scholarly journals Jejunal Intussusception: A Rare Presentation of Carcinoid Tumor

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Umashankkar Kannan ◽  
Amir A. Rahnemai-Azar ◽  
Ashish N. Patel ◽  
Vinaya Gaduputi ◽  
Ajay K. Shah
Keyword(s):  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Pathological Examination ◽  
Rare Presentation ◽  
Metastatic Carcinoid ◽  
Diffuse Abdominal Pain ◽  
Well Differentiated ◽  
Small Bowel Segment ◽  
Distal Jejunum

A 55-year-old male presented to the emergency department with sudden onset of diffuse abdominal pain for one day. Physical examination was remarkable for tenderness in the umbilical region. A CT scan of the abdomen showed intussusception involving the jejunum without any mass. The patient then underwent an exploratory laparotomy. During surgery, the distal jejunum was intussuscepted with mesenteric lymphadenopathy. Liver showed nodular deposits in both lobes of the liver. The involved small bowel segment was resected with primary anastomosis and liver was biopsied. Pathological examination showed multifocal deposits of well-differentiated carcinoids in the jejunum. The liver and mesenteric deposits were positive for metastatic carcinoid. Patient recovered well without any complications.

Sigmoid Volvulus in 16-year-old Boy with an Associated Anomalous Congenital Band

2013 ◽  
Vol 79 (11) ◽  
pp. 1140-1141 ◽  
Author(s):  
Ann A. Albert ◽  
Tracy L. Nolan ◽  
Bryan C. Weidner
Keyword(s):  
Abdominal Pain ◽  
African American Male ◽  
Pediatric Patients ◽  
Primary Anastomosis ◽  
Exploratory Laparotomy ◽  
Sigmoid Volvulus ◽  
Sudden Onset ◽  
Contrast Enema ◽  
Pediatric Age Group ◽  
History Of

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CTwas consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.

scholarly journals Spontaneous Common Bile Duct Perforation in Full Term Pregnancy: A Rare Case Report and Review of Literature

2020 ◽  
Author(s):  
Matiullah Masroor ◽  
Mohammad Arif Sarwari
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Adult Population ◽  
Exploratory Laparotomy ◽  
Interesting Case ◽  
High Morbidity ◽  
Rare Presentation ◽  
Generalize Peritonitis ◽  
Diffuse Abdominal Pain ◽  
Rare Case Report

Abstract Background: Spontaneous biliary system perforation is a rare presentation in clinical practice. It is even rare in adult population than infants. The condition is rarely suspected and diagnosed preoperatively because of small number of cases, vague sign and symptoms and ambiguous presentation.Case presentation: we are presenting an interesting case of spontaneous perforation of common bile duct in a 16 years old lady presented a week after her first delivery to the emergency department with complain of diffuse abdominal pain, abdominal distention, fever, vomiting and constipation. She was having generalize peritonitis but the cause of peritonitis was unknown despite of all available investigations performed. She underwent exploratory laparotomy and a perforation in the supra duodenal region of common bile duct was found intraoperatively. Common bile duct repair over T-tube and cholecystectomy performed and patient recovered.Conclusion: Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy and its belated diagnoses and management is leading to high morbidity and mortality. All physicians especially surgeons should be aware of its possibility and consider it a cause of peritonitis on differential diagnosis especially when there is no apparent etiology available for the presentation.

scholarly journals Spontaneous common bile duct perforation in full term pregnancy: a rare case report and review of literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matiullah Masroor ◽  
Mohammad Arif Sarwari
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Exploratory Laparotomy ◽  
Interesting Case ◽  
High Morbidity ◽  
Rare Presentation ◽  
Diffuse Abdominal Pain ◽  
Generalized Peritonitis ◽  
Rare Case Report ◽  
The Common

Abstract Background Spontaneous biliary system perforation is a rare presentation in clinical practice especially in adults. It is rarely suspected and diagnosed preoperatively due to small number of cases, vague sign and symptoms, and ambiguous presentation. Case presentation We describe an interesting case of spontaneous perforation of the common bile duct in a 16 year-old female who presented a week after her first birth to the emergency department with complaints of diffuse abdominal pain, abdominal distention, fever, vomiting, and constipation. She was having generalized peritonitis but the etiology was unclear despite a thorough workup. She underwent exploratory laparotomy, and a perforation in the supra duodenal region of the common bile duct was found intraoperatively. The common bile duct was repaired over T-tube, and cholecystectomy was performed; the patient was recovered uneventfully. Conclusion Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy. Its delayed diagnoses and management can lead to a high morbidity and mortality. All physicians, especially surgeons, should be aware of this possibility and consider it a cause of peritonitis on differential diagnosis particularly when there is no apparent etiology available for presentation.

scholarly journals A rare case of adult colocolonic intussusception of the descending colon

2019 ◽  
Vol 12 (11) ◽  
pp. e231590
Author(s):  
Randa Taher ◽  
Yael Kopelman ◽  
Aurwa Younis ◽  
Daniel Sheffer
Keyword(s):  
Rare Case ◽  
Pathological Condition ◽  
Primary Anastomosis ◽  
Colonic Obstruction ◽  
Exploratory Laparotomy ◽  
Tubulovillous Adenoma ◽  
Abdominal Ct ◽  
Diffuse Abdominal Pain ◽  
Abdominal Ct Scan ◽  
Descending Colon

A 28-year-old woman approached the emergency department because of recent diffuse abdominal pain and diarrhoea. Peritoneal signs on physical exam led to abdominal CT scan which demonstrated colonic obstruction, resulting from colocolonic intussusception of the descending colon. An exploratory laparotomy confirmed the diagnosis as well as the aetiology of a 4 cm intraluminal polyp. Left hemicolectomy with primary anastomosis was performed. The final pathology revealed a tubulovillous adenoma with multiple foci of high-grade dysplasia. Intussusception is a rare cause for colonic obstruction, and ~90% of cases in adults are secondary to an anatomical or pathological condition. Therefore, we recommend oncological resection of the affected part.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

SECRETORY CARCINOMA OF ENDOMETRIUM: A MORPHOLOGICAL MIMICKER POSING DIAGNOSTIC DILEMMA - A RARE CASE

2021 ◽  
pp. 32-33
Author(s):  
Dharani V C ◽  
Manjunath H K ◽  
Bhargavi Mohan ◽  
Varaprasad B M ◽  
Thej M J
Keyword(s):  
Endometrial Thickness ◽  
Good Prognosis ◽  
Endometrial Biopsy ◽  
Pathological Examination ◽  
Secretory Carcinoma ◽  
Diagnostic Dilemma ◽  
Immunohistochemical Markers ◽  
Obese Female ◽  
Well Differentiated ◽  
Post Menopausal

BACKGROUND: Secretory carcinoma of the endometrium, a rare subtype of endometrioid carcinoma morphologically resembles the early secretory phase of endometrium and is almost always well differentiated and carries excellent prognosis. Very few cases of secretory carcinoma have been reported in the literature till date. Case presentation:A 58 yr old obese female presented with post-menopausal bleeding. Ultrasound revealed increased endometrial thickness and endometrial biopsy showed hyperplasia without atypia in secretory transformation. Pathological examination of the hysterectomy specimen revealed features of secretory carcinoma of the endometrium as an incidental nding. CONCLUSION: Secretory carcinoma, a rare subtype of well differentiated endometrial carcinoma carries very good prognosis and morphologically mimics various pathological conditions of endometrium. Hence, this needs to be carefully evaluated morphologically in addition with immunohistochemical markers to arrive at an accurate diagnosis.

scholarly journals Rare presentation of a testicular angiofibroma treated with testis sparing surgery

2016 ◽  
Vol 88 (4) ◽  
pp. 330 ◽  
Author(s):  
Luca Leone ◽  
Paola Fulvi ◽  
Giulia Sbrollini ◽  
Alessandra Filosa ◽  
Enrico Caraceni ◽  
...  
Keyword(s):  
Case Report ◽  
Malignant Tumor ◽  
Gold Standard ◽  
Conservative Surgery ◽  
Pathological Examination ◽  
Benign Tumors ◽  
Frozen Sections ◽  
Rare Presentation ◽  
Final Histology

Introduction: Testicular benign tumors are very rare (< 5%). Testicular Angiofibroma (AF) is one of those, however the gold standard of treatment and follow-up is still unclear. Case report: A 47 years-old man with only one functioning testis was referred to our clinic for a palpable right testicular mass and atrophic contralateral testis. Patient underwent testis-sparing surgery with inguinal approach and intraoperative frozen sections examination with diagnosis of AF. Final histology confirmed AF. Post-operative follow-up was uneventful. Clinical and ultrasonographic follow-up was negative after 8 months. Conclusion: We report a conservative surgery in a patient with AF of the solitary testis. AF is a benign para-testicular fibrous neoplasm that could be misinterpreted as malignant tumor and treated with orchiectomy. Testis-sparing surgery is recommended in this case with intraoperative pathological examination. The excision of the mass is enough but in front of a possible recurrence a long follow-up is advisable.

scholarly journals An unusual case of pediatric abdominal pain

CJEM ◽  
2011 ◽  
Vol 13 (02) ◽  
pp. 133-138 ◽  
Author(s):  
Lars P. Bjoernsen ◽  
M. Bruce Lindsay
Keyword(s):  
Abdominal Pain ◽  
Colonic Obstruction ◽  
Exploratory Laparotomy ◽  
Symptomatic Treatment ◽  
Systematic Evaluation ◽  
White Female ◽  
Symptomatic Therapy ◽  
Regional Lymph Nodes ◽  
Diffuse Abdominal Pain ◽  
Gastrografin Enema

ABSTRACTChronic and recurrent abdominal pains are common complaints in children and adolescents, but the evaluation in the emergency department (ED) can be challenging. We present a rare yet serious case of a 17-year-old white female who presented to the ED with a 2-day history of diffuse abdominal pain, nausea, and intractable vomiting. Abdominal examination and imaging, including computed tomography (CT), were negative during an episode 6 weeks previously. This was her fifth similar episode in a 2-month period, and she had been seen at three different hospitals and admitted on each occasion. Three days prior to presentation to our ED, she was seen at a gastroenterology clinic and diagnosed with irritable bowel syndrome and an ovarian cyst. Symptomatic therapy during the current presentation, with intravenous fluids, antiemetics, and parenteral narcotics, failed to alleviate her abdominal pain and vomiting. Emergent CT evaluation revealed a high-grade colonic obstruction with focal circumferential narrowing in the transverse colon and a lower gastrointestinal follow-through radiograph with Gastrografin enema showed a classic “apple-core” lesion. Colonic adenocarcinoma with positive regional lymph nodes was found during emergent exploratory laparotomy. Pediatric patients with recurrent, episodic abdominal pain should undergo systematic evaluation and symptomatic treatment. A previous negative workup should not dissuade emergency physicians from proceeding with a systematic and thorough evaluation of the pediatric patient presenting with abdominal pain and vomiting.

scholarly journals LARGE BENIGN OVARIAN TUMOR MIMICKING LATE STAGE MALIGNANT OVARIAN TUMOR

2021 ◽  
Vol 9 (02) ◽  
pp. 848-852
Author(s):  
M. Bendahhou Idrissi ◽  
◽  
K. Aboulfath ◽  
S. Errarhay ◽  
N. Mamouni ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Ovarian Tumor ◽  
Benign Neoplasm ◽  
Exploratory Laparotomy ◽  
Point Of View ◽  
Pathological Examination ◽  
Multiple Biopsies ◽  
Benign Ovarian Tumor ◽  
Peritoneal Effusion ◽  
Fear Of Cancer

Ovarian fibrothecoma is a rare, benign neoplasm of the sex cords and stroma of the ovary. Patients may present with abdominal pelvic pain and / or distension, and sometimes postmenopausal bleeding. Large tumors (> 10cm) are often associated with pleural and peritoneal effusion mimicking an advanced ovarian malignancy (Deimon –Meigs syndrome). We report 2 cases of giant fibrothecoma associated with ascites and pleurisy. Both patients were postmenopausal. The ovarian tumor was discovered during an increase in abdominal volume in the first patient and as part of the etiological workup of encysted pleurisy in the second. The clinical examination made it possible to objectify a tumor with abdominopelvic development of size greater than 10 cm, the clinical examination also noted, in the two patients, a right basithoracic dullness in favor of a pleurisy and an ascites of average abundance suggesting in the first place a malignant tumor of the ovary, with peritoneal carcinoma. the two patients underwent a pelvic ultrasound, supplemented by an abdominal pelvic CT scan objectifying the presence of a large ovarian mass with pleural and peritoneal effusions. Exploratory laparotomy was required in both patients and underwent an extemporaneous examination which was consistent with the definitive pathological examination in both patients. Both patients underwent total hysterectomy with bilateral adnexectomy and omentectomy with multiple biopsies as the clinical picture was highly suggestive of malignancy. The postoperative follow-up was simple with total regression of peritoneal and pleural effusions in the two cases of Demons-Meigs syndrome. The definitive pathological examination revealed a fibrothecoma. Fibrothecal tumors remain a real challenge from a diagnostic and therapeutic point of view. The fear of cancer is even greater in the presence of Demons-Meigs syndrome. The management of these tumors requires a good clinical and radiological analysis, and it is the histological examination that confirms the diagnosis. The surgery corresponds, in post-menopausal patients, to a hysterectomy with bilateral adnexectomy, while conservative treatment by unilateral adnexectomy is entirely justified in young women who still want fertility.

scholarly journals RUPTURED HEPATIC HYDATID CYST : A RARE CASE REPORT

2020 ◽  
pp. 1-3
Author(s):  
Syed Md Sharique ◽  
Mritunjay Sarawagi ◽  
Anjay Kumar
Keyword(s):  
Hydatid Cyst ◽  
Emergency Operation ◽  
Exploratory Laparotomy ◽  
Corticosteroid Treatment ◽  
Sudden Onset ◽  
Hepatic Hydatid Cyst ◽  
Cystic Hydatid Disease ◽  
Abdominal Ultrasonography ◽  
Cyst Rupture ◽  
Hepatic Hydatid

Hydatid cyst rupture into abdomen is a serious complication in cystic hydatid disease of liver. Both microscopic or macroscopic rupture can occur and it is fatal without surgery. It is primarily caused by tapeworm (ECHINOCOCCUS GRANULOSUS) and occurs worldwide with an incidence of 200/100,000in endemic areas. This is a case of 28 yr. female presenting with sudden onset pain abdomen since 4 days. Abdominal ultrasonography demonstrates ruptured hepatic hydatid cyst with free peritoneal fluid. She was managed in emergency operation theatre due to her clinical condition and exploratory laparotomy with omentopexy and toileting were done after fluid resuscitation, antihistaminic and corticosteroid treatment. Postoperatively she received antihelminthic treatment with Albendazol. She made a good recovery following surgery.

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