◽  
Duodenal Ulcer ◽  
Fatty Liver ◽  
Obese Woman ◽  
Abdominal Ultrasound ◽  
Drug Discontinuation ◽  
Computed Tomography Scan ◽  
Case Summary ◽  
Receptor Blockers ◽  
Tomography Scan

OBJECTIVE: To report a case of hepatitis induced by two histamine (H2)-receptor blockers, famotidine and cimetidine. CASE SUMMARY: A 51-year-old obese woman with a duodenal ulcer developed symptomatic, famotidine-induced hepatitis. Other causes for hepatitis were ruled out. Famotidine was discontinued and the patient took omeprazole for a month without incident. Cimetidine therapy was then initiated and shortly thereafter, the patient developed another episode of symptomatic hepatitis that resolved upon drug discontinuation. Two abdominal ultrasound examinations six months apart and an abdominal computed tomography scan obtained later showed what appeared to be a stable, fatty liver. DISCUSSION: This appears to be the first reported case of clinical hepatitis related to famotidine and the first reported case where clinical hepatitis followed the administration of two different H2-receptor blockers. The fatty liver probably was secondary to obesity and incidental to the hepatitis episodes. CONCLUSIONS: Famotidine can cause clinical hepatitis, and druginduced hepatitis can occur after the administration of two different H2-receptor blockers.

scholarly journals Small bowel perforation after low-velocity trauma: a case report

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
S Sinz ◽  
L Benigno ◽  
M A Zadnikar ◽  
M E Biraima-Steinemann
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Diagnostic Laparoscopy ◽  
Bowel Perforation ◽  
Small Bowel Perforation ◽  
Computed Tomography Scan ◽  
Low Velocity ◽  
Tomography Scan

Abstract We report the case of a 63-year-old patient with a low-velocity abdominal trauma and bowel perforation. The patient slipped on a wet floor and fell down the stairs. On admission, the patient complained about abdominal pain. A computed tomography scan showed traumatic hematoma of the jejunum in the left upper quadrant and a small amount of intra-abdominal air. Also rib fractures on the left side were diagnosed. We performed a diagnostic laparoscopy and found a bowel perforation, which was manually repaired.

Bolus ileus-an occasional cause of small bowel obstruction-case report

2017 ◽  
Vol 5 (12) ◽  
pp. 5447
Author(s):  
Jurij Janež
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Computed Tomography Scan ◽  
Food Bolus ◽  
Postoperative Course ◽  
Pathological Conditions ◽  
Tomography Scan

A food bolus can be an occasional cause of small bowel obstruction. Especially older and senile patients are at higher risk for developing a bolus ileus. Certain pathological conditions are associated with a higher risk for developing a bolus ileus, such as duodenal and small bowel diverticula. In this paper is presented a case of a 68-year-old female patient with food bolus, that caused a mehanical small bowel obstruction. The abdominal computed tomography scan before surgery did not show the precise cause of intestinal obstruction. During surgery we found a big grape in the distal ileum, which was removed through enterotomy. Further postoperative course was uneventful.

scholarly journals Evaluating the risk of appendiceal perforation when using ultrasound as the initial diagnostic imaging modality in children with suspected appendicitis

Ultrasound ◽  
2017 ◽  
Vol 25 (3) ◽  
pp. 166-172
Author(s):  
Stephen Alerhand ◽  
James Meltzer ◽  
Ee Tein Tay
Keyword(s):  
Computed Tomography ◽  
Diagnostic Imaging ◽  
Imaging Modality ◽  
Ultrasound Scan ◽  
Computed Tomography Scan ◽  
Perforation Rate ◽  
Suspected Appendicitis ◽  
Significant Difference ◽  
Tomography Scan ◽  
Appendiceal Perforation

Background Ultrasound scan has gained attention for diagnosing appendicitis due to its avoidance of ionizing radiation. However, studies show that ultrasound scan carries inferior sensitivity to computed tomography scan. A non-diagnostic ultrasound scan could increase the time to diagnosis and appendicectomy, particularly if follow-up computed tomography scan is needed. Some studies suggest that delaying appendicectomy increases the risk of perforation. Objective To investigate the risk of appendiceal perforation when using ultrasound scan as the initial diagnostic imaging modality in children with suspected appendicitis. Methods We retrospectively reviewed 1411 charts of children ≤17 years old diagnosed with appendicitis at two urban academic medical centers. Patients who underwent ultrasound scan first were compared to those who underwent computed tomography scan first. In the sub-group analysis, patients who only received ultrasound scan were compared to those who received initial ultrasound scan followed by computed tomography scan. Main outcome measures were appendiceal perforation rate and time from triage to appendicectomy. Results In 720 children eligible for analysis, there was no significant difference in perforation rate between those who had initial ultrasound scan and those who had initial computed tomography scan (7.3% vs. 8.9%, p = 0.44), nor in those who had ultrasound scan only and those who had initial ultrasound scan followed by computed tomography scan (8.0% vs. 5.6%, p = 0.42). Those patients who had ultrasound scan first had a shorter triage-to-incision time than those who had computed tomography scan first (9.2 (IQR: 5.9, 14.0) vs. 10.2 (IQR: 7.3, 14.3) hours, p = 0.03), whereas those who had ultrasound scan followed by computed tomography scan took longer than those who had ultrasound scan only (7.8 (IQR: 5.3, 11.6) vs. 15.1 (IQR: 10.6, 20.6), p < 0.001). Children < 12 years old receiving ultrasound scan first had lower perforation rate (p = 0.01) and shorter triage-to-incision time (p = 0.003). Conclusion Children with suspected appendicitis receiving ultrasound scan as the initial diagnostic imaging modality do not have increased risk of perforation compared to those receiving computed tomography scan first. We recommend that children <12 years of age receive ultrasound scan first.

scholarly journals Hepatic Angiosarcoma Masquerading as Hemangioma: A Challenging Differential Diagnosis

2017 ◽  
Vol 30 (10) ◽  
pp. 750
Author(s):  
Ana Rita Garcia ◽  
João Ribeiro ◽  
Helena Gervásio ◽  
Francisco Castro e Sousa
Keyword(s):  
Computed Tomography ◽  
Malignant Tumors ◽  
Palliative Radiotherapy ◽  
Abdominal Ultrasound ◽  
Gamma Glutamyl Transferase ◽  
Computed Tomography Scan ◽  
Hepatic Angiosarcoma ◽  
Imaging Characteristics ◽  
Glutamyl Transferase ◽  
Tomography Scan

Hemangiomas are usually diagnosed based on ultrasound findings. The presence of symptoms, rapid growth or atipical imagiological findings should make us consider other diagnoses, including malignant tumors such as angiosarcomas. We describe the case of a previously healthy 46-year-old female without a history of exposure to carcinogens who presented with abdominal pain for two months. Diagnostic work-up revealed elevated gamma-glutamyl transferase and lactate dehydrogenase levels. Abdominal ultrasound described a large nodular lesion in the right lobe of the liver described as a hemangioma. One month later, a computed tomography-scan was made and revealed the same lesion, which had grown from 13.5 to 20 cm, maintaining typical imaging characteristics of a hemangioma. A right hepatectomy was performed and pathology revealed an angiosarcoma. After surgery, a positron emission tomography-computed tomography scan showed hepatic and bone metastasis. The patient started taxane-based chemotherapy and lumbar palliative radiotherapy, but died 10 months after surgery. This case shows how difficult it is to diagnose hepatic angiosarcoma relying only on imaging findings. Two abdominal computed tomography -scans were performed and none suggested this diagnosis. Angiosarcoma is a very aggressive tumour with an adverse prognosis. Surgery is the only curative treatment available. However, it is rarely feasible due to unresectable disease or distant metastasis.

scholarly journals Sitagliptin-induced Pancreatitis: A case report and plausible mechanism

2021 ◽  
Vol 11 (3) ◽  
pp. 1-3
Author(s):  
Kamel El-Reshaid ◽  
Shaikha Al-Bader ◽  
Zaneta Markova
Keyword(s):  
Diabetes Mellitus ◽  
Computed Tomography ◽  
Epigastric Pain ◽  
Abdominal Ultrasound ◽  
Biliary Duct ◽  
Computed Tomography Scan ◽  
Drug Induced ◽  
Pain Medications ◽  
Plausible Mechanism ◽  
Tomography Scan

Drugs are rare cause of acute pancreatitis (AP) with an estimate incidence of 0.1-2%. We present an 63-year-man 1 week history of severe and progressive epigastric pain that radiates to the back and is worse on lying down, who was found to have lipase of more than 813 IU/L. The patient denied current alcohol use. Abdominal ultrasound and abdominal computed tomography scan did not show gallstones or biliary duct abnormalities. For his type-2 diabetes mellitus, he was taking Gliclazide and Metformin for years and Sitagliptin was the only drug added 6 months ago. He was managed conservatively with intravenous fluids, pain medications, and control of diabetes with insulin.  Within 3 days, he improved dramatically and was discharged on diabetic diet and Gliclazide 120 mg daily with Lantos 10 units at night.  He was instructed to avoid oral hypoglycemia agents from the dipeptidyl-peptidase IV inhibitors (DPP-4i) group.  Three weeks later, repeat computed tomography scan of the abdomen showed normal pancreas.  On follow up; and up to 1 year, he did not have subsequent AP.  The most plausible mechanism of such late-development of rare drug-induced AP is late-encounter with triggering factor/s for Sitagliptin in genetically-predisposed individuals.    Keywords: CT scan, diabetes mellitus, DPP-4i, metformin, pancreatitis, Sitagliptin.

scholarly journals A prospective study of clinical, biochemical and radiological features in pancreatitis

2017 ◽  
Vol 4 (5) ◽  
pp. 1386
Author(s):  
Raj Kumar Bhimwal ◽  
Mohan Makwana ◽  
Rewat Ram Panwar ◽  
Kanwar Lal
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Imaging Modality ◽  
Biliary Disease ◽  
Computed Tomography Scan ◽  
Medical College ◽  
Acute And Chronic Pancreatitis ◽  
Tomography Scan

Background: Pancreatitis is quite common problem, it may present either as abdominal emergency with fulminant course or as an indolent process leading to long-term medical as well as surgical complications often leading to poor prognosis if not intervened timely.Methods: The present study conducted in the department of medicine, Dr. S. N. medical college, Jodhpur. Participants after understanding the study protocol and procedure, asked to give their written consent for the study. A cross sectional hospital based study in patients admitted in various medical wards of Dr. S. N. medical college, Jodhpur. 50 patients with acute and chronic pancreatitis were studied.Results: In the present study, most common cause of acute pancreatitis is biliary disease (50%) followed by alcoholism (37.5%) and in chronic pancreatitis is alcoholism (80%). Acute pancreatitis was more common in males (62.5%, 25 males) whereas chronic pancreatitis in males (80%, 8 male). Abdominal pain is the most common symptom (97.5%) followed by nausea-vomiting (92.5%) in acute pancreatitis. The history of previous abdominal pain in 100% of cases followed by epigastria pain in 90% of cases, in chronic pancreatitis. The amylase and lipase were elevated in 90% of cases. The amylase and lipase levels did not correlate with the severity. 66.6% of patients had severe pancreatitis with a positive predictive value of 66.6%. The ultrasonography imaging of pancreas was helpful in 70% and 100% in acute and chronic pancreatitis respectively. The CT scan was a better imaging modality as compared to ultrasonography in acute pancreatitis, where as it scored over ultrasonography imaging in chronic pancreatitis with complications.Conclusions: Relevant clinical history, ultrasonography and computed tomography scan of pancreas are helpful in diagnosis of pancreatitis. The computed tomography scan was a better imaging modality as compared to ultrasonography.

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