RESUMO
A 40-year-old man presented to the emergency department with periumbilical pain and fever. A computed tomographic scan confirmed multiple jejunal diverticulum with localized extraluminal air and panniculitis around it, and jejunal diverticulitis with localized perforation was suspected. His symptoms were mild, and extraluminal air was localized;therefore, he was advised bowel rest and administered only antibiotics. The patient's symptoms resolved without surgical treatment, and at the time of writing this report, there had been no recurrence. Small bowel diverticulitis is rare, and careful analysis of imaging studies is necessary for establishing a diagnosis. This was a rare case where small bowel diverticulitis was resolved without surgical treatment.
Assuntos
Diverticulite , Divertículo , Perfuração Intestinal , Doenças do Jejuno , Adulto , Humanos , Intestino Delgado , Jejuno , MasculinoRESUMO
The home care support system, newly established in 2014, is a system that always secures the hospitalization of pre-registered home care patients who need to be hospitalized. Ashigarakami Hospital has operated this system since April 2014. As of May 2018, a total of 215 people registered, and 156 people have died. Among the deceased patients, 77(49.4%)died at home, which was higher than the proportion of home deaths(13.0%)in the Japanese population dynamics survey in 2016. In patients who had malignant diseases, they could spend more than half of the period from their introduction to the system up to death being treated at home. Even in the case of death at a hospital, the duration of the last hospitalization was 18 days on average(median of 12 days). In most cases, patients were treated at home until shortly before death.
Assuntos
Serviços de Assistência Domiciliar , Neoplasias , Assistência Terminal , Hospitalização , Hospitais , HumanosRESUMO
An 83-year-old male presented with distended abdomen. A computed tomography scan demonstrated pleural effusion, ascites, peritoneal thickness, and panniculitis. Multiple small white nodules of peritoneum were observed during a laparoscopy examination, and biopsy specimens revealed noncaseating granulomas. Gallium scintigram demonstrated an accumulation in the peritoneum and revealed a panda sign that has been described as an indication of sarcoidosis. Although sarcoidosis rarely induces peritonitis with ascites, peritoneal sarcoidosis was diagnosed and he began receiving steroid therapy. After primary steroid therapy, his ascites completely disappeared, and he has maintained a complete response with continuous low dose steroid therapy.
Assuntos
Ascite/etiologia , Peritonite/complicações , Sarcoidose/complicações , Idoso de 80 Anos ou mais , Humanos , Masculino , Peritonite/diagnóstico por imagem , Peritonite/tratamento farmacológico , Sarcoidose/diagnóstico por imagem , Sarcoidose/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Pneumatosis cystoides intestinalis is a rare and often presents nonspecific symptoms. In this case, CT imaging revealed air collection within the wall of the ileum, which was more clearly defined using the lung window setting. When we consider pneumatosis cystoides intestinalis, we should evaluate CT using the lung window setting.
RESUMO
A 52-year-old woman presented with recurrent, severe abdominal pain. Laboratory tests and imaging were insignificant, and treatment for functional dyspepsia was ineffective. The poorly localized, dull, and severe abdominal pain, associated with anorexia, nausea, and vomiting, was consistent with abdominal migraine. The symptoms were relieved by loxoprofen and lomerizine, which are used in the treatment of migraine. We herein report a case of abdominal migraine in a middle-aged woman. Abdominal migraine should be considered as a cause of abdominal pain as it might easily be relieved by appropriate treatment.