scholarly journals Clinical features of Fitz-Hugh-Curtis syndrome diagnosed by abdomino-pelvic computed tomography

2011 ◽  
Vol 54 (1) ◽  
pp. 43
Author(s):  
Sang Hyun Shin ◽  
Young Ah Kim ◽  
Doo Young Chang ◽  
Kyung Chul Jun ◽  
Myung Kwon Jeon ◽  
...  
2008 ◽  
Vol 58 (3) ◽  
pp. 277
Author(s):  
Ji Sang Park ◽  
Seong Jin Park ◽  
Hae Kyung Lee ◽  
Boem Ha Yi ◽  
Hyun Sook Hong ◽  
...  

2014 ◽  
Vol 23 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Rajan Iyer ◽  
George F. Longstreth ◽  
Li-Hao Chu ◽  
Wansu Chen ◽  
Linnette Yen ◽  
...  

Background & Aims: Diverticulitis is often diagnosed in outpatients, yet little evidence exists on diagnostic evidence and demographic/clinical features in various practice settings. We assessed variation in clinical characteristics and diagnostic evidence in inpatients, outpatients, and emergency department cases and effects of demographic and clinical variables on presentation features.Methods: In a retrospective cohort study of 1749 patients in an integrated health care system, we compared presenting features and computed tomography findings by practice setting and assessed independent effects of demographic and clinical factors on presenting features.Results: Inpatients were older and more often underweight/normal weight and lacked a diverticulitis past history and had more comorbidities than other patients. Outpatients were most often Hispanic/Latino. The classical triad (abdominal pain, fever, leukocytosis) occurred in 78 (38.6%) inpatients, 29 (5.2%) outpatients and 34 (10.7%) emergency department cases. Computed tomography was performed on 196 (94.4%) inpatients, 110 (9.2%) outpatients and 296 (87.6%) emergency department cases and was diagnostic in 153 (78.6%) inpatients, 62 (56.4%) outpatients and 243 (82.1%) emergency department cases. Multiple variables affected presenting features. Notably, female sex had lower odds for the presence of the triad features (odds ratio [95% CI], 0.65 [0.45-0.94], P<0.05) and increased odds of vomiting (1.78 [1.26-2.53], P<0.01). Patients in age group 56 to 65 and 66 or older had decreased odds of fever (0.67 [0.46-0.98], P<0.05) and 0.46 [0.26-0.81], P<0.01), respectively, while ≥1 co-morbidity increased the odds of observing the triad (1.88 [1.26-2.81], P<0.01).Conclusion: There was little objective evidence for physician-diagnosed diverticulitis in most outpatients. Demographic and clinical characteristics vary among settings and independently affect presenting features.Abbreviations: AD: acute colonic diverticulitis; BMI: body mass index; CT: computed tomography; ED: emergency department; IBS: irritable bowel syndrome; ICD-9-CM: International Classification of Diseases, 9th Revision, Clinical Modification; IP: inpatient; KPSC: Kaiser Permanente Southern California; OP: outpatient.


2015 ◽  
Vol 49 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Urska Lamot ◽  
Ivana Ribaric ◽  
Katarina Surlan Popovic

Abstract Background. Clinical features indicating an ischemic infarction in the territory of posterior cerebral circulation require a comprehensive radiologic examination, which is best achieved by a multi-modality imaging approach (computed tomography [CT], CT-perfusion, computed tomography angiography [CTA], magnetic resonance imaging [MRI] and diffusion weighted imaging [DWI]). The diagnosis of an acute ischemic infarction, where the damage of brain tissue may still be reversible, enables selection of appropriate treatment and contributes to a more favourable outcome. For these reasons it is essential to recognize common neurovascular variants in the territory of the posterior cerebral circulation, one of which is the artery of Percheron. Case report. A 69 year-old woman, last seen awake 10 hours earlier, presented with two typical clinical features of the artery of Percheron infarction, which were vertical gaze palsy and coma. Brain CT and CTA of neck and intracranial arteries upon arrival were interpreted as normal. A new brain CT scan performed 24 hours later revealed hypodensity in the medial parts of thalami. Other imaging modalities were not performed, due to the presumption that the window for the application of effective therapy was over. The diagnosis of an artery of Percheron infarction was therefore made retrospectively with the re-examination of the CTA of neck and intracranial arteries. Conclusions. A multi-modality imaging approach is necessary in every patient with suspicion of the posterior circulation infarction immediately after the onset of symptoms, especially in cases where primary imaging modalities are unremarkable and clinical features are severe, where follow-up examinations are indicated.


2015 ◽  
Author(s):  
Devin Mackay ◽  
Edison Miyawaki

The hyperkinetic movement disorders include heterogeneous diseases and syndromes, all characterized by one or a variety of excessive, involuntary movements. The hyperkinetic movement disorders are heterogeneous in clinical presentation, but a rational and practical approach to diagnosis exists based on new genetic correlations and targeted laboratory investigations. Treatments informed by a still-developing picture of motor pathophysiology offer significant benefit for these disorders. This chapter discusses choreiform disorders, including patterns in choreiform diagnosis; tremor disorders; paroxysmal disorders, including tics and myoclonus; dystonias, including monogenic primary dystonias; and pathophysiology and treatment in the hyperkinetic movement disorders. Figures include clinical photos, computed tomography scans, and an algorithm representing cortical-subcortical circuitry. Tables delineate definitions, distinguishing clinical features, medications, genetics, protein products, and treatments associated with various disorders.  This review contains 6 figures, 12 tables, and 145 references.


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