1/13. Agenesis of the vermiform appendix.Agenesis of the vermiform appendix is very rare. The incidence is estimated to be one in 100,000 laparotomies for suspected appendicitis. Several criteria have to be met before the investigator can conclude that the appendix is congenitally absent. This case is reported to bring this entity to the attention of surgeons who may encounter a similar situation during celioscopy. A 29-year-old patient was admitted through the emergency room with the chief complaint of abdominal pain. Acute appendicitis was suspected, and he was accordingly prepared for celioscopy. This report presents a patient with vermiform appendix agenesis diagnosed at celioscopy with concomitant mesenteric lymphadenitis. Agenesis of the vermiform appendix is very rare, and the diagnosis should not be made unless the ileocecal and retrocecal area are thoroughly explored.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
2/13. Acute abdomen caused by salmonella typhimurium infection in children.Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis. mesenteric lymphadenitis associated with salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. serology results showed that both patients' titers for BO ("B and O agglutinating [BO]") antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852.- - - - - - - - - - ranking = 1.039801927155keywords = abdominal pain, pain (Clic here for more details about this article) |
3/13. A palpable right lower abdominal mass due to Yersinia mesenteric lymphadenitis.infection by yersinia pseudotuberculosis has become of increasing pathological importance. This report describes the case of a 12-year-old female with mesenteric lymphadenitis due to yersinia pseudotuberculosis. The patient presented with fever, abdominal pain, and a palpable right abdominal mass. Abdominal ultrasonic imaging and computerized axial tomography (CT) revealed a mass. An exploratory laparotomy was performed, followed by appendectomy and mesenteric lymph node biopsy. The diagnosis of Yersinia infection was confirmed by serology and bacterial culture of the biopsy material. This condition should be considered in patients with a right lower abdominal mass and symptoms similar to those of appendicitis.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
4/13. Increased through-transmission in abdominal tuberculous lymphadenitis.OBJECTIVE: To describe 2 cases of abdominal tuberculosis in which sonographic evaluation of mesenteric lymphadenopathy showed increased through-transmission suggestive of caseating necrosis. methods: Two patients with abdominal pain and other symptoms (including fever, diarrhea, and weight loss) underwent abdominal sonography with a 6-MHz curved array transducer. One patient also underwent sonographically guided fine-needle aspiration of multiple lymph nodes, and the other underwent computed tomography, colonoscopy, and colon biopsy. RESULTS: In both patients, sonography showed multiple rounded hypoechoic lesions with increased ultrasound through-transmission suggestive of necrotic lymphadenopathy. No color flow was shown. In 1 case, the posterior acoustic enhancement was accentuated in the harmonic imaging mode. In the other case, the lesions shown on sonography corresponded to computed tomographic findings of low-density lymph nodes. Results of fine-needle aspiration and colon biopsy were positive for tuberculosis. CONCLUSIONS: Posterior acoustic enhancement in abdominal lymphadenopathy can suggest the diagnosis of tuberculous lymphadenitis. Detection of this finding is facilitated by scanning in the harmonic mode. Necrotic nodes will lack color flow and can be distinguished from lymphadenopathy of other causes. Sonography can also be used for fine-needle aspiration of necrotic nodes to yield a definitive diagnosis.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
5/13. Mesenteric adenitis caused by salmonella enterica serovar Enteritidis.Mesenteric adenitis is a self-limited condition characterized by fever, localized right lower quadrant abdominal pain, and frequent leukocytosis, making it difficult to differentiate from appendicitis. We report a case of mesenteric adenitis in an 8-year-old boy who presented at the emergency department with right lower quadrant abdominal pain, diarrhea, and fever up to 40 degrees C. Acute appendicitis was initially suspected, but further abdominal ultrasound and contrast enhanced computed tomography studies showed a normal appendix with marked mesenteric adenopathy. Symptomatic treatment was given and pain and fever subsided 2 days later. Follow-up sonography showed resolution of adenopathy, confirming the diagnosis of mesenteric adenitis. The admission stool cultures grew salmonella enterica serovar Enteritidis (S. Enteritidis). Unlike previous reports in western countries where Yersinia species prevails and was thought to be self-limited, S. Enteritidis carries potential risk for serious systemic complications, such as meningitis or septic arthritis. The isolation of this unusual microbiological species thus has both therapeutic and epidemiological implications for mesenteric adenitis in taiwan.- - - - - - - - - - ranking = 2.039801927155keywords = abdominal pain, pain (Clic here for more details about this article) |
6/13. Asymptomatic rhabdomyolysis of unknown etiology.A 7-year-old boy developed rhabdomyolysis with a peak creatine phosphokinase level of 261,400 IU/L after his appendectomy. These abnormalities occurred following a 2-3-day illness consisting of upper respiratory tract symptoms, fever, and abdominal pain mimicking acute appendicitis. At the time of operation, a normal appendix was removed, and mesenteric lymphadenitis was noted. The myoglobinuria and elevation of creatine phosphokinase were transient, and the patient remained asymptomatic. We review various causes of right lower quadrant pain and rhabdomyolysis and address the roles of malignant hyperthermia and infectious agents. The possible cause of the phenomena observed in this patient is discussed.- - - - - - - - - - ranking = 1.039801927155keywords = abdominal pain, pain (Clic here for more details about this article) |
7/13. Mesenterial histiocytic necrotizing lymphadenitis. Case report.A 14-year-old girl was hospitalized with fever, jaundice, vomiting and right sided abdominal pain. A laparotomy was performed because of muscular defence and ascites. There was a mass of enlarged red and blue colored lymph nodes in the mesentery of the lower ileum loop. The histologic diagnosis of HNL without granulocytic infiltration was made. A septic-toxic shock developed after surgery. respiratory insufficiency necessitated the use of a respirator, and acute renal failure with oliguria made hemodialysis necessary. The dramatic clinical course of the illness and the localization of the affected lymph nodes in the abdomen are unusual for an HNL; the lack of granulocytic infiltration contradicts the clinical picture of a bacterial infection. Neither a bacterial nor a viral pathogen could be found. However, the patient had been treated with antibiotics before.- - - - - - - - - - ranking = 1keywords = abdominal pain, pain (Clic here for more details about this article) |
8/13. Recurrent peritonitis with ascites as the predominant manifestation of systemic lupus erythematosus.We describe a patient with abdominal pain and ascites, mesenteric lymphadenitis and peritoneal panniculitis. Initially her ANA was negative. The abdominal pain recurred again three years later and in between the two episodes she had had skin rash, alopecia, arthralgia, and positive Coombs' test-haemolytic anaemia. Her ANA became positive a few years after the initial episode.- - - - - - - - - - ranking = 2keywords = abdominal pain, pain (Clic here for more details about this article) |
9/13. mesenteric lymphadenitis depicted by indium 111-labeled white blood cell imaging.An acutely ill child with abdominal pain and concomitant pharyngitis often presents a diagnostic challenge. This report describes how indium 111-labeled white blood cell imaging helped to clarify the confusing case of a 4-year-old boy with fever, pharyngitis, and abdominal pain. The triad of abnormal white cell localization in the nasopharynx, cervical lymph nodes, and right lower abdominal quadrant supported the diagnosis of a systemic infection rather than appendicitis, abscess, or another surgical condition. mesenteric lymphadenitis associated with systemic infection should be included in the differential diagnosis of abdominal pain in a child with this clinical presentation.- - - - - - - - - - ranking = 3keywords = abdominal pain, pain (Clic here for more details about this article) |
10/13. Tuberculous mesenteric lymphadenitis mimicking pancreatic carcinoma.Tuberculous mesenteric lymphadenitis is a rare clinical entity and non-surgical diagnosis of this condition remains a challenge. A 38-year-old Indian woman presented with a six-week history of epigastric pain, low-grade fever and anorexia. Upper endoscopy showed a gastric ulcer of the posterior wall of the stomach. On CT scan there was a 8 cm abdominal mass involving the pancreatic body and tail and the endoscopic ultrasonography was also compatible with a cystic pancreatic tumor which had eroded into the stomach. An exploratory laparotomy was performed and the diagnosis of tuberculous mesenteric lymphadenitis was confirmed by bacteriological and histological examinations. Medical therapy was started after surgery. At 18 months she is asymptomatic and abdominal CT scan is normal. Tuberculosis of mesenteric lymph nodes usually raises serious diagnostic problems. A high grade of suspicion is necessary in order to perform a pre-operative diagnosis.- - - - - - - - - - ranking = 0.039801927154954keywords = pain (Clic here for more details about this article) |
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