1/3. Pseudo sister mary joseph's nodule.The sister mary joseph's nodule is a significant finding in the physical examination. It is sometimes the only indication of an intra-abdominal metastatic malignancy. We report a patient who presented with an umbilical nodule that was discovered to be an omphalith. A review of the literature discusses the sister mary joseph's nodule and this unusual finding.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/3. Radioisotope bone scanning in pulmonary alveolar microlithiasis.A 30-year-old woman was examined for a history of exertional breathlessness, swelling of her feet, and a mild dry cough of 4 to 5 months' duration. Her symptoms developed during the last month of her pregnancy, with gradually increasing dyspnea, swelling of the feet, and reduced urinary output. There was no history of expectoration, hemoptysis, chest pain, or tuberculosis. General physical examination showed no evidence of clubbing of the nails or lymphadenopathy. Chest auscultation revealed a few end-inspiratory crepitations at both lung bases. Bronchial alveolar lavage showed calcium particles, whereas results of the transbronchial lung biopsy were consistent with alveolar microlithiasis.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/3. Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report.Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. intestinal obstruction due to enterolithiasis is uncommon. We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. On physical examination, there was discomfort on palpation of the upper abdomen. Laboratory tests revealed mild elevation of leucocytes and c-reactive protein. CT scan demonstrated dilatated loops of proximal jejunum with thickening of the wall, suggesting ingestion of a foreign body. Clinical and radiological findings did not indicate conservative therapy; our patient underwent minilaparotomy, and pronounced jejunal diverticulosis was identified. An enterotomy was performed and a cylindrical enterolith, 10cm long and 3cm in diameter, was removed. The operative and postoperative course was uneventful. Enterolithiasis must be considered as a potential source of intestinal obstruction. The differential diagnosis should take gallstone ileus and ingestion of a foreign body into consideration. Initial therapy is nonoperative; if this management fails, surgery is indicated.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |