scholarly journals Rapunzel syndrome trichobezoar in a twelve year old girl: a case report

2019 ◽  
Vol 6 (9) ◽  
pp. 3383
Author(s):  
Dharmendra Kumar Pipal ◽  
Vibha Pipal ◽  
Rajendra Pipal ◽  
Seema Yadav ◽  
Saurabh Kothari
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Abdominal Mass ◽  
Treatment Options ◽  
Rapunzel Syndrome ◽  
Diffuse Abdominal Pain ◽  
Female Patients ◽  
History Of ◽  
Loss Of Appetite ◽  
Ileocaecal Junction

A bezoar refers to a mass of undigestible foreign material found in the gastrointestinal tract, mainly stomach. The second most common bezoar is the trichobezoar, which usually occurs in the young psychiatric female patients with history of trichotillomania and trichophagia. A 12-year-old female psychiatric patient came with complains of diffuse abdominal pain, vomiting, fever, and constipation. Ultrasonography and CT scan were done, which suggested trichobezoar. Thus, trichobezoar should be considered as differential diagnosis of abdominal pain in young psychiatric female patients. In the literature several treatment options are proposed, including removal by conventional laparotomy, laparoscopy and endoscopy. According to our experience and in line with the published results, conventional laparotomy is still the treatment of choice. In addition, psychiatric consultation is necessary to prevent relapses. We here report a case of 12 years old girl presented with complain of vomiting, pain and lump abdomen, loss of appetite and on laprotomy a large, approximately 156 cm trichobezoar was removed which was extending from stomach to ileocaecal junction. Trichobezoar, an underdiagnosed entity, has to be considered in the differential diagnosis of abdominal pain and a non-tender abdominal mass even in young children.

scholarly journals Sarcomatoid carcinoma of the gallbladder: A rare form of gallbladder cancer

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090673
Author(s):  
Mehdi Siddiqui ◽  
Sheetal Hegde ◽  
Tung Nguyen ◽  
Scott DePaul
Keyword(s):  
Abdominal Pain ◽  
Hospice Care ◽  
Abdominal Mass ◽  
Treatment Options ◽  
Sarcomatoid Carcinoma ◽  
Stage Iv ◽  
Large Mass ◽  
Liver Lesions ◽  
Diffuse Abdominal Pain ◽  
Carcinoma Of The Gallbladder

Sarcomatoid carcinoma of the gallbladder or gallbladder carcinosarcoma is an exceedingly rare malignancy. Unfortunately, patients typically present with advanced disease at diagnosis. Symptoms may include abdominal pain, jaundice, anorexia, nausea, weight loss, and a palpable abdominal mass. This malignant tumor has a poor prognosis, and treatment options include surgical resection, radiation, and chemotherapy. We detail the case of a 57-year-old male who presented with diffuse abdominal pain and jaundice. Computed tomography scan of the abdomen and pelvis showed a large mass within the gallbladder, intrahepatic ductal dilation, gastrohepatic lymph node enlargement, and liver lesions concerning for metastatic disease. A core needle biopsy from one of the liver lesions revealed poorly differentiated sarcomatoid carcinoma of the gallbladder. He was assessed to have stage IV disease and deemed not to be a surgical candidate. Palliative chemotherapy was planned; however, treatment was never started due to the development of cholangitis with sepsis. The patient ultimately opted for hospice care and passed away shortly thereafter.

Irritable Bowel Syndrome with Diarrhea

2018 ◽  
Author(s):  
Judy Nee ◽  
Jacqueline L. Wolf
Keyword(s):  
Irritable Bowel Syndrome ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Dietary Advice ◽  
Emerging Therapies ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal condition characterized by abdominal pain and alteration in bowel habits without an organic cause. One of the subcategories of this disorder is IBS with diarrhea (IBS-D). Clinically, patients who present with more than 3 months of abdominal pain or discomfort associated with an increase in stool frequency and/or loose stool form are defined as having IBS-D. This review addresses IBS-D, detailing the epidemiology, etiology and genetics, pathophysiology and pathogenesis, diagnosis, clinical manifestations and physical examination findings, differential diagnosis, treatment, emerging therapies, complications, and prognosis. Figures show potential mechanisms and pathophysiology of IBS, IBS-D suspected by clinical assessment and Rome III criteria, pharmacologic and nonpharmacologic treatment options, potential mechanisms of action of probiotics, and potential treatment modalities. Tables list the Rome criteria for IBS, alarm signs and symptoms suggestive of alternative diagnoses, IBS criteria, differential diagnosis of IBS-D, dietary advice options for IBS-D, and alternative and emerging therapies in IBS-D. This review contains 5 figures, 6 tables and 42 references KEYWORDS: IBS-D, eluxadoline, rifaximin, probiotics, bloating, antidepressants, bile acid malabsorption, microscopic colitis, celiac

scholarly journals A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Aghyad K Danial ◽  
Ahmad Al-Mouakeh ◽  
Yaman K Danial ◽  
Ahmad A Nawlo ◽  
Ahmad Khalil ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Medical History ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Past Medical History ◽  
Abdominal Symptoms ◽  
Diaphragm Disease ◽  
History Of ◽  
Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of NSAID use.

scholarly journals Novel deleterious sequence change in the NLRP12 gene in a child with autoinflammatory syndrome, joint hypermobility and cutis laxa from India.

2019 ◽  
Vol 11 (1) ◽  
pp. e2019018 ◽  
Author(s):  
Kanjaksha Ghosh ◽  
Kanchan Mishra ◽  
Avani Shah ◽  
Parizad Patel ◽  
Shrimati Shetty
Keyword(s):  
Abdominal Pain ◽  
Acute Intermittent Porphyria ◽  
Joint Hypermobility ◽  
Autoinflammatory Syndrome ◽  
Healthy Male ◽  
Diffuse Abdominal Pain ◽  
Sequence Change ◽  
Mediterranean Fever ◽  
Loss Of Appetite ◽  
Work Up

An otherwise healthy male child of 9 years presented with paroxysmal fever and diffuse abdominal pain along with loss of appetite and nausea lasting for 3-4days every 4-6 weeks for last 2 years. He also has stretchable skin and hypermobile joint which he inherited from his mother who never suffered any paroxysmal attack of the kind.  Work up for acute intermittent porphyria, lead poisoning and familial mediterranean fever was negative. A novel harmful sequence change in NLRP12 gene was detected and a diagnosis of NLRP12 associated autoinflammatory syndrome was made. This sequence change with disease has not yet been reported in the literature and is the first such case of NLRP12 related autoinflammatory syndrome from India.

ID: 28: ACQUIRED IMMUNODEFICIENCY SYNDROME RELATED KAPOSI SARCOMA A RARE INTRUDER AFFECTING THE STOMACH

2016 ◽  
Vol 64 (4) ◽  
pp. 938.1-938
Author(s):  
N Vyas ◽  
H Alkhawam ◽  
S Ahmad ◽  
R Companioni ◽  
R Sogomonian ◽  
...  
Keyword(s):  
Gastric Ulcer ◽  
Abdominal Pain ◽  
Kaposi Sarcoma ◽  
Initial Presentation ◽  
Aids Patients ◽  
Diffuse Abdominal Pain ◽  
Gi Symptoms ◽  
Mucosal Involvement ◽  
History Of ◽  
Haart Therapy

IntroductionKaposi sarcoma (KS) is a vascular tumor that is commonly associated with human herpesvirus 8 (HHV-8). The epidemic type of KS is associated with the most common tumor arising in HIV infected people, which is considered by CDC guidelines an AIDS defining illness. Lesions on the skin are the most common initial presentation in patients unlike the involvement of visceral sites. We present a unique case of KS affecting the stomach, initially presenting as abdominal pain and diarrhea.CasePatient is a 34 year old female with past medical history of AIDS/HIV with a CD4 count of 143 cells/μL, VL 46 copies/mL on HAART therapy diagnosed with visceral and cutaneous manifestations presents to the ED with nausea, vomiting, diarrhea and diffuse abdominal pain for three days. The symptoms have progressively gotten worse. Patient denies any history of fevers, recent travel, sick contacts or recent antibiotic use. On examination, the patient had stable vitals and evidence of dark brown, papular skin lesions of various sizes over face, torso and upper extremity. Abdominal examination revealed tenderness in the epigastric area. Laboratory studies and initial abdominal cat-scan with contrast were unremarkable. All infectious workup was negative. However, EGD revealed esophageal nodule in the mid-distal esophagus (figure 1A), non-obstructive lower esophageal (LE) stricture (figure 1B), and a gastric ulcer raised with heaped margins (figure C). Biopsy of the gastric ulcer reveals KS with necrosis. Throughout hospital course, patient received 12 rounds of Doxirubicin for treatment, continued with HAART therapy. Patient is tolerating chemotherapy well, cutaneous lesions are improving and signs and symptoms of diarrhea and abdominal pain have alleviated.DiscussionCutaneous manifestation is usually the initial presentation of KS and visceral involvement is typically a later manifestation of disease. What is interesting in this case is the involvement of both cutaneous and visceral sites. It can be observed in the gastrointestinal (GI) tract, but rarely seen in the stomach. GI lesions may be asymptomatic or may cause weight loss, abdominal pain, nausea, vomiting and obstruction, which is seen in our case. EGD revealed distal LE stricture and gastric ulcer biopsy showing KS with necrosis. For AIDS patients who have KS, HAART therapy should be initiated to induce regression. For systemic treatment chemotherapy with Doxirubicin should be considered when there is symptomatic visceral or mucosal involvement and extensive cutaneous KS. We suggest the KS be included in the differential in AIDS patients with diarrhea and non-specific GI symptoms. Moreover, EGD should be considered for symptomatic patients because untreated GI KS includes hemorrhage and perforation.Abstract ID: 28 Figure 1

scholarly journals Ovarian torsion in infertility treatment

2021 ◽  
Vol 10 (2) ◽  
pp. 787
Author(s):  
Yaramareddy Swapna ◽  
M. Elanchezhian ◽  
Supraja Chegireddy ◽  
Raju Badipati ◽  
V. Devadharshini
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ovulation Induction ◽  
Abdominal Mass ◽  
Infertility Treatment ◽  
Ovarian Torsion ◽  
Symptoms And Signs

Ovarian torsion, a rare problem in women can lead to serious consequences if not diagnosed and treated at the earliest. It is one of the complications that needs to be included in the differential diagnosis of any girl with abdominal pain or a pelvic or abdominal mass as the symptoms and signs are nonspecific and it can be related to other clinical causes. A 29-year-old woman who was under ovulation induction was diagnosed with ovarian torsion which was treated by performing laparoscopy. Investigations for ovarian torsion should be carried out for all the patients treated for infertility presenting with abdominal pain to minimize the risk before it is too late.

scholarly journals Acute Respiratory Distress Syndrome and Feculent Airway Casts due to Severe Constipation

2021 ◽  
Author(s):  
Eric Mull ◽  
Brooke Gustafson ◽  
Brent Adler ◽  
Katelyn Krivchenia
Keyword(s):  
Differential Diagnosis ◽  
Acute Respiratory Distress Syndrome ◽  
Abdominal Pain ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Case Reports ◽  
Severe Constipation ◽  
History Of

Acute respiratory distress syndrome (ARDS) is a disabling and potentially lethal syndrome requiring prompt recognition and urgent interventions to prevent morbidity and mortality[1]. Although constipation is not generally recognized as a cause for ARDS or usually listed within the differential diagnosis, there have been case reports describing such an association[2,3]. We present the case of a patient with history of intermittent constipation presenting with progressive abdominal pain and an acute abdomen that required emergent surgical fecal decompaction. This was followed by hypoxemic respiratory distress leading to respiratory failure in the setting of severe constipation and aspirated feculent material. To our knowledge, this is the first published case report describing aspirated feculent material in a child with respiratory failure due to ARDS.

scholarly journals A Mesothelial Inclusion Cyst Presenting in a 40-Year-Old Woman as Abdominal Pain and Bloating – A Rare Diagnosis

2020 ◽  
Author(s):  
Sonia Canadas ◽  
Rita Fernandes ◽  
Hugo Almeida ◽  
João Santiago Correia
Keyword(s):  
Abdominal Pain ◽  
Abdominal Mass ◽  
Tumour Marker ◽  
Ca 125 ◽  
Inclusion Cyst ◽  
Microcytic Hypochromic Anaemia ◽  
Hypochromic Anaemia ◽  
History Of ◽  
Cystic Abdominal Mass ◽  
Work Up

Cystic mesotheliomas (also called mesothelial inclusion cysts) are rare benign neoplasms that occur more often in young women. Symptoms are usually non-specific, demanding a thorough work-up. We report a case of a 40-year-old female patient with 2 prior caesarean sections presenting with a 3-month history of abdominal pain. Laboratory tests revealed microcytic hypochromic anaemia and an elevated tumour marker CA-125. An investigation identified a large cystic abdominal mass, mostly in the left side of the abdomen. A laparotomy was performed with total resection of the lesion. Histological assessment resulted in a diagnosis of a mesothelial inclusion cyst. The patient had no recurrence after 3 years.

scholarly journals A case of rectus sheath haematoma related to severe coughing in a patient with acute exacerbation of chronic obstructive pulmonary disease

2018 ◽  
Vol 26 (6) ◽  
pp. 371-374 ◽  
Author(s):  
Ching Hin Kevin Wong ◽  
Ho Kai Patrick Tsang ◽  
Oi Fung Wong ◽  
Hing Man Ma ◽  
Chau Hung Albert Lit
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Abdominal Pain ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Abdominal Mass ◽  
Rectus Sheath ◽  
Rare Condition ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of

Introduction: Rectus sheath haematoma is a rare condition which is often misdiagnosed. Apart from abdominal trauma and anticoagulation, severe coughing is an uncommon precipitating cause of this rare condition. Case presentation: An elderly gentleman with history of ischaemic heart disease on aspirin developed rectus sheath haematoma due to severe coughing during an episode of acute exacerbation of chronic obstructive pulmonary disease. He developed severe abdominal pain and was noted to have epigastric bruising extending to bilateral loins. Ultrasound abdomen and computed tomography of the abdomen with contrast revealed haematoma over bilateral upper rectus abdominis muscles, which subsided with conservative management. Discussion and conclusion: Rectus sheath haematoma can be related to severe coughing. In patients, especially those with predisposing factors, presenting with abdominal pain and palpable painful abdominal mass, clinicians should raise the suspicion of this uncommon cause so that timely and appropriate management can be provided.

Abdominal Pain and Abdominal Mass

2018 ◽  
Author(s):  
Blake D. Babcock ◽  
Alexander E. Poor ◽  
Mohammad F. Shaikh ◽  
Wilbur B. Bowne
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Physical Examination ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Gastroesophageal Junction ◽  
Percutaneous Biopsy ◽  
Clinical History ◽  
Diagnostic Process ◽  
Abdominal Masses

Acute abdominal pain and abdominal mass are intimately connected; therefore, the diagnostic process for evaluating abdominal pain and abdominal masses is largely the same and has been preserved since ancient times. The primary goals in the management of patients with abdominal pain and/or abdominal mass are to establish a differential diagnosis by obtaining a clinical history, to refine the differential diagnosis with a physical examination and appropriate studies, and to determine the role of operative intervention in the treatment or refinement of the working diagnosis. This review describes the process of diagnosing abdominal pain, including taking a clinical history and performing a physical examination. Investigative studies, including laboratory tests, imaging, and pathology are reviewed. Management, including surgical treatment, is discussed. Tables describe intraperitoneal and extraperitoneal causes of acute abdominal pain, frequency of specific diagnoses in patients with acute abdominal pain, and common abdominal signs and findings noted on physical examination. Figures show abdominal pain in specific locations, a data sheet, the differential diagnosis of an abdominal mass by quadrant or region, characteristic patterns of abdominal pain, acute appendicitis with associated appendicolith, bilateral adrenal masses, adrenocortical carcinoma, retroperitoneal leiomyosarcoma, pancreatic mass, a sagittal ultrasonogram of the pancreas, ultrasonograms of the liver, a dark and well circumscribed abdominal mass, gastroesophageal junction adenocarcinoma, and percutaneous biopsy of a large abdominal mass. An algorithm outlines the assessment of acute abdominal pain and abdominal mass. This review contains 14 figures, 5 tables, and 143 references.

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