Hemoperitoneum From Bleeding Intra-Abdominal Varices: A Rare, Life-Threatening Cause of Abdominal Pain in a Patient With Cirrhosis

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

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Postpartum ovarian vein thrombosis

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2021-0002 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Kelly Ribeiro ◽

Samir Mahboobani ◽

Katherine Van Ree ◽

Katy Clifford ◽

TG Teoh

Keyword(s):

Abdominal Pain ◽

Complete Resolution ◽

Early Recognition ◽

Ovarian Vein ◽

Transabdominal Ultrasound ◽

Case Presentation ◽

Vein Thrombosis ◽

Prompt Treatment ◽

Life Threatening ◽

Ovarian Vein Thrombosis

Abstract Objectives Postpartum ovarian vein thrombosis (POVT) is a rare pathology that can lead to severe complications such as sepsis, extension of the thrombus leading to organ failure, and pulmonary embolism. It therefore requires early recognition and prompt treatment. Case presentation A patient with right POVT presented four days after delivery with acute right-sided abdominal pain and fever. Appendicitis was initially considered, before an abdominal-pelvic computed tomography raised the suspicion of POVT, subsequently confirmed through transabdominal ultrasound. Antibiotics and anticoagulation were initiated, with rapid clinical improvement and complete resolution of the thrombus three months later. Conclusions Diagnosing POVT is challenging as it clinically mimics other more frequent conditions. It is rare but life-threatening and should be considered in all females presenting with abdominal pain and fever in the postpartum period.

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Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

Case Reports in Surgery ◽

10.1155/2021/5553619 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Marcello Agus ◽

Maria Elena Ferrara ◽

Paola Bianco ◽

Cristina Manieli ◽

Paolo Mura ◽

...

Keyword(s):

Abdominal Pain ◽

Splenic Rupture ◽

Delayed Diagnosis ◽

Caucasian Woman ◽

Threatening Condition ◽

Life Threatening ◽

Atraumatic Splenic Rupture ◽

Rupture Of The Spleen ◽

Delay Of Diagnosis ◽

Possible Cause

Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.

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Ovarian Torsion Presentation, Treatment and Iatrogenic Surgical Management

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i54a33720 ◽

2021 ◽

pp. 70-76

Author(s):

Sheema Sabahath ◽

Hussain Salah AL Sinan ◽

Asalah Tariq Alsaigh ◽

Rawan AlSalamah AlFadhli ◽

Tahani Salman Al Mansour ◽

...

Keyword(s):

Blood Flow ◽

Abdominal Pain ◽

Side Effects ◽

Adverse Events ◽

Surgical Intervention ◽

Clinical Manifestations ◽

Ovarian Torsion ◽

Adult Females ◽

Uterine Ligaments ◽

Life Threatening

Ovarian torsion is among the gynecological life-threatening conditions that may require urgent surgical intervention among the appearance of clinical manifestations. The most common clinical manifestations include severe abdominal pain, nausea extending to vomiting. The ovarian torsion is not limited to children only. However, it can also occur in adult females, either pregnant or non-pregnant. The etiology of the disease tends to be related to the weakness of the uterine ligaments or malpositioning of it due to known and unknown causes. Despite that, the surgical intervention is needed to release the torsion. Sometimes, it can lead to adverse events or side effects such as decreased blood flow to the surrounding structures. Which by role may lead to unpleasant complications and clinical manifestations of hemorrhage and shock. In this article, we reviewed the topic of ovarian torsion from different aspects, including the definition, causes, clinical evaluation, and clinical management and its common complications.

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Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032009000100020 ◽

2009 ◽

Vol 46 (1) ◽

pp. 81-84 ◽

Cited By ~ 7

Author(s):

Fernanda Prata Martins ◽

Erika Pereira de Macedo ◽

Gustavo Andrade de Paulo ◽

Frank Shigueo Nakao ◽

José Celso Ardengh ◽

...

Keyword(s):

Abdominal Pain ◽

Portal Hypertension ◽

Gastric Varices ◽

Study Endpoint ◽

Mild Abdominal Pain ◽

Threatening Condition ◽

Life Threatening ◽

Related Mortality ◽

Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

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Celiac artery aneurysm causing an acute abdomen

BMJ Case Reports ◽

10.1136/bcr-2020-240533 ◽

2021 ◽

Vol 14 (4) ◽

pp. e240533

Author(s):

Rute Castelhano ◽

Khine Myat Win ◽

Sara Carty

Keyword(s):

Abdominal Pain ◽

Acute Abdominal Pain ◽

Artery Aneurysm ◽

Celiac Artery ◽

Common Presentation ◽

Accident And Emergency ◽

Life Threatening ◽

Celiac Artery Aneurysm ◽

Accident And Emergency Department ◽

Surgical Conditions

Abdominal pain is a very common presentation in the accident and emergency department. However, vasculitis is not the usual first differential diagnosis. This paper discusses a case of polyarteritis nodosa presenting with acute abdominal pain alone. Common surgical conditions were obviously considered, but they were not found to cause the patient’s problems. We describe how investigations led to this diagnosis discussed in detail in this paper. It is important to remember that prompt recognition of unusual life-threatening conditions can lead to timely intervention.

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Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

Journal of Pharmacy Practice ◽

10.1177/0897190019825965 ◽

2019 ◽

Vol 33 (3) ◽

pp. 364-367 ◽

Cited By ~ 2

Author(s):

Yoonsun Mo ◽

Shiv Gandhi ◽

Jose Orsini

Keyword(s):

Cardiac Arrest ◽

Abdominal Pain ◽

Sudden Cardiac Arrest ◽

Lower Abdominal Pain ◽

The Past ◽

Life Threatening ◽

History Of ◽

Artery Disease ◽

Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

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Status of Geriatric Patients with Abdominal Pain Presented To Emergency Department

Journal of Chitwan Medical College ◽

10.3126/jcmc.v9i2.24562 ◽

2019 ◽

Vol 9 (2) ◽

pp. 90-96

Author(s):

Daya Ram Lamsal ◽

Jeetendra Bhandari

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Care Center ◽

Tertiary Care ◽

Medical Officer ◽

Common System ◽

Life Expectancy At Birth ◽

Chief Complaints ◽

Life Threatening ◽

The Common

Background: As the development of better health facilities with advanced tools for diagnosis and management our country is not away from global trend. Nepal’s life expectancy at birth is increasing at its pace, it has increased in about 30 years in last 4 decades. Among the various problem presenting to ED abdominal pain is one of the common complain elderly patients are greater risk of missing life-threatening causes during evaluation and investigation. The aim of the study wasEdit to identify the frequency, cause and outcome of patient presenting in Emergency department with abdominal pain. Methods: It is a retrospective study conducted in tertiary care center at Chitwan, Nepal during the period from 01/09/2017 to 30/08/2018. Electronic data entered by medical officer were retrieved and analyzed. Statistical analysis of the record was done using SPSS 16 software. Results: Elderly population who presented with chief complaints of abdominal pain was 1160 (21.79%). Among the patient presented with abdominal pain 605(52.2%) were male and 555(47.8%) were female. Mean age of patients was 71.72±8.50 years. Most common system involved was gastrointestinal and biliary problem 730(62.93%). Most common diagnosis was Urinary tract infection 269 (23.2%) among them, 487(41.98%) required hospital admission. Conclusions: Abdominal pain is one of the common presentations of elderly to emergency department. Disorders of Gastrointestinal and biliary system were among leading causes of emergency visit. Emergency physician should be tactful to identify life threatening conditions and emergency management.

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Acute Gastric Volvulus and Atrial Fibrillation with RVR: A Coincidence or Association

Case Reports in Critical Care ◽

10.1155/2017/9403601 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

Omar Nadhem ◽

Omar Salh ◽

Faisal Khasawneh

Keyword(s):

Atrial Fibrillation ◽

Abdominal Pain ◽

Diaphragmatic Hernia ◽

Gastric Volvulus ◽

Shortness Of Breath ◽

Threatening Condition ◽

Acute Gastric Volvulus ◽

Ventricular Response ◽

Life Threatening ◽

Upper Abdominal

Gastric volvulus is a rare and life-threatening condition that involves the abnormal rotation of the stomach around its axis by more than 180°. The association between acute gastric volvulus and atrial fibrillation with rapid ventricular response is rare with only few cases that have been reported. Our patient was an 86-year-old female who presented with upper abdominal pain, distension, nausea, and shortness of breath. Clinical and laboratory workup revealed acute gastric volvulus with diaphragmatic hernia. On presentation, she was also in atrial fibrillation with rapid ventricular response. She was successfully treated by laparotomy with reduction of the gastric volvulus and repair of the diaphragmatic hernia, with significant improvement.

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Unusual Presentation of Meckel’s Diverticulum: Gangrene due to Axial Torsion

Case Reports in Emergency Medicine ◽

10.1155/2015/571847 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ahmet Rencuzogullari ◽

Kubilay Dalci ◽

Orcun Yalav

Keyword(s):

Congenital Anomaly ◽

Abdominal Pain ◽

Small Bowel ◽

Preoperative Diagnosis ◽

Iliac Fossa ◽

Meckel’S Diverticulum ◽

Meckel's Diverticulum ◽

Life Threatening ◽

Operative Findings ◽

The Right

Meckel’s diverticulum is the most common congenital anomaly of the small bowel. The majority of cases are asymptomatic; however, life-threatening complications can also take place. We present a case of a 37-year-old male who was admitted with symptoms of acute, severe abdominal pain in the right iliac fossa. The patient was operated on with the preoperative diagnosis of acute appendicitis but the operative findings were consistent with torted Meckel’s diverticulum due to presence of mesodiverticular band and he was treated successfully with surgical resection.

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