1/7. Benign periurethral masses in women.Benign periurethral masses were encountered in 4 women. The masses included 2 vaginal leiomyomas, 1 of which was found simultaneously with a urethral diverticulum, a fibrocystic urethral mass and hyperplastic glandular tissue obstructing the bladder outlet and resembling male prostate. The physical and endoscopic features were helpful in establishing the benign nature and extent of the lesions. Although the bladder base was deformed on an excretory urographic cystogram in each case the radiographic features were non-specific except as they applied to a urethral diverticulum. Transvaginal needle biopsy is recommended in contemplation of open surgical excision. Leiomyomas are best approached transvaginally and anterior urethral masses can be reached suprapubically.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. 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) |
3/7. 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) |
4/7. 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 = 15.396362952344keywords = physical examination, physical (Clic here for more details about this article) |
5/7. Recurrent complicated colon diverticulitis in renal transplanted patient.Colon perforation due to diverticulitis is a life-threatening complication in the postoperative course of kidney transplantation. In the immunocompromised patient a diagnosis of diverticulitis is difficult to make. We report a 53-year-old woman being kidney transplanted 14 years ago with known diverticulosis. She was admitted with acute severe pain in the lower left abdomen. Abdominal computed tomography (CT) scan indicated a diagnosis of intestinal abscess in the small pelvis. laparotomy showed a covered sigma perforation with abscess located in the small pelvis (Hinchey-I). Because of the immunocompromised situation of the patient we performed a Hartmann procedure. Her postoperative course was uneventful. In a 6-month interval the intestinal continuity restoration was performed. Twelve days after discharge the patient was readmitted with reduced renal function and increased infection parameters. During physical examination the abdomen was tender. The patient complained of abdominal pain in the left upper abdomen and additional pain in the left shoulder. An antibiotic therapy using ciprofloxacin was already initiated owing to a urinary tract infection. An abdominal CT scan was performed and indicated an intestinal abscess in the left upper abdomen. laparotomy showed an abscess involving transverse colon, distal jejunum, and proximal ileum (Hinchey-II). Segmental resection of the left colonic flexure, proximal jejunum, and ileum was performed. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. The present casuistry emphasizes that the immunocompromised patient can undergo diverticulitis twice, and that primary anastomosis is a feasible option for patients with localized peritonitis due to complicated diverticulitis.- - - - - - - - - - ranking = 15.396362952344keywords = physical examination, physical (Clic here for more details about this article) |
6/7. Sonographic findings of acute appendiceal diverticulitis.Preoperative images of acute appendiceal diverticulitis are rarely reported because of the difficulty of distinguishing appendiceal diverticulitis from other ileocecal diseases like acute appendicitis or cecal diverticulitis. We report a case of preoperatively diagnosed acute appendiceal diverticulitis. A 30-year-old female with a presumptive diagnosis of acute appendicitis from history and physical examination was admitted to our hospital. Ultrasound sonography showed inflamed appendiceal diverticula and inflammatory changes of the surrounding tissue. The swollen appendix was detected but its findings were slightly different from those of typical acute appendicitis in the following points. One difference was the thickened wall of the appendix, the other difference was the presence of air in the appendix. The patient underwent appendectomy and the pathological specimen revealed inflammatory changes of diverticula within the appendix.- - - - - - - - - - ranking = 15.396362952344keywords = physical examination, physical (Clic here for more details about this article) |
7/7. Fine-needle aspiration of a paraesophageal diverticulum masquerading as a thyroid nodule.Fine-needle aspiration (FNA) is a widely utilized cost-effective method for the initial evaluation and triage of thyroid nodules. On occasion, a variety of non-thyroidal lesions can be mistaken for thyroid nodules on physical examination or in imaging studies and aspirated. Paraesophageal/ pharyngoesophageal diverticula masquerading as a thyroid nodule have been reported in the radiology literature but, as far as we know, not in the cytology literature. We describe FNA of a paraesophageal diverticulum that had been reported as a thyroid nodule on ultrasound. Cytologists should be familiar with this entity and suggest the diagnosis when appropriate.- - - - - - - - - - ranking = 15.396362952344keywords = physical examination, physical (Clic here for more details about this article) |