scholarly journals Toothpick Perforation of the Intestines Presenting as Recurrent Abdominal Pain: Possible Roles of Abdominal Ultrasound and MRI

2013 ◽  
Vol 6 ◽  
pp. CCRep.S11486 ◽  
Author(s):  
Robert J. Sealock ◽  
Saman Sabounchi ◽  
David Y. Graham
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Ileocecal Valve ◽  
Abdominal Ultrasound ◽  
Recurrent Abdominal Pain ◽  
Small Bowel Resection ◽  
Wall Thickening ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Bowel Wall Thickening

We report the case of a middle-aged man admitted for five months of unexplained left lower quadrant pain. He had been hospitalized on two prior occasions and treated with broad spectrum antibiotics. His clinical presentation was suggestive peritoneal irritation with severe, focal pain on abdominal palpation. Computed tomography scans showed non-specific inflammation in the left lower abdomen with adjacent small bowel wall thickening. Upper endoscopy and colonoscopy were unremarkable on prior admission. Given the severity and focality of the patient's recurrent abdominal pain he underwent laparoscopy and was found to have a wooden toothpick perforation of the small bowel thirty centimeters from the ileocecal valve requiring partial small bowel resection. The patient did well post-operatively. On retrospective questioning he may have eaten a cabbage roll or bacon wrapped shrimp pierced with a toothpick weeks before the onset of symptoms. Toothpick perforation should be a consideration in edentulous persons with focal, severe abdominal pain and trans-abdominal ultrasound or MRI may be a better choice for detecting wooden foreign objects.

scholarly journals “Meckel’s Diverticulum” – A diagnostic bizarre of abdominal pain in adults

2020 ◽  
Vol 2 ◽  
pp. 58-60
Author(s):  
Vipin Kumar Bakshi ◽  
Manjot Kaur ◽  
Gajendra Bhatti
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Wall Thickening ◽  
Emergency Laparotomy ◽  
Contrast Enhanced ◽  
Antimesenteric Border ◽  
Meckel’S Diverticulitis ◽  
Bowel Wall Thickening ◽  
Subacute Intestinal Obstruction ◽  
Enhanced Computed Tomography

A 30-year-old male presented to the emergency room with complaints of periumbilical abdominal pain and vomiting. A contrast-enhanced computed tomography scan of the abdomen revealed subacute intestinal obstruction with dilated small bowel loops and associated bowel wall thickening of mid and distal ileal bowel loops. There was a fairly large small bowel diverticulum arising from the antimesenteric border of distal ileum. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable post-operative course without any complications and was discharged within a week.

SMALL INTESTINAL CARCINOID TUMOR-A CASE REPORT

2021 ◽  
pp. 36-37
Author(s):  
B. Santhi ◽  
S. Savitha ◽  
V. G. Vikraman
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Exploratory Laparotomy ◽  
Wall Thickening ◽  
Lower Quadrant ◽  
Polypoidal Lesion ◽  
Contrast Enhanced ◽  
Intraluminal Mass ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Carcinoid tumors are neuroendocrine tumours, the most common tumour of the small bowel and its incidence is rising. Most carcinoid tumours grow slowly and mostly asymptomatic or may present with nonspecic abdominal pain or carcinoid syndrome. We had a 38 year old, female patient presented with generalized, intermittent, dull aching abdominal pain accompanied with distension and obstipation for 2 days with associated vomiting. She complained of weight loss and constipation during this period. On examination abdomen showed deep tenderness in periumbilical, right lower quadrant regions. No guarding, rigidity, mass or free uid. On per-rectal examination, there was no tenderness and the rectum was empty. Contrast enhanced computed tomography scan showed enhancing polypoidal lesion noted in distal ileum causing proximal dilatation of small bowel with air uid levels and circumferential wall thickening in dilated ileum proximal to polypoidal lesion, strongly enhancing nodal mass with specs of calcication, multiple mesentric lymph nodes and no liver metastasis. As the conservative management for 48 hours showed no improvement in symptoms, an emergency exploratory laparotomy was performed, and an intraluminal mass was identied from ileocecal junction causing obstruction with dilated loops of ileum and jejunum. Local resection of terminal ileum was performed and a side to side anastomoses was done using GI stapler. Histopathology showed diagnosis of neuroendocrine tumor

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 Intraluminal Meckel’s Duplication Cyst Causing Bowel Obstruction in an Infant: A Role for Laparotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mitchell R. Ladd ◽  
Alejandro V. Garcia ◽  
Derek B. Allison ◽  
Jeffrey R. Lukish
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Ileocecal Valve ◽  
Signs And Symptoms ◽  
Duplication Cyst ◽  
Ectopic Gastric Mucosa ◽  
Lower Quadrant ◽  
Intraluminal Mass ◽  
Enteric Duplication ◽  
Right Lower Quadrant

This report describes a two-month-old girl who presented with signs and symptoms of a distal small bowel obstruction. She underwent an abdominal ultrasound that revealed a right lower quadrant cystic mass. A Technetium-99 scan revealed increased activity in the right lower quadrant consistent with a Meckel’s diverticulum. Following a nondiagnostic laparoscopic evaluation, a laparotomy was performed to allow direct palpation of the small bowel and colon. Direct palpation of the ileum revealed a soft intraluminal mass at the ileocecal valve. The child underwent an ileocecectomy and anastomosis incorporating the intraluminal mass. Pathologic analysis revealed an intraluminal enteric duplication cyst containing ectopic gastric mucosa. This case represents the first report of such an entity in an infant. A discussion of the diagnostic and therapeutic aspects of the case and enteric duplication cysts is provided.

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.

Twelve-year-old boy presenting with recurrent abdominal pain and 25 urinary calculi

2018 ◽  
pp. edpract-2018-315073
Author(s):  
Mario Diplomatico ◽  
Pierluigi Marzuillo ◽  
Daniela Capalbo ◽  
Michela Stanco ◽  
Rosaria Marotta ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Urinary Calculi ◽  
Potassium Citrate ◽  
Dent Disease ◽  
List Type ◽  
Factitious Disorder ◽  
Ct Urography ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain

A 12-year-old boy, with intermittent abdominal pain from 3 years of age, presented with increased frequency of right lower quadrant pain (at least three episodes per week over the past six months) and pain during micturition affecting school attendance. His family history included referred urolithiasis. An abdominal ultrasound performed 1 year before our visit showed a small stone of 4 mm in the right renal pelvis for which he did not receive any therapy. The patient brought 25 hard stones with irregular outline, 2–8 mm in diameter, of deep brown/grey colour that he claimed to have found in his underwear (figure 1). On examination, he looked well with normal vital signs and unremarkable cardiorespiratory and abdominal examinations. Plasma creatinine was 0.41 mg/dL (36.1 μmol/L), urinalysis and urine tests were all normal (including 24 hour calcium, phosphorus, oxalate, citrate, uric acid and cystine). Repeat kidney and urinary tract ultrasound showed no evidence of calculi.Figure 1Twenty-five hard formations brought along by the patient from home.Question 1Which is the most likely diagnosis?Cystinuria.Dent disease.Idiopathic urolithiasis.Factitious disorder imposed on self.Familial hypomagnesemia with hypercalciuria and nephrocalcinosis.Question 2How would you confirm your diagnostic suspicion?Reassurance and clinical follow-up.Mass spectrometry of stones.CT urography.Increase oral fluid intake and administration of potassium citrate.Question 3How would you manage this condition?Administration of placebo.Psychological consultation.Observed 24 hour urine collection.All of the above.Answers can be found on page 2.

Small Bowel Permeability to51Cr-EDTA in Children with Recurrent Abdominal Pain

1990 ◽  
Vol 79 (4) ◽  
pp. 422-426 ◽  
Author(s):  
S. B. MEER ◽  
P. P. FORGET ◽  
G. A. K. HEIDENDAL
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Recurrent Abdominal Pain

scholarly journals Prolonged Intestinal Mucosal Barium Coating due to Ischemic Necrosis

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Vincent H. S. Low
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Mucosal Damage ◽  
Abdominal Radiograph ◽  
Wall Thickening ◽  
Plain Abdominal Radiograph ◽  
Transplantation Surgery ◽  
Abdominal Ct Scan ◽  
Bowel Wall Thickening ◽  
Fluid Collections

A case of a 63-year-old man with small bowel ischemia six weeks after transplantation surgery is presented. Plain abdominal radiograph obtained several days after ingestion of barium shows the sign of prolonged barium coating indicating severe mucosal damage. Abdominal CT scan demonstrates small bowel wall thickening as well as pockets of peritoneal fluid collections. Most critically, CT allows visualization of subtle traces of dense barium within the dependent portions of this fluid indicating bowel perforation.

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