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Cases reported "Goiter, Nodular"

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11/48. pheochromocytoma presenting as an abdominal emergency: association with perforation of the colon.

    A pheochromocytoma is a rare tumor derived from the adrenal medulla (or from chromaffin cells of sympathetic ganglia). Its symptoms derive mostly from the excessive release of catecholamines (adrenaline and noradrenaline). hypertension is the most recognized feature of this disease, but gastrointestinal manifestations can on rare occasions be just as serious and life threatening. This report describes a rare case of a 70-year-old woman with pheochromocytoma who developed an acute abdominal emergency with shock and panperitonitis as a result of perforation of the descending colon which was effectively treated by surgical removal of the tumor and the perforated colon. There have been 2 such cases in the English literature in whom a pheochromocytoma was associated with perforation of the colon. Successful surgical removal of such a pheochromocytoma has been not reported previously. Our case demonstrates the importance of recognizing that a pheochromocytoma presents with a wide spectrum of manifestations, and rapid treatment brings improvement to the patient.
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ranking = 1
keywords = cell
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12/48. 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 = 8
keywords = cell
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13/48. 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 = 6
keywords = cell
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14/48. Cutaneous squamous carcinoma leading to acute abdomen after renal transplantation.

    skin carcinoma is the commonest malignant complication of renal transplantation. We report the first case of a renal transplant recipient who presented with ileal obstruction as a consequence of squamous cell carcinoma metastases to the small intestine. This complication highlights the unusual presentation of malignancies associated with prolonged exposure to immunosuppression and the need for extra vigilance in such cases.
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ranking = 1
keywords = cell
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15/48. Ruptured ovarian granulosa cell tumors as a cause of the acute abdomen.

    A rare case of acute abdomen syndrome due to a ruptured ovarian tumor and a penetrated fallopian tube is described. Based on the intraoperative finding and patient's age, a right-sided salpingo-oophorectomy, appendectomy and peritoneal washings were performed. After a histological diagnosis of malignant granulosa cell tumors and FIGO IIA clinical classification, the patient returned 1 month after the procedure. A relaparotomy with a hysterectomy, left-sided salpingo-oophorectomy and omentectomy were then performed. No spread was found during the laparotomy, and the histologic diagnosis pointed to adenomyosis and chronic cervicitis. The patient regularly presents for control examination, and has now been free for 11 years since the surgery from clinical, biochemical or ultrasonographic signs of a relapse of the disease.
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ranking = 5
keywords = cell
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16/48. Acute abdomen due to brucella melitensis.

    A case of acute abdomen caused by a brucella melitensis is reported. The patient presented with biliary involvement in the form of acute acalculous cholecystitis and developed acute appendicitis that resulted in his surgical treatment.
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ranking = 5
keywords = cell
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17/48. Small intestinal angiosarcoma leading to perforation and acute abdomen: a case report and review of the literature.

    A 76-year-old man presented to the emergency room with abdominal pain and fatigue. The patient had a history of gastrointestinal bleeding. An abdominal computed tomographic scan showed collections of free air in the abdomen with obstruction of the distal small intestine and multiple masses in the liver. laparotomy revealed a widespread malignant neoplasm in the abdomen, with multiple tumor nodules in the ileal wall, mesentery, and liver. The ileal wall was perforated within the area of one of the tumors. Pathologic examination of the lesion showed a neoplasm composed of solid sheets of spindle and undifferentiated cells, forming interlacing delicate vascular channels with atypical endothelial cells. The tumor cells were positive for the endothelial marker CD31, whereas reactivity for a broad panel of epithelial and other endothelial markers was negative. This case demonstrates that although angiosarcomas of the gastrointestinal tract are rare, they should be considered in cases of intestinal perforation or severe bleeding, especially in the elderly. A broad panel of immunochemical markers might be necessary to establish the pathologic diagnosis.
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ranking = 3
keywords = cell
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18/48. Unusual causes of acute abdomen in a Nigerian hospital.

    Acute abdomen is the most common abdominal emergency associated with high morbidity and mortality in General surgical practice. Over a 7-year period, a study of unusual causes of acute abdomen was undertaken, with the aim of identifying these causes and outcome of operative management. Eleven cases were identified accounting for 4% of cases of acute abdomen seen during the period of the study. Four cases of liver diseases (33.3%) comprising 2 patients (16.7%) with ruptured primary liver cell carcinoma, 1 (one) case each of haemoperitoneum due to ruptured liver haemangioma and haemorrhagic disorders from liver cirrhosis. One patient had acute leukaemia with massive haemoperitoneum and acute abdomen. Five (45.5%) had gastrointestinal perforations; 1 patient (9%) each had multiple jejunal perforations, perforation of stomal ulcer at gastrojejunostomy site, perforation of gastric cancer; perforated carcinoid tumour of sigmoid colon and idiopathic perforation of the caecum. There was also a case of caecal volvulus. mortality was 7 patients (63.6%). All patients with liver pathology and acute leukaemia died. The cases of malignant tumour perforation were well and alive 4-6 years after the operation. CONCLUSION: Operation could have been avoided in 45.5% of these cases if the appropriate investigations, had been available and carried out.
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ranking = 1
keywords = cell
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19/48. A case of metastatic squamous cell carcinoma of the hypopharynx manifesting as acute abdomen.

    INTRODUCTION: Squamous cell head and neck cancers are usually confined to local and regional sites but occasionally, patients may present with rare manifestations of distant metastases. CLINICAL PICTURE: A 23-year-old female was treated with concurrent chemo-radiotherapy for stage IVA post-cricoid squamous cell carcinoma. A month later, she presented with acute abdomen and was found to have extensive peritoneal nodules at laparotomy. intestinal obstruction soon followed. TREATMENT: She was managed conservatively for the intestinal obstruction and given weekly paclitaxel. OUTCOME: She continued to deteriorate and succumbed shortly after the diagnosis of carcinomatosis peritoneii. CONCLUSION: This rare and aggressive presentation reminds us to be cognizant of relapsed head and neck cancers manifesting atypically, and the need for more aggressive search of distant disease in at least some subgroups of head and neck cancer.
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ranking = 6
keywords = cell
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20/48. Diagnostic peritoneal lavage for assessing acute abdomen in pediatric oncology and stem cell transplantation patients.

    Diagnostic peritoneal lavage (DPL) is a technique designed to sample the peritoneal cavity for evidence of catastrophic pathology, while incurring minimum risk. The authors describe two unstable pediatric patients, one with acute lymphoblastic leukemia and shock and one with fanconi anemia on high-frequency oscillation after stem cell transplantation, both presumed to have intra-abdominal perforation. DPL was uneventfully performed at the bedside in both patients. The authors suggest DPL be considered as an alternative to laparotomy in critically ill pediatric oncology and stem cell transplantation patients.
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ranking = 6
keywords = cell
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Last update: April 2009
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