1/7. Acute abdomen due to wandering spleen infarction: a case report.We report a rare clinical case of acute abdomen due to partial infarction of a wandering spleen in the pelvis in a 60-year-old woman. The patient was suffering from stabbing pain in the external lower quadrant of the abdomen, irradiating back to the lumbosacral area, together with an unremitting feverish state (38 degrees C), sickness and constipation. After carrying out serological examinations, which revealed an increase in CPK and leukocytosis, ultrasonography and CT examinations were performed, revealing a mass in the left iliac cavity, which in all probability was a wandering spleen with an abnormally long pedicle and a dyshomogeneous lower area bearing witness to a splenic infarction. The patient was therefore submitted to surgery consisting in splenectomy after lysis of the adherences, which were plainly inflammatory. A wandering spleen, especially when infarcted, is a very rare clinical condition that may be congenital or acquired. Its presence can be confirmed by serological, ultrasonographical and CT examinations and must be suspected when there is no clearly defined acute abdomen.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/7. Strangulated umbilical hernia including a mesenteric cyst: a rare cause of acute abdomen.Mesenteric cysts are rare intra-abdominal lesions. They are usually diagnosed as an incidental laparotomy finding in adults but in childhood, they may present with acute abdomen. In this report, a 72-year old female was referred to our hospital, suffering from acute abdominal pain, several episodes of nausea and vomiting. Clinical abdominal examination revealed an irreducible recurrent umbilical hernia. The patient had both muscular defense and abdominal tenderness. Plain abdominal radiography showed multiple air-fluid levels. With these findings, a diagnosis of acute abdominal pathology was accepted and an urgent laparotomy was performed. A 5-cm-diameter mesenteric cyst was excised from the mesentery of the proximal jejunum and a prosthetic mesh was placed for incisional hernia. This is the first report of a strangulated umbilical hernia complicated with a mesenteric cyst.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
3/7. Visceral larva migrans presenting as acute abdomen in a child.An unusual presentation of visceral larva migrans observed in a patient is reported. A 5-year-old boy suffering fever, abdominal pain, tenderness, and rigidity in the right lower and upper quadrant of the abdomen was operated on, with the false diagnosis of acute abdomen, and exploratory surgery was carried out. The pathological examination of the liver biopsy revealed eosinophil-rich necrotizing granulomatous inflammation with toxocara spp larva. The diagnosis was also confirmed by serologic results. Clinicians should remember that toxocaral visceral larva migrans may rarely mimic an acute abdomen and cause unnecessary operations.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
4/7. liver cell adenoma presenting as acute abdomen.A 31-year-old female presented with a sudden onset of acute abdominal pain in the right hypochondrium. Two days later, the patient was in shock and suffering from severe intra-abdominal bleeding. Investigations showed that the bleeding originated in the right lobe of the liver. The patient had been taking oral contraceptives for seven years. She underwent a laparotomy and right lobectomy of the liver which was performed successfully for bleeding cell adenoma. The patient made a full recovery.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
5/7. Acute abdomen masquerading as acute retention.Urologists should remain constantly alert for patients with acute abdominal emergencies who may be admitted under their care with the erroneous diagnosis of acute retention. These cases are not uncommon. The patients may be suffering from suppression of urine, or their inability to pass urine may be the predominant symptom of their intra-abdominal catastrophe. When catheterization has yielded only a small amount of concentrated urine and has failed to relieve the patient's discomfort, think of an acute abdomen, investigate this possibility and treat the patient accordingly.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
6/7. Localized eosinophilic gastroenteritis with necrotizing granulomas presenting as acute abdomen.Eosinophilic gastroenteritis is a condition of unknown aetiology that has been frequently reported involving the stomach and bowel. The colon is rarely cited as a site for the condition. We report a patient suffering from allergic symptoms (asthma, atopic dermatitis, elevated serum IgE levels) who presented with colonic perforation due to eosinophilic colitis with necrotizing granulomas.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
7/7. Lupus peritonitis mimicking acute surgical abdomen in a patient with systemic lupus erythematosus: report of a case.A 25-year-old Japanese woman who had been suffering from systemic lupus erythematosus (SLE) for 12 years was admitted to our hospital with a suspected diagnosis of peritonitis after suddenly developing severe abdominal pain and distention which could not be relieved by treatment with anodyne. Noninvasive examinations did not provide enough evidence to rule out acute appendicitis, bowel perforation, or ischemia due to vasculitis. Therefore, in consideration of the severity of her uncontrollable abdominal pain, an exploratory laparotomy was performed. The operative findings revealed nonbacterial peritonitis with a large amount of ascites and an edematous small bowel. No perforation of the intestine was found. On post-operative day (POD) 3, the severe abdominal pain redeveloped, but responded well to steroid pulse therapy. Based on the operative findings and her clinical course, the most likely diagnosis was thought to be acute lupus peritonitis. It is often difficult to ascertain whether abdominal pain in an SLE patients is due to lupus peritonitis or to an underlying cause requiring surgery. Thus, it is essential that continuous and careful assessment of the surgical abdomen is performed when a patient with SLE develops acute abdominal pain, and if a surgical condition cannot be ruled out, a laparotomy should be performed without delay.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |