1/11. Acute diverticulitis of the caecum.Two cases of inflammation of a solitary diverticulum of the caecum are reported. These probably represent the first cases to be reported in Chinese. The pathogenesis of solitary diverticulum of the caecum is different from that of multiple diverticulosis of the colon. A study of these cases was made to understand better this uncommon entity. Before operation, the symptoms, signs and physical findings of caecal diverticulitis are those found in appendicitis. The diagnosis at operation in some cases is difficult because the inflammatory reaction may simulate a malignant process. Local excision is the operation of choice. Our two patients were treated by right hemicolectomy. Discussion is presented of the clinical presentation, pathology and treatment of this condition, so that its prompt recognition may avoid the incorrect diagnosis of caecal malignancy, which in turn would lead to unnecessary radical surgery resulting in a high mortality rate.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. Appendiceal diverticulitis in a youth.Appendiceal diverticulitis as the etiology of right lower quadrant pain is an uncommon entity in younger populations. The incidence is <1 per cent among patients under 30 years of age undergoing appendectomy. Herein, we present a case of a 17-year-old male with perforated appendiceal diverticulitis. The history, physical findings, diagnosis, and treatment are outlined. Additionally the literature concerning appendiceal diverticulitis is reviewed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. Cecal diverticulitis: a case report and review of the current literature.We report a case of a female patient with a picture of "atypical appendicitis," with 3 days of abdominal pain, localized to the right lower quadrant with no nausea, vomiting, diarrhea, or anorexia. On examination she was febrile to 38.4 degrees C, had tenderness at McBurney's point, and a leukocyte count of 11,200. A computerized axial tomography (CAT) scan was obtained showing changes consistent with appendicitis. On laparoscopic exploration the patient was found to have cecal masses. Definitive surgical treatment was deferred until after adequate evaluation of the colon. Postoperative colonoscopy demonstrated cecal diverticulitis. Management of cecal diverticulitis found during laparotomy for presumed appendicitis has included right hemicolectomy, ileocolic resection or appendectomy, and conservative treatment with antibiotics. The laparoscopic approach in a patient with an equivocal history and physical examination allows for definitive workup of inflammatory cecal masses found during surgery for appendicitis.- - - - - - - - - - ranking = 13.221249765434keywords = physical examination, physical (Clic here for more details about this article) |
4/11. Cecal bascule: an overlooked diagnosis in the elderly.This elderly male with a long history of alcohol abuse presented with an acute pleural trauma and hemopneumothorax, which may have served as the precipitating medical illness for cecal volvulus. He subsequently developed bacterial peritonitis as a complication of his bowel obstruction. It is probable that his pleural cavity was seeded hematogenously via a bacteremia from his peritonitis, thus accounting for the empyema with species typical of bowel flora. Cecal bascule is a type of cecal volvulus that causes intestinal obstruction. Diagnosis is difficult, but a delay in recognition may result in intestinal ischemia, perforation, sepsis, and even death. Cecal ischemia or gangrene cannot always be determined based on physical examination or laboratory findings. Plain films of the abdomen may be helpful, and barium enema has been advocated by some authors. However, laparotomy is often necessary for definitive diagnosis and therapy. While cecal volvulus has not been reported to occur frequently in the elderly, the relatively common occurrence of anatomic predisposition in addition to the widespread use of respirators and the increasing age and number of medical illnesses of our population make it possible that cecal volvulus will be seen with increasing frequency in the future.- - - - - - - - - - ranking = 13.221249765434keywords = physical examination, physical (Clic here for more details about this article) |
5/11. Tube cecostomy as a cause of cecal pseudotumor.A 60-year-old male presented with findings on radiographic and physical examination which were compatible with colonic obstruction. A tube cecostomy was performed. colonoscopy seven months later revealed a pseudotumor composed of granulation tissue in the cecum at the site of the previous cecostomy.- - - - - - - - - - ranking = 13.221249765434keywords = physical examination, physical (Clic here for more details about this article) |
6/11. Appendiceal abscess masquerading as acute urinary retention in children.Two boys with acute urinary retention were found to have a persistent pelvic mass after bladder decompression. Evaluation in each disclosed a large pelvic abscess secondary to a ruptured appendix. The diagnosis of appendicitis may be difficult and appendiceal abscess presenting with acute urinary retention in children has been reported previously in only 7 instances. history, physical examination, laboratory studies, and radiographic and ultrasonic evaluations should lead to the correct diagnosis, and surgical intervention restores normal voiding.- - - - - - - - - - ranking = 13.221249765434keywords = physical examination, physical (Clic here for more details about this article) |
7/11. Pseudo-obstruction of the colon. A postoperative complication in orthopaedic patients.Pseudo-obstruction of the colon is a problem of bowel motility that predominantly involves the large intestine and that can mimic the clinical and radiographic features of mechanical obstruction of the colon. It must not be confused with the much more common and less dangerous complication of post-operative ileus. Although it is most often seen in elderly patients who are confined to bed, it can occur in younger patients. Cecal dilation can develop rapidly to dangerous proportions, and recognition by thorough physical examination and early abdominal radiographs is essential if operative intervention is to be avoided. Nasogastric suction, intravenous fluids, and frequent turning of the patient are often successful if begun early, but are unlikely to be of benefit once cecal dilation approaches fourteen centimeters on plain radiographs. In these advanced cases, tube cecostomy or colostomy may be the only way to avoid necrosis of the bowel wall, perforation, and sepsis.- - - - - - - - - - ranking = 13.221249765434keywords = physical examination, physical (Clic here for more details about this article) |
8/11. intussusception of the appendiceal stump.intussusception of the appendiceal stump is a rare complication of appendectomy. A patient is described in detail and the eighteen previously reported instances are reviewed. Symptoms associated with this entity were abdominal pain (95%), vomiting (47%), blood per rectum (26%), and a palpable abdominal mass (68%). The onset of symptoms occurred within two weeks following appendectomy in 84% of the patients. barium enema examination was diagnostic in 87.5% of patients in whom it was performed. The diagnosis of intussusception of the appendiceal stump in the postoperative period is difficult because of the nonspecificity of symptoms, the paucity of physical findings, and the intermittent nature of the partial bowel obstruction. early diagnosis and appropriate treatment are facilitated by a thorough knownledge of this rare complication of appendectomy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/11. Cecal volvulus in the Cornelia de lange syndrome.Cornelia de lange syndrome is a congenital malformation characterized by severe growth failure, mental retardation, and multiple physical anomalies. A variety of gastrointestinal anomalies have been described, including malrotation, colonic duplication, and nonfixation of the colon. Two patients with Cornelia de lange syndrome presented to our institution with acute distal bowel obstruction. In both cases, emergency laparotomy showed cecal volvulus with necrosis of the terminal ileum, cecum, and ascending colon, secondary to nonfixation of the colon. Resection and an end-ileostomy were performed and later successfully reversed in both patients. intestinal obstruction is a known cause of death in these children, and nonfixation of the colon has been identified during autopsy. parents of children with Cornelia de lange syndrome should be counseled as to the possibility of bowel obstruction resulting from cecal volvulus. This awareness may lead to earlier identification and treatment of this potentially lethal gastrointestinal tract anomaly.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/11. Acute colonic pseudo-obstruction complicated by cecal perforation in a patient with Parkinson's disease.Acute colonic pseudo-obstruction (Ogilvie's syndrome) is characterized by physical examination and radiologic findings indicative of mechanical obstruction but in which no physical obstructive process can be found. Many factors have been associated with this syndrome which include electrolyte imbalance, systemic infection, drugs, and occasionally, neurologic disease. Reported here is a case of acute colonic pseudo-obstruction which developed in a patient with known Parkinson's disease and was complicated by cecal perforation, yet had a favorable outcome.- - - - - - - - - - ranking = 14.221249765434keywords = physical examination, physical (Clic here for more details about this article) |
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