1/13. Sigmoid colon rupture secondary to Crede's method in a patient with spinal cord injury.Crede's method is a manual suprapubic pressure exerted with a clenched fist or fingers, used to initiate micturition, in patients with spinal cord injury (SCI) who have neurovesical dysfunction. It is usually a benign maneuver unassociated with any major complications. This paper will illustrate a case report involving a sigmoid colon rupture secondary to Crede's method in a patient with SCI. Various techniques of Crede's method are briefly described. It is recommended that patients with quadriplegia avoid forceful use of Crede's method, as it may cause contusion of the abdominal wall and injuries to internal viscera, possibly leading to colonic rupture. It is believed that this is the first reported case of such an unusual complication of Crede's method in patients with SCI.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/13. Abdominal problems in patients with spinal cord lesions.The physiatrist faces two major difficulties when dealing with abdominal problems in spinal cord-injured patients: (1) realizing when there is a serious problem; and (2) determining the etiology of the problem. patients are presented which demonstrate these difficulties. One patient with a ruptured appendix and the periappendicial abscess had only mild symptoms whereas another patient with severe abdominal pain, rigidity and rebound tenderness had a viral enteritis. The neurologic innervations of the abdomen and the various signs and symptoms appearing in cord-injured patients with abdominal problems are described. A methodical evaluation procedure for acute problems in paraplegic patients is presented.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
3/13. rupture of noncommunicating rudimentary uterine horn pregnancy.BACKGROUND:We present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks.CASE:A 30-year-old woman presented with a history of two spontaneous abortions. An ultrasound scan showed a bicornuate uterus, with one normal and one hypoplastic horn. hysterosalpingography revealed a single uterine cavity with only one tube, suggesting a unicornuate uterus. hysteroscopy and laparoscopy were recommended but declined.She presented again 2 months later at 7 weeks' gestation. A single intrauterine pregnancy in the hypoplastic right horn was diagnosed. A transvaginal scan showed a single cervical canal in continuity with the left uterine horn, which led to the suspicion of a pregnancy in a rudimentary horn. The option of pregnancy termination was offered. A laparoscopy was repeatedly suggested but declined. Excision of a ruptured noncommunicating rudimentary horn and ipsilateral salpingectomy were performed after an emergency laparotomy at 20 weeks because of the sudden onset of abdominal pain and signs of shock.CONCLUSION:Although a rudimentary horn pregnancy had been suspected before the laparotomy, the patient presented as a clinical emergency. This report, like others, indicates that prompt diagnosis and immediate removal of the rudimentary horn is lifesaving.- - - - - - - - - - ranking = 0.0099279834521083keywords = canal (Clic here for more details about this article) |
4/13. 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 = 1.2keywords = spinal (Clic here for more details about this article) |
5/13. diagnosis of the acute abdomen in the neurologically stable spinal cord-injured patient. A case study.The diagnosis of the acute abdomen in the spinal cord injured patient is difficult. Diagnoses are often so delayed that approximately 10% of these patients die of acute abdominal problems. The presentation also varies with the level and duration of injury. An understanding of the functional neuroanatomy of the abdominal wall and viscera aids in timely diagnosis. I present an illustrative case and describe the pertinent functional neuroanatomy.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
6/13. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review.Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.- - - - - - - - - - ranking = 1.2keywords = spinal (Clic here for more details about this article) |
7/13. Recanalization of a fallopian tube after detorsion of twisted adnexa: report of a case with follow-up by repeat hysterosalpingography.BACKGROUND: Detorsion and cystectomy of twisted adnexa have been performed in young women. However, identification was incomplete, and the function of the affected tube was not investigated. CASE: A 23-year-old, nulligravid woman with an acute abdomen was diagnosed with adnexal torsion. An emergency laparotomy revealed that both ovaries were 12x9x9 cm. the right adnexa were twisted and bluish black. Detorsion of the twisted lesion and ipsilateral fallopian tube was performed, with subsequent cystectomy of both lesions. hysterosalpingography on the 14th postoperative day showed right tubal obstruction; 6 months postoperatively, repeat hysterosalpingography revealed patency of the right tube. CONCLUSION: At least several months may be required for functional recovery of an untwisted tube. For that reason, postoperative repeat hysterosalpingography is a useful method for follow-up of function in an untwisted tube.- - - - - - - - - - ranking = 0.039711933808433keywords = canal (Clic here for more details about this article) |
8/13. hematocolpos associated with a remote history of chronic vaginitis and a diagnostic vaginal biopsy: a case report.Bacterial vaginitis is commonly seen in the pediatric population. Severe or recurrent cases may be associated with ulcerative lesions. We report a case of vaginal biopsies of ulcerative lesions in a 9-year-old which led to severe vaginal adhesions, stenosis, and hematocolpos. A vaginoscopy and resection from below were not successful and an exploratory laparotomy with uterine perforation and sounding into the upper vagina were required to reopen the lower vaginal canal. We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required.- - - - - - - - - - ranking = 0.0099279834521083keywords = canal (Clic here for more details about this article) |
9/13. Acute abdomen in the patient with a ventriculoperitoneal shunt.When patients who have a ventriculoperitoneal shunt present with an acute abdomen, shunt infection may be the cause. The authors relate the cases of three such patients. Two underwent a laparotomy which failed to show any abnormality and which in retrospect might have been avoided. They review the literature and present a systematic approach to the diagnosis and management of this problem. Specific clues from the patient's history, physical examination and further investigation may clarify the diagnosis. When shunt infection cannot be excluded and the clinical setting does not warrant immediate laparotomy, shunt externalization, cerebrospinal fluid culture, empiric antibiotic therapy and close observation of the patient are recommended.- - - - - - - - - - ranking = 0.2keywords = spinal (Clic here for more details about this article) |
10/13. Spinal epidural abscess presenting as acute abdomen in a child.Spinal epidural abscess is seldom encountered in children and rarely occurs in the absence of spinal pain. A case is described in which a child with a thoracic epidural abscess presented with abdominal rather than spinal pain. Thoracolumbar radicular inflammation and visceroparietal reflexes initiated by a s'spinal ileus' probably produced the symptoms and signs of acute intra-abdominal disease. Consideration of intraspinal disease is advisable in all cases of acute abdomen which exhibit atypical features.- - - - - - - - - - ranking = 0.8keywords = spinal (Clic here for more details about this article) |
| | Next -> |