scholarly journals Ingested Foreign Body Migration to the Liver: An Unusual Cause of Persistent Abdominal Pain in a 54-Year-Old Female

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Alan Lucerna ◽  
James Espinosa ◽  
Kelly Schuitema ◽  
Risha Hertz
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Foreign Body ◽  
Bone Fragment ◽  
Common Presentation ◽  
Persistent Abdominal Pain ◽  
Ingested Foreign Body ◽  
History Of ◽  
Small Bone

Abdominal pain is a common presentation in emergency medicine. We describe the case of a 54-year-old female who presented to the emergency department due to worsening abdominal pain. She had a history of right upper quadrant (RUQ) abdominal pain that had been ongoing for several months. The pain had been thought by the primary care team to be related to gastritis and she had been prescribed a proton pump inhibitor (PPI). Her abdominal pain increased in the three days prior to her presentation to the emergency department (ED). The computed tomography (CT) scan of the abdomen showed a foreign body (FB) in the liver which was successfully removed surgically. Pathology results showed that the FB was consistent with a small bone fragment. Ingestions of FB are common but seldom result in complications. When complications do arise, perforation of a hollow viscous is typically seen. Rarely, transmigration of the FB can occur.

Abdominal Surgery

2019 ◽  
pp. 1-18
Author(s):  
Ashis Banerjee ◽  
Anisa J. N. Jafar ◽  
Angshuman Mukherjee ◽  
Christian Solomonides ◽  
Erik Witt
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Foreign Body ◽  
Abdominal Surgery ◽  
Sigmoid Volvulus ◽  
Short Answer ◽  
Ingested Foreign Body ◽  
Accompanying Symptoms ◽  
Short Answer Questions ◽  
Emergency Doctor

This chapter on abdominal surgery contains eight clinical Short Answer Questions (SAQs) with explanations and sources for further reading. Possible causes and accompanying symptoms of abdominal pain that may present in the emergency department include appendicitis, cholecystitis, cholangitis, ingested foreign body, rectal bleeding, gastric or sigmoid volvulus and post-laparoscopy complications.. It will be up to the emergency doctor to assess, diagnose, and decide upon a treatment path for each patient. The cases described in this chapter are all situations any emergency doctor is likely to encounter at some point in his or her career. The materials in this chapter will greatly aid revision for the Final FRCEM examination.

scholarly journals A Curious Case of the Persistent Body Stuffer

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Muhammad Durrani ◽  
Carla Dugas ◽  
Samaresh Dasgupta
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Foreign Body ◽  
Outlet Obstruction ◽  
Oral Contrast ◽  
Foreign Body Removal ◽  
Plastic Bags ◽  
Small Leak ◽  
Body Stuffer

A 29-year-old male presented to our emergency department with complaint of abdominal pain after allegedly ingesting a 4-gram packet of heroin in an attempt to evade detection. Initial evaluation including computed tomography (CT) of the abdomen/pelvis with intravenous and oral contrast, as well as laboratory workup was negative and the patient was discharged. The patient returned 3 days later with complaint of “I feel high” and severe constipation, and demonstrated an opiate toxidrome requiring naloxone with improvement of symptoms. A repeat CT of the abdomen/pelvis, this time without contrast revealed a 2.1 × 1.8 cm foreign body in the gastric antrum. The patient was promptly taken to endoscopy with surgical backup. Foreign body removal included multiple plastic bags encasing heroin, which had sustained a small leak causing a gastric outlet obstruction as well as a slow opiate toxidrome. The foreign body was removed and the patient was observed and discharged with a favorable outcome.

scholarly journals Intussusception Secondary to a Meckel's Diverticulum as Leading Point in fourth decade of Life, Case Report

2020 ◽  
Author(s):  
Faisal Albaqami ◽  
Feras Alsannaa ◽  
Reem Bin Saleem ◽  
Nahla Arab
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Right Hemicolectomy ◽  
Ileocolic Anastomosis ◽  
Ileocecal Region ◽  
Fourth Decade ◽  
History Of ◽  
Laparoscopic Right Hemicolectomy

37-year-old man presented to the emergency department with a three-hour history of severe, generalized abdominal pain. Computed tomography of abdomen revealed two distal ileoileal intussusceptions with high suspicion of 3 cm mass within the intussusception around the ileocecal region. Laparoscopic right hemicolectomy with extracorporeal ileocolic anastomosis which showed Meckel

A Rare Case of Bilateral Incarcerated Obturator Hernias and a Right-Side Femoral Hernia

2020 ◽  
pp. 1-3
Author(s):  
Jinping Xu ◽  
Jinping Xu ◽  
Ruth Wei ◽  
Salieha Zaheer
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Femoral Hernia ◽  
Rare Case ◽  
Hernia Recurrence ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
Abdominal Ct ◽  
Abdominal Ct Scan ◽  
History Of

Obturator hernias are rare but pose a diagnostic challenge with relatively high morbidity and mortality. Our patient is an elderly, thin female with an initial evaluation concerning for gastroenteritis, and further evaluation revealed bilateral incarcerated obturator hernias, which confirmed postoperatively as well as a right femoral hernia. An 83-year-old female presented to the outpatient office initially with one-day history of diarrhea and one-week history of episodic colicky abdominal pain. She returned 4 weeks later with diarrhea resolved but worsening abdominal pain and left inner thigh pain while ambulating, without changes in appetite or nausea and vomiting. Abdominal CT scan then revealed bilateral obturator hernias. Patient then presented to the emergency department (ED) due to worsening pain, and subsequently underwent hernia repair. Intraoperatively, it was revealed that the patient had bilateral incarcerated obturator hernias and a right femoral hernia. All three hernias were repaired, and patient was discharged two days later. Patient remained well postoperatively, and 15-month CT of abdomen showed no hernia recurrence.

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

scholarly journals Foreign Body in abdomen

2015 ◽  
Vol 14 (2) ◽  
pp. 210-212
Author(s):  
Md Zakirul Alam ◽  
Mohibul Aziz
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Medical Science ◽  
X Ray ◽  
Diagnostic Center ◽  
History Of ◽  
Upper Abdominal ◽  
Married Female

A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.210-212

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

scholarly journals Acquired Tracheo-Esophageal Fistula : A Rare Case Report of the Neglected Denture

2018 ◽  
Vol 5 ◽  
Author(s):  
Sharir Asrul Bin Asnawi ◽  
Mohamad Bin Doi ◽  
Abdul Rahman Hikmet Shaker ◽  
Mawaddah Binti Azman
Keyword(s):  
Foreign Body ◽  
Endoscopic Examination ◽  
Esophageal Fistula ◽  
Medical Assessment ◽  
Radiological Investigation ◽  
Rare Case Report ◽  
Patient Will ◽  
Ingested Foreign Body ◽  
History Of ◽  
Background History

Introduction: Dentures are common accidental ingested foreign body (FB) especially among elderly. It is frequent to have foreign body impacted at esophagus in adults however it is very unsual to have Tracheo-esophageal fistula (TEF) caused by denture. The diagnosis of TEF is challenging due to two reasons. Firstly, most of the dental prosthesis is radiolucent and not visible in routine radiological investigation. Secondly, patient with history of swallowed dentures prosthesis may be asymptomatic initially and develops symptoms over time. In contrary, prolonged history of FB in esophagus with TEF has higher risk to develop serious complication such as pneumonia and lung abscess.Case Presentation: We report a case of 62 year old gentleman with background history of hypertension and temporal lobe epilepsy presented with history of choking on taking solid and liquid associated with significant weight loss past 2 months. He had lost his denture for almost 1 year during sleep. Endoscopic examination of the larynx showed normal anatomy but pooling of saliva. CT thorax showed foreign body within a tracheoesophgeal fistula. OGDS showed denture within a well formed tracheoesophageal fistula. He had acquired TEF secondary to the dentures. Conclusion: Symptomatic elderly who lose their denture during sleep should not be neglected. They need immediate medical assessment thus will reduce further debilitating complication. Failing to identify and treat this condition urgently, patient will suffer acquired trachea-oesophageal fistula on which the treatment is challenging and the morbidity and mortality is high.

Pseudodiagnosis of Pseudoseizure

2020 ◽  
pp. 105-110
Author(s):  
Pat Croskerry
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
The Past ◽  
Autopsy Report ◽  
History Of ◽  
History Of Depression ◽  
Tomography Scan ◽  
Surprising Finding

In this case, a 35-year-old male is brought to a community hospital emergency department by ambulance having suffered an apparent seizure in the street. He is well known to the nurses and physician who see him. He has had several visits for seizures, and he has a history of depression. He has had electroencephalography studies and a computed tomography scan of his head in the past and has had assessments by both neurology and psychiatry. While he is in the department, he has an atypical seizure. There is a consensus among the ED staff that his seizures may be factitious. After a period of observation, he is discharged. Approximately 6 months later, the physician hears that the patient has died and tracks down his autopsy report, which had a surprising finding.

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