1/16. Acute abdomen in infants of adolescent mothers: diagnostic challenges.Caring for children of adolescent parents presents unique challenges. Because adolescent parents may lack parenting skills and knowledge of medical terminology, symptoms of life-threatening illnesses may be misinterpreted. We present two cases of unexpected acute abdomen in young infants with adolescent mothers. The first case involves midgut volvulus, which was discovered during a routine newborn visit. The second case, involving pyloric stenosis, presented a clinical management challenge when the adolescent mother refused diagnostic studies.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
2/16. Acute abdomen due to wandering spleen infarction: a case report.We report a rare clinical case of acute abdomen due to partial infarction of a wandering spleen in the pelvis in a 60-year-old woman. The patient was suffering from stabbing pain in the external lower quadrant of the abdomen, irradiating back to the lumbosacral area, together with an unremitting feverish state (38 degrees C), sickness and constipation. After carrying out serological examinations, which revealed an increase in CPK and leukocytosis, ultrasonography and CT examinations were performed, revealing a mass in the left iliac cavity, which in all probability was a wandering spleen with an abnormally long pedicle and a dyshomogeneous lower area bearing witness to a splenic infarction. The patient was therefore submitted to surgery consisting in splenectomy after lysis of the adherences, which were plainly inflammatory. A wandering spleen, especially when infarcted, is a very rare clinical condition that may be congenital or acquired. Its presence can be confirmed by serological, ultrasonographical and CT examinations and must be suspected when there is no clearly defined acute abdomen.- - - - - - - - - - ranking = 1195.9339849383keywords = sickness (Clic here for more details about this article) |
3/16. Splenic anisakiasis resulting from a gastric perforation: an unusual occurrence.We report a case of gastric perforation by anisakis sp. with consequent localization of the larva in the spleen. An 86-year-old white woman was admitted to our surgical department with a diagnosis of acute abdomen. She had a history of abdominal pain, and her laboratory data showed leukocytosis. In the plain abdominal radiograph, pneumoperitoneum was evident; a computed tomography (CT) scan of the abdomen confirmed the presence of extraluminal air. Anamnesis disclosed the ingestion of raw fish during the week preceding her illness. The patient was underwent emergency laparotomy. A small gastric perforation and a nodular area at the superior pole of the spleen were found. Surgical treatment was performed successfully and consisted of excision of the gastric lesion and splenectomy. The histological diagnosis revealed the presence of gastritis with an ulcer, and in the splenic tissue, some necrotic foci containing cross-sectioned degenerated worms compatible with anisakis larva.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
4/16. gastroenteritis due to Salmonella sp: clinical and radiologic signs mimicking surgical peritonitis.salmonella infections most often are self-limited illnesses confined to the gastrointestinal system. They can, however, produce clinical and radiographic findings consistent with peritonitis. Careful attention to evaluation and treatment is required to avoid unnecessary surgery for what may initially appear to be a surgical condition.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
5/16. Pain insensitivity in schizophrenia. Case report and review of the literature.We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illnesses in which pain is characteristically a prominent presenting symptom. While research into the cause of altered pain perception in psychotic patients is continuing, clinicians should maintain a high index of suspicion of serious medical illness when evaluating such patients.- - - - - - - - - - ranking = 2keywords = illness (Clic here for more details about this article) |
6/16. A rare presentation of systemic salmonellosis.We are reporting an unusual case of disseminated salmonella enteritidis D, phage group E2 infection in an 18-year-old male, which was resistant to massive antibiotic treatment. Rare complications such as pylephlebitis, mediastinal adenopathy, osteomyelitis with pathological clavicular fracture, osteitis and spondylitis were observed. We found an immunological defect that no doubt contributed to this severe illness.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
7/16. Acute appendicitis in patients with Gilbert's syndrome.Gilbert's syndrome is a benign disorder characterized by intermittent hyperbilirubinemia. jaundice is provoked by anorexia and fever, conditions associated with acute abdominal illnesses. Three cases of Gilbert's syndrome and acute appendicitis are presented. The presence of jaundice resulted in errors of diagnosis with serious complications.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
8/16. Upper gastrointestinal endoscopy in systemic vasculitis presenting as an acute abdomen.Three cases of upper gastrointestinal vasculitis presenting as acute abdominal emergencies highlight an uncommon but often fatal presentation of systemic vasculitis. Although abdominal symptoms are common in such diseases, there may be a doubt during assessment of the patient as to whether the gastrointestinal tract is the prime target organ. radiology is often negative during the acute illness. endoscopy was important in documenting early and more advanced bleeding lesions of polyarteritis nodosa (PAN) and Henoch-Schoenlein disease, both conditions in which upper gastrointestinal lesions are rare. The gastric and duodenal vasculitic lesions demonstrated by endoscopy in such a clinical setting were confirmed histologically. Endoscopic assessment and early aggressive medical therapy contributed significantly towards the overall successful outcome. Gastroduodenoscopy has not been used either routinely or as an emergency investigation for the assessment of patients with vasculitis who present with acute abdominal pain. Involvement of the stomach and duodenum by vasculitis is therefore poorly appreciated, but remains a serious complication of vasculitic disease when the gastrointestinal tract is the prime target organ, and the information gained by endoscopy in a difficult clinical situation might alter the overall outcome of the disease.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
9/16. Segmental infarction of the greater omentum: a cause of acute abdomen in childhood.Segmental infarction of the greater omentum is an unusual cause of acute abdominal pain in children. Over 30 years at the Hospital for Sick Children in Toronto, this entity was encountered nine times. All children complained of right lower quadrant pain. They were tender in that area and were thought to have acute appendicitis. At operation, the appendix was found to be normal in all and an area of infarcted omentum was identified as the cause of the acute illness. Torsion of the infarcted omentum was noted in four cases. Excision of the omentum was curative.- - - - - - - - - - ranking = 1keywords = illness (Clic here for more details about this article) |
10/16. Factitious illness in gynecology.Factitious or self-induced illness has rarely been mentioned in gynecologic literature. Described herein are 4 nonpregnant women, 3 of whom had vaginal bleeding of unknown origin and 1 who had recurrent fevers and an acute abdomen. In gynecologic practice, factitious illness should be suspected whenever a patient presents with a protracted illness that has eluded diagnosis. Furthermore, the index of suspicion for factitious illness should be high whenever a patient has an abnormal psychiatric history or has worked in a paramedical field.- - - - - - - - - - ranking = 8keywords = illness (Clic here for more details about this article) |
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