scholarly journals Endometriosis-Associated Massive Ascites in an Asian Woman: A Case Report of a Rare Clinical Entity

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Nuntasiri Eamudomkarn ◽  
Naratassapol Likitdee ◽  
Pilaiwan Kleebkaow ◽  
Chumnan Kietpeerakool
Keyword(s):  
Broad Ligament ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Final Diagnosis ◽  
Clinical Entity ◽  
Asian Woman ◽  
Rare Clinical Entity ◽  
Childbearing Age ◽  
Massive Ascites ◽  
History Of

Massive ascites as a presentation of endometriosis is a rare clinical entity that is most commonly seen in black nulliparous females. Herein, we describe a case of a 32-year-old multiparous Thai woman who presented with a two-year history of abdominal distension. Computerized tomography of the abdominopelvic region showed an infiltrative enhancing lesion involving the cul-de-sac and perirectal region with massive loculated ascites, suggesting carcinomatosis peritonei. Abdominal paracentesis was performed to yield fluid samples for evaluation, which revealed no malignant cells, and polymerase chain reaction (PCR) was negative for tuberculosis. The patient underwent exploratory laparotomy which revealed a large amount of serosanguinous ascites, thickened matted bowel loops, and necrotic debris covering the entire surface of the peritoneum and visceral organs. The surgical procedures included drainage of 6.5 liters of ascites, lysis adhesion, biopsy of the peritoneum, and right salpingo-oophorectomy. Histologic examination revealed benign endometrial glands with stroma at the peritoneum tissue and broad ligament. Other causes of ascites were excluded. The ascites responded to drainage and hormonal suppression. A final diagnosis of endometriosis was made based on these findings. Endometriosis should therefore be considered in differential diagnosis in women of childbearing age who present with ascites.

scholarly journals Resection of a colonic mass following trauma: a diagnostic dilemma

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Paul Burchard ◽  
Alan A Thomay
Keyword(s):  
Ct Scan ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Symptomatic Improvement ◽  
Diagnostic Dilemma ◽  
Vehicle Accident ◽  
Abdomen Ct ◽  
History Of ◽  
Mitotic Figures ◽  
The Right

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.

scholarly journals Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity

2012 ◽  
Vol 3 (1) ◽  
pp. 22-23
Author(s):  
Gopinath Maraignanam ◽  
L Somu
Keyword(s):  
Clinical Entity ◽  
Lateral Rhinotomy ◽  
Rare Clinical Entity ◽  
Rare Tumor ◽  
Left Nostril ◽  
Total Excision ◽  
Malignant Teratoma ◽  
Combined Features ◽  
History Of ◽  
Sinonasal Teratocarcinosarcoma

ABSTRACT Sinonasal teratocarcinosarcoma is a rare tumor of the paranasal sinuses, that shows combined features of both malignant teratoma and carcinosarcoma. It was earlier called teratoid carcinosarcoma or blastoma or teratocarcinoma or malignant teratoma. Its pecularity is its highly aggressive nature with a 5 years survival rate of 45% with treatment according to published statistics. Its treatment modality is a combination of surgery and radiotherapy. Here, we report one such case who presented with a history of one episode of torrential bleeding from left nostril and nasal obstruction for 3 months for which total excision of the tumor was done by endoscopic-assisted left lateral rhinotomy approach. Histopathology and Immunohistochemistry confirmed the diagnosis of sinonasal teratocarcinosarcoma and she was subsequently administered radiotherapy postoperatively. How to cite this article Mohanty S, Maraignanam G, Somu L. Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity. Int J Head and Neck Surg 2012;3(1):22-23.

scholarly journals Acquired colonic atresia in a 4-month old term male infant: a rare case report

2017 ◽  
Vol 4 (2) ◽  
pp. 669
Author(s):  
Kamal Nain Rattan ◽  
Gurupriya J. ◽  
Shruti Bansal ◽  
Rohit Kapoor ◽  
Roomi Yadav
Keyword(s):  
Case Report ◽  
Necrotizing Enterocolitis ◽  
Rare Case ◽  
Male Infant ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Inflammatory Mass ◽  
Colonic Atresia ◽  
Rare Case Report ◽  
History Of

Acquired colonic atresias are very rare but, are known in association with necrotizing enterocolitis. We report a case of a 4-month term male infant with recurrent episodes of abdominal distension, bilious vomiting and constipation off and on, without the history of necrotizing enterocolitis. Exploratory laparotomy was performed, an inflammatory mass with multiple dense interloop adhesions were found in the mid-transverse colon. These adhesions were lysed to identify the proximal dilated and distal blind end of the colon.  Rest of the gut was normal.  This case is unique for the fact that, it is a case of acquired colonic atresia without history of necrotizing enterocolitis, unlike other reported cases of acquired colonic atresia.

scholarly journals Salmonella thyroid abscess in a pre-existing multinodular goitre: rare clinical entity with review of literature

2016 ◽  
Vol 4 (1) ◽  
pp. 443 ◽  
Author(s):  
G.S. Murali ◽  
Shubhakar Bhandary
Keyword(s):  
Salmonella Typhi ◽  
Young Female ◽  
Clinical Entity ◽  
Causative Organism ◽  
Rare Clinical Entity ◽  
Upper Respiratory Tract ◽  
Thyroid Abscess ◽  
History Of ◽  
Upper Respiratory ◽  
Resistance To Infection

With its inherent resistance to infection, abscess of the thyroid has been rarely encountered clinically. The disease is usually preceded by an attack of upper respiratory tract infection. The availability of potent broad spectrum antibiotics is one important factor due to which currently thyroid abscess has become a rare clinical entity. But we report a case of thyroid abscess in an otherwise 26 yr old healthy young female with a long standing goitre. She gave no history of preceding URTI. The causative organism was identified as Salmonella typhi.

scholarly journals Pneumatosis intestinalis: cost paid for rheumatoid arthritis treatment

2019 ◽  
Vol 12 (7) ◽  
pp. e229329 ◽  
Author(s):  
Pratyusha Tirumanisetty ◽  
Jose William Sotelo ◽  
Michael Disalle ◽  
Meenal Sharma
Keyword(s):  
Rheumatoid Arthritis ◽  
Bowel Wall ◽  
Loop Ileostomy ◽  
Pneumatosis Intestinalis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Right Hemicolectomy ◽  
Necrotic Bowel ◽  
History Of ◽  
High Index Of Suspicion

A 75-year-old woman with rheumatoid arthritis on rituximab presented with a 1-week history of constipation and abdominal distension. Subsequent workup showed presence of air in the bowel wall without perforation initially. Due to positive blood cultures, worsening leucocytosis and high suspicion for perforation, an exploratory laparotomy was performed revealing necrotic bowel, walled off perforation and abscess. Patient underwent right hemicolectomy with diversion loop ileostomy. Clinicians must recognise that monoclonal antibodies like rituximab can mask signs of inflammation and therefore should maintain a high index of suspicion for intestinal perforation when evaluating patients with minimal symptoms and pneumatosis intestinalis.

scholarly journals Uterine Perforation on Invasive Hydatidiform Mole during EMACO Treatment

2016 ◽  
Author(s):  
Bram Pradipta
Keyword(s):  
Hydatidiform Mole ◽  
Broad Ligament ◽  
Posterior Part ◽  
Exploratory Laparotomy ◽  
Recurrent Bleeding ◽  
Uterine Perforation ◽  
Long Term Treatment ◽  
History Of ◽  
Invasive Mole ◽  
The Right

Objective: Improving skill and knowledge to recognize and manage a rare case of uterine perforation on invasive hydatidiform mole. Method: Case report. Result: A 42 years old Indonesian woman, Parity 2 Abortus 2 with history of 2 c-sections and 2 curettage, came with chief complaint of recurrent vaginal bleeding since 4 months before admission. Patient had a history of previous curettage with indication of hydatidiform mole and recurrent bleeding with no histopathology results. On examination we found a vesicular mass with infiltration, destroying the right-front uterine corpus, size 8x6 cm with an internal echo mass. Chest x-ray showed multiple nodules in the lung. The patient, considered as low risk Gestational Trophoblastic Neoplasia patient with FIGO Score of 6, underwent chemotherapy with 2 series of methotrexate . Due to the non-declining level of -hCG, the regimen was added with EMACO. In the process of chemotherapy, the pa-tient’s-hCG declined but then she complained of major abdominal pain. Exploratory laparotomy was performed and we found a mass sized 5x5x5 cm on the right side of the uterus at the broad ligament with a rupture at the posterior part of the mass sized 0.5x0.5 cm. Upon incision of the uterus, we found a mass from the right side protruding to the isthmus of the uterus. Histopathology showed necrosis, blood and chorionic villi in myometrium corresponding to invasive mole. Patient was then given another 5 series of EMACO and her condition was unremarkable during the remaining course of treatment. Conclusion: Invasive mole treatment is determined based on the risk factors. Uterine perforation still occurred in this case regardless of the decreasing hCG level during EMACO treatment. It emphasizes the importance of clinical examination as chemotherapy responsiveness. Long-term treatment can have a good prognosis but good collaboration between the gynecologist and the patient is essential. [Indones J Obstet Gynecol 2014; 3: 162-165] Keywords: EMACO, invasive mole, perforation

scholarly journals Malformation of a Mesocolon as a Cause of Colic in an Arabian Foal

2021 ◽  
Vol 8 (9) ◽  
pp. 193
Author(s):  
Bernard Turek ◽  
Elżbieta Stefanik ◽  
Natalia Kozłowska ◽  
Olga Drewnowska-Szczepakowska ◽  
Kamil Górski ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Final Diagnosis ◽  
Relieve Pain

This paper describes a case of partial lack of the mesocolon in a 7-month-old colt. The foal was referred to the hospital with clinical signs of severe abdominal distension of a few hours duration. Because analgesics did not relieve pain, the foal remained uncomfortable, and distension of the abdomen increased; an exploratory laparotomy was performed under general anaesthesia in dorsal recumbency. The final diagnosis was confirmed intraoperatively. During exploration of the abdominal cavity, other problems like right dorsal displacement and torsion of the colon were recognized. Correction of all problems was completed, and the mesentery was sutured. Recovery from anaesthesia was uneventful. The foal was recovering well a few months after surgery, and the owner did not complain about the results of the treatment.

scholarly journals Airway Challenges in a Preterm Neonate with Undiagnosed Complete Tracheal Rings Posted for Surgery

2021 ◽  
Author(s):  
Pratika Pradeep Bhokare ◽  
Sayli Rajendra Kulkarni
Keyword(s):  
Difficult Airway ◽  
Preterm Neonate ◽  
Airflow Obstruction ◽  
Failure To Thrive ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Supraglottic Airway ◽  
Preterm Neonates ◽  
History Of ◽  
Airway Anomalies

Preterm neonates are defined as those born before 37 weeks. The anatomical features of preterm neonates vary from that of an adult, such that they have a large tongue, an anterior funnel shaped larynx, angled vocal cords and an omega shaped epiglottis. Their physiological development also differ as they have a greater risk for apnoea of prematurity, airflow obstruction, bronchopulmonary dysplasia, low functional residual capacity and decreased transient oxygen tension. Congenital airway anomalies have a prevalence rate of 0.2-1 in 10,000 live births. Congenital Tracheal Stenosis (CTS) caused by complete tracheal rings is one of the rarest forms of all the airway anomalies that occur, which is characterised by presence of complete ‘O’ shaped cartilaginous rings of trachea devoid of a membranous part. The case discussed in the article is that of a day 26 preterm neonate with increasing abdominal distension and failure to thrive. The neonate was posted for an urgent exploratory laparotomy for abdominal decompression and ileostomy. Patient was kept on Continuous Positive Airway Pressure (CPAP) support for four days immediately after birth; however, intubation was never attempted nor required. With a history of respiratory depression and lack of history of previous intubation, difficult airway cart was kept ready prior to surgery. Supraglottic Airway (SGA) devices were at the core of airway rescue in this case of undiagnosed CTS. This case report shows how and why a preparation for difficult airway in preterm neonates is a necessity. It will provide as a guide if a similar case is encountered by the anaesthetist.

scholarly journals Rare case of midgut volvulus with malrotation in an elderly patient

2019 ◽  
Vol 7 (1) ◽  
pp. 303
Author(s):  
Mezhuneituo Raleng ◽  
Anant Prakash Pore ◽  
Vickey Katheria ◽  
Worshim Khamrang ◽  
R. S. Wungramthing
Keyword(s):  
Elderly Patient ◽  
Intestinal Obstruction ◽  
Conservative Management ◽  
Rare Case ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Midgut Volvulus ◽  
History Of ◽  
Subacute Intestinal Obstruction

A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced. 

scholarly journals Continuous Spinal Anesthesia following Inadvertent Dural Puncture during Epidural Placement for an Emergency Laparotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Andrew Emyedu ◽  
Bernadette Kyoheirwe ◽  
Patience Atumanya
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Emergency Laparotomy ◽  
Continuous Spinal Anesthesia ◽  
Accident And Emergency ◽  
Accidental Dural Puncture ◽  
History Of ◽  
Intrathecal Space

Summary. Emergency exploratory laparotomy conducted under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Background and Objectives. Continuous spinal anesthesia is one of the least utilized regional anesthesia techniques globally. It could be an alternative anesthesia technique for abdominal and lower limb surgeries following an accidental dural puncture. The aim of this report was to describe a case in which continuous spinal anesthesia was successfully conducted for emergency exploratory laparotomy following an accidental dural puncture during epidural placement. Case Report. A 38-year-old male presented to our accident and emergency unit with a one-day history of colicky abdominal pain associated with constipation, abdominal distension, and vomiting. He was diagnosed with intestinal obstruction and underwent an emergency exploratory laparotomy under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Conclusion. This case demonstrates that in case of an accidental dural puncture during epidural placement, the catheter can be advanced into the intrathecal space and continuous spinal anesthesia conducted for abdominal surgeries using a standard epidural catheter.

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