MyMedR

Fulltext Atypical presentation of catastophric spontaneous mesenteric bleeding

Ohn MH, Ng JR, Luen NP, Ohn KM

BMJ Case Rep, 2021 Aug 13;14(8).

PMID: 34389596 DOI: 10.1136/bcr-2021-244051

Spontaneous mesenteric bleeding is an exceptionally rare clinical condition and potentially lethal especially among elderly patients who are taking oral anticoagulant. We present a case of a 79-year-old woman who presented to the emergency department with atypical chest pain which was radiating to the back. She developed profound hypotension with a sudden drop of haemoglobin. Contrast-enhanced CT of the aorta showed active mesenteric bleeding with mesenteric haematoma. The early diagnosis relies solely on a high index of suspicion of occult bleeding in patients with unexplained hypotension with a sudden drop of haemoglobin. Troponin can be falsely positive in mesenteric bleeding. Close monitoring to detect any sign of deterioration and early imaging in diagnosing intra-abdominal bleeding can help to avoid delay in treatment which is essential to prevent mortality and morbidity.

Matched MeSH terms: Peritoneal Diseases*

Fulltext Mesocolic hernia: a rare cause of intestinal obstruction in childhood

Kihne M, Ramanujam TM, Sithasanan N

Med J Malaysia, 2006 Jun;61(2):251-3.

PMID: 16898325 MyJurnal

Mesocolic hernia is a rare cause of intestinal obstruction in children. The diagnosis involves a high index of suspicion and prompt intervention to prevent strangulation and a high morbidity. The embryological basis of the condition is of paramount importance to assist the eventual surgical correction.

Matched MeSH terms: Peritoneal Diseases/complications*; Peritoneal Diseases/diagnosis; Peritoneal Diseases/surgery

Localized Castleman's disease presenting as a vascular right iliac fossa mass

Muhsein KA, Liew NC, Shaker AR, Shahrin IA

Asian J Surg, 2004 Jan;27(1):54-7.

PMID: 14719517

Castleman's disease is a rare lymphoproliferative disorder of unknown aetiology. The presentation is varied, diagnosis is difficult, and optimum management is still unknown. We report our experience with a case of Castleman's disease in a 34-year old woman who presented with pallor, hepatosplenomegaly, and a right iliac fossa mass that was 5 cm in diameter. this was initially diagnosed as a soft tissue sarcoma and preoperative tumour embolization was planned before excision. Mesenteric arteriogram revealed that the feeder arteries arose from the superior mesenteric artery and embolization was aborted for fear of causing bowel ischaemia. On laparotomy, lymphoid enlargement was found between the leaves of the jejunal mesentery. The tumour was relatively avascular and the overlying mesenteric vessels contributed to teh duplex ultrasound and computerized tomography appearance of hypervascularity. The tumour with the mesentery and the overlying segment of jejunum was excised completely. Histopathology confirmed Castleman's disease. The purpose of this report is to present this rare case that caused a diagnostic dilemma and to review the management of this disorder.

Matched MeSH terms: Peritoneal Diseases/pathology*

Fulltext Simultaneous omental infarction and acute appendicitis in a child

Koay HT, Mahmoud HE

Med J Malaysia, 2015 Feb;70(1):42-4.

PMID: 26032530

It is crucial to realize that both omental infarction and acute appendicitis can occur simultaneously in the children as both diseases are managed differently. Omental infarction itself is rare in the pediatric group, and its association with acute appendicitis is even rarer. Both diseases usually present with right sided abdominal pain. Ultrasound is the choice of imaging modality in the investigation of abdominal pain in the children. It should not be content if omental infarction is detected, whilst the normal appendix is not seen. We reported a case of simultaneous omental infarction and acute appendicitis in a child who presented with 3 days history of right sided abdominal pain. It was diagnosed preoperatively by ultrasound. Prompt surgical intervention was proceeded and the child made uneventful recovery.

Matched MeSH terms: Peritoneal Diseases

Fulltext Differences in patient profiles of abdominal and pulmonary tuberculosis: a comparative study

Chong VH

Med J Malaysia, 2011 Oct;66(4):318-21.

PMID: 22299550

Objectives: Tuberculosis remains a common infection and is often associated with non-specific constitutional symptoms or laboratory investigations regardless of site of manifestations. This study compares the profiles of abdominal tuberculosis (ATB) and pulmonary tuberculosis (PTB).
Methods: Patients with ATB (n=34, male-21, mean age 43.3 ± 16.0 years) diagnosed over a nine year period were identified from the National Tuberculosis registry and retrospectively reviewed. Comparisons were made with patients treated for PTB (n=163).
Results: The most commonly affected sites were the ileocecal regions, peritoneum and hepatobiliary system. Common clinical presentations were abdominal pain (61.8%), anorexia (44.1%), weight loss (55.9%), fever (41.1%) and abdominal distension (29.4%). Four patients had concomitant active PTB. Compared to PTB, patients with ATB had significantly lower serum haemoglobin (11.6 ± 2.4 vs. 12.6 ± 2.0 gm/dL, p=0.036) and higher rate of adverse events of antituberculous treatment (50% vs. 15.4%, p<0.001). There were no difference in prevalence of constitutional symptoms (fever, weight loss and anorexia), platelet level, albumin, total protein and erythrocyte sedimentation rate. Importantly, there was no difference in the treatment
response. More patients with ATB and concomitant active PTB had reported weight loss (100% vs. 36.7%, p=0.017).
Conclusion: There are differences in the profiles of ATB and PTB. Awareness of such differences can help to improve the understanding and management of this infection.

Matched MeSH terms: Peritoneal Diseases/complications*; Peritoneal Diseases/drug therapy

An unusual cause of abdominal pain. Omental torsion

Khine M, Roslani AC

Ann Acad Med Singap, 2009 Feb;38(2):180.

PMID: 19271056

Matched MeSH terms: Peritoneal Diseases/complications*; Peritoneal Diseases/surgery

Microfilaria in hydrocele fluid cytology

Chandran PA, Jayaram G, Mahmud R, Anuar AK

Malays J Pathol, 2004 Dec;26(2):119-23.

PMID: 16329565

Filariasis, a parasitic infection endemic in parts of India, Myanmar, islands of the South Pacific, West and East Africa and Saudi Arabia can be diagnosed from various types of cytopathological specimens. This case documents the detection of filarial infection from hydrocele fluid cytology in a 30-year-old Myanmar migrant worker in Malaysia.

Matched MeSH terms: Peritoneal Diseases/parasitology*; Peritoneal Diseases/pathology

Primary torsion of the greater omentum

Gul YA, Jabbar MF, Moissinac K

Acta Chir. Belg., 2001 Nov-Dec;101(6):312-4.

PMID: 11868511

Primary or idiopathic greater omental torsion remains a rare cause of acute surgical abdomen in adults and children. The aetiology is as yet unknown and the treatment of choice, once diagnosis is established, is resection of the torted omentum. We report our experience with three such cases encountered over the last five years, two of which were diagnosed and subsequently managed laparoscopically. The performance of diagnostic laparoscopy for acute abdominal pain of an undetermined origin may lead to an increased detection of this condition and subsequent therapeutic intervention.

Matched MeSH terms: Peritoneal Diseases/diagnosis; Peritoneal Diseases/surgery*

Disseminated tuberculosis - diagnostic challenges of atrial tuberculoma masquerading as atrial myxoma

Alaga A, Yew YX, Razul MK

J R Coll Physicians Edinb, 2017 Dec;47(4):353-355.

PMID: 29537407 DOI: 10.4997/JRCPE.2017.410

A 47-year-old female, with multiple comorbidities, presented with a cough of two months, loss of weight and appetite. She was treated for pneumonia. A chest X-ray showed bilateral reticulonodular opacities. She was noted to have a vague central abdominal mass and a systolic murmur over the mitral region. Ultrasonography and computed tomography of the abdomen showed an omental mass and loculated ascites. Oesophagoduedenoscopy showed antral gastritis and during colonoscopy the surgical team was unable to advance the scope beyond 40 cm due to external compression. An echocardiogram showed a right atrial mass and a pericardial effusion over the posterior wall. A possible diagnosis of atrial myxoma was made. Sputum acid-fast bacillus was negative. The patient was treated empirically for disseminated tuberculosis and scheduled for bronchoscopy by the pulmonology team. The patient showed remarkable improvement after day 7 of anti-tuberculosis medication. GeneXpert study came back as positive. CT abdomen and echocardiogram repeated after 2 weeks of treatment showed reduction in the mass.

Matched MeSH terms: Peritoneal Diseases/drug therapy; Peritoneal Diseases/microbiology

Laparoscopic Management of Dialysate Leakage Secondary to Necrotic Peritoneum

Huang CK, Wang HH, Nor Hanipah Z

J Laparoendosc Adv Surg Tech A, 2016 Nov;26(11):921-924.

PMID: 27560500

Peritoneal dialysate leakage is a well-known complication of continuous ambulatory peritoneal dialysis (CAPD). In late leakage, it is usually managed conservatively and subsequently converted to hemodialysis. We hereby report a case of peritoneal dialysate leakage secondary to necrotic peritoneum, which was managed by laparoscopic excision of the affected peritoneum. Regeneration of new peritoneum was documented and the patient could resume CAPD successfully.

Matched MeSH terms: Peritoneal Diseases/etiology; Peritoneal Diseases/surgery*

Cullen and Grey Turner signs in abdominal pain

Chuah YY, Lee YY

Med J Aust, 2021 03;214(4):164.

PMID: 33458825 DOI: 10.5694/mja2.50924

Matched MeSH terms: Peritoneal Diseases/complications; Peritoneal Diseases/diagnosis*

Education and Imaging. Gastrointestinal: massive intraperitoneal haemorrhage in a young woman with hereditary hemorrhagic telangiectasia

Sivarani S, Chan YK, Liam CK, Kumar G, Abdullah BJ, Mahadeva S

J Gastroenterol Hepatol, 2010 Sep;25(9):1587.

PMID: 20796159 DOI: 10.1111/j.1440-1746.2010.06469.x

Matched MeSH terms: Peritoneal Diseases/etiology*

The effect of Resveratrol and Octreotide on peritoneal adhesions in a rat model

Üreyen O, Üstuner MA, Argon A, Özbilgin M, Egeli T, Ìlhan E, et al.

Malays J Pathol, 2018 Aug;40(2):153-160.

PMID: 30173233

INTRODUCTION: The aim of this study was to investigate the efficacy of resveratrol and octreotide, agents that are used to prevent intra-abdominal adhesions in experimental models, in preventing intraperitoneal adhesions when used alone or in combination.

MATERIALS AND METHODS: The study employed 28 young female Wistar albino rats weighing 250-300 grams. An experimental adhesion model was created in each rat using serosal abrasion and peritoneal excision. They were divided into four groups, each comprising seven rats: Group 1, adhesion induction only; Group 2, resveratrol administration only; Group 3, octreotide administration only; and Group 4, administration of resveratrol and octreotide combination. The rats were monitored under appropriate conditions for 14 days and then underwent laparotomy. Macroscopic intensity and extensiveness of adhesions and microscopic changes in the granulation tissue (cellular intensity, reticular and collagen fibers, capillaries, elastic and smooth muscle fibers, fibrosis) were evaluated and graded. Kruskal-Wallis and Mann-Whitney U-test were used in statistical analysis and the level of statistical significance was established as p <0.05.

RESULTS: There was no significant difference between the groups in terms of the intensity and extensiveness of macroscopic adhesions (p=0.377 and p=0.319). There was a statistically significant difference between the microscopic scores of the groups according to Zühlke's classification (p=0.026). The Bonferroni correction used to test for the differences revealed that the rats in Group 1 achieved significantly higher scores than the rats in Group 3 (p=0.016).

CONCLUSION: Octreotide showed higher efficiency compared to the control group in microscopic classification; however, the two agents were not superior to each other or their combination was not superior in preventing intra-abdominal adhesions.

Matched MeSH terms: Peritoneal Diseases/prevention & control

Fulltext Incidental Detection of Endometriosis with 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in a Patient with Cervical Intraepithelial Neoplasia and Adenomyosis

Khoo ACH, Chew GK

Indian J Nucl Med, 2019 5 2;34(2):162-163.

PMID: 31040534 DOI: 10.4103/ijnm.IJNM_27_19

Endometriosis is commonly associated with chronic pelvic pain and its presentation varies between individuals. The only way to confirm the presence of endometriosis is via keyhole or open surgery. In the presence of hematuria, deep endometriotic infiltration needs to be considered. We share an interesting case highlighting the role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography in evaluating a posterior urinary bladder wall lesion and hypodense liver lesions in a middle-aged woman with presenting with frank hematuria in the background of treated cervical intraepithelial neoplasia and adenomyosis.

Matched MeSH terms: Peritoneal Diseases

Displaying all 14 publications