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Cases reported "Ascites"

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121/691. Acute abdomen due to late retroperitoneal extravasation from a femoral venous catheter in a newborn.

    CONTEXT: The use of parenteral nutrition via a central venous catheter is a common practice in the neonatal intensive care setting. Extravasation of the infusate leading to an acute abdomen is a complication that has only rarely been documented. This report describes the case of a premature infant with a femoral catheter placed in the inferior vena cava, who developed an acute abdomen as a result of late retroperitoneal extravasation of parenteral nutrition. CASE REPORT: A pre-term infant receiving total parenteral nutrition via a femoral venous catheter developed an acute abdomen five days after the catheter placement. Extravascular catheter migration to the retroperitoneal space and extravasation of the infusate was diagnosed by contrast injection. Withdrawal of the catheter was followed by prompt cessation of the signs and full recovery from the acute abdomen, without the need for surgery. A review of the literature is presented, emphasizing the clinical and therapeutic aspects of this unusual complication from femoral venous catheterization and parenteral nutrition.
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122/691. Adnexal torsion presenting as an acute abdomen in a patient with bilateral cystic teratoma of the ovary.

    Benign cystic teratomas are the most common ovarian neoplasms in women. Teratomas are usually benign, unilateral, and most often found in young and premenopausal women. Most are 5 cm to 10 cm in diameter when diagnosed, and on sectioning, they usually contain thick sebaceous material, tangled hair, and various dermal structures. One of the major complications seen in cystic teratoma is torsion, a partial or complete twisting of the ovarian suspensary pedicle causing severe pain, nausea, and tissue necrosis. The patient described had bilateral cystic teratomas, one uncommonly large and torsed, causing an acute abdomen. Discussion includes the diagnosis, operative management, and postoperative findings.
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ranking = 0.57558139534884
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123/691. Abdominal surgical emergencies in the puerperium.

    Since surgical emergencies in the puerperium are rare, surgeons and obstetricians amass little experience of them. There may be considerable delay in making a diagnosis, firstly, because the abdominal symptoms are thought to be related to the pregnancy, and, secondly, because the signs are rarely convincing in contrast to the symptoms. Any of the common surgical emergencies may occur in pregnancy and the puerperium and there are some others that appear to be a particullar problem of the puerperium.
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ranking = 0.51162790697674
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124/691. Meckel's diverticulum perforation with intraabdominal hemorrhage.

    Perforation of Meckel's diverticulum in children is a rare and serious complication. The authors report a case of a 3-year-old boy with perforation and hemoperitoneum caused by Meckel's diverticulum. Difficulty of preoperative diagnosis is discussed, indication for incidental diverticulotomy is established, and the literature is reviewed.
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ranking = 0.33139534883721
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125/691. Torsion of the fallopian tube in an adolescent female: a case report.

    BACKGROUND: Torsion of the fallopian tube is an infrequent but significant cause of acute lower abdominal pain in adolescent females that is difficult to recognize preoperatively, although prompt diagnosis and timely surgical treatment are vital to salvage the oviduct. CASE REPORT: A 17-yr-old virgin presented with sudden and severe right-sided lower abdominal pain with guarding and tenderness, fever, nausea, and vomiting at mid-cycle. Ultrasound scan showed a right ovarian cyst measuring 3 cm in diameter and a normal appendix. There was no leucocytosis. Presumptive diagnosis was a cystic ovarian follicle with ovulatory pain. Her condition improved but did not resolve with supportive treatment. At laparotomy, the right fallopian tube was twisted completely, distended with blood, and necrotic, with a small fimbrial cyst. The left tube, ovaries, appendix, and uterus were normal. Right salpingectomy was performed. Histologic examination revealed diffuse hemorrhagic infarction of the tube and a cyst of the hydatid of Morgagni. She remains well at follow-up. CONCLUSION: Unless a high index of suspicion is maintained for torsion of the fallopian tube in adolescent females, this disorder may not be detected until after tubal destruction.
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ranking = 0.78488372093023
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126/691. Fatal granulomatous disease of childhood: presenting as acute abdomen.

    Fatal granulomatous disease of childhood is a rare disorder of phagocytic function. We report a 6-year-old boy who presented with acute abdomen. The diagnosis was established by mesenteric lymph node biopsy obtained at laparotomy. The boy succumbed within hours of surgery.
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ranking = 0.27325581395349
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127/691. Delayed splenic rupture: an unusual cause of acute surgical abdomen.

    Authors describe an unusual case of acute abdomen after the traffic injury. They remind correct diagnosis of delayed splenic rupture and compare it with other literature findings.
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ranking = 0.26744186046512
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128/691. Peritoneal implanted hepatocellular carcinoma with rupture after TACE presented as acute appendicitis.

    We are reporting a rare case of peritoneal implanted hepatocellular carcinoma with rupture after transarterial chemoembolization mimicking acute appendicitis. A 45-year-old male patient presented with fever and manifestations of acute appendicitis. He received transarterial chemoembolization for hepatocellular carcinoma two months before. Emergent exploratory laparotomy revealed a normal appendix, a ruptured nodule located at the serosal surface of the terminal ileum with hemoperitoneum, and ruptured hepatocellular carcinoma at the junction of segments 4 and 8 of the liver. There was no peritoneal carcinomatosis, direct invasion to the surrounding tissue, or lymph node involvement. Postoperative course was uneventful. Histopathological examination of the resected nodule revealed metastatic hepatocellular carcinoma.
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ranking = 0.81976744186047
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129/691. Gall stone: a rare cause of acute abdomen in a seven years old girl.

    Jamila Khatun a seven years old girl from Shurjunagar, Rajbari, presented with acute pain in the right side of her abdomen. blood test was normal except mild elevation of serum bilirubin. Chest X-ray reveals no fluid level & no gas under the dome of diaphragm. Ultrasonogram of the abdomen reveled multiple stone in the gallbladder.
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ranking = 0.38372093023256
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130/691. Fulminant ischaemic colitis with atypical clinical features complicating sickle cell disease.

    Clinically significant ischaemic bowel injury is an exceedingly rare complication of sickle cell disease. It manifests as acute surgical abdomen and may respond to conservative treatment. An unusual fatal case of ischaemic colitis with minimal abdominal findings in a young male during a sickle cell vaso-occlusive pain crisis is described. This case demonstrates that an acute surgical abdomen should be considered in such patients who fail to respond to conservative management as untreated this condition may be fatal.
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ranking = 0.41279069767442
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Last update: April 2009
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