scholarly journals Airway Challenges in a Preterm Neonate with Undiagnosed Complete Tracheal Rings Posted for Surgery

2021 ◽  
Author(s):  
Pratika Pradeep Bhokare ◽  
Sayli Rajendra Kulkarni
Keyword(s):  
Difficult Airway ◽  
Preterm Neonate ◽  
Airflow Obstruction ◽  
Failure To Thrive ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Supraglottic Airway ◽  
Preterm Neonates ◽  
History Of ◽  
Airway Anomalies

Preterm neonates are defined as those born before 37 weeks. The anatomical features of preterm neonates vary from that of an adult, such that they have a large tongue, an anterior funnel shaped larynx, angled vocal cords and an omega shaped epiglottis. Their physiological development also differ as they have a greater risk for apnoea of prematurity, airflow obstruction, bronchopulmonary dysplasia, low functional residual capacity and decreased transient oxygen tension. Congenital airway anomalies have a prevalence rate of 0.2-1 in 10,000 live births. Congenital Tracheal Stenosis (CTS) caused by complete tracheal rings is one of the rarest forms of all the airway anomalies that occur, which is characterised by presence of complete ‘O’ shaped cartilaginous rings of trachea devoid of a membranous part. The case discussed in the article is that of a day 26 preterm neonate with increasing abdominal distension and failure to thrive. The neonate was posted for an urgent exploratory laparotomy for abdominal decompression and ileostomy. Patient was kept on Continuous Positive Airway Pressure (CPAP) support for four days immediately after birth; however, intubation was never attempted nor required. With a history of respiratory depression and lack of history of previous intubation, difficult airway cart was kept ready prior to surgery. Supraglottic Airway (SGA) devices were at the core of airway rescue in this case of undiagnosed CTS. This case report shows how and why a preparation for difficult airway in preterm neonates is a necessity. It will provide as a guide if a similar case is encountered by the anaesthetist.

scholarly journals Gas-filled urachal abscess with a pinging sound in a heifer calf

2019 ◽  
Vol 64 (No. 8) ◽  
pp. 362-366 ◽  
Author(s):  
R Sato ◽  
K Yamada ◽  
Y Shinozuka ◽  
H Ochiai ◽  
K Onda
Keyword(s):  
Fistulous Tract ◽  
Failure To Thrive ◽  
Abdominal Distension ◽  
Intravenous Urography ◽  
University Hospital ◽  
Growth Depression ◽  
Poor Growth ◽  
History Of ◽  
Heifer Calf ◽  
Urachal Abscess

A 6-month-old crossbred of a Holstein and Japanese Black heifer calf weighing 95 kg presented with a history of intermittent abdominal distension and failure to thrive. The physical examination identified a pinging sound over the dorsal left flank. The abdominal radiography showed a huge gas-filled mass. The intravenous urography revealed no communication between the mass and the urinary bladder. Although the visual examination and palpation of the umbilicus did not reveal visible abnormalities, an umbilical disease was suspected because the animal exhibited poor growth, depression, and a hunched back posture. When the eschar adhering to the centre of the umbilicus was removed, the presence of a fistulous tract was revealed. The umbilical ultrasound examination revealed an intra-abdominal abscess and the fistulography demonstrated that the abscess communicated with the umbilicus. The abscess, compressing into the rumen, was observed by computed tomography. From these images, it was diagnosed as an umbilical cord remnant abscess and a definitive diagnosis of a urachal abscess was obtained by open abdominal surgery and the subsequent removal of the mass. The calf was discharged from the university hospital on day 14 after the operation. This case shows that a urachal abscess should be considered when a pinging sound is present, even if the animal exhibits no swelling or pain of the umbilicus.

scholarly journals Resection of a colonic mass following trauma: a diagnostic dilemma

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Paul Burchard ◽  
Alan A Thomay
Keyword(s):  
Ct Scan ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Symptomatic Improvement ◽  
Diagnostic Dilemma ◽  
Vehicle Accident ◽  
Abdomen Ct ◽  
History Of ◽  
Mitotic Figures ◽  
The Right

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.

scholarly journals Endometriosis-Associated Massive Ascites in an Asian Woman: A Case Report of a Rare Clinical Entity

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Nuntasiri Eamudomkarn ◽  
Naratassapol Likitdee ◽  
Pilaiwan Kleebkaow ◽  
Chumnan Kietpeerakool
Keyword(s):  
Broad Ligament ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Final Diagnosis ◽  
Clinical Entity ◽  
Asian Woman ◽  
Rare Clinical Entity ◽  
Childbearing Age ◽  
Massive Ascites ◽  
History Of

Massive ascites as a presentation of endometriosis is a rare clinical entity that is most commonly seen in black nulliparous females. Herein, we describe a case of a 32-year-old multiparous Thai woman who presented with a two-year history of abdominal distension. Computerized tomography of the abdominopelvic region showed an infiltrative enhancing lesion involving the cul-de-sac and perirectal region with massive loculated ascites, suggesting carcinomatosis peritonei. Abdominal paracentesis was performed to yield fluid samples for evaluation, which revealed no malignant cells, and polymerase chain reaction (PCR) was negative for tuberculosis. The patient underwent exploratory laparotomy which revealed a large amount of serosanguinous ascites, thickened matted bowel loops, and necrotic debris covering the entire surface of the peritoneum and visceral organs. The surgical procedures included drainage of 6.5 liters of ascites, lysis adhesion, biopsy of the peritoneum, and right salpingo-oophorectomy. Histologic examination revealed benign endometrial glands with stroma at the peritoneum tissue and broad ligament. Other causes of ascites were excluded. The ascites responded to drainage and hormonal suppression. A final diagnosis of endometriosis was made based on these findings. Endometriosis should therefore be considered in differential diagnosis in women of childbearing age who present with ascites.

scholarly journals Acquired colonic atresia in a 4-month old term male infant: a rare case report

2017 ◽  
Vol 4 (2) ◽  
pp. 669
Author(s):  
Kamal Nain Rattan ◽  
Gurupriya J. ◽  
Shruti Bansal ◽  
Rohit Kapoor ◽  
Roomi Yadav
Keyword(s):  
Case Report ◽  
Necrotizing Enterocolitis ◽  
Rare Case ◽  
Male Infant ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Inflammatory Mass ◽  
Colonic Atresia ◽  
Rare Case Report ◽  
History Of

Acquired colonic atresias are very rare but, are known in association with necrotizing enterocolitis. We report a case of a 4-month term male infant with recurrent episodes of abdominal distension, bilious vomiting and constipation off and on, without the history of necrotizing enterocolitis. Exploratory laparotomy was performed, an inflammatory mass with multiple dense interloop adhesions were found in the mid-transverse colon. These adhesions were lysed to identify the proximal dilated and distal blind end of the colon.  Rest of the gut was normal.  This case is unique for the fact that, it is a case of acquired colonic atresia without history of necrotizing enterocolitis, unlike other reported cases of acquired colonic atresia.

scholarly journals Pneumatosis intestinalis: cost paid for rheumatoid arthritis treatment

2019 ◽  
Vol 12 (7) ◽  
pp. e229329 ◽  
Author(s):  
Pratyusha Tirumanisetty ◽  
Jose William Sotelo ◽  
Michael Disalle ◽  
Meenal Sharma
Keyword(s):  
Rheumatoid Arthritis ◽  
Bowel Wall ◽  
Loop Ileostomy ◽  
Pneumatosis Intestinalis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Right Hemicolectomy ◽  
Necrotic Bowel ◽  
History Of ◽  
High Index Of Suspicion

A 75-year-old woman with rheumatoid arthritis on rituximab presented with a 1-week history of constipation and abdominal distension. Subsequent workup showed presence of air in the bowel wall without perforation initially. Due to positive blood cultures, worsening leucocytosis and high suspicion for perforation, an exploratory laparotomy was performed revealing necrotic bowel, walled off perforation and abscess. Patient underwent right hemicolectomy with diversion loop ileostomy. Clinicians must recognise that monoclonal antibodies like rituximab can mask signs of inflammation and therefore should maintain a high index of suspicion for intestinal perforation when evaluating patients with minimal symptoms and pneumatosis intestinalis.

scholarly journals Rare case of midgut volvulus with malrotation in an elderly patient

2019 ◽  
Vol 7 (1) ◽  
pp. 303
Author(s):  
Mezhuneituo Raleng ◽  
Anant Prakash Pore ◽  
Vickey Katheria ◽  
Worshim Khamrang ◽  
R. S. Wungramthing
Keyword(s):  
Elderly Patient ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Rare Case ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Midgut Volvulus ◽  
History Of ◽  
Subacute Intestinal Obstruction

A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced. 

scholarly journals Treatment with Micafungin in a Preterm Neonate with an Invasive Candida parapsilosis Infection after a Severe Terlipressin-Induced Skin Necrosis

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 890
Author(s):  
Domenico Umberto De Rose ◽  
Fiammetta Piersigilli ◽  
Bianca Maria Goffredo ◽  
Olivier Danhaive ◽  
Andrea Dotta ◽  
...  
Keyword(s):  
Skin Necrosis ◽  
Candida Parapsilosis ◽  
Preterm Neonate ◽  
Clinical History ◽  
Skin Lesions ◽  
Preterm Neonates ◽  
High Dose ◽  
Skin Grafts ◽  
Extremely Preterm ◽  
History Of

Candida parapsilosis infections are increasingly reported in preterm neonates, but the optimal treatment remains uncertain. We report the clinical history of an extremely preterm neonate, who developed a devastating skin necrosis due to terlipressin administration, with subsequent superinfection by Candida parapsilosis. The infant underwent multiple curettages and skin grafts to resolve skin lesions and was treated with systemic micafungin administration at a high dose (8 mg/kg/day), with resolution of the fungal infection.

scholarly journals Primary ileal volvulus: a rare twist in an elderly patient—case report

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Srikant Agrawal ◽  
Ashwini Ranjan Yadav ◽  
Bikash Nepal ◽  
Pramod Kumar Upadhyay
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Predisposing Factors ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of

Abstract Background Small bowel volvulus is a rare entity and it is even rarer for the ileum to undergo torsion without any known predisposing factors. It presents as acute abdomen with features of intestinal obstruction. As it is a life-threatening condition, it should be kept as a differential for small bowel obstruction despite its rarity. Therefore, we report this case. Case report A 60-year-old gentleman presented to our emergency department with a 2-day history of worsening abdominal pain, vomiting, abdominal distension and obstipation. Exploratory laparotomy was done which revealed ileal volvulus with no predisposing factors. Derotation of the segment was done. The postoperative period was uneventful and on follow up after a month, he had a satisfying recovery. Conclusion Though primary ileal volvulus is a rare diagnosis, it should be kept in mind in any patient with small bowel obstruction with pain out of proportion and resistant to opioid management. Early diagnosis and urgent surgical intervention is the key to prevent bowel necrosis and associated morbidity and mortality.

scholarly journals Continuous Spinal Anesthesia following Inadvertent Dural Puncture during Epidural Placement for an Emergency Laparotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Andrew Emyedu ◽  
Bernadette Kyoheirwe ◽  
Patience Atumanya
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Emergency Laparotomy ◽  
Continuous Spinal Anesthesia ◽  
Accident And Emergency ◽  
Accidental Dural Puncture ◽  
History Of ◽  
Intrathecal Space

Summary. Emergency exploratory laparotomy conducted under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Background and Objectives. Continuous spinal anesthesia is one of the least utilized regional anesthesia techniques globally. It could be an alternative anesthesia technique for abdominal and lower limb surgeries following an accidental dural puncture. The aim of this report was to describe a case in which continuous spinal anesthesia was successfully conducted for emergency exploratory laparotomy following an accidental dural puncture during epidural placement. Case Report. A 38-year-old male presented to our accident and emergency unit with a one-day history of colicky abdominal pain associated with constipation, abdominal distension, and vomiting. He was diagnosed with intestinal obstruction and underwent an emergency exploratory laparotomy under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Conclusion. This case demonstrates that in case of an accidental dural puncture during epidural placement, the catheter can be advanced into the intrathecal space and continuous spinal anesthesia conducted for abdominal surgeries using a standard epidural catheter.

scholarly journals Perforated appendicitis in a preterm neonate: A case report with literature review

2017 ◽  
Vol 3 (4) ◽  
pp. 6
Author(s):  
Sanuja Bose ◽  
Derek Wakeman
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Literature Review ◽  
Gestational Age ◽  
Literature Search ◽  
Preterm Neonate ◽  
Perforated Appendicitis ◽  
Exploratory Laparotomy ◽  
Preterm Neonates ◽  
Rare Entity

Neonatal appendicitis is a rare entity, with a mortality rate that has decreased in past decades but remained high. Of cases reported in the literature, more than 50% occur in preterm neonates, and none have been diagnosed preoperatively. Here, we report the case of a female infant of 27-4/7 weeks’ gestational age, who presented with perforated appendicitis on day of life (DOL) 30. She was thought to have medically refractory necrotizing enterocolitis (NEC), but was found, instead, to have perforated appendicitis during an exploratory laparotomy. A thorough literature search indicates she is the second youngest neonate to survive perforated appendicitis to date.

Sign in / Sign up

Export Citation Format

Share Document