scholarly journals The isolated tubal torsion: an insidious pediatric and adolescent pelvic urgency

2018 ◽  
Vol 40 (2) ◽  
Author(s):  
Carmine Noviello ◽  
Mercedes Romano ◽  
Alfonso Papparella ◽  
Andrea Ciavattini ◽  
Ascanio Martino ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Preoperative Diagnosis ◽  
Acute Abdominal Pain ◽  
Definitive Diagnosis ◽  
Female Adolescents ◽  
Fallopian Tubes ◽  
Blood Tests ◽  
One Year ◽  
Laparoscopic Salpingectomy

Isolated tubal torsion (ITT) is a rare cause of acute abdominal pain. Preoperative diagnosis is difficult because of a lack of specific signs. Surgery is recommended to preserve the integrity of the tube. Seven patients of median age of 13 years (range 9 to 15) came to our observation for worsening abdominal pain, nausea and vomiting. On admission, all girls had blood tests and ultrasound. Laparoscopy was performed for diagnosis in all cases. The girls had one-month and one-year ultrasound and clinic follow up. In all cases diagnosis was delayed, median 66 hours after the onset of symptoms and laparoscopy showed necrosis of the Fallopian tube. In five girls a laparoscopic salpingectomy was performed. In the other two, an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries, but one ovarian cyst. In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of ITT should be considered for a conservative treatment. Laparoscopy allows for definitive diagnosis and treatment.

scholarly journals Isolated Fallopian Tube Torsion: A Rare Entity

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Indranil Banerjee ◽  
Yatin Thakur ◽  
Gargi Mukherjee ◽  
Jitendra Jadhav ◽  
Amita Sahare
Keyword(s):  
Abdominal Pain ◽  
Fallopian Tube ◽  
Acute Abdominal Pain ◽  
Young Female ◽  
Fallopian Tubes ◽  
Rare Entity ◽  
Rare Occurrence ◽  
Laparoscopic Salpingectomy

Isolated fallopian tube torsion is an extremely rare occurrence in a young female. The lady concerned presented with acute abdominal pain and the ovaries were normal on the scan with dilated fallopian tubes. On laparoscopy, it was revealed that she was suffering from fallopian tube torsion and laparoscopic salpingectomy was performed. The patient recovered well postoperatively.

scholarly journals Omental infarction in an obese 10-year-old boy

2011 ◽  
Vol 3 (3) ◽  
pp. 22 ◽  
Author(s):  
Katerina Kambouri ◽  
Stefanos Gardikis ◽  
Alexandra Giatromanolaki ◽  
Aggelos Tsalkidis ◽  
Efthimios Sivridis ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Preoperative Diagnosis ◽  
Acute Abdominal Pain ◽  
Accurate Diagnosis ◽  
Lower Abdomen ◽  
Omental Infarction ◽  
Appropriate Treatment ◽  
Low Incidence ◽  
The Right

Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

scholarly journals Abdominal pain: a survey of clinically important outcomes for future research

CJEM ◽  
2010 ◽  
Vol 12 (06) ◽  
pp. 485-490 ◽  
Author(s):  
Angela M. Mills ◽  
Anthony J. Dean ◽  
Judd E. Hollander ◽  
Esther H. Chen
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Future Research ◽  
Original Research ◽  
Emergency Physicians ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Clinically Significant

ABSTRACT Objective: We aimed to use the consensus opinion of a group of expert emergency physicians to derive a set of emergency diagnoses for acute abdominal pain that might be used as clinically significant outcomes for future research. Methods: We conducted a cross-sectional survey of a convenience sample of emergency physicians with expertise in abdominal pain. These experts were authors of textbook chapters, peer-reviewed original research with a focus on abdominal pain or widely published clinical guidelines. Respondents were asked to categorize 50 possible diagnoses of acute abdominal pain into 1 of 3 categories: 1) unacceptable not to diagnose on the first emergency department (ED) visit; 2) although optimal to diagnose on first visit, failure to diagnose would not be expected to have serious adverse consequences provided the patient had follow-up within the next 2–7 days; 3) if not diagnosed during the first visit, unlikely to cause long-term risk to the patient provided the patient had follow-up within the next 1–2 months. Standard descriptive statistical analysis was used to summarize survey data. Results: Thirty emergency physicians completed the survey. Of 50 total diagnoses, 16 were categorized as “unacceptable not to diagnose in the ED” with greater than 85% agreement, and 12 were categorized as “acceptable not to diagnose in the ED” with greater than 85% agreement. Conclusion: Our study identifies a set of abdominal pain conditions considered by expert emergency physicians to be clinically important to diagnose during the initial ED visit. These diseases may be used as “clinically significant” outcomes for future research on abdominal pain.

scholarly journals Causes and Management of Acute Abdominal Pain in Children: A Review Article

2021 ◽  
pp. 14-22
Author(s):  
May Abdullah S. Alanazi ◽  
Abdulaziz Muslih Muhaylan Alsharari ◽  
Ibrahim Awadh R. Alanazi ◽  
Abdulaziz Mashan R. Alanazi
Keyword(s):  
Abdominal Pain ◽  
Emergency Room ◽  
Acute Abdominal Pain ◽  
Symptomatic Treatment ◽  
Review Article ◽  
Pain Site ◽  
Life Threatening ◽  
Laboratory Investigations ◽  
Surgical Conditions

Acute abdominal pain is one of the commonest prevalent grievances in children, and it frequently requires emergency room diagnosis and management. Abdominal pain in children differs with age, concomitant symptoms, and pain site. While most cases of acute abdominal embarrassment are self-limiting and benevolent, there are certain diseases that can be life-threatening and necessitate instant care, such as appendicitis, intussusception, or intestinal obstruction. To decide the cause of acute abdominal pain and recognize children with surgical conditions, scrupulous history taking and numerous physical checkups are mandatory.The most important and realistic first goal in the evaluation of acute AP is to distinguish between surgical and nonsurgical situations, which are further divided into urgent and non-urgent categories. A thorough history and physical examination, laboratory investigations to evaluate comorbidity, and imaging scans are usually used for these purposes. Management decisions should necessitate teamwork between the emergency room physician, a surgeon, and a radiologist. Consecutivereassessment and symptomatic treatment with hardworking follow-up are necessary for management as soon aspossible in urgent disorder.

scholarly journals Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Dinesh Visva Gunasekeran ◽  
Zhenghong Liu ◽  
Win Jim Tan ◽  
Joshua Koh ◽  
Chiu Peng Cheong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Controlled Trial ◽  
Common Symptom ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Video Consultation

BACKGROUND The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. OBJECTIVE The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. METHODS The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). RESULTS A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (<i>P</i>&gt;.99) and efficacy (<i>P</i>&gt;.99) between the two groups. CONCLUSIONS The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. CLINICALTRIAL ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556.

scholarly journals Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial

10.2196/17417 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17417 ◽  
Author(s):  
Dinesh Visva Gunasekeran ◽  
Zhenghong Liu ◽  
Win Jim Tan ◽  
Joshua Koh ◽  
Chiu Peng Cheong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Controlled Trial ◽  
Common Symptom ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Video Consultation

Background The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. Objective The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. Methods The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). Results A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (P>.99) and efficacy (P>.99) between the two groups. Conclusions The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. Trial Registration ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556.

scholarly journals An unusual appearance of the post-pubertal Herlyn-Werner-Wunderlich syndrome with acute abdominal pain: A case report

2019 ◽  
Author(s):  
Marzieh Ghasemi ◽  
Arezoo Esmailzadeh
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Pelvic Mass ◽  
Mullerian Duct ◽  
Early Puberty ◽  
Vaginal Septum ◽  
Müllerian Duct ◽  
Uterus Didelphys ◽  
Obstructed Hemivagina ◽  
One Year

Background: Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital urogenital defect. It is detected by unilateral low vaginal obstruction, uterus didelphys, and ipsilateral kidney agenesis. It usually becomes apparent with pain, dysmenorrhea, and presence of a vaginal or pelvic mass. Purulent vaginal discharge may also happen rarely because of infective complications of the obstructed hemivagina. In this report, we describe a post-pubertal case with acute abdominal pain. Case: The patient was a 13-yr-old girl who was referred to us with acute abdominal pain one year after the onset of her menarche. In the pelvic examination, we detected hematocolpos. Abdominopelvic-computed tomography scan confirmed the presence of mullerian duct anomalies with uterus didelphys. This case of HWW syndrome along with pyocolpus was managed by vaginal septum resection, drainage of pus, and salpingectomy. Conclusion: The symptoms of HWW syndrome should be monitored in early puberty to prevent more complications. Key words: Herlyn-Werner-Wunderlich syndrome, Uterus didelphys, Kidney agenesis, Mullerian duct anomaly.

The accuracy of the preoperative diagnosis in women undergoing emergent gynecological laparoscopy for acute abdominal pain

2011 ◽  
Vol 284 (6) ◽  
pp. 1439-1442
Author(s):  
Yoav Peled ◽  
Avi Ben-Haroush ◽  
Ram Eitan ◽  
Maya Eiger ◽  
Josef Pardo ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Preoperative Diagnosis ◽  
Acute Abdominal Pain ◽  
Gynecological Laparoscopy

scholarly journals Hanging Noncalculous Gallbladder

HPB Surgery ◽  
1996 ◽  
Vol 9 (3) ◽  
pp. 137-139 ◽  
Author(s):  
E. Tzardinoglou ◽  
J. Prousalidis ◽  
S. Apostolidis ◽  
C. Katsohis ◽  
H. Aletras
Keyword(s):  
Abdominal Pain ◽  
Gall Bladder ◽  
Gallbladder Disease ◽  
Pathological Examination ◽  
Complete Relief ◽  
Biliary Pain ◽  
Abnormal Position ◽  
The Mean ◽  
One Year

The removal of acalculous and not acutely inflamed gall-bladder in patients with typical biliary pain remains a questionable procedure. This study was conducted to present our experience. In the period 1982- 90, 1089 cases of calculous and acalculous gallbladder disease were treated in our clinic. In this period, 27 patients were subjected to cholecystectomy because of an acalculous, non inflamed gallbladder which was elongated lying in an abnormal position with a long cystic duct. The mean duration ofsymptoms supportive of cholelithiasis, was 5 years. Oral cholecystogram and ultrasonography led to the diagnosis and other causes ofchronic abdominal pain were excluded. There were 13 lumbar, 9 pelvic and 5 iliac gallbladders, with poor function in 20 of them. During cholecystectomy, the organ was invested by peritoneum and suspended in 7 cases from a mesentery. On pathological examination mild chronic inflammation was reported in 19 cases and minimal changes in 8. The minimum follow up was one year and the maximum 9 years. Complete relief of symptoms was achieved in all the cases. In conclusion, cholecystectomy should be offered in these symptomatic "hanging" gallbladders.

scholarly journals Acute Abdominal Pain in Children

1980 ◽  
Vol 73 (9) ◽  
pp. 641-645 ◽  
Author(s):  
D P Drake
Keyword(s):  
Urinary Tract Infection ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Tract Infection ◽  
Clinical Assessment ◽  
Acute Abdominal Pain ◽  
Emergency Admission ◽  
Southampton General Hospital ◽  
Mesenteric Adenitis

During a twelve-month period, 416 children with acute abdominal pain required emergency admission to Southampton General Hospital; 46% had operations. Appendicitis was the commonest organic cause of acute abdominal pain identified (31%). Constipation (9%) can present as acute abdominal pain simulating appendicitis. All children should have a urine sample examined microscopically and the finding of significant pyuria is suggestive, but not diagnostic, of a urinary tract infection (7%). Mesenteric adenitis, which can only be diagnosed with certainty at laparotomy, was less common (4%). Despite careful clinical assessment and follow up, 45% of children in this series remained undiagnosed. Sedation but not analgesia may assist in the diagnosis of the acute abdomen in children.

Sign in / Sign up

Export Citation Format

Share Document