1/645. magnetic resonance imaging diagnosis, sonographically directed percutaneous aspiration, and arthroscopic treatment of a painful shoulder ganglion cyst associated with a SLAP lesion.A 30-year-old, right-handed man presented with the insidious onset of right shoulder pain associated with overhead activities. magnetic resonance imaging revealed a perilabral ganglion cyst associated with a SLAP lesion (lesion of the superior labrum, both anterior and posterior). After unsuccessful treatment with sonographically directed percutaneous aspiration of the cyst, arthroscopic techniques were employed to intra-articularly decompress the cyst and stabilize the labral tear.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/645. liver rupture postpartum associated with preeclampsia and hellp syndrome.liver rupture is a rare perinatal complication with high maternal mortality. In a multiparous woman with preeclampsia and hemolysis, Elevated liver enzymes, and Low platelet count (HELLP) syndrome, liver rupture was suspected 10 h after a cesarean section. laparotomy revealed liver rupture which was treated by perihepatic packing. Eventually, the mother was discharged with her baby 88 days after admission. Clinical symptoms, maternal hemodynamics by Swan-Ganz monitoring, and laboratory findings were not predictive until the emergency situation and the consecutive complications required multidisciplinary management.- - - - - - - - - - ranking = 0.010638261806933keywords = area (Clic here for more details about this article) |
3/645. Perforation of acquired small bowel diverticulum.A 77-year old woman was seen with an unusual pathologic entity after emergent abdominal exploration--a ruptured small bowel diverticulum. This patient had a known previous history of colonic diverticulosis when she had acute onset of severe abdominal pain. The patient underwent an exploratory laparotomy with resection of representative segments of small and large bowel. The large bowel had evidence of diverticulosis, while the small bowel resected segment had evidence of diverticulitis with rupture. An extensive review of the literature revealed a very small number of reported cases in the world literature (less than 150 cases). We reviewed the history of reported cases of ruptured and nonruptured small bowel diverticular disease, as well as this case.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
4/645. Spontaneous gastrointestinal perforation in patients with lymphoma receiving chemotherapy and steroids. Report of three cases.Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain roentgenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24 h. Emergency operations were carried out; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
5/645. Spontaneous bladder rupture: rare cause of peritonitis.Spontaneous rupture of the urinary bladder is an uncommon, but important, cause of generalized peritonitis. It is a surgical emergency which may be rapidly fatal if diagnosis and treatment are delayed. Bladder disease or obstruction, coupled with a sudden increase in intra-abdominal pressure usually accounts for the rupture. Characteristic symptoms are acute lower abdominal pain followed by generalized peritonitis. In most cases, the rupture is intra-peritoneal.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
6/645. Post-infarction cardiac rupture.Three allied conditions are described in this paper: (i) haemopericardium with cardiac rupture (5 cases); (ii) haemopericardium without rupture (2 cases); (iii) pseudoaneurysm (1 case). In the first 2 of these, the significant features were clinical deterioration with shock 3 or more days after infarction, recurrent cardiac pain, cardiac tamponade, and immediate or later ineffectiveness of counterpulsation. An additional feature in the second group was the development of haemopericardium after heparin therapy. In the third group, infarction followed by left ventricular failure and progressive cardiac enlargement was the significant feature. An apical systolic murmur was not present, as a false sac had not been formed. Ante-mortem diagnosis depends upon an appreciation of these features. Without it successful surgery is impossible. There were 4 survivors in this group of 8 patients.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
7/645. Management of splenic artery aneurysm rupture during trial of scar with epidural analgesia.We report a case of ruptured splenic artery aneurysm during labor in which the clinical signs were masked by epidural analgesia. A high index of clinical suspicion must be maintained in cases of atypical epidural breakthrough pain, and attending clinicians must be prepared for the unexpected when faced with a maternal collapse.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
8/645. Spontaneous rupture of bladder diverticula in a girl with ehlers-danlos syndrome.A 5-year-old girl with ehlers-danlos syndrome presented with acute abdominal pain and anuria caused by a spontaneous perforation of bladder diverticula. Conservative treatment was successful.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
9/645. Spontaneous rupture of splenic hamartoma: a case report.Splenic hamartomas are rare. The authors report a case of spontaneously ruptured splenic hamartoma in a 5-month-old boy. This rupture led to the death of the child. If abdominal pain is present and a mass is palpated, the splenic hamartoma should be managed surgically in an expeditious manner. There have been only two known previous reports of spontaneous rupture of splenic hamartoma in adults, but none in children.- - - - - - - - - - ranking = 0.2keywords = pain (Clic here for more details about this article) |
10/645. Simultaneous rupturing heterotopic pregnancy and acute appendicitis in an in-vitro fertilization twin pregnancy.The presentation of acute abdominal pain in young women is not an unusual occurrence in casualty and gynaecology departments. Both acute appendicitis and ectopic pregnancy have to be considered and investigated, as these two conditions are accepted as the most common surgical causes of an acute abdomen. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case report presented here describes the extremely unusual occurrence of both these acute conditions happening simultaneously with the added complication of an ongoing twin pregnancy and it highlights the need to look beyond the most obvious diagnosis and always to expect the unexpected.- - - - - - - - - - ranking = 0.4keywords = pain (Clic here for more details about this article) |
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