- Infarcted accessory spleen masquerading as a mesenteric cyst. [Journal Article]
- BCBMJ Case Rep 2018 Aug 16; 2018
- An accessory spleen is a rare entity which is usually asymptomatic. When symptomatic, it presents as an acute abdomen, with either torsion, rupture or haemorrhage. We present the case of a 20-year-ol...
An accessory spleen is a rare entity which is usually asymptomatic. When symptomatic, it presents as an acute abdomen, with either torsion, rupture or haemorrhage. We present the case of a 20-year-old man who presented with chronic lower abdominal pain since 3 months and a lump in the left lower quadrant. On clinical examination and investigations, the lump was diagnosed as a mesenteric cyst, and an uncomplicated laparoscopic excision was performed. The postoperative histopathological examination reported it as an infarcted accessory spleen.
- Subcutaneous Heparin Leads to Rectus Sheath Hematoma: A Rare Complication. [Journal Article]
- CCureus 2018 Jun 08; 10(6):e2769
- Rectus sheath hematoma (RSH) is a rare complication that usually occurs in patients receiving anticoagulation therapy. It can mimic an acute abdomen and be life-threatening. RSH can develop even with...
Rectus sheath hematoma (RSH) is a rare complication that usually occurs in patients receiving anticoagulation therapy. It can mimic an acute abdomen and be life-threatening. RSH can develop even with prophylactic dose of heparin. Early recognition is necessary to decrease morbidity and mortality. RSH should be considered in anticoagulated patients who develop sudden onset of abdominal pain. RSH is usually managed conservatively, but sometimes requires surgery. Patients who are taking antiplatelet require careful monitoring with the use of anticoagulation (AC). It is important to identify them early. This is a case of 69-year-old female who presented with epigastric pain secondary to rectus sheath hematoma. She was receiving subcutaneous injections of heparin for left lower quadrant pain and swelling for venous thromboembolism prophylaxis. Ultrasound of abdomen revealed large rectus sheath hematoma.
- Co-occurring superior mesenteric artery syndrome and nutcracker syndrome requiring Roux-en-Y duodenojejunostomy and left renal vein transposition: a case report and review of the literature. [Journal Article]
- JMJ Med Case Rep 2018 Aug 06; 12(1):214
- CONCLUSIONS: The disorders associated with aortomesenteric compression can lead to serious symptoms and sometimes death. Diagnosis is challenging not only because of the lack of awareness of these rare disorders, but also because they are associated with symptoms that are similar to those seen in less serious diseases. Guidance for health care professionals with respect to relevant radiological and clinical markers needs to be reconsidered in order to clarify the etiology of the diseases and create better diagnostic protocols.
- Epiploic appendagitis: A rare cause of acute abdomen. [Journal Article]
- RCRadiol Case Rep 2018; 13(3):599-601
- Epiploic appendagitis is a rare cause of acute abdomen that often manifests with acute onset of pain in the left or right lower quadrant. Its symptoms can mimic and be mistaken for acute diverticulit...
Epiploic appendagitis is a rare cause of acute abdomen that often manifests with acute onset of pain in the left or right lower quadrant. Its symptoms can mimic and be mistaken for acute diverticulitis, appendicitis, or omental infarction. In this case report, we discuss a 65-year-old woman who presented with sharp right upper and lower quadrant abdominal pain, for which she had an emergent abdominal computed tomography (CT) scan. On CT images, epiploic appendagitis will appear as oval lesions with a central area of fat attenuation, accompanied by surrounding inflammation. Ultrasound and magnetic resonance imaging are more often used to evaluate acute abdominal pain in the pediatric and obstetric populations, so the respective findings of acute epiploic appendagitis must be recognized in those examinations as well. Despite the rarity of the condition and its common omission from differential diagnoses, the ability to recognize and diagnose epiploic appendagitis from its imaging is important for radiologists, especially considering its potential complications. If not diagnosed correctly, epiploic appendagitis can result in unnecessary hospital admission and patient workup, antibiotic use, dietary restrictions, and perhaps even unnecessary surgery. In this case, the diagnosis of epiploic appendagitis using CT allowed the patient to avoid surgery and other invasive treatment, and the patient was eventually discharged on conservative medical management.
- Severe abdominopelvic actinomycosis with colon perforation and hepatic involvement mimicking advanced sigmoid colon cancer with hepatic metastasis: a case study. [Journal Article]
- BSBMC Surg 2018 Aug 02; 18(1):51
- CONCLUSIONS: Abdominopelvic actinomycosis presenting with colon perforation and hepatic involvement is extremely rare; however, it is clinically similar to advanced colon cancer with liver metastasis, therefore, complicating the preoperative diagnosis. A diagnosis of abdominopelvic actinomycosis should be considered in patients with a history of IUD and chronic abdominal pain, along with an abdominal mass or cutaneous abscess. If surgery is indicated, preoperative empirical antibiotic therapy for actinomycosis and frozen biopsy during surgery may be considered.
- Handlebar hernia - A rare complication from blunt trauma. [Journal Article]
- IJInt J Surg Case Rep 2018; 49:118-120
- CONCLUSIONS: A high level of suspicion is required to diagnose handlebar hernias. Even relatively low-speed trauma can result in this insidious injury. Laparoscopic repair has been demonstrated to be successful in this case.Despite being a rare entity, handlebar hernias should be suspected when significant blunt force is applied to the abdominal wall from a handle bar injury. They may not be obvious on physical examination and therefore further imaging is often important. Management involves prompt surgical repair to prevent complications.
- Small bowel perforation by toothpick. [Journal Article]
- BCBMJ Case Rep 2018 Jul 11; 2018
- Toothpick ingestion is a rare but potentially fatal condition which may cause bowel perforation and rare complications if it migrates out of the gastrointestinal tract. This case report describes a d...
Toothpick ingestion is a rare but potentially fatal condition which may cause bowel perforation and rare complications if it migrates out of the gastrointestinal tract. This case report describes a delayed presentation of toothpick-induced small bowel injury leading to abdominal wall abscess and spondylodiscitis. A 51-year-old man was admitted twice with fever and loin pain, but repeated non-contrast CT was reported to be unremarkable. However, 5 months later, he presented with a left lower quadrant abdominal wall abscess and back pain. An updated CT showed a linear hyperdensity which was already present in previous scans, causing small bowel perforation, abdominal wall abscess and spondylodiscitis. Emergency laparotomy identified a toothpick causing small bowel perforation. The abdominal wall abscess was incised and drained, and small bowel was repaired.
- Epiploic Appendagitis Mimicking Recurrent Diverticulitis. [Journal Article]
- CRCase Rep Surg 2018; 2018:1924067
- Here, we report a case in which a patient with an extensive history of diverticulitis of the sigmoid colon presented with left lower quadrant abdominal pain similar to her previous episodes of divert...
Here, we report a case in which a patient with an extensive history of diverticulitis of the sigmoid colon presented with left lower quadrant abdominal pain similar to her previous episodes of diverticulitis. An initial diagnosis of diverticulitis was made based on her history and exam, intravenous antibiotics were given, and an elective surgical resection was considered. However, a subsequent CT scan revealed epiploic appendagitis with no evidence of diverticulitis. Though uncommon, in patients with a history of recurrent diverticulitis, alternative causes of left lower quadrant abdominal pain such as epiploic appendagitis should be considered as this may alter future treatment decisions.
- Left Upper-Quadrant Appendicitis in a Patient with Congenital Intestinal Malrotation and Polysplenia. [Journal Article]
- AJAm J Case Rep 2018 Apr 16; 19:447-452
- CONCLUSIONS: Acute appendicitis may present with atypical symptoms due to unusual appendix locations, such as in malrotation. Most cases are asymptomatic until development of acute complications, requiring imaging for diagnosis. Clinicians and radiologists should have a high index of suspicion and knowledge of its clinical presentations to achieve early diagnosis and intervention.
New Search Next
- Left-sided cecal diverticulitis associated with midgut malrotation. [Journal Article]
- CJCi Ji Yi Xue Za Zhi 2018 Jan-Mar; 30(1):47-50
- Malrotation of the midgut is generally considered as a pediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adults, which sometimes leads to delay in di...
Malrotation of the midgut is generally considered as a pediatric pathology with the majority of patients presenting in childhood. The diagnosis is rare in adults, which sometimes leads to delay in diagnosis and treatment. An index of suspicion is therefore required when dealing with patients of any age group with abdominal symptoms. We present a case of a 26-year-old male who presented with left lower abdominal pain with preoperative computed tomography showing suspected left-sided appendicitis associated with midgut malrotation. The duodenum, small bowel, and cecum were abnormally located, with the presence of a thickened and inflamed appendix with fecalith images. The patient underwent an emergency laparotomy, and ruptured cecal diverticulitis with abscess formation was confirmed. We performed a cecectomy, and the patient did not have an uneventful postoperative recovery. A review of the literature is presented to highlight the rarity of midgut malrotation and the controversies surrounding its surgical management in the adult population with ruptured left-sided cecal diverticulitis.