Intermittent abdominal pain accompanied by defecation difficulties caused by Chilaiditi syndrome: A case report.
Ontology highlight
ABSTRACT:
SUBMITTER: Luo X
PROVIDER: S-EPMC6288512 | biostudies-other | 2018 Dec
REPOSITORIES: biostudies-other
Similar Datasets
Project description: Not available
| S-EPMC10784081 | biostudies-literature
Project description:RationaleComamonas kerstersii mainly causes intra-abdominal infections with favorable outcomes due to high antibiotic susceptibility. We report the first case of pneumonia caused by C Kerstersii, which promoted patient death, and a second urinary tract infection by C Kerstersii with extensive drug resistance.Patient concernsA 46-year-old male (Case 1) with craniocerebral injury underwent emergency decompressive craniectomy, but his condition deteriorated further and presented with discontinuous fever, small moist rales on both lungs, and respiratory failure. Retrospective average nucleotide identity (ANI) analysis of the genomic sequence of the sputum isolate identified it as C Kerstersii 12322-1, antimicrobial susceptibility testing (AST) revealed that it was sensitive to 18 of 21 tested antibiotics.An 82-year-old male (Case 2) with hypertrophic prostate experienced gradual obstruction during urination, and a urine test revealed WBC ++. Retrospective ANI analysis of the urine isolate identified it as C Kerstersii 121606, which was resistant to 18 of 21 tested antibiotics.DiagnosesCase 1 was diagnosed empirically as pneumonia caused by C Kerstersii strain 12322-1 secondary to craniocerebral injury and confirmed by retrospective ANI analysis; case 2 was diagnosed empirically as urinary infection secondary to prostate hyperplasia caused by C Kerstersii strain 121606 confirmed by the retrospective ANI analysis.InterventionsCase 1 was administered cefoxitin, cefodizime, imipenem-cilastatin sodium, and underwent comprehensive salvage management. Case 2 was administered doxycycline alone.OutcomesCase 1 died partially because of untimely identification of the responsible bacteria-12322-1. Case 2 was cured even 121606 exhibited an extensive drug resistance feature.LessonsExcept for intra-abdominal infections with good prognosis, we verified that C Kerstersii could also cause extra-abdominal infections, such as the first pneumonia case and urinary infection. It could promote patient death; actual infections were underestimated due to identification difficulties, posing a health threat due to the presence of extensive drug resistance.
| S-EPMC10843495 | biostudies-literature
Project description:There are a lot of different causes of abdominal pain; in this case, a young woman suffers from three diseases with similar symptoms. Adult intestinal mal-rotation is a rare condition of deviation from the normal 270° counter clockwise rotation of the midgut resulting in, not only mal-position of the small intestine, but also mal-fixation of the mesentery. Fitz-Hugh-Curtis syndrome is a rare complication of pelvic inflammatory disease; it involves liver capsule inflammation associated with genital tract infection, which is usually caused by Neisseria gonorrhoea and Chlamydia trachomatis. Neuroendocrine tumors are enterochromaffin cell neoplasms that arise from cells of the endocrine (hormonal) and nervous systems; the appendicular one is the most common primary malignant lesion of these tumors, it's incidence is about 0.3 - 0.9% of appendectomies done. Just for knowledge, this is the first described case of concomitant presence of all these diseases with clinical symptoms attributable to each one.40-years-old woman suffers from acute abdominal pain, predominantly on the right quadrants, without abdominal distension, no guarding nor rigidity and normal intestinal peristalsis. She has a long history of abdominal intermittent pain, with cramps every 30-40 min, resolving spontaneously. She was diagnosed as intestinal mal-rotation through computed tomography scan which has evidenced a mobilized intra--peritoneal duodenum with cecum/ascending colon predominately lying on the left side and the small intestine almost entirely lying on the right side of abdomen, without evidence of effusion, edema or signs of intestinal ischemia or infarction. Exploratory laparoscopy demonstrated an inflammatory process in the hepatic-renal space, with bloody adhesions above the liver capsule; this is additional to the typical pelvic inflammatory disease signs (Fitz-Hugh-Curtis syndrome). Appendectomy was performed with histological analysis resulting in appendicular neuroendocrine tumor.Although the patient has an intestinal mal-rotation which could explain the abdominal painful symptoms, it is not possible to exclude other concomitant causes, such as perihepatitis on pelvic inflammatory disease or neuroendocrine tumors. Even if all these diseases are rarely seen in daily clinical practice, they should be considered in the differential diagnosis of chronic intermittent abdominal pain in a young woman.
| S-EPMC4715868 | biostudies-other
Project description:Mesenteric cysts are documented as rare intra-abdominal benign tumors, whose etiology and classification controversy still exists. They are considered the rarest variety between the abdominal cysts and both its low incidence and the mistaken belief that was a trivial process without apparent symptoms, had contributed to their scarce knowledge. This study aimed to present a mesenteric cyst case with focal acute inflammation and four lymph nodes with follicular lymphoid hyperplasia. The study was performed 20-year-old female patient, examined in emergency department for abdominal pain 12 hours of evolution located in flank and left upper quadrant, with mild improvement after analgesic treatment, accompanied with mild fever. The patient presented left paramedian cystic formation measuring 4 cm in size with echogenic content inside. Exploratory laparoscopy treatment of emergency was proposed. The postoperative course was favourable remaining afebrile, no abdominal pain and good tolerance to oral intake, so it was hospital discharged within 72 hours of surgery. The diagnosis was mesenteric cyst with focal acute inflammation and four lymph nodes with follicular lymphoid hyperplasia. In conclusion, the type of surgery depended on the size of the cyst, its location in the peritoneal cavity and the experience of the surgeon. Laparoscopy technique was used as a first option.
| S-EPMC6956673 | biostudies-literature
Project description:More than 230 years after the characteristic clinical features of tuberculosis spondylitis were first described, this serious infection can still present diagnostic dilemmas in clinical practice. Atypical presentations of spinal tuberculosis mimicking malignancy have been described. We report a 50-year-old woman with abdominal pain as a presenting symptom of lumbar spinal tuberculosis. She presented with chronic intermittent abdominal pain of 6 months' duration, without low-grade fever and weight loss. There were no bowel/bladder complaints, vomiting, or worm infestation. Magnetic resonance imaging of the lumbar spine showed the L3, L4, and L5 vertebrae bodies had been destroyed and disease had invaded the lumbar spinal canal. There was a giant abscess in the right musculus psoas major. The C-reactive protein level was 130 g/L, and the erythrocyte sedimentation rate was 165 mm/h. A diagnosis of lumbar spinal tuberculosis with abdominal pain was made. After 3 weeks of antituberculosis treatment, an operation was performed to debride the necrotic tissues and reconstruct the L3 vertebrae through an anterior approach combined with a posterior approach to establish the spine stability. On 6-month follow-up, the patient had recovered from the operation and had no focal neurologic deficit.
| S-EPMC5530617 | biostudies-other
Project description:To the best of our knowledge, we report here for the first time a case of exploding head syndrome (EHS) that caused repeating panic attacks. A 62-year-old woman experienced a sudden sensation of a loud noise just before going to sleep. The frequency of these episodes rapidly increased to multiple times per night, and she soon began to fear sleep, which led to the occurrence of nighttime panic attacks. She was diagnosed with EHS at our sleep clinic, and clonazepam was prescribed accompanied by reassurance about the benign nature of this syndrome. The intensity of the loud noise gradually reduced, and her fear of sleep and panic attacks disappeared at around the same time. In this report, we argue the importance of gaining further knowledge about EHS, including that about complicating psychiatric symptoms and that about its treatment.
| S-EPMC7862109 | biostudies-literature
Project description:IntroductionThere are several disease entities subsumed under the heading Necrotizing Enterocolitis (NEC).1The infectious enterocolitis that causes bowel necrosis.2Spontaneous Intestinal Perforation which is linked to the use of Indocin to hasten closure of a patent ductus arteriosus (PDA); the perforation occurs in bowel that is well perfused and viable.3Perforations that occur in bowel that is obstructed by thick or inspissated meconium (Awolaran and Sheth, Sept 2021) [1].4The uncommon variant that is associated with the abdominal compartment syndrome.Case reportA case is presented in which a preemie suddenly developed massive abdominal distension. The neonatologist embarked upon the usual work-up and therapeutic interventions but was stymied by the inability to pass an orogastric tube to relieve the abdominal distension.DiscussionThe purpose of this report is not to criticize the neonatologist, but to emphasize the difference between this case, complicated by the abdominal compartment syndrome, and the usual case of NEC.ConclusionThis is an unusual manifestation of NEC; and in my experience, it is uniformly fatal. Like many diseases with a fulminant course, our therapeutic efforts seem always too little, too late.Perhaps, by calling attention to this unusual association, its dismal outcome may be altered.
| S-EPMC8606709 | biostudies-literature
Project description:Ureteral trauma is a rare case and generally results from severe trauma events. A 6-year-old boy came with the chief complaint open wound in the lower right abdomen after falling from the bike. Abdominal MSCT with contrast showed the free liquid in the peritoneal cavity, and Retrograde Pyelogram showed the contrast extravasation. According to the algorithm, a surgical exploration must be performed because of the contrast extravasation. In this case, there found a total rupture of right distal ureter. Debridement was performed, and Double J Stent was implanted. This patient got treatment quickly so he didn't suffer disability and death.
| S-EPMC6819794 | biostudies-literature
Project description:An unusual clinical case of a dissociative herpes zoster is presented. A right hip-thigh pain preceded the occurrence of a group of herpes zoster lesions at the level of left inguinal fossa.
| S-EPMC5536218 | biostudies-other
Project description:BackgroundPoland syndrome is a congenital malformation characterized by ipsilateral hand and chest wall depression, including an absence or hypoplasia of the breast and pectoral muscles. These hypoplastic defects are reportedly caused by a subclavian artery supply disruption sequence.Case presentationA 45-year-old Japanese woman, an out-patient, underwent an emergency examination for intense left lower abdominal pain. Computed tomography images revealed a hydronephrotic left kidney and dilatation of the left ureter. No ureteral calculus or neoplasm was found. In addition, no abnormalities connected to her left abdominal pain were found. Nephritis was diagnosed based on the results of urine analysis, and a course of antibiotics was administered. Computed tomography images also revealed a history of breast reconstruction with a custom-made silicone implant in her right breast. The present case showed symptoms of Poland syndrome, which were absence of the sternal head of the right pectoralis major and asymmetrical malformation of the chest wall due to hypoplasia of the right rib cage. In addition to typical Poland syndrome symptoms, she had hypoplasia of her right kidney, hypoplasia of the right gluteus minimus muscle, right-sided pelvic hypoplasia, spinal curvature to the right, and a cystic mass in her right ovary.ConclusionsIn the present case of Poland syndrome, computed tomography images revealed malformation of the chest wall, absence of the pectoral muscle, and hypoplasia of a left kidney. Unilateral visceral hypoplasia is reported to be caused by a subclavian artery supply disruption sequence that occurs around 7 to 8 weeks of gestation. The present case can be considered a rare atypical phenotype of Poland syndrome with possible subclavian artery supply disruption sequence with internal iliac artery supply disruption.
| S-EPMC6203193 | biostudies-literature