11/136. Primary segmental infarction of the greater omentum: a rare cause of RLQ syndrome: laparoscopic resection.The authors report a rare case of a patient with a primary segmental infarction of the greater omentum who reported acute abdominal pain. Despite preoperative clinical studies and imaging evaluation, an etiologic diagnosis could not be determined. The diagnosis of this uncommon disease was determined after initial laparoscopic exploration. A laparoscopic resection was performed. The patient had an uneventful recovery and was discharged within 12 hours. The differential diagnosis of the right lower quadrant syndrome includes several disorders, of which the primary segmental infarction of the greater omentum is not frequent. The authors emphasize the usefulness of routine laparoscopic exploration in patients with RLQ syndrome because it adds the possibility of mini-invasive treatment to the initial diagnosis.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
12/136. 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 = disease (Clic here for more details about this article) |
13/136. Recurrent haemoperitoneum in a mild von Willebrand's disease combined with a storage pool deficit.Haemoperitoneum secondary to haemorrhagic corpus luteum has been described in severe bleeding disorders such as afibrinogenaemia, type 3 von Willebrand's disease and patients under oral anticoagulation. We have studied one patient who presented three episodes of severe bleeding at ovulation, requiring surgery twice, with the diagnosis of mild von Willebrand's disease and mild storage pool deficiency. Mild von Willebrand's disease (associated with other thrombopathies or coagulopathies) should be considered in this pathology, although physicians would prefer to find a severe haemorrhagic disorder as the underlying condition in these cases.- - - - - - - - - - ranking = 7keywords = disease (Clic here for more details about this article) |
14/136. Synchronous first manifestation of an idiopathic eosinophilic gastroenteritis and bronchial asthma.Eosinophilic gastroenteritis is a rare disease of the gastrointestinal tract in which the eosinophils seem to play an important role in the inflammation of the gut wall. We report on a case with a synchronous first manifestation of eosinophilic gastroenteritis and bronchial asthma, which also occurred synchronously in all further episodes. The diagnosis was first made at the end of the second episode during which the patient lost more than 13 kg in weight. Under steroid therapy, symptoms of both diseases disappeared quickly in the third episode. We assume that participation of the gastrointestinal tract in patients with bronchial asthma occurs more frequently than expected. In asthma patients with abdominal symptomatology, eosinophilic gastroenteritis should also be considered.- - - - - - - - - - ranking = 2keywords = disease (Clic here for more details about this article) |
15/136. Antiretroviral-induced hepatic steatosis and lactic acidosis: case report and review of the literature.As the prevalence of human immunodeficiency virus (hiv) infection continues to rise the clinician is encountered with a diagnostic challenge. Nonsurgical diseases such as acute colitis or enteritis can appear similar to such true surgical emergencies as abscess, perforation, or mesenteric ischemia. We report a case of fulminant hepatic failure associated with didanosine and masquerading as a surgical abdomen and compare the clinical, biologic, histologic, and ultrastructural findings with reports described previously. This entity should be kept in mind when evaluating the acute abdomen in the hiv-positive patient.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
16/136. A preventable cause of acute abdomen.Haemoperitoneum is an extremely rare presentation of hepatocellular carcinoma in the industrialised world. We present the first reported case in the UK. In contrast, up to 10% of hepatocellular carcinomas in africa present in this way, the median time between presentation and death being just six weeks. hepatitis b infection at birth and during childhood is the major cause of hepatocellular carcinoma in the developing world. The world health Organisation, UNICEF and the World Bank have all advocated routine hepatitis b vaccination of children. This can reduce the burden of disease in these communities, among people in their productive years of life.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
17/136. capnocytophaga canimorsus sepsis presenting as an acute abdomen in an asplenic patient.Acute abdominal symptoms are frequently caused by surgical intra-abdominal problems. However, the differential diagnosis also includes several internal diseases. Overwhelming infections may present with acute abdominal signs, particularly in the immunocompromised host. Asplenic patients are highly susceptible to infections with encapsulated bacteria such as streptococcus pneumoniae, haemophilus influenzae and neisseria meningitidis. Severe infections due to capnocytophaga canimorsus (DF2), are also common in this group. C. canimorsus is a Gram-negative rod, present as a commensal organism in cat and dog saliva. We describe the atypical presentation of a fatal C. canimorsus-sepsis in a 46-year-old man, who underwent traumatic splenectomy two decades earlier.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
18/136. Eosinophilic gastroenteritis: our recent experience: one-year experience of atypical onset of an uncommon disease.Eosinophilic gastroenteritis is an unusual entity that is rarely found in daily clinical practise. Its aetiology is unknown and diagnosis can be made microscopically with evidence of massive eosinophilic infiltration in patients with chronic gastrointestinal symptoms, excluding entities that may cause such findings (parasitic infestation, medical therapy, inflammatory bowel disease, and so on). Allergic processes are usually associated and these normally respond well to steroids. We present our last year's experience of four women with eosinophilic gastroenteritis with an extraordinary atypical clinical onset. Two of the women presented with an acute abdomen and two with isolated colonic involvement. The management of acute abdomen avoiding surgery and a complete response with azathioprine are the outstanding variables that make our recent cases of special interest. Demographic variables were similar to others reported from our medium, with the exception of a higher incidence of women. Our cases suggest the wide spectrum of clinical presentations and show the high suspicion index needed for a diagnosis that is made by pathologists.- - - - - - - - - - ranking = 5keywords = disease (Clic here for more details about this article) |
19/136. Ruptured granulosa cell tumor of the left ovary and mature cystic teratoma of the right ovary: a case report of unusual acute abdominal syndrome.Although granulosa cell tumor combined with a dermoid cyst in the same ovary is rarely seen, adult granulosa cell tumor of the ovary with contralateral teratoma has not been reported to date. In this report we present the first case in the English language literature of a ruptured granulosa cell tumor of the left ovary and mature cystic teratoma of the right ovary presenting as acute abdominal syndrome. The patient underwent total abdominal hysterectomy, bilateral-ophorectomy, and multiple pelvic lymph node sampling and infracolic omentectomy. She received combined chemotherapy consisting of bleomycin, etoposide. and cisplatin for six cycles. Subsequent follow-up and workups have revealed no evidence of disease. At 19 months after initial diagnosis, she is disease-free.- - - - - - - - - - ranking = 2keywords = disease (Clic here for more details about this article) |
20/136. Perforation peritonitis in primary intestinal tuberculosis.Primary intestinal tuberculosis is unusual in European and North American countries today. Its diagnosis is often surprising and differentiation from inflammatory bowel diseases is difficult. The authors present a rare case of severe stercoral peritonitis caused by multiple intestinal perforations in a patient with primary ileocecal tuberculosis. Initial clinical and laboratory investigations led to the suspicion of inflammatory bowel disease. The subsequent diagnostic workup included colonoscopic examination of the cecal and terminal region of the ileum with multiple biopsies. After the pathologist had assessed the specimen as indicating Crohn's disease, appropriate therapy was initiated. Several days later, however, the patient was readmitted to a surgical intensive care unit with clinical signs of peritonitis and immediately operated on. The final diagnosis from a resection specimen confirmed the diagnosis of primary intestinal tuberculosis. The follow-up was complicated by a subhepatic abscess formation with the necessity for surgical drainage. The patient's recovery was uneventful, she underwent intensive antituberculotic therapy and is asymptomatic at present. Surgeons caring for patients with acute abdomen should be aware of tuberculous perforation peritonitis even in non-risk groups of patients.- - - - - - - - - - ranking = 3keywords = disease (Clic here for more details about this article) |
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