scholarly journals Micropapillary carcinoma of the bladder presented with spontaneous intraperitoneal bladder rupture

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Miroslav M. Stojadinović ◽  
Slobodanka Lj. Mitrović ◽  
Dragan R Milovanović
Keyword(s):  
Unusual Case ◽  
Clinical Presentation ◽  
Emergency Operation ◽  
Bladder Perforation ◽  
Bladder Rupture ◽  
High Morbidity ◽  
Micropapillary Carcinoma ◽  
Diffuse Abdominal Pain ◽  
Intraperitoneal Bladder Rupture ◽  
Carcinoma Of The Bladder

Spontaneous bladder perforation is a rare presenting feature of bladder malignancy. We describe an unusual case of a patient, admitted to emergency, with diffuse abdominal pain due to spontaneous bladder rupture in association with a micropapillary carcinoma. A diagnosis of an intraperitoneal bladder perforation was made during an emergency operation. Aspects of etiology, clinical presentation, diagnosis and management are described. Although cases of spontaneous carcinomatous bladder rupture are associated with high morbidity and mortality, prompt identification and treatment can lead to favourable outcomes.

scholarly journals Acute gall bladder perforation: case series over three years

2017 ◽  
Vol 4 (2) ◽  
pp. 538 ◽  
Author(s):  
Desh Pal Singh ◽  
Sharadendu Bali ◽  
Maneshwar Singh Utaal
Keyword(s):  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Clinical Presentation ◽  
Case Series ◽  
Bladder Perforation ◽  
High Morbidity ◽  
Delay In Diagnosis ◽  
Generalized Peritonitis ◽  
Abdominal Symptoms ◽  
Acute Perforation

Background: Acute perforation of gall bladder is a life threatening condition. It is a complication of acute cholecystitis. This is not an uncommon condition and resembles acute cholecystitis in its presentation. If there is delay in diagnosis and management there is high morbidity and mortality. It should be diagnosed as early as possible for better prognosis.Methods: This is a retrospective study wherein data of cholelithiasis, acute and chronic cholecystitis and perforated gall bladder from our hospital for the last three years 2014-2016 was collected. The clinical presentation, investigations routine and radiological, surgical and medical management was analysed.Results: Total numbers of patients with chronic cholelithiasis were 3534, patients with acute cholecystitis were 133, and numbers of patients with gall bladder perforations were 22, making it 0.6% of gall bladder disease patients and 16.5% among patients with acute cholecystitis. TLC was invariably raised in all the cases. 12 out of 22 cases were managed conservatively while others underwent surgery. There was no mortality in the series.Conclusions: Gall bladder perforation occurs in about two weeks or several weeks after episode of acute cholecystitis, the incidence of occurrence of perforation increases to four folds if there is delay in proper management of acute cholecystitis more than two days after the onset of symptoms. Clinical presentation varies from an acute generalized peritonitis to nonspecific abdominal symptoms and thus requires prompt diagnosis for better prognosis.

Clinical Presentation, Quality of Care, Risk Factors and Outcomes in Women with Acute ST-Elevation Myocardial Infarction (STEMI): An Observational Report from Six Middle Eastern Countries

2019 ◽  
Vol 17 (4) ◽  
pp. 388-395 ◽  
Author(s):  
Abdulla Shehab ◽  
Khalid F. AlHabib ◽  
Akshaya S. Bhagavathula ◽  
Ahmad Hersi ◽  
Hussam Alfaleh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Quality Of Care ◽  
Middle East ◽  
Clinical Presentation ◽  
Middle Eastern ◽  
High Morbidity ◽  
Inhospital Mortality ◽  
Acute Stemi

Background: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. Aims: To examine the clinical presentation, patient management, quality of care, risk factors and inhospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. Methods: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries. The study included 2928 patients; 296 women (10.1%) and 2632 men (89.9%). Clinical presentations, management and in-hospital outcomes were compared between the 2 groups. Results: Women were 10 years older and more likely to have diabetes mellitus, hypertension, and hyperlipidemia compared with men who were more likely to be smokers (all p<0.001). Women had longer median symptom-onset to emergency department (ED) arrival times (230 vs. 170 min, p<0.001) and ED to diagnostic ECG (8 vs. 6 min., p<0.001). When primary percutaneous coronary intervention (PPCI) was performed, women had longer door-to-balloon time (DBT) (86 vs. 73 min., p=0.009). When thrombolytic therapy was not administered, women were less likely to receive PPCI (69.7 vs. 76.7%, p=0.036). The mean duration of hospital stay was longer in women (6.03 ± 22.51 vs. 3.41 ± 19.45 days, p=0.032) and the crude in-hospital mortality rate was higher in women (10.4 vs. 5.2%, p<0.001). However, after adjustments, multivariate analysis revealed a statistically non-significant trend of higher inhospital mortality among women than men (6.4 vs. 4.6%), (p=0.145). Conclusion: Our study demonstrates that women in our region have almost double the mortality from STEMI compared with men. Although this can partially be explained by older age and higher risk profiles in women, however, correction of identified gaps in quality of care should be attempted to reduce the high morbidity and mortality of STEMI in our women.

scholarly journals When less is more: a daring conservative approach to postpneumonectomy oesophago-pleural fistula

2019 ◽  
Vol 30 (1) ◽  
pp. 146-148
Author(s):  
Lara Girelli ◽  
Elena Prisciandaro ◽  
Niccolò Filippi ◽  
Lorenzo Spaggiari
Keyword(s):  
Clinical Presentation ◽  
Clinical Status ◽  
High Morbidity ◽  
Conservative Approach ◽  
Chronic Fistula ◽  
Less Is More ◽  
Primary Surgery ◽  
History Of ◽  
Uncommon Complication

Abstract Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient’s good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.

scholarly journals Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report

2019 ◽  
Vol 59 ◽  
pp. 31-34 ◽  
Author(s):  
Ismaeel Aghaways ◽  
Rawa Bapir ◽  
Tahir A. Hawrami ◽  
Nishtman M. Thahir ◽  
Mohammed Abed Al Kadum Hassan ◽  
...  
Keyword(s):  
Case Report ◽  
Conservative Management ◽  
Caesarean Delivery ◽  
Bladder Rupture ◽  
Delayed Presentation ◽  
Intraperitoneal Bladder Rupture

Intraperitoneal Urinary Bladder Rupture as a Cause of Pneumoperitoneum

2021 ◽  
pp. 000313482110257
Author(s):  
Dar Parvez M ◽  
Kour Supreet ◽  
Sharma Ajay ◽  
Kumar Subodh
Keyword(s):  
Urinary Bladder ◽  
Primary Repair ◽  
Exploratory Laparotomy ◽  
Pelvic Trauma ◽  
Bladder Rupture ◽  
Abdominal Pressure ◽  
Trauma Patients ◽  
Hollow Viscus ◽  
Sudden Rise ◽  
Intraperitoneal Bladder Rupture

The most common cause of pneumoperitoneum in trauma patients is hollow viscus injury; however, in patients with pneumoperitoneum on imaging and normal hollow viscus during the laparotomy, other rare causes of pneumoperitoneum like intraperitoneal urinary bladder rupture should be ruled out. Urinary bladder can rupture either extraperitoneally or intraperitoneally or both. Rupture of the urinary bladder is commonly seen in patients with abdominal trauma; however, pneumoperitoneum is usually not seen in patients with traumatic bladder rupture. Intraperitoneal bladder rupture is usually due to the sudden rise in intra-abdominal pressure following abdominal or pelvic trauma. However, it is a rare cause of pneumoperitoneum and is managed by surgical repair. We present a case of blunt trauma abdomen with pneumoperitoneum due to isolated intraperitoneal bladder rupture who was managed by exploratory laparotomy and primary repair of the urinary bladder.

A Case of Multiple Chemical Sensitivities: Cognitive Therapy for Somatization Disorder and Metaworry

2003 ◽  
Vol 17 (3) ◽  
pp. 267-277 ◽  
Author(s):  
Scott Temple
Keyword(s):  
Cognitive Therapy ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Somatization Disorder ◽  
Case Conceptualization ◽  
Marital Problems ◽  
Multiple Chemical Sensitivities ◽  
Common Clinical Presentation ◽  
History Of ◽  
Multiple Chemical

“Multiple chemical sensitivities” has become an increasingly common clinical presentation to physicians, though it is infrequently seen by psychotherapists. This case report describes a 61-year-old woman who presents with a long history of chemical sensitivities, that led to a somatization disorder with debilitating agoraphobia, depression, and marital problems. Features of a variety of anxiety disorders are present, as are metacognitions that required an unusual case conceptualization. A cognitive therapy case conceptualization and treatment are described, which address the highly idiosyncratic clinical presentation of this patient.

scholarly journals Spontaneous Intraperitoneal Bladder Rupture: A Rare Case Report

2019 ◽  
Author(s):  
Anwesa Chakraborty ◽  
Kaushik Mandal ◽  
Anirban Bhunia ◽  
Saikat Hasnat ◽  
Santanu Dutta
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Bladder Rupture ◽  
Rare Case Report ◽  
Intraperitoneal Bladder Rupture
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