1/7. Unusual cases of intussusception.intussusception occurs most commonly in the first five years of life and is classically associated with intense intermittent abdominal pain, vomiting, bloody mucoid diarrhea, and a palpable abdominal mass. These cardinal findings are frequently not present, however, particularly outside the usual age range. The emergency physician must therefore be vigilant in considering intussusception as a potential cause for intestinal obstruction in all patients, if ischemic complications are to be avoided. We present three cases of "unusual" intussusception, and provide a review of this entity and a guide to its consideration and work-up in the emergency department.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Two children with lethargy and intussusception.The cases of two patients with lethargy as the predominant symptom of intussusception are described. The first patient was admitted to the pediatric ICU with unexplained lethargy. The diagnosis of intussusception was made after he developed right lower quadrant abdominal tenderness and heme-positive stool. The second patient was diagnosed after presenting to the emergency department with intermittent lethargy, right lower quadrant abdominal tenderness, and heme-positive stool. The presence of gastrointestinal symptoms or signs in association with lethargy should alert the physician to the possibility of an intussusception.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. oligohydramnios, renal insufficiency, and ileal perforation in preterm infants after intrauterine exposure to indomethacin.Three preterm infants exposed antenatally to indomethacin developed a characteristic syndrome consisting of edema and hydrops with a bleeding disorder at birth, oliguric renal failure during the first 3 postnatal days, and acute pneumoperitoneum resulting from localized ileal perforation(s) at the end of the first week of life. Despite the value of indomethacin for arresting preterm labor, the physician must take into account the potential hazards of drug toxicity.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. intussusception in association with childhood cocaine intoxication: a case report.A case report of an 11-month-old infant with cocaine intoxication and intussusception is presented. We present this case because there are no prior reports in the literature of cocaine intoxication associated with intussusception. The diagnosis was not initially considered in this patient. We feel the association is biologically plausible and alert physicians to consider intussusception in the differential diagnosis of the cocaine-exposed child with vomiting and abdominal pain.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Enteric fistulization of a common iliac artery aneurysm: an unusual cause of gastrointestinal hemorrhage and shock.A 78-year-old man with a history of recent unexplained lower gastrointestinal bleeding presented to the emergency department with the acute onset of abdominal pain, tenesmus, and shock. Computed tomography of the abdomen showed a fistula between a common iliac artery aneurysm and the small intestine. laparotomy demonstrated a saccular aneurysm of the common and proximal internal iliac arteries with fistulous communication to the distal ileum. Aneurysmectomy, arteriorrhaphy, and segmental ileal resection with primary anastomosis were successfully performed. This case illustrates a rare complication of an uncommon aneurysm, emphasizing the need for emergency physicians to consider complicated vascular disease in the evaluation of a patient with abdominal pain and shock.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. cocaine-associated intestinal gangrene in a pregnant woman.A 31-year-old pregnant woman who was an active cocaine abuser presented to our emergency department five times in 1 week for abdominal pain and vomiting. She continued to use cocaine regularly despite having abdominal pain. Her fifth admission was for seizures. There were no objective signs of peritoneal inflammation and the rectal guiac examination was repeatedly negative. The patient progressed to severe septic shock. Intraabdominal sepsis and/or bowel perforation was suspected. Exploratory laporatomy revealed gangrene and perforation of the small intestine and fecal peritonitis. She rapidly developed multiorgan failure and died. Gastrointestinal complications resulting from cocaine use are uncommon. Our case is unique in that the patient was pregnant, used cocaine by the intranasal route, and lacked objective signs of acute abdomen. Emergency physicians should be aware of the morbidity associated with the use of cocaine.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Ultrasound and CT findings of a cecal lymphangioma presenting with intussusception.A rare case of cecal lymphangioma which presented as intussusception was reported. The patient was a 28-year-old female who suffered from vomiting, abdominal pain and mass for 6 days. ultrasonography revealed a multilocular cyst that measured 7 cm in maximal diameter, and an adjacent target-like mass with concentric layering in the right abdomen. Computed tomography confirmed the sonographic findings with fatty component in the target-like mass. intussusception in adults is a diagnostic challenge to a physician due to its vague and nonspecific presentations. Laparatomy is indicated because of underlying pathology in a vast majority of cases. diagnosis can be established by the characteristic findings mentioned above.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |