Spontaneous intramural duodenal hematoma in a young woman

2021 ◽  
Vol 75 (6) ◽  
pp. 535-539
Author(s):  
Petra Vrbová ◽  
Tomáš Koller

Summary: Non-traumatic spontaneous intramural duodenal hematoma is a rare cause of proximal gastrointestinal obstruction which may present with hemorrhage, jaundice and pancreatitis. In this case report we present a case of spontaneous duodenal hematoma in a 28-year-old female with a history of acute pancreatitis, admitted to hospital for convulsive upper abdominal pain with vomiting as suspected pancreatitis. An MRI examination of the abdomen confi rmed intraluminal bleeding into the duodenum. Following supportive therapy the clinical symptoms spontaneously subsided and laboratory parameters improved. Due to early dia gnosis and therapy the patient had a good outcome, without requiring surgery. Repeated imaging showed hematoma resorption. Key words: abdominal pain – vomitus – duodenal hematoma – hemorrhage

1970 ◽  
Vol 6 (2) ◽  
pp. 64-66 ◽  
Author(s):  
Rajat Roy ◽  
Anil Bhattarai ◽  
Prativa Shrestha ◽  
Upama Paudel ◽  
Sudip Parajuli

One 11 year old female attended dermatology OPD of College of Medical Sciences, Bharatpur. She was undergoing treatment with Dapsone for one month for Borderline lepromatous leprosy. There was history of dry scales for 3 weeks over trunk, buttock, face, back and lower extremities suggestive of Exfoliative Dermatitis. The patient was treated with Prednisolone with supportive therapy for one month. Recovery is good. Key words: Dermatology; lepromatous leprosy; exfoliative dermatitis. DOI: 10.3126/jcmsn.v6i2.3621 Journal of college of Medical Sciences-Nepal, 2010, Vol.6, No-2, 64-66


2021 ◽  
Vol 10 (31) ◽  
pp. 2535-2537
Author(s):  
Syed Athhar Saqqaf ◽  
Amar Taksande ◽  
Revat Meshram

It is difficult to diagnose pancreatic cysts in children. Any previous history of acute pancreatitis is very important because it can lead to a wide set of complications like pseudocyst, pancreatic necrosis, splenic venous thrombosis etc. The most known and common cause of pancreatic pseudocyst in children is trauma. The characteristic features of pancreatitis include abdominal pain, serum lipase or amylase values three times more than that of the normal range and characteristic radiological features. Pancreatic pseudocyst may occur in 15 % of children with acute pancreatitis as a complication.1 Pancreatic juice collection enclosed by a wall of granulation or fibrous tissue, is defined as a pseudocyst. As the resulting cyst has no true endothelial lining, it is classified as a pseudocyst.2 The pseudocyst contains inflammatory pancreatic fluid, mainly the lipase enzyme or semisolid matter. The incidence of pseudocyst is relatively low 1.6 % - 4.5 %, or 0.5 - 1 per 100 000 adults per year.2 Very few cases of pancreatic pseudocyst have been reported in world literature. Commonly, it develops as a sequel of acute or chronic pancreatitis. It develops around 4 weeks after the episode of acute pancreatitis.3 It is characterized by pancreatic inflammation, abdominal pain and raised levels of serum digestive enzymes.4 Here we discuss a case report of pancreatic pseudocyst in a 10-year-old male child presenting with history of abdominal pain and decreased appetite.


2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Kazuo Eguchi ◽  
Akihiro Tsujita ◽  
Syoji Ono ◽  
Kazuomi Kario

We experienced a reproducible supine syncope followed by upper abdominal pain. A 66-year-old man was transferred to our hospital after an episode of syncope during sleep. He had a history of acute pancreatitis, diabetes, hypertension, and dyslipidemia, but no history of presyncopal attack. One night, his wife noticed he was snoring abnormally in bed, and he did not respond to her voice until after she tried many times to wake him. The same attack was reproduced three times in the same situation. One of the attacks was recorded under a continuous ECG and radial tonometry. In this case, a presyncopal attack and a sense of ill-feeling were provoked by the patient lying in a prolonged supine position. He was eventually diagnosed as metastatic liver tumor 5 months after the first attack. Because few cases of syncopal attack have been reported in the supine position, its underlying mechanisms deserve consideration.


2021 ◽  
Vol 84 (2) ◽  
pp. 367-370
Author(s):  
V Desmedt ◽  
S Desmedt ◽  
E D’heygere ◽  
G Vereecke ◽  
W Van Moerkercke

Acute pancreatitis (AP) is an inflammatory process of the pancreas. It is a relatively common cause of acute upper abdominal pain and is potentially associated with high morbidity and mortality. Underlying hypercalcemia as a cause of AP is very rare. We present a case of a hypercalcemia-induced acute pancreatitis with an underlying parathyroid adenoma in an 81-year-old woman with no previous symptoms of hypercalcemia. The parathyroid adenoma was semi-urgently surgically resected with normalization of calcium-levels. This case report summarizes the causes of acute pancreatitis and hypercalcemia and its management.


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 ◽  
Vol 30 (5) ◽  
pp. 82-84
Author(s):  
Ilja Skalskis

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.


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 14 (9) ◽  
pp. e244081
Author(s):  
Christopher Fang ◽  
Junice Wong ◽  
Wei Wen Ang

An 81-year-old woman with no history of immunocompromise presented with 2 days of upper abdominal pain associated with nausea. On arrival, her physical examination was unremarkable apart from mild epigastric and right hypochondriac tenderness, and laboratory investigations were unremarkable apart from mild thrombocytopenia and transaminitis. A CT scan performed on the day of admission revealed a tiny 0.3 cm stone in the common bile duct, with no upstream dilatation. On day 2 of admission, she developed a vesicular rash and with acutely worsening transaminitis. She deteriorated rapidly and demised from complications of acute liver failure within the next 24 hours. The diagnosis of varicella was confirmed with antibody testing. Fulminant varicella hepatitis is an extremely rare and lethal condition with only a handful of reported cases in the current literature. We aim to share our clinical experience and summarise the salient points from existing case reports.


1993 ◽  
Vol 27 (1) ◽  
pp. 36-37 ◽  
Author(s):  
Anthony E. Zimmermann ◽  
Brian G. Katona ◽  
Joginder S. Jodhka ◽  
Richard B. Williams

OBJECTIVE: To report a case of probable ceftriaxone-induced acute pancreatitis. CASE SUMMARY: A patient with a history of short-bowel syndrome on home total parenteral nutrition developed fever, chills, and right flank pain. She was diagnosed with gram-negative catheter sepsis and prescribed antibiotic therapy to be administered for four weeks. After completion of the first week of therapy, the antibiotic regimen was changed to intravenous injections of ceftriaxone to be given daily at home. Prior to discharge the patient developed acute abdominal pain, leukocytosis, jaundice, and markedly elevated lipase and amylase concentrations consistent with acute pancreatitis. The patient's condition improved upon discontinuation of the ceftriaxone and the remainder of her stay was uneventful. DISCUSSION: There is only one other case report in the literature of probable ceftriaxone-induced pancreatitis. Multiple other medications have been implicated in causing acute pancreatitis. The exact mechanism of this uncommon adverse effect of ceftriaxone is unknown. CONCLUSIONS: There was a temporal relationship between the development of this patient's signs and symptoms and the administration of ceftriaxone. We could not identify any other factors that may have been responsible for the development of her acute pancreatitis. Ceftriaxone should be considered as a possible etiologic agent in patients who present with acute abdominal pain and elevated lipase and amylase concentrations.


2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.


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