scholarly journals An Unusual Case of Stercoral Perforation in a Patient with 86 cm of Small Bowel

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Alfin Okullo ◽  
Ghiyath Alsnih ◽  
Titus Kwok
Keyword(s):  
Primary Closure ◽  
Unusual Case ◽  
Wedge Resection ◽  
Right Hemicolectomy ◽  
Uneventful Recovery ◽  
Rectal Perforation ◽  
Faecal Contamination ◽  
Abdominal Tenderness ◽  
X Ray ◽  
Work Up

A 77-year-old male who previously had extensive enterectomy due to ischaemic gut with loss of all but 86 cm of jejunum in addition to a right hemicolectomy presented to the emergency department (ED) with abdominal pain and constipation of 12-day duration. Abdominal imaging with X-ray and CT revealed pneumoperitoneum in addition to a grossly redundant and faecally loaded colon. At laparotomy, rectal perforation was found. In view of the patient’s advanced age, comorbidities, and the absence of intraperitoneal faecal contamination, manual disimpaction followed by wedge resection and primary closure of the perforation was done. On postop day 11, a perforation in the sigmoid colon with free subdiaphragmatic gas was picked up on CT after a work up for abdominal tenderness. In the absence of peritonism and other signs of deterioration, conservative management was chosen with subsequent uneventful recovery for the patient.

scholarly journals Rapid four-component synthesis of dihydropyrano[2,3-c]pyrazoles using nano-eggshell/Ti(IV) as a highly compatible natural based catalyst

BMC Chemistry ◽  
2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Arefeh Dehghani Tafti ◽  
Bi Bi Fatemeh Mirjalili ◽  
Abdolhamid Bamoniri ◽  
Naeimeh Salehi
Keyword(s):  
Thermo Gravimetric Analysis ◽  
Reaction Times ◽  
Diffraction Field ◽  
Gravimetric Analysis ◽  
X Ray Diffraction ◽  
X Ray ◽  
Solvent Free Conditions ◽  
High Yields ◽  
Work Up

AbstractNano-eggshell/Ti(IV) as a novel naturally based catalyst was prepared, characterized and applied for the synthesis of dihydropyrano[2,3-c]pyrazole derivatives. The characterization of nano-eggshell/Ti(IV) was performed using Fourier Transform Infrared spectroscopy, X-ray Diffraction, Field Emission Scanning Electron Microscopy, Energy-Dispersive X-ray Spectroscopy, and Thermo Gravimetric Analysis. Dihydropyrano[2,3-c]pyrazoles were synthesized in the presence of nano-eggshell/Ti(IV) via a four component reaction of aldehydes, ethyl acetoacetate, malononitrile and hydrazine hydrate at room temperature under solvent free conditions. The principal affairs of this procedure are mild condition, short reaction times, easy work-up, high yields, reusability of the catalyst and the absence of toxic organic solvents.

Unusual case of rectal perforation

2021 ◽  
Author(s):  
Michelle Zhiyun Chen ◽  
Eric Daniel
Keyword(s):  
Unusual Case ◽  
Rectal Perforation

Synthesis and structure of large 24-mer and 36-mer oxamate-based macrocycles

2017 ◽  
Vol 72 (7) ◽  
pp. 461-474 ◽  
Author(s):  
Saddam Weheabby ◽  
Mohammad A. Abdulmalic ◽  
Evgeny A. Kataev ◽  
Tatiana A. Shumilova ◽  
Tobias Rüffer
Keyword(s):  
Oxalyl Chloride ◽  
Spectroscopic Studies ◽  
Equimolar Amount ◽  
X Ray Diffraction ◽  
Intermolecular Hydrogen Bonds ◽  
X Ray ◽  
Accessible Volume ◽  
Hydrogen Bond Interactions ◽  
Work Up ◽  
Solid State Structures

AbstractPoly(cyclic) oxamates represent novel and potentially multidentate ligands for coordination chemistry. To obtain them, the treatment of 2-nitroaniline with two equivalents of oxalyl chloride afforded N,N′-bis(2-nitrophenyl)oxalamide (1), and by reduction of 1 with [NH4][CO2H] and Pd/C, N,N′-bis(2-aminophenyl)oxalamide (2, bapoxH6) was synthesized. After the addition of an equimolar amount of oxalyl chloride to a THF solution of 2 and aqueous work-up the 24-membered macrocycle H8L2 was obtained. In analogues experiments, the addition of ethoxalyl and oxalyl chloride to 2 afforded the 36-membered macrocycle H12L3. The addition of Cu(OAc)2·H2O and NaOH to 2 gave rise to the formation of [Cu2(bapoxH4)(OAc)2] (4). The identities of 1, 2 and H8L2 were determined by elemental analysis, IR, NMR spectroscopic studies and by mass spectrometry. The solid state structures of H8L2, H12L3 and 4 have been determined by single-crystal X-ray diffraction studies. Macrocycle H12L3 forms chains through intermolecular hydrogen bonds, while packing of 4 consists of layers held by intermolecular dispersion and hydrogen bond interactions. 24-mer H8L2 forms a cavity with a diameter of about 7.5 Å corresponding to an accessible volume of about 120 Å3 according to the well-established 55% solution and was found to bind bromide and iodide anions selectively.

scholarly journals An Unusual Case of Rectal and Ileal Carcinoid Tumors

2017 ◽  
Vol 10 (3) ◽  
pp. 793-799
Author(s):  
Molham Abdulsamad ◽  
Naeem Abbas ◽  
Bhavna Balar
Keyword(s):  
Gastrointestinal Tract ◽  
Neuroendocrine Tumor ◽  
Carcinoid Tumor ◽  
Terminal Ileum ◽  
Incidental Findings ◽  
Unusual Case ◽  
Right Hemicolectomy ◽  
Surveillance Colonoscopy ◽  
Stage 1 ◽  
Ileal Carcinoid

Carcinoid tumor is the most common neuroendocrine tumor affecting the gastrointestinal tract. The coexistence of multifocal carcinoid lesions is a well-established phenomenon. Although intubation of the terminal ileum is not routinely attempted during colonoscopy, it can occasionally reveal the presence of some incidental findings. We present a patient with known rectal carcinoid, who was found to have another carcinoid lesion in the terminal ileum during surveillance colonoscopy. The patient underwent right hemicolectomy, and no chemotherapy was required as the patient was found to have stage 1 carcinoid tumor.

Substernal goitre presenting with upper and lower extremity oedema

2021 ◽  
Vol 14 (11) ◽  
pp. e245036
Author(s):  
Rebekah LeAnn Bennett Daggett ◽  
Daniel Farishta ◽  
Hugo Cuellar ◽  
Cherie-Ann O Nathan
Keyword(s):  
Lower Extremity ◽  
Initial Assessment ◽  
Uneventful Recovery ◽  
Surgical Removal ◽  
Extensive Literature ◽  
Rare Presentation ◽  
Clinical Presentations ◽  
Left Innominate Vein ◽  
Home Placement ◽  
Work Up

Substernal goitre is characterised by compressive symptoms of the airway and oesophagus. Chronic, progressive symptoms usually result in surgical removal. We report a rare presentation of substernal goitre in a male in his early 70s who suffered from severe bilateral lower extremity (LE) lymphoedema, resulting in immobility and nursing home placement, and left upper extremity lymphoedema. Our initial assessment led to a filariasis work-up, which was negative, due to the patient’s prior 2-year residence in India and service overseas. Chest CT scan revealed an incidental substernal goitre extending posterior to the left innominate vein and aortic arch to the level of the left mainstem bronchus. The patient underwent a left hemithyroidectomy via cervical excision and sternotomy and had an uneventful recovery with resolution of lymphoedema and mobility. Despite extensive literature regarding clinical presentations of substernal goitre, severe lymphoedema of the LE is not a well-established association.

scholarly journals Extensive Surgical Emphysema in a Child after Primary Closure of Tracheocutaneous Fistula

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
R. Gurung ◽  
B. M. Shakya ◽  
H. Dutta
Keyword(s):  
Primary Closure ◽  
Signs And Symptoms ◽  
Oxygen Supplementation ◽  
X Ray ◽  
Close Observation ◽  
The Face ◽  
Chest X Ray ◽  
Tracheocutaneous Fistula ◽  
Surgical Emphysema ◽  
Upper Abdomen

A 4-year-old child had closure of tracheocutaneous fistula under general anaesthesia. He developed extensive surgical emphysema over the face, chest, and upper abdomen immediately in the recovery room. We gave him oxygen supplementation, removed surgical stitch, and inserted a 4 mm tracheostomy tube to secure airway. Chest X-ray ruled out pneumothorax or pneumomediastinum. After a week, a tight bandage was applied which approximated the tissue and helped in the closure of stoma; no suture was applied. The patient was discharged home on the fourth postoperative day. The patient needs close observation in the postoperative period with likely complication in mind. Recognizing early signs and symptoms of respiratory distress with quick intervention is lifesaving during the complication of tracheocutaneous fistula surgery. In absence of pneumothorax or pneumomediastinum, extensive surgical emphysema occurring during primary closure of tracheocutaneous fistula can be treated without inserting any drainage tube.

scholarly journals Unusual Case of a Missing Vibrator Device in the Pelvis

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Greg J. Marchand ◽  
Katelyn M. Sainz ◽  
Ali Azadi ◽  
Alexa King ◽  
Sienna Anderson ◽  
...  
Keyword(s):  
Emergency Room ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Traumatic Injury ◽  
The United States ◽  
X Ray ◽  
Sexual Stimulation ◽  
Emergency Room Setting ◽  
Careful History

Emergency room admissions and surgery secondary to the malfunctioning of devices intended for sexual stimulation are extremely common. Emergency room staff in the United States are commonly skilled in the detection and removal of some of these frequent occurrences. Occasionally, surgical intervention can be warranted if the device enters a cavity that cannot safely be explored in the emergency room setting. We report a case of a vibrator which was lost during sexual activity and appeared on flat plate X-ray to be in the abdominal cavity. A careful history showed that the device was of an unusually narrow diameter, and surgical intervention showed the device ultimately ended up in the bladder without traumatic injury. Following laparoscopic confirmation of the device’s location in the bladder, cystoscopic removal was performed and the patient recovered uneventfully.

Carcinosarcoma of the Pancreas Arising in a Mucinous Cystic Neoplasm

2006 ◽  
Vol 72 (4) ◽  
pp. 351-355 ◽  
Author(s):  
Mark Bloomston ◽  
Jose Chanona-Vilchis ◽  
E. Christopher Ellison ◽  
Nilsa C. Ramirez ◽  
Wendy L. Frankel
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Nodal Metastasis ◽  
Uneventful Recovery ◽  
Cystic Neoplasm ◽  
Painless Jaundice ◽  
Head Of The Pancreas ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Immunohistochemical Studies ◽  
Work Up

We report a carcinosarcoma of the pancreas in a 67-year-old woman who presented with nausea, vomiting, and painless jaundice. A work-up demonstrated a well-circumscribed mass in the head of the pancreas. After pylorus-preserving pancreaticoduodenectomy, the tumor was found to be grossly yellow, and it compressed the common bile duct and pancreatic duct. Histological examination of the neoplasm showed a 4.0 x 4.0 x 3.0-cm mucinous cystadenocarcinoma with invasive poorly differentiated carcinoma, well-differentiated squamous cell carcinoma, and sarcomatous stroma invading into the duodenum. There was no evidence of nodal metastasis (pT3N0M0). Immunohistochemical studies showed that the epithelial cells stained positive for cytokeratin 7, cytokeratin AE1/3, cytokeratin monoclonal antibody 5.2, epithelial membrane antigen, M-carcinoembryonic antigen, and low-molecular-weight kininogen, and the sarcomatous component was immunoreactive with vimentin. The patient had an uneventful recovery, but died 4 months later of rapidly progressive metastatic disease to the liver and peritoneum. To the best of our knowledge, this is the second case of carcinosarcoma with invasive epithelial and sarcomatous areas in the background of a mucinous cystic neoplasm of the pancreas.

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