-
Journal of Medical Case Reports Nov 2023The duodenal web is a thin, elongated, web-like structure that is one of the factors contributing to duodenal obstruction. Only 100 cases have been reported in the...
BACKGROUND
The duodenal web is a thin, elongated, web-like structure that is one of the factors contributing to duodenal obstruction. Only 100 cases have been reported in the literature. We present a 2.5-year-old cachectic Afghan child who did not have any overt signs and symptoms of intestinal obstruction, like recurrent vomiting, abdominal distention, and weight loss. The web was discovered near the intersection of the third and fourth portions, which is an uncommon location for the duodenal web. The late presentation of congenital duodenal web with partial obstruction is rare but well-known and has been reported in this case.
CASE PRESENTATION
A 2.5-year-old cachectic Afghan child who had recurrent vomiting and experienced abdominal distention was brought to Maiwand Teaching Hospital from the Jabelsuraj region of Parwan province. The patient was suffering from unusual signs and symptoms like recurrent vomiting, abdominal distention, weight loss, and constipation. The diagnosis of these anomalies was established by a detailed history, clinical features, and abdominal CT scan. In the computerized tomography scanning (CT-Scan) image reported, there was a web with stenosis and partial obstruction in the distal aspect of the third-to-fourth portion of the duodenum. After preoperative stabilization, the child was taken for surgery. The abdomen was opened by a right upper abdominal transverse incision. After web resection and duodenoplasty, the patient was shifted to the recovery room in satisfactory condition. The child was allowed to feed after 8 days, which he tolerated well.
CONCLUSION
Congenital duodenal web with partial obstruction is typically observed in the second and third years of life. It is suspected in patients with recurrent vomiting, abdominal distention, weight loss, and constipation. Partial obstruction may not have an overt presentation, making it a challenging diagnosis for general practitioners. Abdomen X-ray and CT scan usually confirm the diagnosis, and successful surgical intervention is recommended.
Topics: Male; Humans; Child, Preschool; Duodenum; Duodenal Diseases; Duodenal Obstruction; Constipation; Vomiting; Weight Loss
PubMed: 37996900
DOI: 10.1186/s13256-023-04179-3 -
Revista Espanola de Enfermedades... Dec 2022A neonate at 31 weeks of gestation presented with aggravated abdominal distention on the 2th day after birth. The birth weight was 2110 g. Radiography of the abdomen...
A neonate at 31 weeks of gestation presented with aggravated abdominal distention on the 2th day after birth. The birth weight was 2110 g. Radiography of the abdomen showed pneumoperitoneum. The neonate was complicated with respiratory distress, electrolyte disturbance and coagulation disorders. Laparoscopic exploration revealed an approximately 6 cm length rupture of the greater curvature, extending from cardia to proximal pylorus. After trimming necrosis tissue of the edge, the gastric wall perforation was repaired surgically. Thinning and disappearance of muscularis were showed at edge of defect. The neonate's condition improved and oral feeding was started on postoperative day 7. The birth weight was 2300 g at discharge.
Topics: Infant, Newborn; Humans; Birth Weight; Pneumoperitoneum; Stomach Diseases; Abdomen
PubMed: 35607938
DOI: 10.17235/reed.2022.8913/2022 -
Turkish Journal of Medical Sciences Apr 2018Background/aim: Tuberculous peritonitis may be difficult to diagnose due to its insidious and variable clinical manifestations as well as characteristics similar to...
Background/aim: Tuberculous peritonitis may be difficult to diagnose due to its insidious and variable clinical manifestations as well as characteristics similar to malignancy. In this study, case reports from Turkey over the last 10 years were reviewed systematically using pooled analysis. Materials and methods: Thirty-four suitable articles were found and 163 tuberculous peritonitis cases were included in the study. Results: The mean age was 34.1 years (17–79 years), and 146 (98.6%) of the patients were female and 17 (10.4%) were male. The most common complaints of these patients were abdominal pain (77.4%) and abdominal distention (73.5%). Ascites in the abdomen (75%), fever (42%), abdominal tenderness (33%), and abdominal distention (30.7%) were the most common physical examination findings. The mean adenosine deaminase level was 120.3 IU/L. In the subsets of patients with relevant data, acid-fast bacilli were found in 23.3%, culture was positive in 22.2%, and Mycobacterium tuberculosis polymerase chain reaction was positive in 20%. In abdominal imaging, ascites was reported in 92%. Elevated serum CA-125 was reported in 96.7% of the patients. Of 105 patients with data available following the antituberculous therapy prognosis, four (3.8%) died and the other 101 (96.2%) showed good treatment response. Conclusion: Tuberculous peritonitis should be kept in mind during the differential diagnosis of patients admitted with the triad of ascites, fever, and abdominal distention.
PubMed: 29714445
DOI: 10.3906/sag-1701-32 -
Physiological Research Dec 2017Abdominal aortic aneurysm (AAA) is a prevalent and potentially life threatening disease. Many animal models have been developed to simulate the natural history of the... (Review)
Review
Abdominal aortic aneurysm (AAA) is a prevalent and potentially life threatening disease. Many animal models have been developed to simulate the natural history of the disease or test preclinical endovascular devices and surgical procedures. The aim of this review is to describe different methods of AAA induction in animal models and report on the effectiveness of the methods described in inducing an analogue of a human AAA. The PubMed database was searched for publications with titles containing the following terms "animal" or "animal model(s)" and keywords "research", "aneurysm(s)", "aorta", "pancreatic elastase", "Angiotensin", "AngII" "calcium chloride" or "CaCl(2)". Starting date for this search was set to 2004, since previously bibliography was already covered by the review of Daugherty and Cassis (2004). We focused on animal studies that reported a model of aneurysm development and progression. A number of different approaches of AAA induction in animal models has been developed, used and combined since the first report in the 1960's. Although specific methods are successful in AAA induction in animal models, it is necessary that these methods and their respective results are in line with the pathophysiology and the mechanisms involved in human AAA development. A researcher should know the advantages/disadvantages of each animal model and choose the appropriate model.
Topics: Angiotensin II; Animals; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Calcium Chloride; Dilatation, Pathologic; Disease Models, Animal; Disease Progression; Female; Genetic Predisposition to Disease; Hemodynamics; Humans; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Pancreatic Elastase; Phenotype; Rabbits; Rats; Rats, Sprague-Dawley; Rats, Wistar; Sus scrofa; Vascular Remodeling
PubMed: 28937252
DOI: 10.33549/physiolres.933579 -
International Medical Case Reports... 2022Wandering spleen is a rare condition characterised by laxity or lack of splenic ligaments as a result of acquired or congenital causes. There is a possibility of...
INTRODUCTION
Wandering spleen is a rare condition characterised by laxity or lack of splenic ligaments as a result of acquired or congenital causes. There is a possibility of misdiagnosis due to its vague symptoms. In order to make a proper diagnosis, imaging techniques including abdominal ultrasonography and CT scanning are essential. Surgery is the main option of management. If the spleen is viable and there is no thrombosis in the splenic veins, splenopexy is the preferred surgical procedure. Alternatively, splenectomy plus prophylactic antibiotic and vaccination usage may be employed if spleen has infarction.
CASE PRESENTATION
A 12-year-old male child who had previously experienced constipation, mucoid diarrhoea, and abdominal distention arrived with crampy abdominal pain that had lasted for four days. The patient was tachycardic with abdominal tenderness. Whirlpool sign and lack of a spleen in its normal position were visualized on an abdominal ultrasound. The spleen was located intraoperatively in the lower abdomen, adhered to the ileum and appendix. It was 720° twisted and had necrotic areas. The patient underwent an appendectomy with splenectomy with a smooth post-operative course; combination meningococcal and pneumococcal vaccines were administered; and antibiotic prophylaxis was started for the patient.
CONCLUSION
High clinical suspicion and the use of imaging modalities like ultrasound and CT scan are extremely crucial to diagnose wandering spleen and perform splenic salvage surgery because its clinical diagnosis is challenging.
PubMed: 36388241
DOI: 10.2147/IMCRJ.S388271 -
Medicine Sep 2022Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.
RATIONALE
Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult.
PATIENT CONCERNS
We report a case of a 34-year-old man with solid abdominal cystic echo mass. Physical examination showed that the patient had a flat and soft abdomen without tenderness or rebound pain, no fluid wave tremor, and no obvious abdominal mass was touched. The patient complained of repeated abdominal distention with nausea for 5 days. Sonographic examination suspected pseudomyxoma peritoneum.
DIAGNOSIS
Conventional ultrasound examination showed a cystic solid echo mass in the right abdominal cavity of the patient, with uneven internal echo and honeycomb change, and clear boundary with surrounding organs. Color Doppler suggested that the blood flow in the mass was not obvious. Contrast-enhanced computed tomography of the abdomen revealed hypodensity foci in hepatic and renal crypts and right paracolic sulcus.
INTERVENTIONS
Laparoscopic resection of the mass was performed, and the postoperative pathological findings were polycystic mesothelioma (greater omentum).
OUTCOMES
After mass resection, all laboratory tests and abdominal ultrasound were normal, and abdominal distension and nausea disappeared.
LESSONS
Improved ultrasound diagnosis of MM is useful for clinical decision-making.
Topics: Adenomatoid Tumor; Adult; Diagnostic Errors; Humans; Male; Mesothelioma; Nausea; Omentum
PubMed: 36086679
DOI: 10.1097/MD.0000000000030441 -
Journal of Ayub Medical College,... 2022Papillary renal cell carcinoma comprises around 15% of all renal cell carcinomas. Patients are usually asymptomatic, and 25 percent of individuals have advanced...
Papillary renal cell carcinoma comprises around 15% of all renal cell carcinomas. Patients are usually asymptomatic, and 25 percent of individuals have advanced locoregional disease at presentation. Papillary renal cell carcinoma presenting as a huge abdominal cystic mass is uncommon and is reported rarely in literature. We present a case of renal cell carcinoma presenting with abdominal pain, distention, and constipation. A retroperitoneal cystic lesion measuring 23.4×23.8 cm cyst was reported on ultrasonography as potential cause of the symptoms. We now talk about the case of a 57- year-old male who presented to us with abdominal pain, distension, and constipation. He also had a history of on and off low-grade fever for the last seven months. A computed topography (CT scan) of the abdomen and pelvis with intravenous and oral contrast revealed a large retroperitoneal cystic mass extending from the left hypochondrium to the left kidney and into the pelvis crossing the midline. Internal calcific foci, enhancing septa, irregularly thickened walls and hyperdense nodules were also demonstrated. A radical left nephrectomy via a midline laparotomy was performed electively. The cystic mass was excised and the specimen was sent for histopathological evaluation which revealed papillary renal cell carcinoma with PAX-8 and CK-7 positivity. Patient made an uneventful recovery post-operatively and was discharged. Cystic tumors of renal origin can rarely present as a huge abdominal cystic mass confusing them for masses of intestinal or hepatic origin. Timely diagnosis can be made with a detailed history, examination, imaging studies and histopathology, and instigate timely intervention.
Topics: Male; Humans; Middle Aged; Carcinoma, Renal Cell; Kidney Neoplasms; Kidney; Abdominal Pain; Abdomen
PubMed: 36566423
DOI: 10.55519/JAMC-04-10865 -
Revista Espanola de Enfermedades... Jun 2024A 63-year-old man presented with left abdominal pain, abdominal distention, and black stool following emotional stress and strenuous exercise. CT examination revealed a...
A 63-year-old man presented with left abdominal pain, abdominal distention, and black stool following emotional stress and strenuous exercise. CT examination revealed a large cystic mass in the left abdominal cavity, as well as the presence of a teratoma in the hepatogastric space and a descending duodenal diverticulum. Subsequently, he underwent surgical resection, and the pathological findings indicated that the cyst wall consisted of mucinous glandular epithelium and smooth muscle, displaying a structure similar to normal intestinal wall tissue. Furthermore, the cyst was lined with ciliated columnar epithelium, confirming the diagnosis of an isolated enterogenous cyst (EC). Due to the potential trauma associated with excising the EC, the patient did not undergo resection of the teratoma, especially given its proximity to a branch of the trunk abdominal artery.
Topics: Humans; Male; Teratoma; Middle Aged; Cysts; Tomography, X-Ray Computed; Retroperitoneal Space
PubMed: 37539533
DOI: 10.17235/reed.2023.9799/2023 -
BMJ Case Reports Feb 2013A term male neonate presented to his paediatrician for a routine follow-up after hospital discharge. Prenatal care had been excellent and labour and delivery had been...
A term male neonate presented to his paediatrician for a routine follow-up after hospital discharge. Prenatal care had been excellent and labour and delivery had been unremarkable. He had been feeding, gaining weight and was not in distress though significant abdominal distention was noted. Lab tests revealed electrolytes derangements, metabolic acidosis and renal failure. An ultrasound revealed severe unilateral hydronephrosis and echogenic kidneys. A voiding cystourethrogram revealed the definitive diagnosis which was posterior urethral valves.
Topics: Abdomen; Diagnosis, Differential; Dilatation, Pathologic; Humans; Infant, Newborn; Male; Renal Insufficiency; Ultrasonography; Urethra; Urethral Obstruction
PubMed: 23429016
DOI: 10.1136/bcr-2012-007955 -
Acta Bio-medica : Atenei Parmensis Mar 2022Liposarcoma is a rare tumor that can be treated by surgery in the absence of distant metastases. Management of liposarcoma, including diagnosis and therapy, is...
Liposarcoma is a rare tumor that can be treated by surgery in the absence of distant metastases. Management of liposarcoma, including diagnosis and therapy, is challenging because it has no characteristic symptoms and no established effective treatment. Here, we report two rare cases of primary mesenteric liposarcoma. In the first case, the tumor caused small bowel obstruction, and the patient presented with abdominal distention and severe abdominal pain. The second case is an occasional finding that occurred during laparoscopic surgery for incisional hernia. Both patients underwent successful resection of the tumor. Histopathology found a well-differentiated liposarcoma in both cases.
Topics: Humans; Intestinal Obstruction; Intestine, Small; Lipoma; Liposarcoma; Mesentery
PubMed: 35261391
DOI: 10.23750/abm.v92iS1.12010