scholarly journals L’Ambulatorio protetto: visitare ai tempi del Covid-19

QUADERNI ACP ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 173
Author(s):  
Davide Ursi ◽  
Cristina Scozzafava ◽  
Sara Immacolata Orsini ◽  
Andrea Apicella
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Histological Analysis ◽  
Abdominal Mass ◽  
Sudden Onset ◽  
Lymphatic Malformation ◽  
Surgical Removal ◽  
Lymphatic Malformations ◽  
Cystic Structure ◽  
Abdominal Masses

A 3-months baby comes to our emergency department for an abdominal mass of elastic consistency that suddenly appeared for a week and grown exponentially in the last few days. Blood examinations identify a septic state of the child, and the emergency CT recognizes the abdominal mass’s cystic structure. The surgical removal and the histological analysis will confirm the diagnosis of Infected Common Macrocystic Lymphatic Malformation. This case allows us to remember to pediatricians the main features of Cystic Lymphatic Malformations that should always be considered during the differential diagnosis of abdominal masses of sudden onset in an infant.

scholarly journals Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected

2021 ◽  
Vol 43 (05) ◽  
pp. 414-416
Author(s):  
Daniela Alexandra Gonçalves Pereira ◽  
Eliana Patrícia Pereira Teixeira ◽  
Ana Cláudia Martins Lopes ◽  
Ricardo José Pina Sarmento ◽  
Ana Paula Calado Lopes
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Course ◽  
Malignant Tumors ◽  
Sudden Onset ◽  
Drug Reactions ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
Inflammatory Processes ◽  
Genital Ulcers

AbstractThe diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.

scholarly journals Isolated Epiglottic Lymphatic Malformation in a 2-Year-Old: Diagnosis and Treatment

2016 ◽  
Vol 95 (9) ◽  
pp. E28-E29 ◽  
Author(s):  
Tate Naylor ◽  
Anthony Sheyn ◽  
Felicity Lenes-Voit ◽  
Eric Berg
Keyword(s):  
Differential Diagnosis ◽  
Radiofrequency Ablation ◽  
Laser Ablation ◽  
Airway Obstruction ◽  
Lymphatic Malformation ◽  
Diagnosis And Treatment ◽  
Lymphatic Malformations ◽  
Extrinsic Compression ◽  
Mucosal Lesions ◽  
Clinically Significant

Airway obstruction in children has a wide differential diagnosis that includes laryngomalacia, infectious processes, paralysis, extrinsic compression, and other rare anatomic anomalies. Isolated laryngeal lymphatic malformations are rare developments that can manifest with clinically significant airway obstruction. To the best of our knowledge, there have been fewer than 20 reported cases. These laryngeal mucosal lesions are best managed with radiofrequency ablation or laser ablation. We present a case of a 2-year-old child who presented with airway obstruction, initially diagnosed with laryngomalacia, who was subsequently diagnosed and treated for an isolated epiglottic lymphatic malformation.

scholarly journals Gastro-Splenic Fistula Related to Large B Cell Lymphoma

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 17
Author(s):  
Diana Triantafyllopoulou ◽  
Ioannis Gkikas ◽  
Jagdish Adiyodi ◽  
Iain Crossingham ◽  
Shofiq Al-Islam ◽  
...  
Keyword(s):  
Emergency Department ◽  
B Cell ◽  
Cell Lymphoma ◽  
Abdominal Mass ◽  
B Cell Lymphoma ◽  
Large Mass ◽  
Surgical Removal ◽  
Large B Cell Lymphoma ◽  
Palpable Abdominal Mass ◽  
Large B Cell

We report a case of spontaneous gastrosplenic fistula in a 57 year old female who presented to the emergency department with abdominal pain and weight loss. From the physical examination, she had a palpable abdominal mass. A CT scan was performed and showed a mass involving the proximal greater curve of the stomach, infiltrating the spleen and pancreas. There was a 12 mm defect in the cardia of the stomach with gas entering the large mass but there was no free gas in the abdomen. The defect was a gastrosplenic fistula. A gastroscopic biopsy confirmed the diagnosis of diffuse large B cell lymphoma. Surgical removal of the mass was not feasible; therefore she was treated with RCHOP chemotherapy, achieving complete remission.

Abdominal Pain and Abdominal Mass

2018 ◽  
Author(s):  
Blake D. Babcock ◽  
Alexander E. Poor ◽  
Mohammad F. Shaikh ◽  
Wilbur B. Bowne
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Physical Examination ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Gastroesophageal Junction ◽  
Percutaneous Biopsy ◽  
Clinical History ◽  
Diagnostic Process ◽  
Abdominal Masses

Acute abdominal pain and abdominal mass are intimately connected; therefore, the diagnostic process for evaluating abdominal pain and abdominal masses is largely the same and has been preserved since ancient times. The primary goals in the management of patients with abdominal pain and/or abdominal mass are to establish a differential diagnosis by obtaining a clinical history, to refine the differential diagnosis with a physical examination and appropriate studies, and to determine the role of operative intervention in the treatment or refinement of the working diagnosis. This review describes the process of diagnosing abdominal pain, including taking a clinical history and performing a physical examination. Investigative studies, including laboratory tests, imaging, and pathology are reviewed. Management, including surgical treatment, is discussed. Tables describe intraperitoneal and extraperitoneal causes of acute abdominal pain, frequency of specific diagnoses in patients with acute abdominal pain, and common abdominal signs and findings noted on physical examination. Figures show abdominal pain in specific locations, a data sheet, the differential diagnosis of an abdominal mass by quadrant or region, characteristic patterns of abdominal pain, acute appendicitis with associated appendicolith, bilateral adrenal masses, adrenocortical carcinoma, retroperitoneal leiomyosarcoma, pancreatic mass, a sagittal ultrasonogram of the pancreas, ultrasonograms of the liver, a dark and well circumscribed abdominal mass, gastroesophageal junction adenocarcinoma, and percutaneous biopsy of a large abdominal mass. An algorithm outlines the assessment of acute abdominal pain and abdominal mass. This review contains 14 figures, 5 tables, and 143 references.

scholarly journals Bilateral Lower Extremity Paralysis in a Caucasian Male Presenting to the Emergency Department

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Yicheng K. Bao ◽  
Vishwanath C. Ganesan ◽  
Richard Rapp ◽  
Shunzhong S. Bao
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Lower Extremity ◽  
Lumbar Puncture ◽  
Emergency Physician ◽  
Sudden Onset ◽  
Periodic Paralysis ◽  
Thyrotoxic Periodic Paralysis ◽  
Bilateral Lower Extremity ◽  
Negative Results

Reported is a case of a 39-year-old Caucasian man who presented to the emergency department with sudden onset bilateral lower extremity paralysis after consuming a large amount of carbohydrates and alcohol. A CT, MRI, and lumbar puncture were performed with negative results; lab results showed hyperthyroidism and hypokalemia. The patient was diagnosed with thyrotoxic periodic paralysis. In a patient presenting with sudden onset paralysis and hypokalemia, the emergency physician should include thyrotoxic periodic paralysis in the differential diagnosis and focus on treating and working up the hypokalemia instead of the paralysis.

scholarly journals A Rare Case: Bilateral Hydronephrosis Due to Bilateral Abdominoscrotal Hydrocele in an Infant

2020 ◽  
Author(s):  
Levent Cankorkmaz ◽  
Mehmet Haydar Atalar ◽  
İsmail Şalk ◽  
Gökhan Köyoğlu
Keyword(s):  
Differential Diagnosis ◽  
Rare Case ◽  
Abdominal Mass ◽  
Surgical Removal ◽  
Renal Ultrasound ◽  
Rare Entity ◽  
Tunica Vaginalis ◽  
Postoperative Course ◽  
Bilateral Hydronephrosis ◽  
Abdominoscrotal Hydrocele

Abdominoscrotal hydrocele is a rare entity and first described by Dupuytren in 1834. Its etiology is still unclear. Rare complications are hydroureter/hydronephrosis, testicular flattening and malignant mesothelioma of tunica vaginalis associated with intraabdominal testis in an abdominoscrotal hydrocele. Herein we report a 7-month-old boy with bilateral abdominoscrotal hydrocele with secondary bilateral hydronephrosis due to contiguous pressure. Bilateral hydrocelectomies were performed. The postoperative course was uneventful without complication. Six month after the operation the renal ultrasound was normal. This entity, although unusual, should be considered in the differential diagnosis of a lower abdominal mass in children, as well as a cause of hydronephrosis. After surgical removal, healing is usually complete, including regression of the hydronephrosis.

Abdominal Pain and Abdominal Mass

2020 ◽  
Author(s):  
Madison M. Crutcher ◽  
Darshak S. Thosani ◽  
Mohammad F. Shaikh ◽  
Wilbur B. Bowne
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Physical Examination ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Gastroesophageal Junction ◽  
Percutaneous Biopsy ◽  
Clinical History ◽  
Diagnostic Process ◽  
Abdominal Masses

Acute abdominal pain and abdominal mass are intimately connected; therefore, the diagnostic process for evaluating abdominal pain and abdominal masses is largely the same and has been preserved since ancient times. The primary goals in the management of patients with abdominal pain and/or abdominal mass are to establish a differential diagnosis by obtaining a clinical history, to refine the differential diagnosis with a physical examination and appropriate studies, and to determine the role of operative intervention in the treatment or refinement of the working diagnosis. This review describes the process of diagnosing abdominal pain, including taking a clinical history and performing a physical examination. Investigative studies, including laboratory tests, imaging, and pathology are reviewed. Management, including surgical treatment, is discussed. Tables describe intraperitoneal and extraperitoneal causes of acute abdominal pain, frequency of specific diagnoses in patients with acute abdominal pain, and common abdominal signs and findings noted on physical examination. Figures show abdominal pain in specific locations, a data sheet, the differential diagnosis of an abdominal mass by quadrant or region, characteristic patterns of abdominal pain, acute appendicitis with associated appendicolith, bilateral adrenal masses, adrenocortical carcinoma, retroperitoneal leiomyosarcoma, pancreatic mass, a sagittal ultrasonogram of the pancreas, ultrasonograms of the liver, a dark and well circumscribed abdominal mass, gastroesophageal junction adenocarcinoma, and percutaneous biopsy of a large abdominal mass. An algorithm outlines the assessment of acute abdominal pain and abdominal mass. This review contains 16 figures, 5 tables, and 164 references. Keywords:  anatomy, swellings, inflammatory, opioid, palpatation, PET, COVID 19

Gastrointestinal Basidiobolomycosis: An Emerging, and A Confusing, Disease in Children (A Multicenter Experience)

2017 ◽  
Vol 28 (02) ◽  
pp. 194-199 ◽  
Author(s):  
Mervat Saleem ◽  
Mayssa Saeedd ◽  
Mohamed Eissa ◽  
Khalid Shreef
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Inflammatory Markers ◽  
Abdominal Mass ◽  
Final Diagnosis ◽  
Prolonged Treatment ◽  
Laboratory Findings ◽  
Abdominal Masses ◽  
Diagnostic Confusion ◽  
High Index Of Suspicion

Introduction Gastrointestinal basidiobolomycosis (GIB) is an emerging fungal infection in children that leads to diagnostic confusion. Aim Our study aim was twofold: a systematic review of published literature and an update of some Saudi Arabia hospital series to analyze their as well as our own experience in diagnosis and management of GIB. Material and Methods This clinical study included 18 children whose final diagnosis was GIB. The patients, who ranged in age from 5 to 10 years, were admitted between November 2009 and November 2015 with vague abdominal pains with or without abdominal masses for further investigation. Results Abdominal pain was the most common presenting symptom (94.4%) followed by constipation and abdominal mass (83.3 and 77.8%, respectively); fever was present in only 22.2% of the cases. Elevated inflammatory markers and eosinophilia (94.4%) appeared as prominent laboratory findings. Conclusion We conclude that diagnosing GIB in children requires a high index of suspicion, awareness, and consideration of its possibility in the differential diagnosis in patients with abdominal masses and eosinophilia, particularly in areas where it is endemic. Increased awareness of this clinical entity, early surgical resection of the infected tissue, and prolonged treatment with itraconazole offer the best chance for curing the disease.

scholarly journals Large renal leiomyoma: A multidisciplinary approach to diagnosis

2021 ◽  
Vol 15 (8) ◽  
pp. 18-26
Author(s):  
Sotiris Chaniotakis ◽  
Yi Yang ◽  
Tulsi Patel ◽  
James Banks
Keyword(s):  
Differential Diagnosis ◽  
Multidisciplinary Approach ◽  
Abdominal Mass ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
Imaging Features ◽  
Computed Tomographic ◽  
Abdominal Masses ◽  
Additional Testing ◽  
Palpable Abdominal Mass

We report the case of a 45-year-old woman who presented with a large palpable abdominal mass. Initial sonographic and computed tomographic studies prompted a differential diagnosis of retroperitoneal or renal sarcoma, leiomyoma, and lipid-poor angiomyolipoma. A final diagnosis of renal leiomyoma was reached based on a consensus among radiology, surgery and pathology. In addition to reviewing the features of this entity, this case demonstrates the process of developing a working diagnosis, narrowing the differential as additional testing is performed and establishing a final diagnosis with interdepartmental coordination. Despite the rarity of this condition, the ability to recognize and apply imaging features to differentiate between abdominal masses of unknown origin is important for clinicians and researchers.

Afternoon Tea Hemichorea

2021 ◽  
pp. 10.1212/CPJ.0000000000001048
Author(s):  
Stefan Williams ◽  
Joshua Kirby ◽  
Ana Maria Garcia
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Blood Glucose ◽  
Reperfusion Therapy ◽  
Sudden Onset ◽  
Past Medical History ◽  
Drug Induced ◽  
History Of ◽  
The Right ◽  
Possible Cause

A 78 year old lady, with a past medical history of hypertension, presented to the Accident & Emergency department after a sudden onset of right sided involuntary movements while she was having afternoon tea with her friends. Examination showed isolated unilateral chorea, affecting the right arm and leg (video). Her blood glucose and sodium levels were normal. The MRI head scan showed a left globus pallidus infarct (figure 1). Tetrabenazine was prescribed with very good response, and weaned off after 4 weeks. Hyperkinetic movement disorders are uncommon in acute stroke (1%)1. Lesions in regions functionally connected to the posterolateral putamen are implicated in hyperkinetic movement disorders2. The differential diagnosis includes hyperglycaemia, hyponatraemia and drug-induced chorea. In cases of sudden onset, it is important to recognise stroke as a possible cause to avoid missing reperfusion therapy opportunities

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