Case Report: Gastrointestinal Basidiobolomycosis with Multi-Organ Involvement Presented with Intussusception

2021 ◽  
Author(s):  
Zahra Jafarpour ◽  
Gholamreza Pouladfar ◽  
Alireza Dehghan ◽  
Mohammad Hossein Anbardar ◽  
Hamid Reza Foroutan
Keyword(s):  
Liposomal Amphotericin ◽  
Colonic Mucosa ◽  
Bowel Wall ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Peripheral Eosinophilia ◽  
Liver Sample ◽  
Erythrocyte Sedimentation ◽  
Life Threatening ◽  
High Erythrocyte Sedimentation Rate

Gastrointestinal basidiobolomycosis (GIB) is a rare, life-threatening fungal infection affecting immunocompetent individuals in tropical and subtropical regions. A diverse presentation of GIB has been reported, but no report has yet been published on intussusception. We describe a 23-month-old immunocompetent boy from a subtropical area in Iran who presented with intussusception. Prolonged fever, an abdominal mass, hepatomegaly, high erythrocyte sedimentation rate, and peripheral eosinophilia strongly suggested GIB. Accordingly, GIB was diagnosed based on the characteristic histopathology (the Splendore-Hoeppli phenomenon) detected in a liver sample taken via biopsy. Exploratory laparotomy showed several organs, including the colon, gall bladder, liver, and abdominal wall, were involved. Antifungal therapy with trimethoprim/sulfamethoxazole, liposomal amphotericin B, a saturated solution of potassium iodide, and surgical resection of involved tissues were used with improved outcome. The presence of non-septate fungal hyphal elements in the colonic mucosa led to the thickening of the bowel wall, leading to secondary intussusception.

scholarly journals Eosinophilic fasciitis: an atypical presentation of a rare disease

2019 ◽  
Vol 65 (3) ◽  
pp. 326-329
Author(s):  
Catia Cabral ◽  
António Novais ◽  
David Araujo ◽  
Ana Mosca ◽  
Ana Lages ◽  
...  
Keyword(s):  
Rare Disease ◽  
Rare Case ◽  
Unknown Etiology ◽  
Eosinophilic Fasciitis ◽  
Atypical Presentation ◽  
Peripheral Eosinophilia ◽  
First Line ◽  
Erythrocyte Sedimentation ◽  
High Doses ◽  
High Erythrocyte Sedimentation Rate

SUMMARY Eosinophilic fasciitis, or Shulman's disease, is a rare disease of unknown etiology. It is characterized by peripheral eosinophilia, hypergammaglobulinemia, and high erythrocyte sedimentation rate. The diagnosis is confirmed by a deep biopsy of the skin. The first line of treatment is corticotherapy. We present a rare case of eosinophilic fasciitis in a 27-year-old woman with an atypical presentation with symmetrical peripheral edema and a Groove sign. The patient responded well to treatment with corticosteroids at high doses and, in this context, was associated with hydroxychloroquine and azathioprine. After two and a half years, peripheral eosinophilia had increased, and more of her skin had hardened. At that time, the therapy was modified to include corticoids, methotrexate, and penicillamine. It is of great importance to publicize these cases that allow us to gather experience and better treat our patients.

Mesenteric Cystic Lymphangioma “Intra-abdominal Catastrophe”

2020 ◽  
pp. 1-5
Author(s):  
R. S. Kiran ◽  
S. Sarmukh ◽  
H. Azmi
Keyword(s):  
Intestinal Obstruction ◽  
Histopathological Examination ◽  
Primary Anastomosis ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Small Bowel Resection ◽  
Cystic Lymphangioma ◽  
Co Morbidity ◽  
Mesenteric Mass ◽  
Life Threatening

Lymphangioma is a benign tumour of lymphatic origin. Lymphangioma in peritoneal cavity is extremely rare (5%), particularly in adults. Hereby, we are reporting a case of a Malay gentleman with no co morbidity presented with sign and symptoms of intestinal obstruction. We proceeded with exploratory laparotomy with small bowel resection with primary anastomosis. Intraoperatively, revealed soft mesenteric mass measuring around 5X5 cm and it was 80 cm from duodenum-jejunum flexure. Histopathological examination showed mesenteric cystic lymphangioma (MCL). Cystic intra-abdominal mass should be included MCL as a diagnosis although it’s rare. Surgical management is still a mainstay of treatment due to its potential to invade vital structures and develop life threatening complication such as intestinal obstruction and bleeding. The surgical outcome after a complete clear margin resection can avoid recurrence.

scholarly journals Acute Uterine Torsion Mimicking Tumor Lysis Syndrome

2020 ◽  
pp. 1-3
Author(s):  
Helena C van Doorn ◽  
H (Dineke) PM Smedts ◽  
Helena C van Doorn ◽  
Kinge Bergsma
Keyword(s):  
Laboratory Tests ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Tumor Lysis Syndrome ◽  
Exploratory Laparotomy ◽  
Hemoglobin Level ◽  
Tumor Lysis ◽  
Total Hysterectomy ◽  
Uterine Torsion ◽  
Life Threatening

Background: Non-gravid uterine torsion is rare and mostly diagnosed at surgery. This report describes a patient with a large abdominal mass, critical illness, and tumor lysis syndrome. Case: A female presented with acute abdominal pain. Physical exam showed a large abdominal mass and abdominal rigidity. Serial laboratory tests showed a drop in hemoglobin level, progressive renal failure and serum uric acid and phosphate concentrations compatible with tumor lysis syndrome. Computed tomography showed a 30 cm mass filling the pelvis and abdomen. At an emergency exploratory laparotomy, a 360 degrees torsion of the uterus was found. An uneventful total hysterectomy was done. After surgery renal function restored. Conclusion: Uterine torsion is rare and can be potentially life threatening when presenting as tumor lysis syndrome

scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

A Rare Cause of Mechanical Intestinal Obstruction: A Neoplastic Intra-Abdominal Testis

2016 ◽  
Vol 101 (3-4) ◽  
pp. 167-170
Author(s):  
Fatih Ciftci ◽  
Suat Benek ◽  
Cem Kezer
Keyword(s):  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Undescended Testis ◽  
Abdominal Mass ◽  
Relevant Literature ◽  
Large Diameter ◽  
Exploratory Laparotomy ◽  
Clinical Findings ◽  
Surgical Units ◽  
Mechanical Intestinal Obstruction

The acute abdomen has many etiologies frequently encountered in emergency surgical units. Approximately 20% of surgical admissions for acute abdominal conditions are for intestinal obstruction. Clinicians often overlook rarer causes. A 43-year-old man presented to the emergency ward with the clinical findings of ileus. Computed tomography revealed a heterogeneous necrotic 168 × 100-mm mass between the sigmoid colon and urinary bladder. Physical examination revealed a palpable intra-abdominal mass that was removed via exploratory laparotomy. On histopathologic examination, the mass was identified as a seminoma. The literature contains few reports of seminoma as a cause of acute abdomen and ileus, mostly seen between the ages of 30 and 40 years. We report a patient with seminoma arising in an undescended testis that presented as a palpable painful lower abdominal mass and mechanical intestinal obstruction, despite the large diameter of the mass, as well as review relevant literature.

Painless spontaneous haemoperitoneum secondary to a uterine leiomyoma/fibroid: unusual presentation of a life-threatening differential

2021 ◽  
Vol 14 (10) ◽  
pp. e243465
Author(s):  
Chiamaka Maduanusi ◽  
Sathiyaa Balachandran ◽  
Sahathevan Sathiyathasan ◽  
Kazal Omar
Keyword(s):  
Uterine Leiomyoma ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Haemodynamic Instability ◽  
Hypovolaemic Shock ◽  
Important Differential Diagnosis ◽  
Life Threatening ◽  
Definitive Management

This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.

scholarly journals MUCINOUS CYSTADENOCARCINOMA

2018 ◽  
Vol 16 (2) ◽  
pp. 59
Author(s):  
Sadia Anwar ◽  
Nasim Saba
Keyword(s):  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Abdominal Hysterectomy ◽  
Genetic Mutation ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Ca 125 ◽  
Invasive Adenocarcinoma ◽  
Epithelial Tumor ◽  
Glandular Cells

A 55 years old lady presented to Gynecology outpatient of MMM Teaching Hospital, D.I.Khan in January 2018 with history of abdominal mass. Her abdominal hysterectomy was done one year back. On examination a huge cystic mass reaching up to the xiphisternum and occupying the whole abdomen was palpable. Her ultrasound revealed a mass arising from pelvis, most likely ovarian in nature. Her CA-125 level was 29.62 IU/ml (in normal range). Exploratory laparotomy revealed a huge cystic mass which was excised. Histopathology reported mucinous cystadenocarcinoma of the ovary. Chemotherapy was then done. There was no recurrence by the end of nine months follow-up as evaluated by ultrasonography. Mucinous cystadenocarcinoma is an invasive adenocarcinoma composed of malignant glandular cells containing intracytoplasmic mucin. It is relatively common in middle-aged women. Genetic mutation such as KRAS gene have been reported. It is a rapidly growing epithelial tumor usually presenting as a single solid mass. Treatment involves surgery and chemotherapy. The prognosis depends upon the stage of tumor.

scholarly journals Multiple Mycotic Aneurysms of the Abdominal Aorta Illustrated on MDCT Scanner

2015 ◽  
Vol 5 ◽  
pp. 49 ◽  
Author(s):  
Amit Nandan Dhar Dwivedi ◽  
Ananthakrishnan Srinivasan ◽  
Shivi Jain
Keyword(s):  
Early Detection ◽  
Abdominal Aorta ◽  
Mycotic Aneurysm ◽  
Abdominal Mass ◽  
Young Male ◽  
Aortic Aneurysms ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Mycotic Aneurysms ◽  
Mdct Scanner

Infective mycotic aneurysm of the aorta is a rare and life-threatening disease. A patient presenting with constitutional symptoms and pulsatile abdominal mass should raise a suspicion of mycotic aneurysm. Early detection of aortic mycotic lesions in such patients should play a key role in the treatment of aortic aneurysms. Multiple mycotic aneurysms of abdominal aorta in a young male are a rare manifestation of the disease. Multidetector computerized tomography (CT) is an essential tool in identifying the etiology, pathogenesis, protean manifestations of systemic tuberculosis, and ultimately deciding the course of treatment.

Getting around the gut: a unique management challenge of thyroid storm precipitated by amphetamine-associated duodenal ischaemia leading to compromised enteric absorption

2021 ◽  
Vol 14 (8) ◽  
pp. e238889
Author(s):  
Jin Sol Gene Lee ◽  
Ian Elliott Brown ◽  
Alison M Semrad ◽  
Amir A Zeki
Keyword(s):  
Mortality Rate ◽  
Exploratory Laparotomy ◽  
Thyroid Storm ◽  
Critically Ill Patient ◽  
Duodenal Perforation ◽  
Mesenteric Ischaemia ◽  
Biochemical Control ◽  
Clinical Criteria ◽  
Life Threatening ◽  
Management Challenge

Thyroid storm is a rare, life-threatening endocrine emergency with a high mortality rate of up to 30%. We present a unique management challenge of a critically ill patient who developed thyroid storm in the setting of a duodenal perforation from amphetamine-associated non-occlusive mesenteric ischaemia. The diagnosis of ‘thyroid storm’ was made based on clinical criteria and a Burch-Wartofsky score of 100. During emergent exploratory laparotomy, a 1 cm duodenal perforation with surrounding friable tissue was found and repaired. Intraoperatively, a nasogastric tube was guided distal to the area of perforation to allow for enteric administration of medications, which was critical in the setting of thyroid storm. Therapeutic plasma exchange achieved biochemical control of our patient’s thyroid storm but ultimately did not prevent in-hospital mortality.

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