11/48. Juvenile dermatomyositis complicated with vasculitis and duodenal perforation.Duodenal perforation has been reported in patients taking steroids and non-steroidal anti-inflammatory drugs (NSAIDs). However, its association with juvenile dermatomyositis is extremely rare. A 4-year-old boy with dermatomyositis presented with intractable abdominal pain which was aggravated after steroid and NSAID therapies. A widespread retroperitoneal abscess was noted on abdominal computerized tomography. An emergency operation showed an ulcer and perforation at the junction of the third and fourth portions of the duodenum. debridement of the necrotic tissue and repair of the perforation were performed. The postoperative course was complicated by an anastomotic leak, which was corrected by reanastomosis. In addition to intestinal vasculitis, duodenal vasculitis complicated with ulcers and perforation should be included in the differential diagnosis of a child with juvenile dermatomyositis presenting with abdominal complaints.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
12/48. Tumour of the diaphragm mimicking liver lesion.Tumours of the diaphragm bordering the liver may impose diagnostic difficulties. We report the case of a 46-year-old patient diagnosed with a tumour of the liver based on ultrasound and CT. MRI of the liver depicted a tumour growing from the chest wall towards the liver. Surgery revealed the rare entity of a malignant fibrous histiocytoma of the diaphragm.- - - - - - - - - - ranking = 0.00058655762227112keywords = chest (Clic here for more details about this article) |
13/48. burkholderia pseudomallei: abscess in an unusual site.melioidosis is an infection caused by burkholderia pseudomallei. It is an important human pathogen in tropical area. The clinical manifestations are protean and multisystem involvement. We report an unusual case of melioidosis with abscess at root of mesentery in an elderly, non-insulin dependent diabetic Thai women. She presented with prolonged fever and chronic abdominal pain. The early clinical diagnosis was carcinomatous mass with peritonitis. Diagnosis of melioidosis arose from the surgical finding and pus culture. Treatment with surgical drainage and ceftazidime followed by co-trimoxazole plus doxycycline had a good clinical outcome.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
14/48. choriocarcinoma with diffuse intraabdominal abscess and disseminated intravascular coagulation. A case report.BACKGROUND: Management of choriocarcinoma complicated by diffused intraabdominal abscess is difficult, especially when disseminated intravascular coagulation (DIC) ensues. CASE: A 29-year-old woman presented with massive vaginal bleeding, fever and severe abdominal pain. choriocarcinoma with pulmonary and vaginal metastases was diagnosed along with diffused intraabdominal abscess. hysterectomy and hypogastric artery ligation were performed after the fever and abdominal symptoms failed to respond to intravenous antibiotics. Although the patient developed DIC after surgery, transfusion, antibiotics and immediate combination chemotherapy improved her condition and controlled the malignancy. She was free of disease for > 20 months after treatment. CONCLUSION: Timely surgery, aggressive antibiotics and immediate postoperative chemotherapy are recommended for patients with choriocarcinoma complicated by intraabdominal abscess and DIC.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
15/48. Severe low back pain due to retroperitoneal abscess formation in diabetic patients.We report two cases of diabetic patients with severe low back pain associated with retroperitoneal abscesses. In the first case, multiple retroperitoneal and spinal epidural abscesses were detected. paraplegia due to the spinal epidural abscess was not relieved by drainage of the abscess and subsequent antibiotic therapy. In the second case, drainage of the retroperitoneal abscess and antibiotics were immediately started, resulting in successful recovery. Thus, we suggest that if a diabetic patient complains of low back pain, potential abscess formations should be considered and given appropriate treatment before administering epidural anesthetic injections for pain relief.- - - - - - - - - - ranking = 0.042771232167403keywords = back (Clic here for more details about this article) |
16/48. Lumbar artery pseudoaneurysm in traumatic spinal cord injury: a case report.Lumbar artery pseudoaneurysm is a rare vascular complication of trauma. This case report concerns a 24-year-old man with a lumbar-level spinal cord injury (SCI) secondary to a gunshot wound who developed severe exacerbation of low back and flank pain during inpatient rehabilitation. Diagnostic investigations at an acute care hospital revealed a left lumbar artery pseudoaneurysm. This was treated by transcatheter embolization, which resulted in a marked reduction in pain. The patient resumed inpatient rehabilitation without further complications. This case report highlights the importance of early diagnosis of lumbar artery pseudoaneurysm, a potentially fatal complication that can occur in patients with traumatic lumbosacral SCI. Physiatrists should include lumbar artery pseudoaneurysm in the differential diagnosis for back, flank, or abdominal pain in this patient population.- - - - - - - - - - ranking = 1.0142570773891keywords = abdominal pain, back (Clic here for more details about this article) |
17/48. Ruptured renal microaneurysms complicated with a retroperitoneal abscess for a patient with systemic lupus erythematosus.renal artery aneurysm is extremely rare among patients with systemic lupus erythematosus.(SLE). Herein, we report on a 22-year-old male lupus patient who presented with acute abdominal pain, anemia and subsequent hypertension. Abdominal computed tomography revealed a peri-renal hematoma over the right kidney. A renal angiography revealed bilateral renal microaneurysms. The patient subsequently developed a right-side retroperitoneal abscess 4 weeks after hematoma formation and received an emergent laparotomy with drainage. Subsequent culture ofthe abscess-derived fluid revealed the presence of proteus mirabilis and escherichia coli. Following appropriate antipyretic and immunosuppressive drugs therapy, the patient recovered successfully. To the best of our knowledge, this is the first report of SLE associated with a retro-peritoneal abscess probably secondary to a ruptured renal microaneurysm.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
18/48. Falciform ligament abscess: report of a case.Falciform ligament abscess is rare. We report a case of a 65-year-old man who presented with right upper quadrant abdominal pain, postprandial fullness, and fever. Computed tomography disclosed a cylindrical mass in the anterior abdomen that aroused suspicion of a hepatic abscess. At laparoscopic surgery, an abscess of the falciform ligament was found and drained. Two months later, the patient developed recurrence of the abscess secondary to acute calculous cholecystitis. Abscess drainage and cholecystectomy were performed. The presence of right uppper quadrant abdominal pain, epigastric tenderness, fever, leukocytosis, and a mass in the anterior abdomen should arouse suspicion of falciform ligament abscess. Its treatment consists of abscess drainage.- - - - - - - - - - ranking = 2.0041799747189keywords = abdominal pain, upper (Clic here for more details about this article) |
19/48. Normolipemic plane xanthoma associated with adenocarcinoma and severe itch.Normolipemic plane xanthomas are yellow-red-colored flat patches or plaques with barely palpable borders, under normolipemic conditions usually involving the eyelids, the lateral sides of the neck, the upper aspect of the trunk, or the flexural folds. Histologically the lesions are characterized by an infiltrate consisting of foamy macrophages in the papillary and middermis with a distinct perivascular localization. Plane xanthoma has been associated with monoclonal gammopathy, cryoglobulinemia, and myeloproliferative disorders. We present a patient in whom plane xanthoma developed on the upper aspect of the back, which was accompanied by severe itch in the affected area. These symptoms started 1 month after resection of an adenocarcinoma of the rectum that was complicated by recurrent abdominal abscesses and, currently, by ongoing inflammatory bowel disease. A hypothetic pathophysiologic scheme of events leading to xanthoma formation in this patient is presented.- - - - - - - - - - ranking = 0.015488488132335keywords = back, upper (Clic here for more details about this article) |
20/48. Mycotic abdominal aortic pseudoaneurysm caused by a penetrating atherosclerotic ulcer: report of a case.We report a case of mycotic abdominal aortic pseudoaneurysm caused by a penetrating atherosclerotic ulcer (PAU). An 81-year-old woman was admitted to a local hospital with fever and abdominal pain, and when her symptoms were not improved by antibiotics, she was referred to our department. Computed tomography (CT) and angiography showed a saccular aneurysm below the renal arteries, and an emergency laparotomy was performed because we suspected a mycotic abdominal aortic pseudoaneurysm. An abscess was found on the proximal side of the jejunum, caused by an aneurysm penetrating the serosa. We diagnosed a mycotic pseudoaneurysm after finding the anterior wall of the aorta penetrated by intense calcification. The pseudoaneurysm was resected with the abscess and the area was covered with a pedicled omental flap to prevent infection. An axillofemoral bypass was also done. The patient recovered well.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
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