Abdominal cavity

2006 ◽  
pp. 190-192
Keyword(s):  
VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 495-498 ◽  
Author(s):  
Rajkovic ◽  
Zelic ◽  
Papes ◽  
Cizmek ◽  
Arslani

We present a case of combined celiac axis and superior mesenteric artery embolism in a 70-year-old patient that was examined in emergency department for atrial fibrillation and diffuse abdominal pain. Standard abdominal x-ray showed air in the portal vein. CT scan with contrast showed air in the lumen of the stomach and small intestine, bowel distension with wall thickening, and a free gallstone in the abdominal cavity. Massive embolism of both celiac axis and superior mesenteric artery was seen after contrast administration. On laparotomy, complete necrosis of the liver, spleen, stomach and small intestine was found. Gallbladder was gangrenous and perforated, and the gallstone had migrated into the abdominal cavity. We found free air that crackled on palpation of the veins of the gastric surface. The patient’s condition was incurable and she died of multiple organ failure a few hours after surgery. Acute visceral thromboembolism should always be excluded first if a combination of atrial fibrillation and abdominal pain exists. Determining the serum levels of d-dimers and lactate, combined with CT scan with contrast administration can, in most cases, confirm the diagnosis and lead to faster surgical intervention. It is crucial to act early on clinical suspicion and not to wait for the development of hard evidence.


2020 ◽  
Vol 5 (5) ◽  

Background and Objective: Rosai-Dorfman disease (RDD) are usually misdiagnosed because of rarity and nonspecific clinical and radiological features. The aim of our study is to explore the clinical and imaging characteristics of RDD to improve diagnostic accuracy. Methods: Clinical and imaging data in 10 patients with RDD were retrospectively analyzed. 7 patients were underwent CT scanning and 3 patients were underwent MR examination. Results: 8 (8/10) patients presented with painless enlarged lymph nodes (LNs) or mass. 3 cases were involved with LNs, 5 cases were involved with extra-nodal tissues, and the remaining 2 cases were involved with LNs and extra-nodal tissue simultaneously. In enhanced CT images, enlarged LNs displayed mild or moderate enhancement, and 2 cases showed heterogeneous ring-enhancement. MR features of 3 patients with extra-nodal RDD, 2 cases showed a mass located in the subcutaneous and anterior abdominal wall respectively, and 1 case showed an intracranial mass. Besides, all lesions showed high signal foci on DWI images, and were characterized by marked heterogeneous enhancement with blurred edge. The dural/fascia tail sign and dilated blood vessels could be seen around all the lesions on enhanced MRI. Radiological features of 2 cases with LN and extranodal tissue involved, one case presented with the swelling and thickening of pharyngeal lymphoid ring and nasopharynx, meanwhile with enlarged LNs in bilateral submandibular area, neck and abdominal cavity, and also companied with osteolytic lesion in right proximal humerus. All these LNs displayed mild and moderate enhancement on CT images. Another case showed enlarged LNs in bilateral neck accompanied with soft tissue mass in the sinuses. Conclusions: RDD occurred commonly in young and middle-aged men and presented with painless enlarged LNs or mass.RDD had a huge diversity of imaging findings, which varied with different location. The radiological features, such as small patches of high signal foci in the masses on DWI images, heterogeneous enhancement and blood vessels around the masses, are helpful in diagnosis of extranodal RDD.


2018 ◽  
Vol 8 (1) ◽  
pp. 69-75
Author(s):  
R. R. Ishtukov ◽  
M. A. Nartailakov ◽  
V. S. Panteleev ◽  
V. V. Rezyapov

Introduction. One of the worst complication of different surgical diseases of abdominal cavity organs and of performed, on that regard, operational interventions, are intestinal festulas including without limitation deodenum fistulas. Longterm experience of surgical treatment of patients with unformed duodenal and high enteric fistulas show that it is feasible to have a clear surgical tactics with account of location level and type of fistulas, their quantity, volume of sarcous reduction, peritonitis and multi-organ failure syndrome. In this regard, the objective of this research is to find optimal surgical tactics and to determine the most effective method of treating duodenum fistulas of various causation.Materials and methods. Experimental work was carried out under conditions of experimentally formed intestinal fistula in rabbits of “Shinshilla” breed. After formation of fistula the animals were divided into 3 groups based on the method of removing artificially installed duodenal fistula: sealing through Albert — Schmieden — Lembert suture without fastening of suture line; sealing through fastening of intestinal suture with biological surgical glue; sealing through fastening with swine dermal collagen. Mechanical constancy of the sutures was measured with pneumocompression of sealed intestinal tract areas as well as with morphological study of surgical wound edges.Results. The results of histological study show that experiments with application of bio-implant demonstrated less vascular congestion and interstitial swelling. Phologistic infiltration also responded more efficiently both quantitatively (manifestation rate) and qualitatively (quick change of cell elements) in the group that used bio-implant.Conclusion. Results of morphological studies and pneumocompression data under modelling of duodenal fistulas in experimental animals show that application of bio-implant helps to earlier restore microcirculatory abnormality. 


2019 ◽  
Vol 3 (1) ◽  
pp. 48-55
Author(s):  
Putri Zelfitri Zen ◽  
Yusrawati Yusrawati

Objective: To report a case of Ectopic pregnancy with implant receptorsMaterials and Methods: This article describes the case of a 41-year-old woman, diagnosed with an Ectopic Pregnancy on the gravid G5P4A0H4 11-12 weeks. Patients are using implant contraception, which has been used since 2009-2018 (3 installations). The patient came to the obstetrics and gynecology clinic Dr. M. Djamil Padang. The ultrasound gives the impression of Ectopic pregnancy in the infindibule tube. Analysis Ectopic pregnancy can also occur due to the influence of hormonal contraceptive use (progesterone).Results: Patient gets intervention performed laparotomy After the peritoneum is opened it appears fresh red blood amounting to ± 500 cc filling the abdominal cavity. Blood evacuation and exploration are performed, it appears that the source of bleeding originates from the left tubal rupture (Infundibulum) Impression of the left tubal rupture (Infundibulum) ecectic ectopic pregnancy is impaired. Sinistal salpingectomy is performed.Conclusion: Ectopic pregnancy Ectopic pregnancy is all pregnancies where the ovum fertilized by spermatozoa implant and grows outside the uterine cavity endometrial.


2018 ◽  
Vol 3 (2) ◽  
pp. 175-180
Author(s):  
F. G. Jamalov ◽  
◽  
M. M. Abdullaev ◽  
E. V. Nabieva ◽  
Т. P. Jamalova ◽  
...  

Author(s):  
N.N. Bondarenko, E.Yu. Andreeva , N.B. Filippova

A case of prenatal ultrasound diagnosis of a rare congenital ovarian tumor is presented. By ultrasound examination at 36–37 weeks of gestation the intra-abdominal mass 66  47  74 mm occupying the entire abdominal cavity was discovered. At 38 weeks of pregnancy spontaneous delivery occurred with girl weight 2840 g. On the eighth day after birth the child has been successfully undergone surgery. Histological examination revealed congenital germ-cell tumor with structures of dysgerminoma and yolk sac tumor.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammed Nagdi Zaki ◽  
Aafia Mohammed Farooq Gheewale ◽  
Nada Ibrahim ◽  
Ibrahim Abd Elrahman

Abstract Background An adenomyoma is a well circumscribed form of adenomyosis and can be located within the myometrium, in the endometrium as a polyp, or extrauterine with the last being the rarest presentation amongst the three. With the ongoing advancement in gynecological surgery, the use of electromechanical morcellators have made the removal of large and dense specimens possible with minimally invasive techniques. However, it has also caused an increase in complications which were previously rare. Whilst the tissue is being grinded within the abdominal cavity, residual tissue can spread and remain inside, allowing for implantation to occur and thereby giving rise to recurrence of uterine tissue as a new late postoperative complication. Case presentation A 45-year-old woman presented with worsening constipation and right iliac fossa pain. Her past surgical history consists of laparoscopic supra-cervical hysterectomy that was indicated due to uterine fibroids. Computerized tomography and magnetic resonance imaging were done, which showed an irregular lobulated heterogeneous mass seen in the presacral space to the right, located on the right lateral aspect of the recto-sigmoid, measuring 4.5 × 4.3 × 4.3 cm in size. A transvaginal ultrasound revealed a cyst in the left ovary. The patient had a treatment course over several months that included Dienogest (progestin) and Goserelin (GnRH analogue) with add-back therapy. In line with the declining response to medications, the patient was advised for a laparoscopic ovarian cystectomy. During the surgery, an additional lesion was found as a suspected fibroid and the left ovarian cyst was identified as pockets of peritoneal fluid which was sent for cytology. The surgical pathology report confirmed adenomyosis in both specimens, namely the right mass and the initially suspected fibroid. Conclusion In this case report, we showcase a rare occurrence of an extrauterine adenomyoma presenting two years post laparoscopic morcellation at hysterectomy. This poses questions regarding the benefits versus risks of power morcellation in laparoscopic hysterectomy.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Miss Charlotte L. Moss ◽  
Ajay Aggarwal ◽  
Asad Qureshi ◽  
Benjamin Taylor ◽  
Teresa Guerrero-Urbano ◽  
...  

Abstract Background Patient reported outcome measurements (PROMs) are emerging as an important component of patient management in the cancer setting, providing broad perspectives on patients’ quality of life and experience. The use of PROMs is, however, generally limited to the context of randomised control trials, as healthcare services are challenged to sustain high quality of care whilst facing increasing demand and financial shortfalls. We performed a systematic review of the literature to identify any oncological benefit of using PROMs and investigate the wider impact on patient experience, in cancers of the pelvic abdominal cavity specifically. Methods A systematic review of the literature was conducted using MEDLINE (Pubmed) and Ovid Gateway (Embase and Ovid) until April 2020. Studies investigating the oncological outcomes of PROMs were deemed suitable for inclusion. Results A total of 21 studies were included from 2167 screened articles. Various domains of quality of life (QoL) were identified as potential prognosticators for oncologic outcomes in cancers of the pelvic abdominal cavity, independent of other clinicopathological features of disease: 3 studies identified global QoL as a prognostic factor, 6 studies identified physical and role functioning, and 2 studies highlighted fatigue. In addition to improved outcomes, a number of included studies also reported that the use of PROMs enhanced both patient-clinician communication and patient satisfaction with care in the clinical setting. Conclusions This review highlights the necessity of routine collection of PROMs within the pelvic abdominal cancer setting to improve patient quality of life and outcomes.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.


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