scholarly journals Unique Presentation of Urachal Cyst Disease: Incidental Finding to Complicated Infection

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Seong K. Lee ◽  
Chauniqua Kiffin ◽  
Rafael Sanchez ◽  
Eddy Carrillo ◽  
Andrew Rosenthal
Keyword(s):  
Abdominal Pain ◽  
Adult Patient ◽  
Computerized Tomography ◽  
Incidental Finding ◽  
Ct Scans ◽  
Urachal Cyst ◽  
Unique Case ◽  
Urachal Remnant ◽  
Abdominal Infection

Urachal remnant disease is uncommon in adults and can present with symptoms ranging from drainage near the umbilicus to a severe abdominal infection. Most cases are referred for treatment once diagnosed either clinically or radiographically with ultrasound or computerized tomography. We present a unique case of an infected urachal cyst visualized on a series of CT scans in an adult patient with abdominal pain over a period of years.

Intra-abdominal Infection

2015 ◽  
Author(s):  
Robert G. Sawyer ◽  
Zachary C. Dietch ◽  
Puja M. Shah
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Ct Scans ◽  
Emphysematous Cholecystitis ◽  
Abdominal Infection ◽  
Cdc Guidelines ◽  
Upper Abdominal ◽  
Abdominal Infections ◽  
Extraluminal Air

The basic principles of rapid diagnosis, timely physiologic support, and definitive intervention for intra-abdominal infections have remained unchanged over the past century; however, specific management of these conditions has been transformed as a result of numerous advances in technology. This review covers clinical evaluation, investigative studies, options for intervention, early source control and duration of antimicrobial therapy, infections of the upper abdomen, infections of the lower abdomen, other abdominal infections, and special cases. Figures show an algorithm outlining the approach to a suspected upper abdominal infection, abnormal abdominal ultrasounds showing calculi in the gallbladder and confirming the diagnosis of acute acalculous cholecystitis, endoscopic retrograde cholangiopancreatographies showing a distal common bile duct stone in acute pancreatitis, extrinsic compression of the common hepatic duct by a stone in the Hartmann pouch, and endoscopic sphincterotomy for acute biliary decompression in acute obstructive cholangitis, air outlining the gallbladder and bile ducts in emphysematous cholecystitis, abdominal and pelvic CT scans showing pancreatic findings graded by Ranson into five categories, a splenic abscess, an inflamed and thickened appendix with surrounding fat stranding, appendiceal perforation and abscess formation, diverticulitis with a small amount of extraluminal air, left lower quadrant fluid collection consistent with peridiverticular abscess, diffuse inflammation and right upper quadrant extraluminal air, and thickening of the colonic wall with both intramural and extramural air, an algorithm outlining the approach to the patient with a suspected lower abdominal infection, upright chest x-ray and abdominal CT scans of patients with sudden-onset diffuse abdominal pain, and an omental (Graham) patch. Tables list diagnostic indicators of upper abdominal pain and fever, comparison of acute cholecystitis and emphysematous cholecystitis, Hinchey system for classification of perforated diverticulitis, Centers for Disease Control and Prevention (CDC) guidelines for diagnosis of pelvic inflammatory disease, and CDC guidelines for antibiotic treatment of pelvic inflammatory disease. This review contains 16 highly rendered figures, 5 tables, and 238 references

Intra-abdominal Infection

2016 ◽  
Author(s):  
Robert G. Sawyer ◽  
Zachary C. Dietch ◽  
Puja M. Shah
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Ct Scans ◽  
Emphysematous Cholecystitis ◽  
Abdominal Infection ◽  
Cdc Guidelines ◽  
Upper Abdominal ◽  
Abdominal Infections ◽  
Extraluminal Air

The basic principles of rapid diagnosis, timely physiologic support, and definitive intervention for intra-abdominal infections have remained unchanged over the past century; however, specific management of these conditions has been transformed as a result of numerous advances in technology. This review covers clinical evaluation, investigative studies, options for intervention, early source control and duration of antimicrobial therapy, infections of the upper abdomen, infections of the lower abdomen, other abdominal infections, and special cases. Figures show an algorithm outlining the approach to a suspected upper abdominal infection, abnormal abdominal ultrasounds showing calculi in the gallbladder and confirming the diagnosis of acute acalculous cholecystitis, endoscopic retrograde cholangiopancreatographies showing a distal common bile duct stone in acute pancreatitis, extrinsic compression of the common hepatic duct by a stone in the Hartmann pouch, and endoscopic sphincterotomy for acute biliary decompression in acute obstructive cholangitis, air outlining the gallbladder and bile ducts in emphysematous cholecystitis, abdominal and pelvic CT scans showing pancreatic findings graded by Ranson into five categories, a splenic abscess, an inflamed and thickened appendix with surrounding fat stranding, appendiceal perforation and abscess formation, diverticulitis with a small amount of extraluminal air, left lower quadrant fluid collection consistent with peridiverticular abscess, diffuse inflammation and right upper quadrant extraluminal air, and thickening of the colonic wall with both intramural and extramural air, an algorithm outlining the approach to the patient with a suspected lower abdominal infection, upright chest x-ray and abdominal CT scans of patients with sudden-onset diffuse abdominal pain, and an omental (Graham) patch. Tables list diagnostic indicators of upper abdominal pain and fever, comparison of acute cholecystitis and emphysematous cholecystitis, Hinchey system for classification of perforated diverticulitis, Centers for Disease Control and Prevention (CDC) guidelines for diagnosis of pelvic inflammatory disease, and CDC guidelines for antibiotic treatment of pelvic inflammatory disease. This review contains 16 highly rendered figures, 5 tables, and 238 references

Quick Looks Into the Acute Abdomen- Findings from A 1 Year Audit of Asian Emergency Department Ct Scans

2021 ◽  
Author(s):  
Siang Hiong Goh ◽  
Calvin Yit-Kun Goh ◽  
Hong Choon Oh ◽  
Narayan Venkataraman ◽  
Ling Tiah
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Clinical Performance ◽  
Biliary Tract Disease ◽  
Renal Stones ◽  
Adverse Outcomes ◽  
Ct Scans ◽  
Lower Quadrant ◽  
Lengths Of Stay ◽  
The Common

Abstract BackgroundMuch of the literature regarding Emergency Department CT scan usage for abdominal pain has been in American and European settings, and less so in the rest of the world. We performed an audit for this in our Southeast Asian hospital to see how we compare with international data, also to glean some insights into optimising its use locally.Results – An anonymised de-identified electronic database of all ED patients had been set up since 2020 with the aim of capturing 10 years of ED retrospective data for audit of our clinical performance. From this master database, a subset of all CTAPs done in 2020 was created and then extracted for analysis. Costs, length of stay in the ED and wards, CT reports, disposal from ED, and other data were captured for study. A description was made of the common conditions found, with a subgroup analysis of the elderly, and disposal outcomes from the ED. Specific analysis was done for appendicitis using Mann-Whitney U tests. For 2020, 1860 patients (56% male, and ages 14 to 99 years) had ED CTAPs done. Top indications included right upper and lower quadrant pains, flank pains, persistent abdominal pain despite analgesia, and suspicion for intestinal obstruction. Acute appendicitis, biliary tract disease, renal stones, ovarian disease, and bowel disease were the common diagnoses. 16.2% of CTAPs revealed no abnormality. Malignancies were uncommon diagnoses. For the patients that were discharged from the ED after a negative CTAP, no patient returned within 72 hours nor were there any adverse outcomes. When analysed using Mann-Whitney U tests, patients who had ED CTAPs done for appendicitis had significantly faster time to CT and surgery than those with inpatient imaging, with lower inpatient costs and lengths of stay.Conclusion – CT scans in the ED for appendicitis patients reduces costs, time to surgery, and lengths of stay. Generally, ED CTAPs allows better siting and disposition of patients. Presence of RLQ pain increases the likelihood of a positive scan. Our negative scan rate of 16.2% is comparable to other studies. Protocols and senior inputs can improve accuracy of this important ED resource.

scholarly journals Micro-CT to Document the Coffee Bean Weevil, Araecerus fasciculatus (Coleoptera: Anthribidae), Inside Field-Collected Coffee Berries (Coffea canephora)

Insects ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 100 ◽  
Author(s):  
Ignacio Alba-Alejandre ◽  
Javier Alba-Tercedor ◽  
Fernando Vega
Keyword(s):  
Computerized Tomography ◽  
Instar Larva ◽  
Coffea Canephora ◽  
Ct Scans ◽  
Coffee Bean ◽  
Micro Ct ◽  
Adult Beetle ◽  
Bean Weevil ◽  
Coffee Berry ◽  
First Time

The coffee bean weevil, Araecerus fasciculatus (De Geer) (Coleoptera: Anthribidae), is a cosmopolitan insect with >100 hosts, and has been reported as a pest of stored coffee. During a study involving the coffee berry borer, we observed coffee bean weevils emerging from field-collected coffee berries and used micro-computerized tomography (micro-CT) scans to observe the insect inside the berry. Two eggs had eclosed inside the berry, resulting in observations of a newly eclosed adult beetle and a 5th instar larva, each feeding on one of the two seeds. This is the first time since 1775, when the insect was first described, that the insect has been observed inside a coffee berry.

Clinicopathological investigation of gyral high density on computerized tomography following severe head injury in children

1995 ◽  
Vol 82 (6) ◽  
pp. 995-1001 ◽  
Author(s):  
Takehide Onuma ◽  
Yasuko Shimosegawa ◽  
Motonobu Kameyama ◽  
Hiroaki Arai ◽  
Kiyoshi Ishii
Keyword(s):  
Computerized Tomography ◽  
Head Trauma ◽  
Brain Atrophy ◽  
High Density ◽  
Ct Scans ◽  
Severe Head Trauma ◽  
Content Type ◽  
Subacute Stage ◽  
Fine Print ◽  
Diffuse Brain

✓ The authors have treated five cases of severe head trauma in children in which abnormally high density along gyri, “gyral high density,” was seen on plain computerized tomography (CT) scans in the subacute stage of the injury. The prognosis in all cases was poor, with either severe disability or a vegetative state as the outcome due to significant brain atrophy following gyral high density. This pathology was classified into three clinical stages: 1) acute stage, cerebral ischemia in which there is diffuse low density of the cerebrum on CT scans (most marked on the 3rd and 4th days); 2) subacute stage, hemorrhagic infarction showing gyral high density on plain CT scans (between 1 and 4 weeks); and 3) chronic stage, brain atrophy (beginning 4 weeks after the trauma). In their consecutive series of head-injured patients (516 children, 1459 adults), the authors did not find gyral high density on CT scan in adults. This is probably due to the fact that adults who suffer the severe head trauma associated with diffuse brain swelling or diffuse brain edema cannot survive, thus making this gyral high density unique to children.

Ureterocele as a cause of chronic intractable abdominal pain

2021 ◽  
Vol 14 (11) ◽  
pp. e245262
Author(s):  
Gaurav Chauhan ◽  
Isaiah Levy ◽  
Samuel Wadie Samuel
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Tests ◽  
Clinical Characteristics ◽  
Incidental Finding ◽  
Obstructive Uropathy ◽  
Therapeutic Interventions ◽  
Pain Clinic ◽  
Diagnostic Challenge ◽  
Underlying Disorder ◽  
Chronic Pain Clinic

A ureterocele is a submucosal, cystic dilation of the terminal ureter, either congenital or acquired, as it enters the bladder. It is a rare clinical entity that can be entirely asymptomatic and present as an incidental finding or can manifest in the form of distressing symptoms such as unremitting abdominal pain, haematuria, obstructive uropathy, to name a few. The authors present a case of abdominal pain in a 43-year-old woman who was presumptively attributed to various clinical entities and was finally referred to the chronic pain clinic. The patient underwent numerous diagnostic tests, psychological evaluations and therapeutic interventions, including surgeries, over the years that failed to mitigate her symptoms until urologic imaging reported intravesical ureterocele as the underlying disorder. The case report entails the diagnostic challenge faced by the authors along with the clinical characteristics of ureterocele.

Massive mesenteric tumor in an adult patient with chronic abdominal pain

Surgery ◽  
2021 ◽  
Author(s):  
Javier Arredondo Montero ◽  
Ana Cristina Recreo Baquedano ◽  
Mónica Bronte Anaut ◽  
Javier Suárez Alecha
Keyword(s):  
Abdominal Pain ◽  
Adult Patient ◽  
Chronic Abdominal Pain ◽  
Mesenteric Tumor

Use of CT Scans for Abdominal Pain in the ED: Factors in Choice

2020 ◽  
Vol 86 (4) ◽  
pp. 324-333 ◽  
Author(s):  
Aubrey A. Mwinyogle ◽  
Astha Bhatt ◽  
Onyebuchi U. Ogbuagu ◽  
Neer Dhillon ◽  
Anne Sill ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Primary Diagnosis ◽  
Socioeconomic Disparities ◽  
Ct Scans ◽  
Utilization Rate ◽  
Rebound Tenderness ◽  
High Index Of Suspicion ◽  
Ct Finding

Overutilization of healthcare resources is a threat to long-term healthcare sustainability and patient outcomes. CTis a costly but efficient means of assessing abdominal pain; however, 97 per cent of ED physicians acknowledge its overutilization. This study sought to understand factors that influence ED providers’ decision regarding CT use in the evaluation of abdominal pain. After evaluating a patient for acute abdominal pain, ED providers filled in a form in which the primary diagnosis and index of suspicion were recorded. Bivariate and multivariate analyses were used to identify predictors of outcomes. The CT scan utilization rate was 54.82 per cent. Whereas 34.11 per cent of CT scans were normal, 30 per cent yielded an acute abdominal pathology. Tenderness and rebound tenderness were positive predictors of high index of suspicion [odds ratio (OR) 2.09 and 2.54, respectively]. These variables were also predictive of obtaining a CT scan [OR 2.64 and 3.41, respectively]. Compared with whites, the index of suspicion was 26 per cent and 56 per cent less likely to be high when patients were black [OR 0.73] or Hispanic [OR 0.44] respectively. Blacks and Hispanics were less likely to have CT scans performed than whites [OR 0.58 and 0.48, respectively]. Leukocytosis significantly affected the index of suspicion for acute abdominal pathology, obtaining a CTscan and the acuity of CTscan diagnosis on multivariate analysis. Patients aged ≥60 years had 2.03 odds of acute CT finding compared with those aged <60 years. There is a need for committed efforts to optimize CT scan utilization and eliminate socioeconomic disparities in health care.

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