scholarly journals Primary Peritonitis: An Index Case of Mycoplasma hominis Infection in a Healthy Female

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sabrina Drexel ◽  
Daniel Tseng
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Fluid ◽  
Case Reports ◽  
Uterine Fibroids ◽  
Healthy Woman ◽  
Systemic Infection ◽  
Mycoplasma Hominis ◽  
Unknown Etiology ◽  
Primary Peritonitis ◽  
First Case

Introduction. Primary peritonitis in healthy immunocompetent individuals is rare. Several case reports of Streptococcus species causing peritonitis have been described. Here, we present the first case of Mycoplasma hominis as the cause of primary peritonitis in a healthy woman. Case Report. A 42-year-old female with history of uterine fibroids was admitted with abdominal pain and intraperitoneal fluid of unknown etiology. She was initially managed nonoperatively and empirically treated with broad spectrum antibiotics. Blood and urine cultures were unrevealing. Increasing abdominal pain and peritoneal fluid prompted diagnostic laparoscopy which revealed a dense fibrinous exudate covering the entire peritoneal cavity. Peritoneal fluid and biopsies were sent for cytology and culture. The peritoneal fluid was eventually sent for 16 s ribosomal analysis, which discovered Mycoplasma hominis RNA. Her antibiotics were narrowed, and she eventually made a full recovery. Discussion. M. hominis is a rare source of systemic infection but has been known to colonize the urogenital tract and cause localized infections. This is the first presentation of M. hominis causing primary peritonitis in a healthy immunocompetent female. Multidisciplinary management of these patients is critical to achieve a timely diagnosis. Surgical exploration is often unavoidable to rule out secondary peritonitis.

scholarly journals Acute abdominal pain and nephrotic syndrome: pediatric case reports and review of the literature

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Giovanni Conti ◽  
Nicolina Stefania Carucci ◽  
Valentina Comito ◽  
Pietro Impellizzeri ◽  
Carmela Visalli ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Case Reports ◽  
Team Approach ◽  
Pediatric Case ◽  
Correct Treatment ◽  
Spontaneous Reduction ◽  
Primary Peritonitis ◽  
First Case

Abstract Background Acute abdominal pain in nephrotic syndrome (NS) is a well-known clinical symptom and is mainly related to peritonitis. The presence, although rare, of red umbilicus may guide the diagnosis as a suggestive sign of peritonitis also in the non-neonatal period. Instead, the association between intussusception and NS is quite limited. We reviewed all published cases in the literature, and to our knowledge, this is one of the few pediatric cases of spontaneous resolution of intussusception in the setting of NS. Finally, a review of the causes of abdominal pain during the course of NS was made. Cases presentation We report two pediatric patient cases who complained of acute abdominal pain during a relapse episode of their NS. The first case is a 4-year-old boy with NS (fourth relapse) who presented with acute abdominal pain, ascites, and red umbilicus. Our suspect of primary peritonitis was clinically confirmed because of the subsequent appearance of the classical peritoneal signs. The second case is a 4-year-old boy who developed an ileo-ileal intussusception during the treatment of his first NS relapse, with spontaneous reduction. Conclusions Gastrointestinal disorders are frequently encountered in the course of NS. The appearance of acute abdominal pain in children with NS requires quick management, both clinical and instrumental. A multidisciplinary team approach needs to be encouraged to lead to an accurate diagnosis and a correct treatment.

scholarly journals Double Perforated Kissing Ulcers of Duodenum: A Brief Report

2019 ◽  
Vol 103 (1-2) ◽  
pp. 36-39
Author(s):  
Tania Triantafyllou ◽  
Kokoroskos Nikolaos ◽  
Papailiou Joanna ◽  
Linardoutsos Dimitrios ◽  
Zografos Georgios ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Case Reports ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Surgical Department ◽  
Helicobactor Pylori ◽  
Urgent Surgery ◽  
First Case ◽  
Chest X Ray

Helicobactor pylori infection has been associated with peptic ulcer disease and is currently treated with proton pump inhibitors (PPIs), which have reduced the complications of the disease. Perforation of either a gastric or duodenal ulcer is rarely treated with surgery. We report the case of double-perforated synchronous duodenal ulcers, which is an extremely infrequent condition. To our knowledge, no English case reports have yet been published. Therefore, awareness of the physician in the field of diagnosis and treatment of this peptic ulcer is required. We report the case of a 46-year-old male patient who presented with acute abdominal pain at the emergency surgical department of our hospital. According to patient history, smoking, alcohol consumption, and frequent postprandial abdominal pain were noted. A physical examination revealed a rigid abdomen and tachycardia, and the temperature was 37.8°C. Laboratory testing showed increased levels of leukocytes, and free subdiaphragmatic air was found in the chest X-ray. Due to rapid deterioration of his clinical condition, the patient underwent urgent surgery. An explorative laparotomy showed 2 perforated kissing ulcers at the first segment of the duodenum, in the anterior and posterior walls. A peripheral gastrectomy was performed. Postoperative follow-up did not result in any complications. In regard to this case we present, simultaneous perforation of two synchronous duodenal ulcers is an uncommon but possible incident of which the clinician should be aware. To our knowledge, this is the first case published in the literature.

Cecal Mucosal Myxoma: The First Report of a New Type of Mesenchymal Colon Polyp

2019 ◽  
Vol 27 (6) ◽  
pp. 693-696
Author(s):  
Caroline Bsirini ◽  
Jennifer J. Findeis-Hosey ◽  
Aaron R. Huber
Keyword(s):  
Case Reports ◽  
Colonic Polyp ◽  
Screening Colonoscopy ◽  
Unknown Etiology ◽  
Positive Staining ◽  
Gi Tract ◽  
Sessile Polyp ◽  
First Case ◽  
S 100 ◽  
New Type

Myxomas are benign mesenchymal neoplasms of unknown etiology that most commonly occur in the cardiac atrium; however, other reported sites include the skin, joints, skeletal muscles, maxillofacial bones, and sinonasal tract. Myxomas involving the gastrointestinal (GI) tract are rare and are limited to a few published case reports. We are presenting, to our knowledge, the first case report of a mucosal myxoma in the colon presenting as a colonic polyp. A 49-year-old woman underwent a screening colonoscopy and was found to have a 0.2-cm sessile polyp in the cecum. Histologically, the polyp was composed of bland spindled cells in the lamina propria set in a hypocellular, myxoid stroma. The lesion was relatively well-demarcated from the surrounding mucosa. The overlying colonic epithelium showed no dysplasia. S-100 immunohistochemical stain showed only focal nonspecific positivity, while CD34, CD117, SMA, EMA, and desmin were all negative. Alcian blue special stain showed positive staining, supporting the diagnosis of myxoma. Myxomas in the GI tract are very rare, with this being the first reported case of a polypoid colonic mucosal myxoma. Previous reports of GI myxomas are limited to examples in the stomach, small bowel, and one recently reported case in the colon, all of which were submucosal lesions and not limited to the mucosa. In some of the prior reports, the patients had synchronous cardiac atrial myxomas. Mucosal colonic myxoma represents a newly identified mesenchymal polyp of the colon and pathologists should be aware of this diagnostic entity.

scholarly journals Clostridium difficile colitis complicating Kawasaki disease in children: Two case reports

2018 ◽  
Vol 6 ◽  
pp. 2050313X1878174
Author(s):  
Maria Belen Rojas Gallegos ◽  
Chaowapong Jarasvaraparn ◽  
Lynn Batten ◽  
Haidee Custodio ◽  
David A Gremse
Keyword(s):  
Abdominal Pain ◽  
Clostridium Difficile ◽  
Kawasaki Disease ◽  
Case Reports ◽  
Unknown Etiology ◽  
Fulminant Colitis ◽  
Asymptomatic Carriage ◽  
Associated Symptoms ◽  
Clostridium Difficile Colitis ◽  
High Index Of Suspicion

Clostridium difficile infection is increasingly diagnosed in children with a wide clinical spectrum ranging from asymptomatic carriage to fulminant colitis. Symptomatic patients typically present with diarrhea, with or without blood, fever, and abdominal pain. Kawasaki disease, a vasculitis of unknown etiology, occurs primarily in young children. Establishing the diagnosis of Kawasaki disease can be challenging given the lack of a confirmatory diagnostic test or pathognomonic features as well as the appearance of symptoms over time rather than simultaneously. In addition, commonly occurring nonspecific associated symptoms, such as diarrhea and abdominal pain, may confound the clinical presentation. We present two cases of children with Kawasaki disease presenting with fever and Clostridium difficile colitis to illustrate the importance of keeping a high index of suspicion for Kawasaki disease.

Metformin-Associated Exacerbation of Chronic Pancreatitis: A Possible Adverse Drug-Disease Interaction

2012 ◽  
Vol 28 (5) ◽  
pp. 208-210 ◽  
Author(s):  
Thomas G Wadsworth ◽  
Jo Kiester ◽  
E Gregory Thompson
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Case Reports ◽  
Severe Exacerbation ◽  
Metformin Therapy ◽  
First Case ◽  
Persistent Abdominal Pain ◽  
Elevated Glucose ◽  
The Right

Objective: To report a case of metformin-associated exacerbation of chronic pancreatitis and examine this possible drug-disease interaction. Case Summary: A 59-year-old woman with chronic pancreatitis (CP) experienced a severe exacerbation of her characteristic chronic abdominal pain 3 weeks after initiation and titration of metformin therapy; the exacerbation resolved upon discontinuation of metformin. The patient presented to the emergency department experiencing nausea and severe right upper quadrant abdominal pain with radiation to the right flank. Persistent abdominal pain, which had been a primary feature of CP, was previously mild and easily controlled with oral analgesics. Laboratory studies ruled out acute pancreatitis and were significant only for elevated glucose (168 mg/dL). Subsequently, she was given intravenous pain and nausea medications and discharged to home. The pain and nausea shortly returned and continued for 3 more days, at which point she telephoned her gastroenterologist, who advised that she discontinue metformin because of possible adverse reaction. Within a few days of discontinuing metformin, the nausea resolved and abdominal pain gradually returned to baseline level. Discussion: Metformin is not generally known to cause or exacerbate pancreatitis, although cases of acute pancreatitis associated with metformin therapy have been reported in the literature. No cases involving chronic pancreatitis have been reported. Consequently, metformin's prescribing guidelines do not contain precautions or contraindications for patients with chronic pancreatitis. Use of the Naranjo probability scale for assessment of this case revealed that the adverse drug effect was possible, reflecting the symptomatic resolution upon discontinuation while accounting for the lack of causative certainty, previous conclusive case reports, as well as the presence of possible nondrug causes. Conclusions: To our knowledge, this is the first case describing metformin-associated exacerbation of chronic pancreatitis. Although this occurrence may be rare, cautionary consideration, education, and monitoring should accompany initiation of metformin therapy in select patients with chronic pancreatitis.

scholarly journals Management of Fibroids Prior to in Vitro Fertilization. Case Reports

2021 ◽  
Author(s):  
Teresa Gastañaga-Holguera ◽  
Virginia González González ◽  
Marta Calvo Urrutia ◽  
Isabel Campo Gesto ◽  
Marta Vidaurreta Lázaro ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Case Reports ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Surgical Approaches ◽  
Uterine Neoplasms ◽  
Vitro Fertilization ◽  
First Case ◽  
Pharmacologic Treatments

Abstract BACKGROUND. Uterine fibroids are common benign uterine neoplasms in women in reproductive age and pregnancy desire. Several surgical approaches for symptomatic fibroids are available, such as surgical or pharmacologic treatments. We report three cases of fibroids treatment in women with primary sterility. CASE PRESENTATION. The first case of a successful in vitro fertilization (IVF) after ulipristal acetate (UPA) as an alternative treatment to reduce the fibroids size in a patient with two previous abdominal myomectomies, resulting in an evolutive pregnancy. The second patient underwent several myomectomies (both abdominal and hysteroscopic) in a long period of time. And the third one of a successful IVF after UPA in a patient with a submucous fibroid which induced myoma migration leading to its prolapse.CONCLUSIONS. Myomectomy appears to be the gold standard treatment for fibroids in women with reproductive desires. Nevertheless, more series are essential for establishing the safety of UPA as a treatment of symptomatic fibroids prior to pregnancy.

scholarly journals Buccal bifurcation cyst as an incidental finding in cone beam computed tomography scans

2018 ◽  
Vol 66 (4) ◽  
pp. 385-389
Author(s):  
Anne Caroline OENNING ◽  
Luciana Butini OLIVEIRA ◽  
José Luiz Cintra JUNQUEIRA ◽  
Saulo L. SOUSA MELO
Keyword(s):  
Incidental Finding ◽  
Case Reports ◽  
Young Patients ◽  
Unknown Etiology ◽  
Second Molar ◽  
First Case ◽  
Dental Practitioners ◽  
Close Proximity ◽  
Computed Tomography Scans ◽  
Inferior Alveolar Canal

ABSTRACT Buccal bifurcation cyst is an unusual inflammatory odontogenic cyst of unknown etiology which occurs at the buccal region of the permanent mandibular first molars in children and adolescents aged 6-15 years old. The aim of this manuscript is to present two clinical cases of buccal bifurcation cyst incidentally detected in adolescents referred for tomographic exams (CBCT) as part of the treatment planning for the management of impacted mandibular molars. The first case is very interesting due to the proximity of the lesion to the inferior alveolar canal. In the second case the inferior alveolar canal was not in close proximity to the lesion, but in contact with the mesiobuccal root of the second molar. The diagnosis of Buccal bifurcation cyst is of utmost importance in order to avoid complications during surgical procedures. In addition, the present case reports have highlighted the importance for dental practitioners to be aware of the possibility of a buccal bifurcation cyst being present as an incidental finding in CBCT images, especially in young patients.

scholarly journals Eosinophilic Gastroenteritis With Ascites During Pregnancy

2021 ◽  
Author(s):  
Hyo-In Rhyou ◽  
So Ra Oh ◽  
Young-Hee Nam
Keyword(s):  
Abdominal Pain ◽  
Antibiotic Treatment ◽  
Abdominal Distension ◽  
Eosinophilic Gastroenteritis ◽  
Unknown Etiology ◽  
Wall Thickening ◽  
Blood Eosinophil ◽  
Rare Type ◽  
Presenting Symptoms ◽  
First Case

Abstract Background: Eosinophilic gastroenteritis (EGE), a rare disorder of unknown etiology, is characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of secondary causes for eosinophilia. EGE has nonspecific symptoms, but abdominal pain, nausea, and vomiting are the most common presenting symptoms. Eosinophilic ascites is a very unusual presentation. Case presentation: A 38-year-old women at 11 weeks of gestation presented with nausea, diarrhea, and abdominal pain. Magnetic resonance imaging revealed diffuse bowel wall thickening and a small amount of ascites. Despite antibiotic treatment, her symptoms were persistent and she developed marked abdominal distension and weight gain despite antibiotic treatment. Her blood eosinophil count was high, and ultrasonography showed large ascites. Diagnostic paracentesis revealed significant eosinophilia. She completely recovered with steroid treatment and delivered a healthy baby without any complications.Conclusions: To our knowledge, this is the first case of EGE presenting with ascites during pregnancy. The serosal EGE is very rare type of EGE, but it can occur during pregnancy. The augmented Th2 immunity during pregnancy may be related with EGE.

scholarly journals Primary Hepatic Angiosarcoma: A Case Report with 10-Year Patient Medical Data

2017 ◽  
Vol 10 (3) ◽  
pp. 851-856 ◽  
Author(s):  
Masanori Ogawa ◽  
Ryusuke Ae ◽  
Teppei Sasahara
Keyword(s):  
Abdominal Pain ◽  
Fatty Liver ◽  
Case Reports ◽  
Disease Onset ◽  
Health Checkup ◽  
Thorium Dioxide ◽  
Hepatic Angiosarcoma ◽  
First Case ◽  
Primary Hepatic Angiosarcoma ◽  
Case Presentations

In the current study, we report a case of a 46-year-old man who presented with sudden abdominal pain and was diagnosed with rupture of hepatic angiosarcoma (HAS). He underwent surgery, but died 13 days after the onset of the abdominal pain. Chronic exposure to carcinogens, such as thorium dioxide, arsenic, vinyl chloride, and radium, is associated with HAS. However, our patient had not been exposed to such carcinogens. He had submitted himself for annual medical checkups since he was employed. His liver was cirrhotic, and medical history data showed that he had had fatty liver for at least 10 years before HAS onset. Although liver cirrhosis may play a role in the occurrence of HAS, the connection of chronic fatty liver in the tumorigenesis remains unclear. Case reports regarding HAS with fatty liver are few. To the best of our knowledge, this is the first case of HAS occurring in a cirrhotic liver that advanced from persistent fatty stage. Given that HAS is a rare tumor, data collection is important for investigating its pathophysiology. Case presentations considering health conditions before HAS onset are limited; therefore, we present a case of HAS with annual health checkup data before disease onset.

scholarly journals SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain: two case reports

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Albert Martin-Cardona ◽  
Josep Lloreta Trull ◽  
Raquel Albero-González ◽  
Marta Paraira Beser ◽  
Xavier Andújar ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Endothelial Cells ◽  
Abdominal Pain ◽  
Case Reports ◽  
B Cell Lymphoma ◽  
Ischaemic Colitis ◽  
Intestinal Tissue ◽  
First Case ◽  
Transmission Electron

Abstract Background SARS-CoV-2 may produce intestinal symptoms that are generally mild, with a small percentage of patients developing more severe symptoms. The involvement of SARS-CoV-2 in the physiopathology of bowel damage is poorly known. Transmission electron microscopy (TEM) is a useful tool that provides an understanding of SARS-CoV-2 invasiveness, replication and dissemination in body cells but information outside the respiratory tract is very limited. We report two cases of severe intestinal complications (intestinal lymphoma and ischaemic colitis) in which the presence of SARS-CoV-2 in intestinal tissue was confirmed by TEM. These are the first two cases reported in the literature of persistence of SARS-CoV-2 demonstrated by TEM in intestinal tissue after COVID 19 recovery and SARS-CoV-2 nasopharyngeal clearance. Case presentation During the first pandemic peak (1st March–30th April 2020) 932 patients were admitted in Hospital Universitari Mútua Terrassa due to COVID-19, 41 (4.4%) required cross-sectional imaging techniques to assess severe abdominal pain and six of them (0.64%) required surgical resection. SARS-CoV-2 in bowel tissue was demonstrated by TEM in two of these patients. The first case presented as an ileocaecal inflammatory mass which turned to be a B-cell lymphoma. Viral particles were found in the cytoplasm of endothelial cells of damaged mucosa. In situ hybridization was negative in tumour cells, thus ruling out an oncogenic role for the virus. SARS-CoV-2 remained in intestinal tissue 6 months after nasopharyngeal clearance, suggesting latent infection. The second patient had a severe ischaemic colitis with perforation and SARS-CoV-2 was also identified in endothelial cells. Conclusions Severe intestinal complications associated with COVID-19 are uncommon. SARS-CoV-2 was identified by TEM in two cases, suggesting a causal role in bowel damage.

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