1/9. Acute abdomen as an atypical presentation of meningococcal septicaemia.The clinical manifestations and course of meningococcal disease have been well described, but atypical presentations may, if unrecognized, lead to a delay in treatment. We describe here an unusual case of this disease in a 21-y-old woman who presented with an acute rigid abdomen, clinical and laboratory features of sepsis, shock and early DIC with no indication of meningococcal infection. She developed a rapidly spreading purpuric rash, conjunctival haemorrhages, hypotension and tachycardia and a low urine output. Laboratory investigations showed a low platelet count, low haemoglobin and normal WBC. A presumptive diagnosis of meningococcal septicaemia was made and recovery followed treatment with cefotaxime, fluids and inotropes. A fully sensitive neisseria meningitis Group C, type 2a, subtype NT was isolated from blood cultures, but not from CSF obtained after antibiotic treatment.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/9. Intramural haemorrhage of the colon.Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a 69-year-old Caucasian woman with a haemorrhage in the colonic splenic flexure and descending colon. Both had a one-stage resection with anastomosis. The child survived; the woman died two days after the operation. The preoperative diagnosis of bleeding colonic lesions remains difficult especially when facilities for investigation are scarce. It is re-emphasized that in patients with acute abdomen it is not necessary to insist on accurate preoperative diagnosis before offering appropriate treatment.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
3/9. A case of "silent" pheochromocytoma presenting as spontaneous retroperitoneal hematoma.pheochromocytoma of the adrenal gland can be the cause of massive and lethal retroperitoneal haemorrhage presenting as acute abdomen. Here we report a case of retroperitoneal hematoma, with concomitant peritoneal spillage, due to the spontaneous rupture of a silent pheochromocytoma. The main clinical findings of this disease will be described. Therapy and prognosis will be also discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/9. Rectus sheath hematoma in an elderly woman under anti-coagulant therapy.Rectal sheath hematoma has been a well-known clinical entity from the ruin of the ancient greece. It is relatively rare, however, to encounter this abdominal disorder in the clinical setting. Furthermore, the initial symptoms of rectus sheath hematoma are often similar to those of acute abdominal disorders. Therefore, the majority of the patients with rectus sheath hematoma have been treated with operative procedures because of the difficulty of a differential diagnosis from other abdominal disorders. We recently treated a 74-year female diagnosed with rectus sheath hematoma with the anticoagulants after an episode of cerebral infarction. From the findings of the physical examinations, ultrasound, and computed tomography, we could correctly diagnose, and could treat her with completely conservative methods without any invasive techniques. It is stressed that it is important to recognize this entity of rectus sheath hematoma when patients are examined, after complaining of acute abdominal pain and with evidence abdominal masses in the clinical setting.- - - - - - - - - - ranking = 22.480578736305keywords = cerebral (Clic here for more details about this article) |
5/9. Acute myeloid leukemia presenting as splenic rupture.We describe a rare case of acute myeloid leukemia presenting primarily as an acute abdomen due to spontaneous splenic rupture in a 19 years male patient. He was treated with splenectomy after failure of conservative management for splenic preservation but later succumbed to an intracerebral haemorrhage.- - - - - - - - - - ranking = 49.296121587746keywords = intracerebral haemorrhage, cerebral, haemorrhage, intracerebral (Clic here for more details about this article) |
6/9. focal nodular hyperplasia presenting as acute abdomen.focal nodular hyperplasia (FNH) is a benign liver tumour with an asymptomatic course, rarely causing complications. When the diagnosis is certain, only watchful observation is necessary. We highlight an interesting case of a 42-year-old woman with a FNH that ruptured and became haemorrhagic, thus presenting as an acute surgical abdomen. The diagnosis was only established after surgical resection with histopathological confirmation. Although haemorrhage of hepatic FNH is extremely rare, this case highlights the small risk of rupture in large lesions.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/9. Tension pneumoperitoneum.A 26-year-old woman developed the adult respiratory distress syndrome after a post-partum haemorrhage. After mechanical ventilation was started the signs of a tense and distended acute abdomen developed. The aspiration and subsequent analysis of copious intra-peritoneal gas confirmed the diagnosis of a tension pneumoperitoneum secondary to pulmonary barotrauma.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/9. Spontaneous rupture of the kidney.Two cases of spontaneous rupture of the kidney manifesting as acute abdomen are described. In both cases urgent transabdominal nephrectomy was carried out. The whole distal half of the kidney was tumorous and rupture, with extensive perirenal and retroperitoneal haemorrhage. Histological findings showed in the first instance renal liposarcoma, in the second instance an atypical lipoma of the kidney. The first patient survives 4 years, the second one year, after the operation both are in a good condition.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
9/9. Acute presentation of tuberous sclerosis: case report.Incomplete form of tuberous sclerosis (TS) may present with acute complications such as haematuria, retroperitoneal haemorrhage or pneumothorax. Such cases may pose diagnostic difficulty. A patient with incomplete form of TS without any cerebral impairment who presented as an acute surgical abdomen is reported. The diagnostic criteria of TS are reviewed. Visceral manifestations of TS including acute complications are discussed. The importance of recognising such presentations is stressed.- - - - - - - - - - ranking = 23.480578736305keywords = cerebral, haemorrhage (Clic here for more details about this article) |