scholarly journals Torsion of Fatty Appendage of Falciform Ligament: Acute Abdomen in a Child

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Caroline Maccallum ◽  
Sarah Eaton ◽  
Daniel Chubb ◽  
Stephen Franzi
Keyword(s):  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Early Recognition ◽  
Rare Condition ◽  
Severe Abdominal Pain ◽  
Greater Omentum ◽  
Falciform Ligament ◽  
Imaging Characteristics

Torsion of the fatty appendage of the falciform ligament is an extremely rare condition that leads to severe abdominal pain and raised inflammatory markers. It can be recognised on ultrasound or CT scan. The pathophysiology is the same as that involved in the more common torsion and/or infarction of the greater omentum or epiploic appendages. The condition is best managed conservatively with anti-inflammatory analgesia, and the early recognition of this type of torsion may prevent unnecessary operative intervention to look for a source of abdominal pain. There have been five reported adult cases of a torted fatty appendage of the falciform ligament identified on ultrasound and CT scan, but no paediatric cases. We report a case of torsion of the fatty appendage of the falciform ligament in a ten-year-old boy and describe its imaging characteristics on CT scan.

Torsion of the gallbladder: a rare but important differential to consider when treating acute cholecystitis non-operatively

2021 ◽  
Vol 14 (1) ◽  
pp. e237842
Author(s):  
Arun Ahluwalia ◽  
Matthew George Roy Allaway ◽  
Serena Giga ◽  
Richard James Curran
Keyword(s):  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Epigastric Pain ◽  
Vital Signs ◽  
Rare Condition ◽  
Liver Function Tests ◽  
Uneventful Recovery ◽  
Imaging Characteristics ◽  
Gallbladder Torsion ◽  
Torsion Of The Gallbladder

A 79-year-old woman presented with postprandial epigastric pain. She had normal vital signs, inflammatory markers and liver function tests. Ultrasound and CT of the abdomen demonstrated features consistent with acute cholecystitis. Her medical comorbidities and extensive abdominal surgical history prompted the decision to treat non-operatively. Despite optimal medical management, worsening abdominal pain and uptrending inflammatory markers developed. She underwent an emergency laparoscopy which revealed a necrotic gallbladder secondary to an anticlockwise complete gallbladder torsion; a rare condition associated with significant morbidity and mortality if managed non-operatively. Laparoscopic cholecystectomy was achieved without complication and the patient had an uneventful recovery. Preoperative diagnosis of torsion of the gallbladder is difficult. However, there are certain patient demographics and imaging characteristics that can help surgeons differentiate it from acute cholecystitis; a condition which can be safely managed non-operatively in selected patients. The differentiating features are elaborated on in this case report.

scholarly journals Conservative Management of Segmental Infarction of the Greater Omentum: A Case Report and Review of Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Ramawad Soobrah ◽  
Mohammad Badran ◽  
Simon G. Smith
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Conservative Management ◽  
Acute Abdominal Pain ◽  
Correct Diagnosis ◽  
Greater Omentum ◽  
Review Of Literature ◽  
Segmental Infarction

Segmental omental infarction (SOI) is a rare cause of acute abdominal pain. Depending on the site of infarction, it mimics conditions like appendicitis, cholecystitis, and diverticulitis. Before the widespread use of Computed Tomography (CT), the diagnosis was usually made intraoperatively. SOI produces characteristic radiological appearances on CT scan; hence, correct diagnosis using this form of imaging may prevent unnecessary surgery. We present the case of a young woman who was treated conservatively after accurate radiological diagnosis.

Appendiceal Intussusception: A Diagnostic Challenge

2017 ◽  
Vol 28 (01) ◽  
pp. 030-033 ◽  
Author(s):  
Adriana Nica ◽  
Yaniv Lakovski ◽  
Enrique Freud ◽  
Inbal Samuk
Keyword(s):  
Abdominal Pain ◽  
Early Recognition ◽  
Average Length ◽  
Medical Center ◽  
Rare Condition ◽  
Abdominal Ultrasound ◽  
Ileocolic Intussusception ◽  
Diagnostic Challenge ◽  
Intermittent Abdominal Pain ◽  
Appendiceal Intussusception

Introduction Appendiceal intussusception is a rare condition in children characterized by an invagination of the appendix into the cecum to various degrees. The treatment is appendectomy; however since symptoms are not specific, clinical diagnosis is challenging and frequently only intraoperative. We present a series of five patients with appendiceal intussusception and discuss features that may direct the pediatric surgeon to achieve early recognition and provide optimal treatment. Materials and Methods The database of a tertiary medical center was retrospectively reviewed for all patients treated for appendiceal intussusception during the period from January 1995 to January 2016. Data collected by chart review included demographics, clinical characteristics, imaging studies, surgical technique, and outcome. The findings were analyzed by descriptive statistics. Results This series included five patients (two females and three males) with ages ranging between 27 and 42 months (mean: 35.2). Patients presented with intermittent abdominal pain (IAP, all five patients), alternate vomiting (three of five patients), alternate diarrhea (two of five patients), fever (two of five patients), and rectal bleeding (one of five patients). The average length of symptoms was 22.6 days. Eighteen diagnostic studies were performed, including abdominal ultrasound for all patients, barium enema for three patients with secondary ileocolic intussusception, and abdominal computed tomography (CT) for one patient. The average number of studies per patient was 3.6. In surgery, the appendiceal intussusception was found to be complete in four patients, whereas it was partial in the remaining patient. In all patients, appendectomy was performed with resection of a small rim of cecal wall due to marked congestion and edema in an attempt to decrease recurrence. Conclusion The mainstay of clinical presentation is intermittent abdominal pain while patients may be completely asymptomatic between attacks. Appendiceal intussusception may act as a leading point to ileocolic intussusception and is frequently concealed by it. The treatment is appendectomy. Both pediatric surgeons and radiologists should be aware of this occurrence to provide adequate management and avoid complications.

Abdominal Trauma - Child Abuse

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 892-892
Author(s):  
MARCIA DWORKIND ◽  
GEORGE MCGOWAN ◽  
JEFFREY HYAMS
Keyword(s):  
Differential Diagnosis ◽  
Child Abuse ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Abdominal Trauma ◽  
Acute Onset ◽  
Severe Abdominal Pain ◽  
Midgut Volvulus ◽  
Incarcerated Hernia ◽  
History Of

To the Editor.— The development of severe abdominal pain and vomiting in an infant is frequently an ominous event with a large differential diagnosis including midgut volvulus, intussusception, and incarcerated hernia. Recently we cared for an infant who developed an acute abdomen as a result of child abuse which was not appreciated until after laparotomy. A 3-month-old girl was transferred to our hospital with a history of an acute onset of vomiting, diarrhea, fever, and lethargy.

IgA vasculitis with terminal ileitis and giant duodenum ulceration and review of the literatures

2021 ◽  
Author(s):  
Wang Fengge ◽  
Wang Xiaoli ◽  
Wu Daiqin
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Early Recognition ◽  
Gastrointestinal Symptoms ◽  
Lower Limbs ◽  
Iga Vasculitis ◽  
Terminal Ileitis ◽  
Patients Âgés ◽  
Female Patients ◽  
Schonlein Purpura

Abstract BackgroundImmunoglobulin A vasculitis (IgA V), formerly Henoch–Schönlein purpura, is one of the most common self-limiting vasculitis in children. In 15-20% IgA V cases, gastrointestinal symptoms precede the rashes,they no specific gastrointestinal symptoms and often present as acute abdomen, making the diagnosis difficult.Case presentationWe present two female patients, ages 8 years old and 5 years old, who presented to vomiting and abdominal pain, rashes appeared on the lower limbs a few days later, they were subsequently diagnosed with IgA V. Both patients were given IV methylprednisolone, achieved benign clinical results.ConclusionsWhen gastrointestinal symptoms precede the rashes, it is difficult to diagnose IgA vasculitis, resulting in unnecessary surgery. Early recognition and treatment will promote the remission of the children and avoid unnecessary surgery.

scholarly journals A rare case of lupus-related gastrointestinal vasculitis presenting as rectal gangrene

2019 ◽  
Vol 2019 (4) ◽  
Author(s):  
Yi Liang ◽  
Angelina Di Re ◽  
Toufic El Khoury
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Acute Abdomen ◽  
Case Studies ◽  
Lupus Erythematosus ◽  
Rare Case ◽  
Rare Condition ◽  
Free Fluid ◽  
Systemic Lupus ◽  
Current Case

Abstract Systemic lupus erythematosus (SLE) related gastrointestinal vasculitis is a rare condition limited to case studies within the literature however, no cases of rectal gangrene and perforation have been previously described. A 32-year-old male presented with abdominal pain, vomiting and fevers. CT demonstrated free gas and free fluid around the rectum indicative of a perforation. He proceeded to urgent laparotomy, confirming a diagnosis of rectal infarction and perforation. Uniquely, the involved segment of gangrene extended from the rectosigmoid to the anorectal junction. A Hartmanns procedure was performed. Histopathology confirmed underlying stenosis of the rectal arteries secondary to chronic vasculitis related to the affected areas. The current case is a unique presentation of SLE-related vasculitis. It highlights the need to judiciously investigate SLE patients presenting with surgical acute abdomen.

scholarly journals Case Report of Presumed (In)voluntary Capsaicin Intoxication Mimicking an Acute Abdomen

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Simona Koprdova ◽  
Christine Schürmann ◽  
Dirk Peetz ◽  
Thomas Dürbye ◽  
Frank Kolligs ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Clinical Laboratory ◽  
Severe Abdominal Pain ◽  
Complete Regression ◽  
Food Tolerance ◽  
Case Presentation ◽  
Spicy Food ◽  
Chili Peppers ◽  
Bhut Jolokia

Background. The clinical features of a presumed capsaicin intoxication have not been reported so far. Case Presentation. A 27-year-old man took part in a qualifying for a competition in spicy food tolerance. During this qualifying, he swallowed 4 chili peppers type Bhut jolokia (about 1 million Scoville units) and other extremely spicy foods; the total amount of capsaicin ingested (roughly calculated retrospectively) accounted for at least 600 mg. After 2½ hours, the patient developed severe abdominal pain, which led to hospital admission. In contrast to the severe symptoms, clinical, laboratory, and imaging examinations (ultrasound and plain X-ray of the abdomen) did not reveal any significant abnormalities. Treatment with analgesics resulted in complete regression of the abdominal pain within 30 hours. Conclusions. The clinical picture in the view of pharmacological investigations on intestinal capsaicin infusions suggests that excessive doses of capsaicin can induce severe abdominal pain; the prolonged symptoms were probably due to the failure to vomit. Thus, a capsaicin intoxication must be considered in the differential diagnosis of an acute abdomen.

scholarly journals Torsion of the omentum: A rare cause of acute abdomen.

2021 ◽  
Vol 28 (12) ◽  
pp. 1869-1873
Author(s):  
Sajid Malik ◽  
Gul e Lala ◽  
Abdullah Khan
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Ct Scan ◽  
Acute Abdomen ◽  
Preoperative Diagnosis ◽  
Clinical Signs ◽  
Lower Abdominal Pain ◽  
X Rays ◽  
Omental Torsion ◽  
Operative Recovery

Omental torsion is a rare cause of acute abdominal pain. Diagnosis of omental torsion is usually difficult because clinical signs and symptoms are similar to other common causes of abdominal pain. The most common preoperative diagnosis is acute appendicitis and the proper preoperative diagnosis is important for the appropriate treatment option. Diagnosis of omental torsion is difficult and mainly based on ultrasound and computed tomography (CT) scan analysis. Case Presentation: A 26 years old male patient presented to emergency department with acute abdomen mimicking acute appendicitis. The chest and abdominal X-rays were normal. Due to intense clinical signs and worsening of the symptoms the patient underwent an operation with the probable diagnosis of acute appendicitis. In this case patient explored via gridiron incision, the omentum was found to be gangrenous that had encased the appendix so midline incision given. Post-operative recovery was uneventful. Conclusion: Omental torsion is highly uncommon cause of right lower abdominal pain and difficult to diagnose preoperatively. It presents with non-specific symptoms, mimicking other abdominal conditions presenting a similar clinical settings. CT scan is very helpful in diagnosis. Surgical treatment is the procedure of choice with laparoscopy being the preferable approach. 

scholarly journals Wandering Spleen - A Rare Entity

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdomen ◽  
High Index ◽  
Wandering Spleen ◽  
Rare Entity ◽  
Rare Differential Diagnosis ◽  
High Index Of Suspicion ◽  
Very High

Wandering spleen is a rare differential diagnosis of an acute abdomen and must be suspected if a patient presents with abdominal pain along with a palpable lump and displacement of bowel to left upper quadrant and should be confirmed by CT scan. As the condition is very rarely diagnosed pre-operatively, it requires a very high index of suspicion.

scholarly journals A Case of Solitary Fibrous Tumor from the Greater Omentum Presenting with Severe Abdominal Pain Caused by Torsion

2019 ◽  
Vol 52 (5) ◽  
pp. 263-271
Author(s):  
Yumi Suzuki ◽  
Kiyoshi Hiramatsu ◽  
Takeshi Amemiya ◽  
Takashi Seki ◽  
Toshiyuki Arai
Keyword(s):  
Abdominal Pain ◽  
Solitary Fibrous Tumor ◽  
Severe Abdominal Pain ◽  
Greater Omentum ◽  
Fibrous Tumor
Sign in / Sign up

Export Citation Format

Share Document