scholarly journals A case of meconium peritonitis due to bowel perforation diagnosed at anomaly scan at 20 weeks.

2020 ◽  
Vol 19 (4) ◽  
pp. 163-166
Author(s):  
Prabha Sinha ◽  
Shabnum Sibtain ◽  
Hakmi Aoun
Keyword(s):  
Bowel Resection ◽  
Bowel Perforation ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Meconium Peritonitis ◽  
Antenatal Period ◽  
Diagnosis And Management

Meconium peritonitis is a rare condition in a fetus which occurs due to perforation of the bowel in the antenatal period. It has serious neonatal consequences resulting in death if the diagnosis is delayed soon after delivery. However, its detection is difficult as the presentation is very variable. A case of meconium peritonitis and pseudocyst detected in a fetus at 33 weeks and 2 days of gestation is discussed regarding its diagnosis and management. Final diagnosis was made only after delivery and managed by surgery (bowel resection). The outcome after treatment was favourable because of the timely intervention.

scholarly journals Malrotated Subhepatic Caecum with Subhepatic Appendicitis: Diagnosis and Management

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Hock Chin Chong ◽  
Feng Yih Chai ◽  
Dhayal Balakrishnan ◽  
Siti Mohd Desa Asilah ◽  
Irene Nur Ibrahim Adila ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Surgical Management ◽  
Severe Pain ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Diagnostic Approach ◽  
Rare Entity ◽  
Epigastric Region ◽  
Diagnosis And Management ◽  
Surgical Emergency

Subhepatically located caecum and appendix is a very rare entity. It occurs due to the anomaly in fetal gut rotation that results in an incomplete rotation and fixation of the intestine. Appendicitis, which is a common surgical emergency, in combination with the abnormal subhepatic location, presents a great challenge in its diagnosis and management. Here, we describe a 42-year-old male with chronic dyspepsia who presented with sepsis and severe pain at his right hypochondriac and epigastric region. The final diagnosis was acute appendicitis of the subhepatic appendix. Our discussion focuses on the diagnostic approach and clinical and surgical management. We hope that our report will increase the awareness among the clinicians and hasten the management of such rare condition to avoid complications.

Bowel Perforation Presenting as Head and Neck Subcutaneous Emphysema

2021 ◽  
pp. 000313482199508
Author(s):  
Dezarae R. Leto ◽  
Derek T. Clar ◽  
David A. Goodman
Keyword(s):  
Head And Neck ◽  
Chest Wall ◽  
Clinical Evaluation ◽  
Subcutaneous Emphysema ◽  
Balloon Dilatation ◽  
Soft Tissues ◽  
Bowel Resection ◽  
Bowel Perforation ◽  
Endoscopic Balloon Dilatation ◽  
Endoscopic Balloon

This patient with Crohn's disease underwent endoscopic balloon dilatation of an ileocolic stricture, and shortly thereafter developed subcutaneous emphysema in the soft tissues of her face, neck, and chest wall. Clinical evaluation and imaging revealed peritonitis from perforated bowel. She underwent laparotomy and bowel resection and recovered well. Subcutaneous emphysema in the head and neck from perforated bowel is a rare but recognized presentation of viscus perforation.

Extraarticular joint ankylosis: a rare presentation

2021 ◽  
Vol 14 (11) ◽  
pp. e244616
Author(s):  
Saurabh Kumar ◽  
Arun Paul Charllu
Keyword(s):  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Rare Condition ◽  
Rare Disorder ◽  
Progressive Decrease ◽  
Rare Presentation ◽  
Diagnosis And Management ◽  
Posterior Maxilla ◽  
Mechanical Interference ◽  
Joint Ankylosis

Pseudoankylosis is a rare condition that causes inability to open the mouth due to condition related to outside of the temporomandibular joint. Most literature refers to this hypomobility disorder, a result of fusion of the zygomatic bone to the coronoid process, and very rarely is insidious coronoid hyperplasia causing mechanical interference with the posterior maxilla has been reported. We present a case of a 45-year-old woman, who presented with coronoid malformation and overgrowth resulting in progressive decrease in mouth opening. She was managed with coronoidectomy, following which good mouth opening was obtained. In this paper we discuss about the diagnosis and management of this rare disorder.

scholarly journals PERIPARTUM CARDIOMYOPATHY – A CLINICAL CASE

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
І.Т. Rusnak ◽  
V.K. Tashchuk ◽  
N.O. Slyvka ◽  
V.T. Kulachek ◽  
Y.V. Kulachek
Keyword(s):  
Heart Failure ◽  
Medical Treatment ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Clinical Case ◽  
State Institution ◽  
Final Diagnosis ◽  
Peripartum Cardiomyopathy ◽  
The State ◽  
Diagnosis And Management

This article presents a clinical case of peripartum cardiomyopathy in a 21-year-oldpatient with a gestational age of 32 weeks, accompanied by clinical manifestationsof heart failure and Lown-Ganong-Levine (LGL) syndrome. The patient underwentlaboratory and instrumental examinations, including echocardiography and Holtermonitoring. Thyrotoxic cardiomyopathy was ruled out in the process of differentialdiagnosis. The final diagnosis and management of the patient were determinedafter consultation with the State Institution "Institute of Pediatrics, Obstetrics andGynecology, named after Academician O.M. Lukyanova, of the National Academy ofMedical Sciences of Ukraine". Medical treatment significantly improved the patient'scondition and vaginal delivery went without complications. Manifestations of theperipartum cardiomyopathy gradually regressed and completely disappeared 6 monthsafter delivery.This case indicates the importance of timely diagnosis of peripartum cardiomyopathyfor a positive prognosis of patients.

scholarly journals Meconium peritonitis in a preterm infant: a surgical emergency

2021 ◽  
Vol 8 (4) ◽  
pp. 753
Author(s):  
Priyanka Yadav ◽  
Ankit Agarwal
Keyword(s):  
Intestinal Perforation ◽  
Surgical Intervention ◽  
Bowel Resection ◽  
Postnatal Period ◽  
Meconium Peritonitis ◽  
Clinical Presentations ◽  
Good Clinical Condition ◽  
Severe Peritonitis ◽  
Emergency Surgical Intervention ◽  
Chemical Peritonitis

Meconium peritonitis is sterile chemical peritonitis that occurs after intestinal perforation resulting in meconium leakage and subsequent inflammatory cascade within the peritoneal cavity. The clinical presentations after birth can range from completely sealed-off peritonitis without any symptoms, to severe peritonitis requiring emergency surgical intervention. We describe a case of meconium peritonitis in a premature infant following intestinal perforation. In the immediate postnatal period, the patient was intubated and a peritoneal drain was placed. Laparotomy with bowel resection was performed the following day. The postoperative course was uneventful and the patient was discharged home in good clinical condition.

scholarly journals Successful Endovascular Treatment for Aortic Thrombosis Due to Primary Antiphospholipid Syndrome: A Case Report and Literature Review

2018 ◽  
Vol 53 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Yoshito Kadoya ◽  
Kan Zen ◽  
Yohei Oda ◽  
Satoaki Matoba
Keyword(s):  
Endovascular Treatment ◽  
Antiphospholipid Syndrome ◽  
Laboratory Data ◽  
Ankle Brachial Index ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Primary Antiphospholipid Syndrome ◽  
Aortic Thrombosis ◽  
Good Treatment Option ◽  
The Right

A 60-year-old man with a history of Raynaud’s phenomenon presented with bilateral intermittent claudication and an ulcer on his right toe. The ankle–brachial index of the right and left legs was 0.77 and 0.75, respectively. Laboratory data showed prolongation of the activated partial thromboplastin time and a positive result on the lupus anticoagulant test. Computed tomography angiography revealed isolated infrarenal aortic stenosis with irregular surface and noncalcified plaques. Intravascular ultrasonography examination demonstrated a noncalcified, irregular, and mobile plaque, suggestive of abdominal aortic thrombosis. In addition to anticoagulant and dual antiplatelet therapy, endovascular treatment was performed. A total of three 40-mm-long balloon-expandable stents were successfully implanted on a 15-mm balloon. The final angiography showed good results except for minimal plaque shifting in the terminal aorta. Three months later, the ulcer resolved and a final diagnosis of primary antiphospholipid syndrome (APS) was made. Clinicians should recognize that APS can affect the abdominal aorta, leading to aortic thrombosis. Endovascular treatment may be the one good treatment option for this rare condition.

Artery of Percheron infarct: a diagnostic challenge

2021 ◽  
Vol 14 (4) ◽  
pp. e236189
Author(s):  
Joana Morais ◽  
Ana Andrade Oliveira ◽  
Inês Burmester ◽  
Olga Pires
Keyword(s):  
Anatomical Variation ◽  
Sudden Change ◽  
Rare Event ◽  
Rare Condition ◽  
Final Diagnosis ◽  
Diagnostic Challenge ◽  
Cranial Ct ◽  
Artery Of Percheron ◽  
Ischaemic Lesion ◽  
Change Of Consciousness

The artery of Percheron is a rare anatomical variation that supplies thalamus and the midbrain. A stroke in this area is a rare event. The presentation varies widely, with some bizarre disturbances, like transient episodic loss of consciousness similar to coma, somnolence, cognition and memory impairment and psychosis. We report a case of a patient who presented at the emergency department with a sudden change of consciousness. During the observation, she oscillated reactive state of consciousness with obnubilation similar to coma. The first exams were normal, which include a cranial CT of the brain, and so the patient was kept under observation. The final diagnosis was only possible 24 hours later with cranial CT where an ischaemic lesion on the Percheron territory was identified. This case highlights an unusual clinic and a difficult neuroimaging stroke diagnosis of a rare condition, that is unknown to most of the physicians.

scholarly journals P1736 An unexpected cause of ventricular tachycardia in a young patient

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Tomoaia ◽  
R S Beyer ◽  
M Puiu ◽  
A Dadarlat ◽  
F I Fringu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Young Patient ◽  
Young Male ◽  
Rare Condition ◽  
Lateral Wall ◽  
Final Diagnosis ◽  
Reduced Ejection Fraction

Abstract Introduction Hypoplastic coronary artery disease (HCAD) refers to a congenital underdevelopment of one or more coronary arteries, which are greatly reduced in diameter or length. It is a rare congenital abnormality which has rarely been documented in living patients and which may lead to myocardial infarction (MI) and sudden cardiac death (SCD). This case describes an otherwise healthy young male, which was admitted in the emergency department (ED) for repeated sustained ventricular tachycardia (VT) and was thereby diagnosed with an isolated hypoplasia of the left circumflex coronary artery (CX). Investigations revealed scar-related tachycardia, due to a prior silent myocardial infarction caused by HCAD. These findings were suggested by echocardiography and coronary angiography and were later confirmed by magnetic resonance and 3D cardiac mapping. Case Report A 34-year-old male patient was admitted to the intensive care unit with recurrent sustained VT causing hemodynamic instability. After receiving two electric shocks and amiodarone in the ambulance, the patient became hemodynamically stable. There was no remarcable medical history besides a syncopal fall 5 years before and no symptoms prior to the current event. Initial physical examination, ECG and laboratory testing were normal. Echocardiography revealed a dilated left ventricle with akynesia of the lateral wall and a mildly reduced ejection fraction (EF = 45%), moderate mitral regurgitation due to restriction of the posterior mitral leaflet. A subsequent emergent coronary angiography was therefore performed, which showed no sign of atherosclerotic lesions, yet it revealed a hypoplastic CX, without compensatory collateral vessels supplying the lateral wall. Cardiac MR demonstrated delayed enhancement with transmural necrosis and no viability in the lateral wall of the LV, suggesting a long-standing MI. Therefore, the final diagnosis was scar-related VT, due to a prior silent MI caused by HCAD. The management of this patient included implantation of an ICD in the secondary prevention of SCD. Moreover, we performed an EPS, which identified a scar at the level of the lateral and inferolateral LV walls as a substrate for VT (electroanatomic 3D voltage mapping) and of the critical istmus (3D activation mapping). The next step was radiofrequency ablation of the critical isthmus, with no inducibility of the VT after the procedure. After 6-months follow-up, there was no recurrence of the VT. Conclusion Finding the cause of myocardial infarction in a young patient with VT can be very challenging. We emphasise the role of imaging for the diagnosis and management of these patients. HCAD is a rare congenital anomaly, which can lead to progressive fibrosis in the territory with poor blood supply, MI and SCD. Although it is a rare condition, it should be considered in young adults who present with MI and/or SCD. Abstract P1736 Figure. Investigations

Coblation of paediatric cystic laryngeal lymphovascular malformations: a safe and effective alternative to tracheostomy

2020 ◽  
Vol 13 (9) ◽  
pp. e235596
Author(s):  
Christopher St Clair Gaston Thompson ◽  
Lucy Qian Li ◽  
Alok Sharma
Keyword(s):  
Literature Review ◽  
Work Of Breathing ◽  
Rare Condition ◽  
Emergency Team ◽  
Diagnosis And Management ◽  
Laryngeal Lesion ◽  
Paediatric Case ◽  
Newborn Girl ◽  
The Subject ◽  
Nose And Throat

We describe the case of a 12-hour-old, full-term newborn girl referred to the Ear, Nose and Throat emergency team with increased work of breathing and stridor present at birth. Flexible nasendoscopy revealed a cystic laryngeal lesion obstructing the glottis that prompted securing of the airway with intubation and transfer to a tertiary paediatric centre. On further investigation with MRI and direct visualisation, the lesion was identified as a mixed macro/microcystic laryngeal lymphovascular malformation. The patient successfully underwent a series of microlaryngo–bronchoscopy and coblations of the laryngeal lesion with the aim of avoiding a tracheostomy. We describe the presentation, diagnosis and management of this rare condition in a paediatric case, along with a literature review of the subject.

Emergency Management of Complicated Jejunal Diverticulosis

2014 ◽  
Vol 80 (6) ◽  
pp. 600-603 ◽  
Author(s):  
Kevin N. Johnson ◽  
Grant T. Fankhauser ◽  
Alyssa B. Chapital ◽  
Marianne V. Merritt ◽  
Daniel J. Johnson
Keyword(s):  
Emergency Management ◽  
Medical Records ◽  
Surgical Intervention ◽  
Nonoperative Management ◽  
Bowel Perforation ◽  
Rare Condition ◽  
Traditional Management ◽  
Tertiary Referral Center ◽  
Presenting Symptoms ◽  
Jejunal Diverticulosis

Jejunal diverticulosis is a rare condition that is usually found incidentally. It is most often asymptomatic but presenting symptoms are nonspecific and include abdominal pain, nausea, diarrhea, malabsorption, bleeding, obstruction, and/or perforation. A retrospective review of medical records between 1999 and 2012 at a tertiary referral center was conducted to identify patients requiring emergency management of complicated jejunal diverticulosis. Complications were defined as those that presented with inflammation, bleeding, obstruction, or perforation. Eighteen patients presented to the emergency department with acute complications of jejunal diverticulosis. Ages ranged from 47 to 86 years (mean, 72 years). Seven patients presented with evidence of free bowel perforation. Six had either diverticulitis or a contained perforation. The remaining five were found to have gastrointestinal bleeding. Fourteen of the patients underwent surgical management. Four patients were successfully managed nonoperatively. As a result of the variety of presentations, complications of jejunal diverticulosis present a diagnostic and therapeutic challenge for the acute care surgeon. Although nonoperative management can be successful, most patients should undergo surgical intervention. Traditional management dictates laparotomy and segmental jejunal resection. Diverticulectomy is not recommended as a result of the risk of staple line breakdown. The entire involved portion of jejunum should be resected when bowel length permits.

Sign in / Sign up

Export Citation Format

Share Document