scholarly journals Perforated Appendix in a Neonate: A Review of Literature and a Case Report from Northern Tanzania

2021 ◽  
Vol 18 (2) ◽  
pp. 115-118
Author(s):  
Lodhia Jay ◽  
Philemon Rune ◽  
Wapalila Daudi ◽  
Sadiq Adnan ◽  
Amsi Patrick ◽  
...  
Keyword(s):  
Clinical Features ◽  
Perforated Appendicitis ◽  
Abdominal Distension ◽  
Premature Neonate ◽  
Sudden Onset ◽  
Emergency Laparotomy ◽  
High Morbidity ◽  
Neonatal Appendicitis ◽  
Perforated Appendix ◽  
The Right

Acute perforated appendicitis is rare in neonates and is associated with high morbidity and mortality. This is mainly because the rarity of the pathology and the abnormal clinical features cause delays in diagnosis and definitive management. We report a case of a  premature neonate who presented with sudden onset of abdominal distension associated with an inability to pass stools. The initial abdominal X-ray showed free air under the right hemi-diaphragm. An emergency laparotomy was performed revealing a perforation at the appendicular tip. An appendectomy was done, and the neonate recovered well with a mild surgical site infection during the course of recovery. Neonatal perforated appendicitis is rare, and clinicians need to consider it as a differential diagnosis due to the atypicalpresentations. This preterm neonate presented with clinical features of intestinal obstruction and was found at laparotomy to have a perforated appendix at the tip due to neonatal appendicitis. Keywords: Neonate, Neonatal appendicitis, Neonatal perforated appendicitis

scholarly journals Huge Ovarian Cyst- A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 87-90
Author(s):  
Sunita Maharjan ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Tissue ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Ultrasound Finding ◽  
Emergency Laparotomy ◽  
Diagnosis And Management ◽  
The Right

Ovarian cyst torsion (also termed as adnexal torsion) refers to partial or complete rotation of the ovary and a portion of fallopian tube along with its supply to vascular pedicle. It occurs commonly in females of all age group, more on the right side (60%) and often with acute lower abdominal pain lasting for few hours up to 24 hours. Ovarian cyst torsion is one of the devastating conditions hampering blood supply of ovary which may lead to total necrosis of ovarian tissue like in our case. Delayed diagnosis and management can lead to various complications. Here, we present a case of 46 years old perimenopausal female, para 2, living 2 who presented to our emergency department with complain of sudden onset severe pain abdomen since morning. Emergency exploratory laparotomy was done due to high clinical suspicion of torsion based on previous ultrasound finding of ovarian cyst done a day prior to the presentation. On intraoperative finding, the cyst was already necrosed. Due to timely diagnosis and management by emergency laparotomy, anticipated complications were reduced.    

scholarly journals Intraperitoneal Rupture of Ectopic Varices—a Rare Complication of Portal Hypertension

HPB Surgery ◽  
1994 ◽  
Vol 7 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Alastair N. J. Graham ◽  
Paul Mcaleese ◽  
R. John Moorehead
Keyword(s):  
Rare Complication ◽  
Abdominal Distension ◽  
Emergency Laparotomy ◽  
High Dose ◽  
Rare Occurrence ◽  
Ectopic Varices ◽  
Intraperitoneal Rupture ◽  
High Dose Aprotinin ◽  
The Right ◽  
Intraperitoneal Haemorrhage

A 50 year old man presented with sudden abdominal pain, abdominal distension and shock. At emergency laparotomy a large amount of blood was found in the peritoneal cavity. There was micronodular cirrhosis of the liver and the spleen was enlarged. The bleeding was traced to distended veins in the right paracolic gutter which were oversewn and the abdomen closed. A coagulopathy was diagnosed and treatment including high dose aprotinin commenced. However, he continued to bleed and at a second laparotomy the area of previous haemorrhage was packed. Further deterioration continued until death 12 hours later. Intraperitoneal haemorrhage from ectopic varices is a rare occurrence. There is a high mortality rate usually due to an advanced coagulopathy. This is the first report of aprotinin being used in an attempt to treat this. On the basis of this report aprotinin would not seem to be of benefit for this condition.

scholarly journals An Experience with 31 Cases of Neonatal Appendicitis: A Retrospective Study

2019 ◽  
Vol 8 (3) ◽  
pp. 21
Author(s):  
Xuxu Huang ◽  
Xuefei Huang ◽  
Juma Mfaume Mbugi ◽  
Liu Wei ◽  
Hua Ziyu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Abdominal Distension ◽  
Abdominal Sepsis ◽  
Reactive Protein ◽  
Neonatal Appendicitis ◽  
Normal White Blood Cell ◽  
High Index Of Suspicion ◽  
Medical University ◽  
Specific Symptoms ◽  
Symptoms And Signs

Background: Neonatal appendicitis (NA) is rarely diagnosed due to lack of specific symptoms and signs. The aim of this study is to share our experience with NA.Methods: We performed a retrospective data review from electronic medical records of patients admitted at Children’s Hospital of Chongqing Medical University (CHCMU) with the clinical diagnosis of NA from October 2001 to July 2018.Results: Of 31 neonates, male neonates (n=20) accounted for 64.5%. Abdominal distension and anorexia were the most common clinical features (61.3%, n=19). Neonates with elevated C- reactive protein (CRP) accounted for 92.6% (n=25) where as 51.6% (n=16) had normal white blood cell count (WBC). Of 29 neonates who underwent surgery, 69% (n=20) had perforated appendicitis.Conclusion: Neonatal appendicitis lacks specific clinical features, and early diagnosis is difficult. Clinicians need to have high index of suspicion when attending neonates with features of abdominal sepsis.

scholarly journals Intestinal obstruction by Toxocara vitulorum in a calf

2014 ◽  
Vol 83 (6) ◽  
pp. 299-305 ◽  
Author(s):  
L. Van Der Steen ◽  
B. Pardon ◽  
C. Sarre ◽  
B. Valgaeren ◽  
D. Van Hende ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Sudden Onset ◽  
Complete Obstruction ◽  
Bull Calf ◽  
Toxocara Vitulorum ◽  
Punctum Maximum ◽  
The Right

A one-month-old Belgian blue bull calf was referred to the animal hospital of the Faculty of Veterinary Medicine (UGhent) because of the sudden onset of severe colic. The animal showed intermittent recumbency, kicking to the abdomen, abdominal distension of the right quadrants, absence of feces and fluid-splashing and the presence of ping sounds on auscultation of the right side. Abdominal ultrasound showed distended, but still contractile small intestines with thickened walls. On exploratory laparotomy, a complete obstruction with adult Toxocara vitulorum extending from duodenum to mid-jejunum was diagnosed. On the punctum maximum of the obstruction, the ascarides were partially removed through an enterotomy. After vermifugation with doramectin, ascarides were found in the animal’s feces in the next days. In contrast to ascaride infections in puppies, piglets and foals, to the author’s knowledge, intestinal obstruction caused by T. vitulorum has not been described previously in calves.

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

scholarly journals Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer

2021 ◽  
pp. 446-450
Author(s):  
Marco Mazzola ◽  
Laura Premoli ◽  
Cristian Metrangolo ◽  
Jennifer Cattaneo ◽  
Elias Premi ◽  
...  
Keyword(s):  
High Myopia ◽  
Sudden Onset ◽  
Fiber Layer ◽  
Characteristic Finding ◽  
Macular Telangiectasia ◽  
Complete Restoration ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Specific Sign ◽  
The Right

This case report describes a simple hemorrhage (SH) presenting as radial hemorrhage in Henle’s fiber layer (HFL) in a patient with high myopia. A 26-year-old girl with high myopia was referred to our center for sudden onset of decreased vision and a central scotoma in the right eye (OD). Best corrected visual acuity (BCVA) was 20/100 OD. Fundus examination showed a stellate intraretinal hemorrhage in the fovea of the OD. The hemorrhage was organized in a peculiar petaloid pattern with feathery distal edges, suggesting localization within the radially oriented HFL. The presence of both choroidal neovascularization and microvascular abnormalities consistent with macular telangiectasia type 2 (MacTel 2) were excluded. Based on these findings, a diagnosis of myopic SH was made. At 4-month follow-up BCVA OD spontaneously improved to 20/40, without any treatment been ever administered to the patient. Spectral-domain optical coherence tomography OD showed reabsorption of the hemorrhage and almost complete restoration of the foveal architecture. The intraretinal location and spread of the hemorrhage into the HFL in our patient are an unusual presentation of SH, which vividly highlights the anatomy of the fovea. Since fibers in HFL are quite delicate and loosely arranged, this layer is very susceptible to deposition of transudates, exudates, hemorrhage, and other products. Radial hemorrhage in HFL has been originally reported in 4 patients as complication of MacTel 2. It has been previously postulated that it may represent a characteristic finding in MacTel 2 that may develop as a result of microvascular abnormalities of the deep retinal capillary plexus. On the contrary, our data suggest that radial hemorrhage in the HFL does not represent a characteristic finding of MacTel 2, but must rather be considered a non-specific sign with multiple possible etiologies.

scholarly journals Ovarian epithelioid angiosarcoma complicating pregnancy: a case report and review of the literature

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110196
Author(s):  
Xiaotong Peng ◽  
Zhi Duan ◽  
Hongling Yin ◽  
Furong Dai ◽  
Huining Liu
Keyword(s):  
Adverse Events ◽  
Soft Tissues ◽  
Malignant Tumors ◽  
Cystic Teratoma ◽  
Abdominal Distension ◽  
Epithelioid Angiosarcoma ◽  
History Of ◽  
New Ideas ◽  
The Right ◽  
Clinical Awareness

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.

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!

Kawasaki disease complicated by cerebral infarction

2003 ◽  
Vol 13 (1) ◽  
pp. 103-105 ◽  
Author(s):  
Kenji Suda ◽  
Masahiko Matsumura ◽  
Shigeru Ohta
Keyword(s):  
Kawasaki Disease ◽  
Cerebral Infarction ◽  
Clinical Situation ◽  
Sudden Onset ◽  
X Ray ◽  
Coronary Aneurysms ◽  
Intracoronary Thrombolysis ◽  
Tissue Plasminogen ◽  
X Ray Computed ◽  
The Right

An 8-month-old boy presented with right hemiplegia of sudden onset after 20 days of Kawasaki disease, which was not initially treated by gamma globulin. Cranial X-ray computed tomography confirmed cerebral infarction as the cause of the right hemiplegia. In subsequent weeks, he developed multiple thromboses in coronary aneurysms. He successfully underwent intracoronary thrombolysis using tissue plasminogen activator without haemorrhagic complications. Cerebral infarction as a complication of Kawasaki disease is rare, and is a difficult clinical situation to manage.

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