951/1382. Major hemorrhage and perforation due to a solitary cecal ulcer in a patient with end-stage renal failure. A case of solitary cecal ulcer with major hemorrhage followed by perforation after treatment with intra-arterial vasopressin in a patient with end-stage renal failure is presented. Though vasopressin has been used with success in the treatment of colonic hemorrhage, caution should be applied in patients with a bleeding cecal ulcer as the vasoconstriction produced by vasopressin may cause perforation in an area whose blood supply is already compromised. ( info) |
952/1382. Evaluation of the gasless abdomen in the newborn and young infant with metrizamide. The finding of a gasless abdomen on the abdominal radiograph of an infant over 12 hr old is usually abnormal and may reflect a serious pathologic disorder. Accurate diagnosis is important to plan appropriate therapy. A careful review of the clinical history and the plain chest and abdominal radiographs will often permit an accurate diagnosis to be made. In cases where the diagnosis remains in doubt, contrast studies of the bowel with metrizamide have proved helpful. This report presents six infants with gasless abdomens of unknown cause. In each case, a metrizamide contrast study of the bowel was helpful in providing an accurate diagnosis. ( info) |
953/1382. Perforation of the ileum as a complication of suprapubic catheterization. Although suprapubic catheterization is a useful technique in managing the postoperative patient who requires prolonged urinary drainage, the potential exists for iatrogenic damage to the abdominal contents. Two cases of perforation of the distal ileum occurring during catheter placement after vaginal procedures are presented. Such complications may be kept at a minimum by adequate bladder distention, careful bladder palpation, placement of the patient in the Trendelenburg position before filling the bladder, and catheter insertion before closure of the surgical incision. ( info) |
954/1382. The antemortem diagnosis of pyogenic liver abscess due to perforation of the gut by a foreign body. Perforation of the gastrointestinal tract by ingested foreign bodies is rare; the diagnosis of pyogenic liver abscess resulting from such perforations is usually made at post-mortem. We present a case of perforation of the gut, due to an ingested dental plate, with a resultant pyogenic liver abscess, which presented as a pyrexia of unknown origin. ( info) |
955/1382. A case of ovarian dermoid cyst with malignant transformation perforated into the rectosigmoid colon and small intestine. A 72-year-old female was admitted to hospital with diarrhea containing hair. The abdominal plain film showed teeth-like structures in the right lower quadrant. barium enema and endoscopic examination were performed, and the results indicated a possible dermoid cyst perforated into the rectosigmoid colon and small intestine. The operation revealed a dermoid cyst of the right ovary perforated into the rectosigmoid colon and small intestine. Histopathologically, a dermoid cyst and in part well-differentiated squamous cell carcinoma invading the rectosigmoid and small intestine were demonstrated. ( info) |
956/1382. Bilateral ureteral obstruction as a complication to a perforated appendix. Report of a case. A 44-year-old man developed anuria 8 days after an operation for a perforated appendix. An intravenous pyelography showed delayed excretion on both sides with hydronephrosis, a right dilated ureter and no contrast passing to the bladder. On neither sides a ureter-catheter could be passed through the obstructions from below. By surgical intervention no ureter-catheter could be passed through the obstructions from above, and both ureters were drained with a T-tube. The benign obstruction was caused by a periappendicular abscess with inflammation and oedema of the ureteral and periureteral tissues. The condition was normalized within 7 days. ( info) |
| A case of meconium thorax resulting from spontaneous perforation of the colon associated with a right Bochdalek's foramen, without herniation, is presented. The baby had immediate respiratory distress postpartum resulting from the meconium in the pleural cavity. No fetal distress was detected, in spite of electrode monitoring in labor, to account for the colonic perforation. ( info) |
958/1382. Complications of drainage. Several complications, resulting from drainage, are discussed. These include severe tissue reactions, leakage from bowel anastomoses, obstruction and perforation of small or large bowel, herniation, leaving behind a foreign body, severe bleeding and the induction of infection. Several of these complications are illustrated with case histories. Moreover a review of the literature on the subject is given. In view of these complications, the author warns against too liberal or too long drainage procedures. ( info) |
| Perforated appendicitis is sometimes accompanied by pneumoperitoneum, often localized beneath the diaphragmatic dome. This may lead to very dangerous diagnstoic errors, which every roentgenologist and surgeon should be aware of. A historical review is followed by three case reports. ( info) |
960/1382. Neonatal intestinal perforation caused by congenital defects of the intestinal musculature. Spontaneous perforation of the small intestine in the newborn is rare. In most cases the etiology is unknown. Three cases of perforation in preterm newborn infants are described. The clinical diagnosis was necrotizing enterocolitis (NEC), and an urgent laparotomy was performed. The histologic examination was compatible with the diagnosis of a congenital defect of the intestinal musculature. All three infants survived. ( info) |