1/19. carcinoma of the colon in children: a report of six new cases and a review of the literature.Of six children with carcinoma of the colon, none had ulcerative colitis or a family history of carcinoma of the colon or colonic polyposis. In 75 cases traced in the literature, a common early symptom of carcinoma of the colon in children is acute, crampy abdominal pain. At laparotomy for suspected appendictis, the possibility of the acute pain being due to carcinoma of the colon should be borne in mind. Otherwise the symptoms of carcinoma of the colon in children do not differ substantially from those in adults. The prognosis is unfavorable; in only 2.5% of the cases on record did the children survive 5 yr after the operation.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
2/19. Ovarian cavernous hemangioma in an 8-year-old girl.The case of an ovarian cavernous hemangioma with torsion in an 8-year-old girl is described. Current literature records less than 50 cases of which only 8 are in children. The presenting symptoms of acute abdomen and the ultrasonographic study led to the preoperative diagnosis of torsion of an ovarian tumor. Salpingo-oophorectomy and appendicectomy were performed with an uneventful postoperative course. The histological pattern of the tumor was that of an entirely cavernous hemangioma. The case is reported in view of its rarity.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
3/19. Primary repair of cornual rupture occurring at 21 weeks gestation and successful pregnancy outcome.The successful delivery in a 31 year old woman at 33 weeks gestation is reported, after repair to a cornual rupture which occurred at 21 weeks gestation. The patient exhibited acute abdominal pain and pending shock. Emergency laparotomy showed a cornual rupture and an intrauterine vital fetus having intact amnion membrane. On the patient's family's insistence, primary repair for a cornual rupture was performed and preservation of the fetus attempted. Postoperatively, tocolytic agent with ritodrine hydrochloride was administered and close follow-up of the patient was uneventful. The patient had a smooth obstetric course until 33 weeks gestation when premature rupture of the membranes occurred, soon followed by the onset of labour. She underwent an elective Caesarean section and delivered a normal male fetus weighing 2140 g with Apgar scores at 1, 5 and 10 min of 6, 8, and 9 respectively. Because of this successful outcome, we suggest that primary repair for such an unusual patient should be accepted.- - - - - - - - - - ranking = 21.957887198997keywords = bite (Clic here for more details about this article) |
4/19. Pain as a presenting feature of acute abdomen in spinal injuries.The diagnosis of acute abdomen can be difficult in patients with spinal injuries. We reviewed all the 1039 case records of patients admitted with spinal injuries to the Queen Elizabeth National spinal injuries Unit, Glasgow over a 7-year-period and found 5 (0.48%) cases of acute abdomen that required surgical intervention and were not caused by original injury. Their presenting signs and symptoms were analysed. Pain was found to be an unreliable symptom in these patients.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
5/19. Midgut volvulus in an adult patient.The authors report on a case of midgut volvulus in a 27-year-old man who presented with bilious vomiting and acute abdominal pain. US demonstrated a reversal of the normal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV). A clockwise whirlpool sign, diagnostic for midgut volvulus, was not visualised. In a further assessment, upper gastrointestinal series demonstrated obstruction in the second part of the duodenum highly suspicious of Ladd's bands. Malpositioning of bowel structures, as already suggested by the reversal of the SMA and SMV on ultrasound, and a distinctive whirl pattern due to the bowel wrapping around the SMA was demonstrated on CT. Furthermore angiography revealed focal twisting of the SMA. US is the first imaging modality to perform in suspicion of midgut volvulus. When inconclusive, CT is in our opinion the next stage in the diagnostic work-up.- - - - - - - - - - ranking = 0.49678805345668keywords = relation (Clic here for more details about this article) |
6/19. Peritoneoscopic placement of peritoneal dialysis catheter and bowel perforation: experience of an interventional nephrology program.BACKGROUND: Bowel perforation is an uncommon but serious complication of peritoneoscopic peritoneal dialysis (PD) catheter insertion. The approach to diagnosis of bowel perforation utilizing this technique has not been previously published. The authors report their experience with the diagnosis and management of bowel perforation in the context of peritoneoscopic placement of PD catheters. methods: The authors retrospectively reviewed the records of 750 PD catheters inserted over a 12-year period (January 1991 to May 2003) utilizing peritoneoscopic technique. RESULTS: Six (0.8%) patients experienced bowel perforation during the procedure. The diagnosis was made immediately during the procedure in 5 (83%) of the 6 patients. Of these 5, peritoneoscopy confirmed intrabowel position of the cannula by visualizing bowel mucosa (n = 3) and hard stool (n = 1). The fifth patient showed extrusion of fecal matter upon trocar withdrawal before peritoneoscopy. All 5 had emanation of foul-smelling gas through the cannula. Bowel rest and broad-spectrum intravenous antibiotics were initiated. Of the 5, 1 required surgery, whereas the others were discharged home after 3 days. The sixth patient had fever, severe peritoneal irritation, and polymicrobial peritonitis the morning after the procedure. In this patient, no evidence of bowel injury was noted during the procedure except for brief emanation of foul-smelling gas. He required surgical intervention. CONCLUSION: Bowel perforation can be diagnosed immediately in most patients undergoing peritoneoscopic PD catheter insertion. A majority of these patients can be treated medically. The surgical team should be consulted if the patient shows clinical deterioration or has signs of peritoneal irritation.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
7/19. Salmonellosis and ulcerative colitis. A causal relationship or just a coincidence.Coincidence of salmonellosis and ulcerative colitis is a rare clinical problem. salmonella infection was reported to complicate the ulcerative colitis, as either facilitating its occurrence or activation. In this article, we present a case with salmonellosis whose clinicopathological findings also suggested ulcerative colitis. The patient improved rapidly after taking additional mesalazine to norfloxacin treatment. We conclude that salmonella infection might have either been coincidentally present or might have triggered an early ulcerative colitis in this patient who did not have history of inflammatory bowel diseases. In case of persistent severe diarrhea despite appropriate treatment, the possibility of a coincident inflammatory bowel disease such as ulcerative colitis should always be considered, especially in endemic regions for salmonellosis.- - - - - - - - - - ranking = 1.9871522138267keywords = relation (Clic here for more details about this article) |
8/19. Coexistence of Crohn's disease and inflammatory fibroid polyp of the small bowel. Report of a case and review of the literature.BACKGROUND/AIM: The Authors report a case of a woman aged 35, with concurrent appearance of Crohns disease and Inflammatory Fibroid Polyp of the terminal ileum. CASE REPORT: The combination of the two disorders was clinically manifested as an obstructive ileus. On the operative table, a 4-cm polypoid mass causing intussusception of the bowel was obvious. The resected specimen of the ileum showed profound distention, several ulcerations and fissures. The histological examination confirmed the diagnosis of Crohn's disease coexisting with an Inflammatory Fibroid Polyp. Immunostaining of the lesion for actin showed focal positivity. However, staining for desmin, CD31, S100-protein, PGM-1 CD34, CD117, and bc1-2, was negative. CONCLUSION: Coexistence of Inflammatory Fibroid Polyp with Crohn's disease causing obstructive ileus could be the first manifestation of the disease. The combination of the two disorders corroborates the reparative character of the lesion. Nevertheless, the exact etiopathogenetic relationship between the two entities remains obscure.- - - - - - - - - - ranking = 0.49678805345668keywords = relation (Clic here for more details about this article) |
9/19. Radiological reasoning: incidentally discovered liver mass.OBJECTIVE: A 49-year-old woman presented to the emergency department after a fall in which she sustained a right subcapital hip fracture. During her hospital stay she developed abdominal pain, and a hypoechoic liver mass was found on sonography. Multiphase CT showed a hepatic mass with brisk arterial phase enhancement, rapid washout on the portal venous phase, and delayed phase hypodensity. The final pathology diagnosis was hepatocellular carcinoma. CONCLUSION: Incidental lesions are frequently discovered during routine radiographic evaluations. Correlation with clinical history and additional confirmatory imaging is essential for appropriate diagnosis and management.- - - - - - - - - - ranking = 0.49678805345668keywords = relation (Clic here for more details about this article) |
10/19. Ovarian haemangioma.Although ovaries have a very rich vasculature, haemangiomas of the ovary are extremely rare. There are only another 39 cases of ovarian haemangioma recorded in the literature. We describe an 11-year-old girl with an ovarian haemangioma who presented clinically with an acute abdomen. The patient has been well without complications for a year.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
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