A case report of abdominal sponge in ileum in a patient with intestinal obstruction

Author(s):  
Ahmed Siddique Ammar

Abstract A 36-year-old woman presented in the emergency department of East Surgical Ward of MAYO Hospital Lahore, Pakistan, in August 2019 with compliant of abdominal pain and vomiting for the past five days. The patient had a history of three Caesarean sections, the last one three years back. Off and on, she experienced abdominal pain and distension which was relieved after taking local medicines. She had no comorbid conditions and her baseline investigations were normal. On examination she had tachycardia with pulse 110/min and her whole abdomen was tender with exaggerated bowel sounds. X ray of the abdomen showed multiple air fluid levels in the small intestine. Exploration plan was made; a distended segment of ileum was later found to have abdominal sponge inside its lumen. Continuous...  

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Shadi Rezai ◽  
Stephen LoBue ◽  
Daniel Adams ◽  
Yewande Oladipo ◽  
Ramses Posso ◽  
...  

Background.Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients.


Author(s):  
Faisal Albaqami ◽  
Feras Alsannaa ◽  
Reem Bin Saleem ◽  
Nahla Arab

37-year-old man presented to the emergency department with a three-hour history of severe, generalized abdominal pain. Computed tomography of abdomen revealed two distal ileoileal intussusceptions with high suspicion of 3 cm mass within the intussusception around the ileocecal region. Laparoscopic right hemicolectomy with extracorporeal ileocolic anastomosis which showed Meckel


PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 1066-1069
Author(s):  
A. BARRY BELMAN

Two or three times each year children are seen by the Urology Service at Children's Hospital, Washington, DC, who have a history of intermittent, severe midabdominal pain associated with vomiting due to intermittent ureteropelvic junction obstruction. These symptoms may have been on-going for years. The following case history serves as a typical example. CASE REPORT A 6-years-old boy was referred to the Urology Service from the Gastrointestinal Service where he had been sent by his primary physician. He had a 1-year history of episodic abdominal pain occurring one to two times per month initially, but becoming more frequent during the past few months.


2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.


2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.


2015 ◽  
Vol 14 (2) ◽  
pp. 210-212
Author(s):  
Md Zakirul Alam ◽  
Mohibul Aziz

A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.210-212


2021 ◽  
Vol 19 ◽  
Author(s):  
Michela Pontolillo ◽  
Katia Falasca ◽  
Jacopo Vecchiet ◽  
Claudio Ucciferri

Background: The current COVID-19 pandemic has attracted great attention from the medical world. In the past year, there have been reports of missed or delayed treatments for conditions that mimic COVID-19. The main symptoms caused by SARS-CoV-2, such as fever and cough, belong to different clinical conditions. It is of the utmost importance that the diagnostic thinking used to analyze data and information to reach a COVID-19 diagnosis does not overlook the plethora of different diagnoses related to these symptoms. Case report: The aim of this work is to present the clinical case of a patient having unrecognized HIV infection with a 4-week history of fever, cough, and hypoxia. When tests were allowed to highlight HIV-related immunodeficiency status, a CMV assay was performed in order to evaluate opportunistic pneumonia. Through this, diagnosis of HIV combined with CMV pneumonia was made, thus excluding COVID-19 respiratory insufficiency. Conclusion: The diagnosis of the two conditions in the COVID-19 era is challenging due to overlapping clinical and radiological features and limitations of current diagnostic assays. This causes clinical implications due to diagnostic delays.


Crystals ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 676
Author(s):  
Tom L. Blundell

Over the past 60 years, the use of crystals to define structures of complexes using X-ray analysis has contributed to the discovery of new medicines in a very significant way. This has been in understanding not only small-molecule inhibitors of proteins, such as enzymes, but also protein or peptide hormones or growth factors that bind to cell surface receptors. Experimental structures from crystallography have also been exploited in software to allow prediction of structures of important targets based on knowledge of homologues. Crystals and crystallography continue to contribute to drug design and provide a successful example of academia–industry collaboration.


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