scholarly journals The First Report of an Intraperitoneal Free-Floating Mass (an Autoamputated Ovary) Causing an Acute Abdomen in a Child

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ibrahim Uygun ◽  
Bahattin Aydogdu ◽  
Mehmet Hanifi Okur ◽  
Selcuk Otcu
Keyword(s):  
Small Intestine ◽  
Acute Abdomen ◽  
Terminal Ileum ◽  
Signs And Symptoms ◽  
Pathological Examination ◽  
Necrotic Tissue ◽  
First Case ◽  
The Right ◽  
Almost All ◽  
Thin Band

A free-floating intraperitoneal mass is extremely rare, and almost all originate from an ovary. Here, we present the first case with an intraperitoneal free-floating autoamputated ovary that caused an acute abdomen in a child and also review the literature. A 4-year-old girl was admitted with signs and symptoms of acute abdomen. At surgery, the patient had no right ovary and the right tube ended in a thin band that pressed on the terminal ileum causing partial small intestine obstruction and acute abdomen. A calcified mass was found floating in the abdomen and was removed. The pathological examination showed necrotic tissue debris with calcifications. An autoamputated ovary is thought to result from ovarian torsion and is usually detected incidentally. However, it can cause an acute abdomen.

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

scholarly journals Galinės klubinės žarnos obstrukcinis užspaudimas kirmėlinės ataugos kilpa

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Eglė Zakarauskaitė ◽  
Raimundas Lunevičius
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Terminal Ileum ◽  
Closed Loop ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Vermiform Appendix ◽  
Clinical Report ◽  
Vilnius University ◽  
The Right

Eglė Zakarauskaitė, Raimundas LunevičiusVilniaus universitetas, Gastroenterologijos, chirurgijos ir nefrourologijos klinikosBendrosios chirurgijos centras, Vilniaus universitetinė greitosios pagalbos ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Tikslas Aprašyti ir įvertinti visišką klubinės žarnos galinės dalies obstrukcinį nepraeinamumą dėl jos užspaudimo atipinės padėties kirmėlinės ataugos kilpa suaugusiam pacientui. Klinikinis atvejis Ligonis B. A., 71 metų, dėl sąrėmių pobūdžio skausmų visame pilvo plote, pilvo pūtimo ir pykinimo skubos tvarka hospitalizuotas į pilvo chirurgijos skyrių. Pacientas anksčiau nė karto nebuvo operuotas. Objektyvaus tyrimo rezultatai: pilvas išsipūtęs, skausmingas, maksimalaus skausmingumo ir pilvaplėvės dirginimo vieta – dešinioji klubinė sritis, auskultuojant žarnyną girdėti kliūtinė peristaltika. Apžvalginėje pilvo rentgenogramoje matyti daug Kloiberio dubenėlių išsipūtusioje plonojoje žarnoje. Diagnozavus konservatyviam gydymui atsparų visišką mechaninį žarnyno nepraeinamumą, atlikta vidurinė laparotomija. Operaciniai radiniai: stipriai išsipūtusi, iki galinės dalies perpildyta skysčių ir dujų plonoji žarna. Priežastis – apie galinę klubinės žarnos dalį kilpa apsisukusi, ją visiškai užspaudusi ir prie jos priekinės dalies pasaito prisitvirtinusi kirmėlinė atauga. Atlikta apendektomija, plonoji žarna intubuota peroraliniu enterodekompresiniu zondu. Kirmėlinės ataugos histologiniu tyrimu nustatyti antrinio uždegimo požymiai: paviršinis apendicitas ir hemoraginis periapendicitas. Pooperacinis laikotarpis buvo sklandus. Išvada Šis klinikinis atvejis patvirtina, jog galima labai reta komplikacija dėl atipinės kirmėlinės ataugos padėties: klubinės žarnos galinės dalies obstrukcinis užspaudimas kirmėlinės ataugos kilpa. Pagrindiniai žodžiai: apendiksas, atipinė padėtis, klubinės žarnos obstrukcija Strangulated terminal ileal obstruction due to closed-loop appendix Eglė Zakarauskaitė, Raimundas LunevičiusVilnius University, General Surgery Center of Clinic of Gastroenterology,Nephrourology and Surgery, Vilnius University Emergency Hospital,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Objective To describe and estimate a strangulated (by atypical appendix) closed-loop obstruction of the terminal ileum in an adult. Case report 71-year-old male was admitted because of crampy abdominal pain associated with nausea. There was no history of previous intraabdominal operations. On examination, the patient had obvious abdominal distention with peritoneal signs localized in the right iliocecal region. Bowel sounds were decreased. X-ray films showed multiple air fluid levels in the small intestine. Small-bowel obstruction was diagnosed and exploratory laparotomy was performed. The small intestine was heavily dilatated, overflowed by fluids and air because of a vermiform appendix wrapped around the terminal ileum and its mesenterium, and by its tip adhered to the ileocecal recessus. An appendectomy was performed, the small bowel was intubated using an enterodecompressive probe. Histopathology confirmed the diagnosis of secondary superficial appendicitis and hemorrhagic periappendicitis. The convalescence was not delayed. There were no postoperative complications. Conclusions This clinical report shows an unusual but possible very rare complication of atypically located appendix in an adult: a strangulated closed-loop obstruction of the terminal ileum. Key words: appendix, atypical positioning, acute ileal obstruction

Guided Endodontics in Root Canals with Complex Access: Two Case Reports

2021 ◽  
Vol 32 (6) ◽  
pp. 115-123
Author(s):  
Wesley Fernandes Gonçalves ◽  
Lucas da Fonseca Roberti Garcia ◽  
Daniela Peressoni Vieira-Schuldt ◽  
Eduardo Antunes Bortoluzzi ◽  
Luiz Carlos de Lima Dias-Júnior ◽  
...  
Keyword(s):  
Root Canal ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Radiographic Examination ◽  
Free Access ◽  
Filling Material ◽  
Radiographic Images ◽  
Root Canals ◽  
First Case ◽  
The Right

Abstract This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.

scholarly journals The Unusual Case of a Rapidly Enlarging Thyroid Gland in a Patient With Pendred Syndrome

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A960-A960
Author(s):  
Neal Maler ◽  
Ellis R Levin
Keyword(s):  
Thyroid Gland ◽  
Early Adulthood ◽  
Signs And Symptoms ◽  
Thyroid Function Tests ◽  
Pendred Syndrome ◽  
First Case ◽  
Patient Reported ◽  
Associated Symptoms ◽  
The Right ◽  
Left Thyroid Lobe

Abstract Pendred syndrome is a genetic condition that is characterized by sensorineural hearing loss, abnormalities of the vestibular system, and goiter. In patients with Pendred syndrome, goiter tends to develop in late childhood or early adulthood and the literature details a progressive enlargement of goiter in these individuals. Here we report the case of a 26 year old female with Pendred syndrome and congenital deafness who presented with a rapidly enlarging thyroid gland over 1 week with associated symptoms of dysphagia, dyspnea, insomnia, and diaphoresis. Thyroid function tests at the time showed no abnormalities. Diagnostic thyroid ultrasound was performed and showed enlarged, multinodular goiter and bilateral thyroid nodules measuring 1.2 cm and 1.1 cm in the right and left thyroid lobe, respectively, with TI-RADS 2 classification. The patient had a thyroid core biopsy performed showing benign appearing thyroid follicles without any evidence of malignancy. After approximately one month following the initial presentation, the patient reported resolution of her goiter and associated symptoms without intervention. To our knowledge, this is the first case in the literature detailing a rapidly enlarging goiter in a patient with Pendred Syndrome, with subsequent resolution of signs and symptoms.

scholarly journals Studies on intestinal digestion in the sheep

1969 ◽  
Vol 23 (2) ◽  
pp. 377-387 ◽  
Author(s):  
J. C. Macrae ◽  
D. G. Armstrong
Keyword(s):  
Small Intestine ◽  
Large Intestine ◽  
Terminal Ileum ◽  
Dry Matter ◽  
Alimentary Tract ◽  
Crude Fibre ◽  
Proximal Duodenum ◽  
Glucose Polymer ◽  
Gross Energy ◽  
Almost All

1. In seven experiments sheep were given diets ranging from all-hay to all-barley, and also a diet comprising one part hay to two parts flaked maize. Each sheep was equipped with a cannula into the rumen and a re-entrant cannula in the proximal duodenum; six of the ten also had a re-entrant cannula in the terminal ileum. Paper impregnated with chromic oxide (Cr2O3) was given twice daily by rumen fistula.2. Amounts of α-linked glucose polymer entering and leaving the small intestine and excreted in the faeces were measured. Some values for a fraction designated non-glucose reducing polymer for cellulose and for gross energy were also obtained. The amounts passing the proximal duodenum and the terminal ileum were adjusted to give 100% recovery of Cr2O3 and the values were used to measure the extent of digestion in various parts of the alimentary tract.3. When rolled or whole barley was given alone or was the major feed constituent the amount of α-linked glucose polymer entering the small intestine was 6.0±0.76% of that ingested (range 2.6–8.1%). The value was significantly lower than that found for the diet of hay and flaked maize (10.4±1.3%, range 8.0–13.6 %).The α-linked glucose polymer which entered the small intestine was almost completely digested there.4. The digestibility of the non-glucose reducing polymer, which included much of the hemicelluloses present, ranged from 51 to 73% and almost all the digestible fraction (93–97%) was digested before the small intestine when hay or predominantly hay diets were given. On high-cereal diets only 71–85% of the digested fraction disappeared before the small intestine and appreciable amounts were digested in the large intestine.5. On the all-hay diet 91% of the digestible cellulose and 67% of the digestible energy were lost before the small intestine, 0 and 21% in the small intestine and 9 and 12% in the large intestine.6. Mean digestibility coefficients determined in sheep fed solely on either whole or rolled barley were: for dry matter 88.1 and 87.9%, for nitrogen 83.5 and 82.1%, for crude fibre 53.7 and 56.6% and for gross energy 87.7 and 88.0%.

scholarly journals The first case of papillary thyroid carcinoma in an adolescent with congenital dyshormonogenetic hypothyroidism in Serbia

2014 ◽  
Vol 71 (11) ◽  
pp. 1078-1080 ◽  
Author(s):  
Jelena Eremija ◽  
Tatjana Milenkovic ◽  
Katarina Mitrovic ◽  
Sladjana Todorovic ◽  
Rade Vukovic ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Pathological Examination ◽  
Pediatric Malignancy ◽  
First Case ◽  
Thyroid Papillary ◽  
Right Lobe ◽  
The Right

Introduction. Differentiated thyroid carcinoma (DTC) is a rare childhood malignancy, as it represents 0.3-0.4% of pediatric malignancies. Papillary carcinoma is the most common type of pediatric DTC and it represents about 90% of all DTC patients. Although rare, DTC arising from dyshormonogenetic goiter is the most serious complication of congenital hypothyroidism. Case report. We presented the development of thyroid papillary carcinoma in a 15-year-old girl diagnosed with congenital dyshormonogenetic hypothyroidism at neonatal age. Considering the early initiation and proper dosage of hormonal substitution, normal levels of thyreotropin and thyroid hormones were achieved quickly and maintained through a follow-up period. The girl remained euthyroid and asymptomatic until 13.8 years of age, when she presented with a large multinodular goiter. The patient underwent total thyroidectomy. Pathological examination revealed intrathyroid microcarcinoma in the right lobe. Conclusion. Although differentiated thyroid carcinoma is a rare pediatric malignancy, it is of great importance to have a certain degree of clinical caution and provide a multidisciplinary approach during the follow-up of patients with dyshormonogenetic hypothyroidism.

scholarly journals Right retrocolic intrasaccular duodenum: Is it a novel variant of isolated duodenal nonrotation? A case report

2022 ◽  
Vol 11 ◽  
pp. 5
Author(s):  
Mirzaman Huseynov
Keyword(s):  
Terminal Ileum ◽  
Rare Variants ◽  
Ascending Colon ◽  
Right Colon ◽  
Ileocecal Region ◽  
Case Presentation ◽  
Bilious Vomiting ◽  
Novel Variant ◽  
The Right ◽  
Almost All

Background: Almost all of the studies on anomalies of the midgut rotation and fixation in the literature and related sections in textbooks were designed according to Dott's classification. Focusing only on common rotation anomalies has led to the exclusion and neglect of other rare variants. Isolated pure duodenal nonrotation is such a variant. Case Presentation: We report a case of an unusual form of isolated pure duodenal nonrotation, in a 3-day-old newborn presenting with bilious vomiting. Ultrasonographic examination revealed the sign of 'whirlpool'. When this finding was evaluated together with bilious vomiting, midgut volvulus was considered and the patient was operated on urgently. Peroperatively, it was observed that the jejunum entered between the leaves of the terminal ileum mesentery. Proximally, the duodenum was located posterior to the right colon in a "sack". This "sack" was surrounded by thick Ladd's bands laterally, mesentery of the ascending colon medially, the posterior surface of the cecum and ascending colon anteriorly, and by the posterior abdominal wall posteriorly. Conclusion: In isolated duodenal nonrotation, the duodenum may be completely retro-colic. Consequently, the duodenojejunal junction and the ileocecal region may almost overlap. Unlike isolated duodenal nonrotation cases, in the surgical treatment of this variant, separation of Ladd bands alone is not sufficient, additionally, the right colon should be placed in a nonrotation position and care should be taken not to kink the terminal ileum under the cecum.

scholarly journals Right Testicular Artery Occlusion and Acute Appendicitis by Angiostrongylus costaricensis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Luis Enrique Sánchez-Sierra ◽  
Roberto Antonio Martínez-Quiroz ◽  
Héctor S. Antúnez ◽  
Humberto Cabrera-Interiano ◽  
Fernando Josué Barrientos-Melara
Keyword(s):  
Acute Abdomen ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Artery Occlusion ◽  
Histopathological Study ◽  
Testicular Artery ◽  
Case Presentation ◽  
First Case

Introduction. Angiostrongylus costaricensis is a nematode from the superfamily Metastrongyloidea, whose etymology is “roundworm that lives in blood vessels”. This parasite can be found from the southern United States to northern Argentina and southern Brazil. In 1983, Morera and Ruiz published the first case of a testicular artery occlusion by A. costaricensis. Case Presentation. A five year old boy presented with eight days of pain, denying trauma backgrounds and followed with an increase of volume. The treatment was a right simply orchiectomy, finding necrosis of the testicle, the biopsy showed reddish-purple aspect and soft consistency. Histologic studies reveled the presence of a worm inside the testicular artery. Conclusion. The diagnosis of A. costaricensis infection should be considered in all pediatric patients, with signs and symptoms of orchitis or acute abdomen, from endemic areas, may cause occlusion of the testicular artery and appendicular artery causing testicular and cecal appendix necrosis, respectively, even putting the patient’s life at risk. The diagnosis is complex, because the clinical manifestations are similar to an orchitis or acute abdomen, therefore, the definitive diagnosis is made during the surgical intervention and histopathological study.

Metastatic Adrenal Cortical Carcinoma: Biochemical Changes Accompanying Clinical Regression During Therapy with o,p'-DDD

1971 ◽  
Vol 17 (12) ◽  
pp. 1191-1193 ◽  
Author(s):  
Lawrence Helson ◽  
Norma Wollner ◽  
M Lois Murphy ◽  
Morton K Schwartz
Keyword(s):  
Lung Metastases ◽  
Abdominal Mass ◽  
Signs And Symptoms ◽  
Bone Age ◽  
Acth Stimulation ◽  
History Of ◽  
Bilateral Lung ◽  
The Right ◽  
Almost All ◽  
Dexamethasone Suppression

Abstract A 7-year-old girl with a six-month history of increasing virilism, growth, and acne excreted supranormal amounts of urinary 17-ketosteroids (87.6 mg/24 h). ACTH stimulation and dexamethasone suppression studies indicated adrenal tumor. A large left adrenal carcinoma was removed. Metastases were not observed. Postoperatively, 24-h urinary ketosteroids remained supranormal (16 mg). Sudden fever, cough, and hemoptysis precipitated hospitalization 42 months later. Bilateral lung metastases, a mass in the right upper quadrant, virilism, advanced bone age, and supranormal 24-h urinary ketosteroids (166 mg) and hydroxysteroids (16 mg) were found. The patient received 240 g of o,p'-dichlorodiphenyl-dichloroethane (o,p'-DDD), whereupon the abdominal mass and lung lesions regressed and 24-h urinary ketosteroids and hydroxysteroids decreased. Since this treatment (which ended April, 1968) the patient has been maintained at home on 7.5 g o,p'-DDD/day and replacement therapy with 9-α-fluorohydrocortisone and cortisone acetate. Almost all signs and symptoms have disappeared and urinary steroids are normal.

scholarly journals COVID-19 Could Trigger Systemic Juvenile Idiopathic Arthritis: First Case Report

2020 ◽  
Author(s):  
Vadood Javadi Parvaneh ◽  
Khosro Rahmani
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Acute Abdomen ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Signs And Symptoms ◽  
The Body ◽  
Case Presentation ◽  
Systemic Jia ◽  
First Case ◽  
Inflammatory Syndrome

Abstract Background: COVID-19 has been reported to cause a variety of signs and symptoms during its three known phases.Case presentation: We report a 7 years-old boy with COVID-19 first presented with an acute abdomen. Then he showed pictures of Kawasaki-like syndrome, a multiorgan inflammatory syndrome in children (MIS-C), and finally systemic juvenile idiopathic arthritis.Conclusion: MIS-C is a result of the hyperinflammatory response of the body to SARS-CoV-2. Although there are increasing reports of this state in children, we reported the first case presenting systemic JIA triggered by COVID-19.

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