scholarly journals Complicated intra-abdominal focal fat infarction: Emphasis on falciform ligament infarction with abscess formation: A case series

2021 ◽  
Author(s):  
Berton Monteiro ◽  
◽  
Saurabh Joshi ◽  
Sunita Gopalan ◽  
Ravikumar Hanumaiah ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Case Series ◽  
Pathological Process ◽  
Abscess Formation ◽  
Falciform Ligament ◽  
Fatty Tissue ◽  
Epiploic Appendagitis ◽  
Antiinflammatory Therapy ◽  
Focal Fat ◽  
Symptoms And Signs

The term “Intra-Abdominal Focal Fat Infarction” (IFFI) encompasses a range of conditions where infarction of fatty tissue is the underlying pathological process, including Epiploic appendagitis, omental infarction, fat necrosis related to trauma or pancreatitis as well as rarer entities such as falciform ligament infarction. Uncomplicated IFFI is usually self-limiting and managed conservatively with oral antiinflammatory therapy. Rarely complications such as liquefaction and secondary abscess formation may arise with associated deterioration in symptoms and signs prompting a change in management including Laparoscopic resection or Percutaneous drainage. We present 3 cases of complicated IFFI with emphasis on the rarer Falciform ligament infarction with abscess formation.

Falciform ligament appendagitis after Roux-en-Y bypass surgery mimicking acute cholecystitis

2020 ◽  
Vol 13 (8) ◽  
pp. e235642
Author(s):  
Lee K Rousslang ◽  
McHuy F McCoy ◽  
C Frank Gould
Keyword(s):  
Severe Pain ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Falciform Ligament ◽  
Rare Type ◽  
Epiploic Appendagitis ◽  
Radiological Features ◽  
Follow Up Studies ◽  
Focal Fat

Fatty falciform ligament appendage torsion (F-FLAT) is a rare type of intraperitoneal focal fat infarction that involves torsion of a fatty appendage of the falciform ligament. It may cause severe pain, mimicking an acute abdomen, but is typically self-limited and does not require hospitalisation or surgery. As a type of intraperitoneal focal fat infarction, it shares many of the same physiological, clinical and radiological features of epiploic appendagitis. To our knowledge, F-FLAT has not previously been reported in a patient following a laparoscopic Roux-en-Y gastric bypass surgery. Identifying falciform ligament appendagitis is critical because it can prevent unnecessary hospitalisation, follow-up studies and surgery.

scholarly journals Not Just Fat: Imaging in Abdominal Fat Pathology

2020 ◽  
Author(s):  
Aruna R. Patil ◽  
Shrivalli Nandikoor ◽  
Pramod Jagannath ◽  
Amit Bansal
Keyword(s):  
Abdominal Fat ◽  
Falciform Ligament ◽  
Imaging Features ◽  
Fat Necrosis ◽  
Diagnostic Dilemma ◽  
Epiploic Appendagitis ◽  
Characteristic Imaging ◽  
Focal Fat ◽  
And Function ◽  
Fat Stranding

AbstractFat in abdomen has diverse distribution and function. Insult to fat due to several causes can result in infarction or necrosis and present as acute abdomen clinically. Intra-abdominal focal fat infarction is one such condition that comprises of epiploic appendagitis, perigastric appendagitis, omental infarction, and torsion of fatty appendage of falciform ligament that have characteristic imaging features. Secondary causes of fat necrosis include pancreatitis or trauma related. Metabolic or responsive fat changes, like hypertrophy and dystrophy, can be diagnosed on imaging especially on computed tomography. Mesentric fat stranding including the mesentric panniculitis spectrum poses diagnostic dilemma and the causes and imaging role are covered in this review. Some infections and neoplasms that preferably affect abdominal fat compartments may mimic benign conditions, although some have specific patterns of involvement.

scholarly journals Atypical presentation of testicular torsion: a case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya
Keyword(s):  
Physical Examination ◽  
Testicular Torsion ◽  
Age Groups ◽  
Case Series ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
Future Fertility ◽  
Urological Emergency ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.

SERIAL NERVE CONDUCTION STUDIES IN A GUILLAIN-BARRÉ SYNDROME VARIANT: THE EVOLUTION OF DEMYELINATING CHANGES

2015 ◽  
Vol 86 (11) ◽  
pp. e4.158-e4
Author(s):  
Catherine Morgan ◽  
Benjamin Wakerley ◽  
Geraint Fuller
Keyword(s):  
Nerve Conduction ◽  
Case Series ◽  
Pathological Process ◽  
Nerve Conduction Studies ◽  
Guillain Barre Syndrome ◽  
Facial Weakness ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Underlying Pathology ◽  
Serial Assessments

Guillain Barré syndrome (GBS) varies both in terms of clinical phenotype and underlying pathology. Serial assessments allow greater understanding of the pathophysiology. The evolution of neurophysiological changes is particularly helpful in distinguishing between demyelination and reversible axonal conduction failure.Bilateral facial weakness with distal paraesthesias is a rare subtype of GBS. In the largest case series 64% had abnormalities in motor and 27% in sensory conduction on single neurophysiological assessments; this was interpreted as a demyelinating neuropathy.We report an 18-year-old male with bilateral lower motor neurone facial weakness preceded by distal paraesthesias following a ‘flu-like illness. Examination of power and sensation was normal. Deep tendon reflexes were present. Cerebrospinal fluid showed albuminocytologic dissociation. By 6 weeks his facial weakness had almost completely resolved without treatment.Serial nerve conduction studies were performed. The first study (day 4) found prolonged distal motor latency and delayed F waves in posterior tibial and common peroneal nerves; normal sensory studies. Second study (day 18) found distal motor latencies and F waves had increased in upper and lower limb nerves. Third study (day 60) found improvement but abnormalities remained with changes similar to the first study.The neurophysiological changes became more marked while he improved clinically. These serial studies confirmed the primary pathological process of this GBS variant to be demyelination.

scholarly journals Acute Pancreatitis: An Atypical Presentation

2017 ◽  
Vol 11 (2) ◽  
pp. 359-363 ◽  
Author(s):  
Omar Nadhem ◽  
Omar Salh
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Reports ◽  
Case Series ◽  
Normal Serum ◽  
Intravenous Fluids ◽  
Serum Enzyme ◽  
Serum Lipase ◽  
Upper Abdominal ◽  
Symptoms And Signs

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.

scholarly journals Neurological status and imaging spinal cord in patients with infectious spondylitis: is it possible to comparisons with spondylogenic myelopathy?

2017 ◽  
Vol 15 (2) ◽  
pp. 64-72 ◽  
Author(s):  
Marina E Makogonova ◽  
Aleksandr Yu Mushkin ◽  
Pavel V Gavrilov
Keyword(s):  
Spinal Cord ◽  
Neurological Disorders ◽  
Neurological Status ◽  
Pathological Process ◽  
Literary Analysis ◽  
Resonance Imaging ◽  
Radicular Symptoms ◽  
Symptoms And Signs ◽  
Infectious Spondylitis

Spend a literary analysis of the role of radiation diagnosis in the first place - magnetic resonance imaging to visualize changes in the spinal cord in infectious spondylitis. Neurological disorders, manifested by radicular symptoms and signs of spinal cord irritation to deep paresis and plegia in violation of the pelvic organs, are observed in the majority of patients with spondylitis and may be due to the spinal cord and its roots and / or a breach of its microcirculation on the background of the pathological process in the vertebrae. Dynamic (pre- and postoperative) imaging of the spinal canal and its contents in tuberculous and nonspecific spondylitis is important for a more complete assessment of the disease, and for the prediction of the dynamics of neurological disorders. (For citation: Makogonova ME, Mushkin AYu, Gavrilov PV. Neurological status and imaging spinal cord in patients with infectious spondylitis: is it possible to comparisons with spondylogenic myelopathy?. Reviews on Clinical Pharmacology and Drug Therapy. 2017;15(2):64-72. doi: 10.17816/RCF15264-72).

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