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Author(s):  
A. I. Кoushnerou ◽  
I. A. Hadji-Ismail ◽  
A. V. Vorobei ◽  
S. I. Rudenka

Aim. A definition and systematisation of sigmoid diverticulitis semiotics in a comprehensive ultrasonic check-up for early illness diagnosis.Materials and methods. Ultrasound examination data on 64 patients with sigmoid diverticulum have been analysed. The primary visit reason was recurrent varying-intensity pain in left abdominal quadrant, unstable stool and flatulence. The patients were 28 (43.75%) men and 36 (56.25%) women aged 38–85 years, mean age 55.6 years; 31 (48.44%) were diagnosed with diverticulitis. We used the HD15 (Philips, the Netherlands), HS 60 (Samsung, South Korea) and Hi Vision Preirus (Hitachi, Japan) ultrasound instruments equipped with convex and intracavitary microconvex 2–12 MHz linear transducers. Patients were examined on an empty stomach and unprepared intestine. Colon and rectum were explored at different approaches, transabdominally, transperineally, transrectally and transvaginallyResults. The findings laid out a more elaborated ultrasound semiotics of diverticulitis. Ultrasound check-up enables a reliable estimation of blood supply and peristalsis, colonic wall thickness and layers, presence of asymptomatic diverticula, signs of acute diverticulitis (pain on sensor touch, mesocolic tissue infiltration, presence of faecal calculi and gas in diverticulum, peridiverticulitis) and other complications of diverticular disease (fistulae, abscess or peritonitis), as well as a consistent differential instrumental diagnosis of other organ illnesses.Conclusion. Ultrasound is an indispensable supplement in clinical diagnosis of diverticula, diverticulitis and their complications in the cases when other methods like X-ray, CT or colonoscopy are contraindicated.


2021 ◽  
Vol 14 (12) ◽  
pp. e246681
Author(s):  
Orlando De Jesus ◽  
Christian Rios-Vicil ◽  
Joel E Pellot Cestero ◽  
Eric F Carro-Figueroa

The formation of an intraperitoneal pseudocyst as a complication of ventriculoperitoneal shunts is well known. However, the formation of a pseudocyst at the subcutaneous extraperitoneal abdominal space is unusual and likely secondary to the migration of the peritoneal catheter. We present a 53-year-old male who had placement of a ventriculoperitoneal shunt for hydrocephalus secondary to a vestibular schwannoma. Five months later, he presented with an enormously distended abdomen. Investigations showed the peritoneal catheter in the extraperitoneal space within a large right lower quadrant abdominal wall pseudocyst. The patient was taken to the operating theatre, and the shunt was externalised at the original abdominal incision. Approximately 3 L of cerebrospinal fluid were aspirated from the distal peritoneal catheter. After negative cultures, a new peritoneal catheter was placed intraperitoneally at the contralateral lower abdominal quadrant. The contralateral quadrant was utilised to prevent fluid accumulation into the old extraperitoneal cavity.


Author(s):  
Alexandr Bronstein ◽  
Svetlana Burova ◽  
Nikolay Malishev ◽  
Irina Davidova

Acute stages of parasitic diseases are rare diagnosed and therefore, clinicians have limited knowledge of their clinical features. We describe five autochtnonous acute cases of opisthorchiasis in Moscow region acquired from eating raw ides (L. idus). The most frequent clinical symptoms were febrile, eosinophilic syndrome with cholestasis. The patients were positive for IgG antibodies to O.felineus . Eggs of O.felineus were found in one patient. As egg production O.felineus starts 1 month after exposure and opisthorchiasis cases in Moscow region have low numbers of worms, the sensitivity of microscopy is low. Therefore we consider opisthorchiasis in all patients of unexplained acute fever, pain in upper right abdominal quadrant, and eosinophilia with cholestasis, when patients confirm the ingestion of raw fish. We recommend one day of praziquantel 25 mg/kg TID to patients infected with O.felineus. In previous publications describing the autochtnonous cases of opisthorchiasis in Moscow region the authors supposed that cases of local infection will be found again in Moscow region, and this is just a matter of time. The cases reported here confirm that this infection is endemic in Moscow region. The local people living close to rivers especially those who eat raw fish are at risk of infection O. felineus. There is a clear need to undertake special studies pertaining to the ways of promoting people living in Moscow region become aware of opisthorchiasis and to be motivated in preventive measures and treatment.


2021 ◽  
Vol 10 ◽  
pp. 38
Author(s):  
Samira Sinacer ◽  
Bilal Zakaria Semari ◽  
Soumia Khemari ◽  
Ahlem Kharchi ◽  
Assia Haif ◽  
...  

Background: Spigelian hernia (SH) is a rare entity characterized by a defect of the anterior abdominal wall located along the Spigelian line, it may be congenital or acquired.Association with other anomalies is worth reporting. Case Presentation: A 22-day-old male newborn was admitted with strangulated right inguinal hernia and operated on emergently. Clinical examination also revealed a Spigelian hernia in the left lower abdominal quadrant with bilateral cryptorchidism, associated with polydactyly of the small right finger and anal stenosis. At surgery, the SH contained a part of the small intestine and the ipsilateral undescended testis. Conclusion: Pediatric SH is rare, but its association with undescended ipsilateral testis is frequent. Other abnormalities can be concomitant to this association.


Author(s):  
Muhammed Ihsan Muhammad ◽  
Abdullah Hasem Alhassan ◽  
Abdulmohsen Yaseer Alkhars ◽  
Rayan Abdulkhaliq Alzahrani ◽  
Mohammed Hamad Al Mansour ◽  
...  

Post-cholecystectomy syndrome is suspected when the patients complain about the persistent presence of pain in the right upper abdominal quadrant. Other symptoms might appear which are related to the gastrointestinal tract. These symptoms appear after performing cholecystectomy. The manifestations are usually similar to those experienced before the procedure. In this study, the aim to conduct a literature review to increase the knowledge and to explore facts related to the clinical patterns and causes of post-cholecystectomy syndrome. The most commonly reported cause of this syndrome is the prior development of an extra-biliary disorder, which includes many modalities as peptic ulcer, reflux esophagitis, chronic pancreatitis, irritable bowel syndrome, and biliary-related disorders. However, the etiology of postcholecystectomy is hugely variable across the different studies in the literature. Patients that develop postcholecystectomy syndrome usually present with non-specific gastrointestinal symptoms that may or may not be similar to the symptoms that were exhibited before conducting the surgery. Some of the common physiological changes that have been reported with postcholecystectomy syndrome include the disruption of cholecysto-antral reflex, the cholecystosphincter of oddi reflex, and the cholecysto-esophageal related reflexes. In addition, the development of other changes that can significantly affect the normal physiology of the gastrointestinal tract leads to the development of significant symptoms and clinical patterns.


2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110212
Author(s):  
Yu Sun ◽  
Guangyu Jin

Primary squamous cell carcinoma of the liver is extremely rare, very difficult to diagnose, and carries an extremely poor prognosis. In this study, we discuss the imaging features of a patient with primary hepatic squamous cell carcinoma. The patient was admitted to hospital owing to discomfort in the right upper abdominal quadrant and a loss of appetite. He had no previous risk factors associated with hepatic squamous cell carcinoma and no history of systemic squamous cell carcinoma. We diagnosed primary hepatic squamous cell carcinoma by pathological analysis. Primary hepatic squamous cell carcinoma is rare, and its histological features are controversial, which makes the clinical and imaging diagnosis difficult. Therefore, it is urgent to improve the understanding of this disease in clinical practice to avoid misdiagnosis, and to identify the best treatment. This case provides a basis for the clinical diagnosis of primary hepatic squamous cell carcinoma.


2021 ◽  
Vol 14 (4) ◽  
pp. e240634
Author(s):  
Andrew Webster ◽  
Rishabh Singh ◽  
John Stebbing

We report the case of a 48-year-old man with spina bifida and history of previous ventriculoperitoneal (VP) shunt placement for hydrocephalus. On attempted removal of the shunt 2 years prior to presentation at a neurosurgical unit, the peritoneal component was left in situ due to difficulties with removal. He presented acutely to our general surgical department with an enterocutaneous fistula precipitated by the retained fragment discharging to the right upper abdominal quadrant that required urgent surgical intervention. Although abdominal complications of VP shunts are documented, there is minimal literature as to the risks of remnant catheters being left in situ. This case demonstrates the possible risks with retained VP shunt catheters and the necessity to remove any redundant foreign bodies to prevent significant delayed complications.


2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Marie Burgard ◽  
Floryn Cherbanyk ◽  
François Pugin ◽  
Bernhard Egger

Symptomatic Meckel’s diverticulum is rare in adults. The most frequent complications are intestinal obstruction and diverticulitis. Diagnosis of Meckel’s diverticulitis can be challenging due to nonspecific clinical manifestation of pain in the right lower abdominal quadrant, mimicking acute appendicitis. If associated with congenital malformation, such as intestinal malrotation, the anomalous anatomy makes the diagnosis even more challenging. In such cases, radiological imaging is essential to guide further management. We present a case of Meckel’s diverticulitis in which physicians were initially misguided because of the atypical clinical presentation. Yet, anamnestic details directed to a potential underlying malformation, leading to supplementary radiological examination and the final diagnosis.


2020 ◽  
Vol 3 (1) ◽  
pp. 30-32
Author(s):  
Andreea Neculcea ◽  
Andreea Spînu ◽  
Diana Cisleanu ◽  
Anca Nicolescu ◽  
Cristina Enache ◽  
...  

We present the case of a 46-year-old male patient who came to our emergency department in December 2019 for pain in the left abdominal quadrant. The patient had no fever, night sweats or a history of weight loss. The la­bo­ra­tory tests revealed important leucocytosis and the ab­do­mi­nal ul­tra­sound highlighted a massive sple­no­me­ga­ly. He was hos­pi­ta­lized for further investi­ga­tions. We performed all the necessary laboratory tests to establish the diagnosis of the patient. Even though the osteomedullar biopsy and the flow cytometry suggested the diagnosis of acute B-cell lymphoblastic leukemia, the fluorescence in situ hybri­di­za­tion exam – the translocation t(9;22) was present in 100% of the analyzed cells – and the detection of BCR-ABL1 b2a2 trans­cript established the diagnosis of chronic myeloid leu­ke­mia, B-cell lymphoblastic crisis. We decided to start the treat­ment with the GRAAPH 2005 pro­to­col associated with ima­ti­nib, and the patient was a candidate for allogeneic trans­plan­ta­tion. We chose to pre­sent this case because the pa­tient was young, without sig­ni­fi­cant comorbidities, with chronic myeloid leukemia – B-cell lymphoblastic crisis as the initial diagnosis, whose evo­lu­tion was negative, despite his favorable prognosis.


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