scholarly journals Intestinal Anisakiasis Treated Successfully with Prednisolone and Olopatadine Hydrochloride

2016 ◽  
Vol 10 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Hideki Toyoda ◽  
Kyosuke Tanaka
Keyword(s):  
Abdominal Pain ◽  
Clinical Course ◽  
Wall Thickening ◽  
Proximal Jejunum ◽  
Abdominal Ultrasonography ◽  
Raw Fish ◽  
Intestinal Anisakiasis ◽  
Clinical Characteristic ◽  
Jejunal Wall ◽  
Olopatadine Hydrochloride

The clinical characteristic of gastrointestinal anisakiasis is severe abdominal pain after eating raw fish. Intestinal anisakiasis is more uncommon than gastric anisakiasis. Most patients with intestinal anisakiasis need hospitalization because anisakiasis can cause intestinal obstruction, ileus, peritonitis or intestinal perforation. We report a case of intestinal anisakiasis. A 43-year-old woman presented with symptoms of intermittent abdominal pain 2 days after eating raw fish. Her brother had eaten the same food and had been suffering from gastric anisakiasis. Abdominal ultrasonography in this patient showed localized jejunal wall thickening with dilated lumen of proximal jejunum and ascites. According to the clinical course and examinations, she was diagnosed with intestinal anisakiasis. Administration of prednisolone 5 mg/day and olopatadine hydrochloride 10 mg/day improved her symptoms quickly without hospitalization. Prednisolone was administered for 10 days, and olopatadine hydrochloride was administered for a total of 6 weeks according to ultrasonographic findings. Six months after the treatment, the abdominal ultrasonography demonstrated normal findings. This case demonstrates that ultrasonography was quite useful for the diagnosis and surveillance of intestinal anisakiasis. Furthermore, treatment with corticosteroid and an antiallergic agent could be an option for patients with intestinal anisakiasis.

scholarly journals Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Manouchehr Aghajanzadeh ◽  
Mohammad Taghi Ashoobi ◽  
Hossein Hemmati ◽  
Pirooz Samidoust ◽  
Mohammad Sadegh Esmaeili Delshad ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Biliary Obstruction ◽  
Abdominal Ultrasound ◽  
Sporadic Case ◽  
Gallbladder Wall ◽  
Liver Cyst ◽  
Biliary Duct ◽  
Wall Thickening

Abstract Background Hydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity. Case presentation A 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst. Conclusion Intrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.

scholarly journals Diagnosis of Fibrotic Distal Ileum Stenosis after Ischemic Enteritis Using Transabdominal Ultrasonography

2021 ◽  
pp. 568-577
Author(s):  
Ryo Katsumata ◽  
Noriaki Manabe ◽  
Masaki Matsubara ◽  
Jun Nakamura ◽  
Kazuma Kawahito ◽  
...  
Keyword(s):  
Blood Flow ◽  
Case Reports ◽  
Blood Perfusion ◽  
Distal Ileum ◽  
Wall Thickening ◽  
Current Case ◽  
Abdominal Ultrasonography ◽  
Transabdominal Ultrasonography ◽  
Stenotic Lesion ◽  
Ischemic Enteritis

Ischemic enteritis (IE) is a rare disorder which is caused by inadequate blood flow to small intestine. The diagnostic procedure of this disease has not sufficiently established because of its rarity. Here, we report a case of IE in a hemodialysis-dependent 70-year-old man and summarize the diagnostic options for IE. The patient was admitted to our hospital because of acute abdominal distention and vomiting. He presented with mild tenderness in the lower abdomen and slightly elevated C-reactive protein level as revealed by blood tests. Radiographic imaging showed small bowel obstruction due to a stricture in the distal ileum. Contrast-enhanced abdominal ultrasonography revealed a 7-cm stenotic site with increased intestinal wall thickening, which preserved mucosal blood perfusion. Elastography revealed a highly elastic alteration of the stenotic lesion, indicating benign fibrotic changes resulting from chronic insufficient blood flow. Based on a clinical diagnosis of IE with fibrous stenosis, a partial ileostomy was performed. After surgical treatment, oral intake was initiated without recurrence of intestinal obstruction. Pathological findings revealed deep ulceration with inflammatory cell infiltration at the stenotic site. Occlusion and hyalinization of the venules in the submucosal layer indicated IE. In addition to current case, we reviewed past case reports of IE. Through this case presentation and literature review, we summarize the usefulness and safety of transabdominal ultrasonography for diagnosing IE.

Approach to the Patient with Abdominal Pain

2020 ◽  
Author(s):  
Dana Sajed
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Chronic Conditions ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Abdominal Ultrasonography ◽  
Pediatric Populations ◽  
Ed Visits ◽  
Point Of Care Ultrasonography

Abdominal pain is the most common presenting complaint in the emergency department (ED), accounting for nearly 8% of ED visits. Although many chronic conditions may cause pain in the abdomen, acute abdominal pain, defined as undiagnosed pain present for less than 1 week, is of greatest concern to the emergency practitioner. For many reasons, acute abdominal pain is often diagnostically challenging. Abdominal pain may be due to numerous causes, including gastrointestinal, genitourinary, cardiovascular, pulmonary, and other sources. Symptoms may fluctuate or change in nature, and the quality of pain can be difficult for the patient to describe. Physical examination findings, although important, are variable and can even be misleading. Despite being such a common presenting complaint, misdiagnosis is not uncommon and results in a high percentage of medicolegal actions in both and adult and pediatric populations. This review contains 5 figures, 8 tables, and 92 references Key words: abdominal computed tomography, abdominal pain, abdominal ultrasonography, pain management, point-of-care ultrasonography

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

scholarly journals An unhealthy holiday on Lake Bolsena

2013 ◽  
pp. 39-42
Author(s):  
Lucio Brugioni ◽  
Maurizio Tognetti ◽  
Cristina Gozzi
Keyword(s):  
Abdominal Pain ◽  
Hypereosinophilic Syndrome ◽  
Central Italy ◽  
Clinical Tests ◽  
Opisthorchis Felineus ◽  
Specific Analysis ◽  
Patient Reported ◽  
Stool Samples ◽  
Raw Fish ◽  
Abdominal Echography

A 70-year old man (OL) was hospitalized due to fever (up to 40°C) associated with malaise and abdominal pain. Tests showed hypereosinophilic syndrome, and increased liver and inflammation indexes. Abdominal echography showed a nonhomogeneous liver and the spleen was enlarged. Abdominal computed tomography showed multiple abscesses on the liver. The patient reported that he had recently gone on holiday to Lake Bolsena where he had eaten raw fish. A specialist in infectious diseases confirmed that in that area there is an infestation of Opisthorchis felineus. Analysis of blood and stool samples confirmed the presence of this parasite. The patient was treated with praziquantel with resolution of fever and improvement in clinical tests and general condition. Opisthorchis felineus is a parasite that commonly infects dogs and cats. Infection is sometimes transmitted to man and is usually related to eating raw fish. The parasite enters the liver and its eggs are found in the patient’s stool samples. Acute symptoms are: fever, diarrhea, abdominal pain, and malaise. Hypereosinophilic syndrome and increase in liver index are typical. Chronic infection could result in cholangiocarcinoma. Presence of the parasite is confirmed through specific analysis of blood and stool. Therapy consists of praziquantel or, as second choice, abendazol. In the 20th century, there were 4 epidemics in Italy, on Lakes Trasimeno and Bolsena in Central Italy. The latest epidemic was reported in that area in summer 2012.

Biliary pain in the structure of episodes of right upper abdominal pain

2020 ◽  
Vol 18 (6) ◽  
pp. 42-52
Author(s):  
Yu.O. Shulpekova ◽  
◽  
V.M. Nechaev ◽  
V.T. Ivashkin ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Cholecystitis ◽  
Heart Diseases ◽  
Biliary Colic ◽  
Recurrent Pain ◽  
Biliary Pain ◽  
Abdominal Ultrasonography ◽  
Locomotor System ◽  
Upper Abdominal ◽  
The Right

Acute or recurrent pain in the right upper part of the abdomen is a common cause for visits to physicians. Not less than two thirds of episodes of pain in this area are conditioned by biliary colic and acute cholecystitis. Other most common causes include diseases of the liver, pancreas, prepyloric and pyloric parts of the stomach and the beginning portion of the small intestine, the right kidney, and also subhepatic appendicitis. Some cases of developing pain are associated with the right lung affection and involvement of the diaphragmatic pleura, with heart diseases, involvement of the locomotor system and nerves. Taking into account a high prevalence of cholelithiasis in Russia – around 10–12% – we can conclude that episodes of biliary colic develop every year in 1 of 500–1000 individuals. In Russia, approximately half a million cholecystectomies are performed annually. The prevalence of gall stones among the paediatric population amounts to 2%. As distinct from adults, who in 80% of cases have an asymptomatic course of disease, pain episodes in children manifest themselves in 60–67% of cases. The diiagnosis of acute cholecystitis might meet with considerable difficulties; a scale for assessment of the likelihood of acute cholecystitis has been developed. Unlike in adults, in children a significantly large proportion of cases occur due to acalculous cholecystitis. Differentiating the causes of pain might be difficult, therefore, its character and concomitant symptoms should be thoroughly analysed, and the findings of additional examinations should also be taken into consideration (at the first step – assessment of haematological and biochemical parameters, urinalysis, electrocardiogram and abdominal ultrasonography). Key words: right upper abdominal pain, biliary colic, biliary dyskinesia, cholelithiasis

Peritoneal dialysis-associated peritonitis caused by Enterococcus avium

2021 ◽  
Vol 14 (3) ◽  
pp. e240272
Author(s):  
Rita Calça ◽  
Francisca Gomes da Silva ◽  
Ana Rita Martins ◽  
Patrícia Quadros Branco
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Dialysis ◽  
Antibiotic Therapy ◽  
Rare Case ◽  
Clinical Course ◽  
Catheter Removal ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Laboratory Findings ◽  
Microbial Agents

Peritonitis remains a common and serious complication of peritoneal dialysis. Peritonitis caused by gram-positive organisms includes coagulase-negative staphylococci, Streptococcus spp and Enterococcus spp. We present a rare case of peritoneal dialysis-associated peritonitis, where persisting abdominal pain and worsening laboratory findings despite antibiotic therapy led to the identification of Enterococcus avium, requiring Tenckoff catheter removal and temporary transfer to haemodialysis. The available literature reports only few cases where peritonitis is caused by this agent, underlining the need to consider atypical microbial agents when heterogeneous clinical course is presented.

scholarly journals Epiploic Appendagitis: An Often Misdiagnosed Cause of Acute Abdomen

2019 ◽  
Vol 13 (3) ◽  
pp. 364-368
Author(s):  
Vishnu Charan Suresh Kumar ◽  
Kishore Kumar Mani ◽  
Hisham Alwakkaa ◽  
James Shina
Keyword(s):  
Abdominal Pain ◽  
Bowel Wall ◽  
Acute Diverticulitis ◽  
Lower Abdominal Pain ◽  
Wall Thickening ◽  
Antibiotic Administration ◽  
Epiploic Appendagitis ◽  
High Attenuation ◽  
History Of ◽  
Bowel Wall Thickening

Epiploic appendages are peritoneal structures that arise from the outer serosal surface of the bowel wall towards the peritoneal pouch. They are filled with adipose tissue and contain a vascular stalk. Epiploic appendagitis is a rare cause of acute lower abdominal pain. It most commonly results from torsion and inflammation of the epiploic appendages, and its clinical features mimic acute diverticulitis or acute appendicitis resulting in being often misdiagnosed as diverticulitis or appendicitis. This frequently leads to unnecessary hospitalization, antibiotic administration, and unwarranted surgeries. Epiploic appendagitis is usually diagnosed with CT imaging, and the classic CT findings include: (i) fat-density ovoid lesion (hyperattenuating ring sign), (ii) mild bowel wall thickening, and (iii) a central high-attenuation focus within the fatty lesion (central dot sign). It is treated conservatively, and symptoms typically resolve in a few days. Therefore, epiploic appendagitis should be considered as one of the differential diagnosis for acute lower abdominal pain and prompt diagnosis of epiploic appendagitis can avoid unnecessary hospitalization and surgical intervention. In this case report, we discuss a 72-year-old woman who presented with a 2-day history of acute left lower abdominal pain.

scholarly journals Congenital band adhesion causing a proximal jejunal obstruction: an uncommon presentation and diagnosis

2019 ◽  
Vol 12 (7) ◽  
pp. e229235
Author(s):  
David Ashley Cruise ◽  
Kim Goddard
Keyword(s):  
Abdominal Pain ◽  
Acute Onset ◽  
Greater Omentum ◽  
Proximal Jejunum ◽  
Complete Obstruction ◽  
Uncommon Presentation ◽  
Surgical History ◽  
Crampy Abdominal Pain ◽  
Contrast Swallow ◽  
Jejunal Obstruction

A 20-year-old woman with no medical or surgical history presented with acute onset crampy abdominal pain on a background of uninvestigated similar chronic abdominal pain. She became obstructed during her admission and a contrast swallow showed a complete obstruction at the level of the proximal jejunum. A diagnostic laparoscopy revealed a congenital band adhesion from the greater omentum to the proximal jejunum to be the cause, and dissection of the band relieved her obstruction. This case presents a rare cause of mechanical obstruction, and highlights the seriousness of investigating obstructive symptoms even in atypical patient populations.

scholarly journals Acalculous acute cholecystitis during the course of an enteroviral infection

2019 ◽  
Vol 12 (4) ◽  
pp. e228306 ◽  
Author(s):  
Ana Sofia Simões ◽  
Andreia Marinhas ◽  
Paulo Coelho ◽  
Sandra Ferreira
Keyword(s):  
Acute Cholecystitis ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Clinical Report ◽  
Healthy Children ◽  
First Line ◽  
Abdominal Ultrasonography ◽  
Laboratory Findings ◽  
Enteroviral Infection ◽  
Underlying Diseases

Gallbladder diseases are uncommon in children. Acalculous acute cholecystitis, although rare, is the most frequent form of acute cholecystitis in childhood. In acalculous acute cholecystitis, clinical presentation and laboratory findings are unspecific, making the diagnosis challenging. Abdominal ultrasonography is the first-line exam. Most cases of paediatric acalculous acute cholecystitis have been described in critically ill patients, but can occur in previously healthy children, without underlying diseases or severe conditions. The authors present a clinical report of a child with acalculous acute cholecystitis and enteroviral infection. Diagnosis, treatment, clinical course and prognosis are described. Pathophysiology, aetiology, diagnosis and treatment of acalculous acute cholecystitis are also discussed.

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