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1.
Vasc Health Risk Manag ; 18: 595-601, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35924006

RESUMEN

Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis affecting small- to medium-sized arteries. The most common gastrointestinal manifestation of PAN is postprandial abdominal pain from mesenteric arteritis causing bowel ischemia. When transmural ischemia develops, there may be ischemic necrosis and perforation of the bowel wall, which are life-threatening. Severe, life-threatening gastrointestinal involvement is relatively rare in pediatric PAN and may require different management in adult patients. We report a pediatric PAN case in a patient who presented with acute abdominal pain and superimposed cytomegalovirus enteritis with jejunoileal perforation. The patient improved with emergency small intestinal resection followed by conventional immunosuppressive drugs of a corticosteroid and cyclophosphamide, and anti-viral drugs. Before increasing the immunosuppressive drug dosage, initial screening of infectious cytomegalovirus and comprehensive evaluation for surgical conditions are essential in pediatric PAN with severe gastrointestinal involvement. Early aggressive treatment for acute abdomen is useful in reducing morbidity and mortality in pediatric PAN.


Asunto(s)
Enteritis , Poliarteritis Nudosa , Dolor Abdominal/etiología , Adulto , Niño , Citomegalovirus , Enteritis/complicaciones , Enteritis/diagnóstico , Enteritis/tratamiento farmacológico , Humanos , Inmunosupresores/efectos adversos , Isquemia/diagnóstico por imagen , Isquemia/tratamiento farmacológico , Poliarteritis Nudosa/complicaciones , Poliarteritis Nudosa/diagnóstico , Poliarteritis Nudosa/tratamiento farmacológico
2.
BMC Infect Dis ; 22(1): 664, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35915394

RESUMEN

BACKGROUND: Numerous scoring tools have been developed for assessing the probability of SARS-COV-2 test positivity, though few being suitable or adapted for outpatient triage of health care workers. METHODS: We retrospectively analysed 3069 patient records of health care workers admitted to the COVID-19 Testing Unit of the Ludwig-Maximilians-Universität of Munich between January 27 and September 30, 2020, for real-time polymerase chain reaction analysis of naso- or oropharyngeal swabs. Variables for a multivariable logistic regression model were collected from self-completed case report forms and selected through stepwise backward selection. Internal validation was conducted by bootstrapping. We then created a weighted point-scoring system from logistic regression coefficients. RESULTS: 4076 (97.12%) negative and 121 (2.88%) positive test results were analysed. The majority were young (mean age: 38.0), female (69.8%) and asymptomatic (67.8%). Characteristics that correlated with PCR-positivity included close-contact professions (physicians, nurses, physiotherapists), flu-like symptoms (e.g., fever, rhinorrhoea, headache), abdominal symptoms (nausea/emesis, abdominal pain, diarrhoea), less days since symptom onset, and contact to a SARS-COV-2 positive index-case. Variables selected for the final model included symptoms (fever, cough, abdominal pain, anosmia/ageusia) and exposures (to SARS-COV-positive individuals and, specifically, to positive patients). Internal validation by bootstrapping yielded a corrected Area Under the Receiver Operating Characteristics Curve of 76.43%. We present sensitivity and specificity at different prediction cut-off points. In a subgroup with further workup, asthma seems to have a protective effect with regard to testing result positivity and measured temperature was found to be less predictive than anamnestic fever. CONCLUSIONS: We consider low threshold testing for health care workers a valuable strategy for infection control and are able to provide an easily applicable triage score for the assessment of the probability of infection in health care workers in case of resource scarcity.


Asunto(s)
COVID-19 , SARS-CoV-2 , Dolor Abdominal , Adulto , COVID-19/diagnóstico , Prueba de COVID-19 , Femenino , Humanos , Reacción en Cadena de la Polimerasa , Estudios Retrospectivos , SARS-CoV-2/genética , Triaje
3.
J Coll Physicians Surg Pak ; 32(8): 1067-1069, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35932136

RESUMEN

Cecal diverticulitis is a rare cause of right lower-quadrant abdominal pain. As its symptoms mimic those of acute appendicitis, the final diagnosis in the patients is generally confirmed after surgery. Herein, we report a 45-year man who was admitted to the department of emergency with lower right abdominal pain. Cecal diverticulitis was diagnosed on computed tomography (CT) images, and a conservative treatment approach was recommended. He was hospitalised, and intravenous antibiotics and hydration were administered immediately. Oral feeding was interrupted. After five days of intensive medical care, the patient was discharged without any further complications. Based on my experience, I advise that CT can be used to differentiate cecal diverticulitis from the acute appendicitis. In uncomplicated cases, conservative approaches are advised. Key Words: Cecal diverticulitis, Computed tomography, Acute appendicitis, Conservative treatment.


Asunto(s)
Apendicitis , Enfermedades del Ciego , Diverticulitis , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Enfermedad Aguda , Apendicitis/diagnóstico por imagen , Apendicitis/cirugía , Enfermedades del Ciego/cirugía , Diagnóstico Diferencial , Diverticulitis/diagnóstico por imagen , Diverticulitis/terapia , Humanos , Masculino
4.
J Coll Physicians Surg Pak ; 32(8): 1070-1072, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35932137

RESUMEN

Ingestion of a foreign body is generally observed in the psychiatric patients and children. Healthy adult individuals may also swallow a foreign body unintentionally. Here, we report a case of a patient who swallowed a plastic fork and treated with laparoscopic repair. A 46-year man was admitted to the emergency room with the abdominal pain. His physical evaluation and diagnostic imaging revealed free air in the abdomen. Further imaging with CT scan showed a foreign body in the proximal ileum. On taking details of his swallowing history, he remembered swallowing a broken part of a plastic fork unwittingly during dinner. Following the removal of the foreign body, the perforation area was primarily repaired in double layers. The postoperative course was uneventful. An accurate diagnosis of the small intestinal perforation caused by the ingested foreign bodies, particularly in cases where the patient is unaware of the ingestion, can be difficult. CT scan is a useful tool when available to establish the diagnosis before the surgical intervention. Key Words: Small intestine, Perforation, Foreign body, Laparoscopic surgery.


Asunto(s)
Cuerpos Extraños , Perforación Intestinal , Dolor Abdominal/etiología , Adulto , Niño , Cuerpos Extraños/complicaciones , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Humanos , Íleon/diagnóstico por imagen , Íleon/cirugía , Perforación Intestinal/diagnóstico por imagen , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Masculino , Plásticos
5.
Am J Case Rep ; 23: e936311, 2022 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-35933583

RESUMEN

BACKGROUND The blind-ending branch of a bifid ureter is a rare congenital anomaly which is usually asymptomatic but can occasionally give rise to various symptoms, such as chronic abdominal pain. Diagnosis is most often confirmed radiologically, and treatment is usually conservative. Surgical resection of the blind ending of a bifid ureter should be considered in cases of persistent symptoms. CASE REPORT A female patient of 49 years of age presented with intermittent right lumbar pain, repetitive urinary infections and microscopic hematuria. We present here the diagnostic work-up of the case, leading to the identification of the existence of ureteral bifidity located at the lower third of the ureter and of a blind ending of the bifid ureter. Several regimens of various antibiotics failed to resolve the symptoms. It was decided to carry out a laparoscopic resection of the blind ending of the bifid ureter. We describe the practical procedures of the surgical operation and discuss briefly the embryological etiology and the physiopathology of the condition as well as the principal diagnostic modalities. Since the surgery, the patient has been symptom-free. CONCLUSIONS Despite being usually asymptomatic, the rare congenital anomaly of a bifid ureter with a blind ending can occasionally give rise to symptoms such as recurrent infections and persistent abdominal pain. Laparoscopic-based resection of the blind ending should be considered in such cases.


Asunto(s)
Laparoscopía , Uréter , Obstrucción Ureteral , Infecciones Urinarias , Dolor Abdominal/etiología , Dolor Abdominal/cirugía , Femenino , Humanos , Uréter/cirugía
6.
Front Endocrinol (Lausanne) ; 13: 900325, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35928892

RESUMEN

Introduction: Despite the use of technology, recurrent diabetic ketoacidosis (DKA) prevention remains an unmet need in children and adolescents with T1D and may be accompanied by life-threatening acute complications. We present a rare case of non-occlusive mesenteric ischemia (NOMI) with overt manifestation after DKA resolution and a discussion of recent literature addressing DKA-associated NOMI epidemiology and pathogenesis in children and adolescents. Case Presentation: A 13-year-old female with previously diagnosed T1D, was admitted at our emergency department with hypovolemic shock, DKA, hyperosmolar state and acute kidney injury (AKI). Mildly progressive abdominal pain persisted after DKA correction and after repeated ultrasound evaluations ultimately suspect for intestinal perforation, an intraoperative diagnosis of NOMI was made. Conclusion: The diagnosis of DKA-associated NOMI must be suspected in pediatric patients with DKA, persistent abdominal pain, and severe dehydration even after DKA resolution.


Asunto(s)
Diabetes Mellitus Tipo 1 , Cetoacidosis Diabética , Isquemia Mesentérica , Dolor Abdominal/complicaciones , Adolescente , Niño , Diabetes Mellitus Tipo 1/complicaciones , Cetoacidosis Diabética/complicaciones , Cetoacidosis Diabética/diagnóstico , Femenino , Humanos , Isquemia Mesentérica/complicaciones , Isquemia Mesentérica/etiología
7.
Arch Iran Med ; 25(4): 274-276, 2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-35943000

RESUMEN

The differential diagnosis of acute abdominal pain is a challenging task for medical doctors working in the department of gastroenterology. It is clear that acute abdominal pain may be associated with a number of pathologic conditions. We report an unusual case of an unnoticed swallowed wooden toothpick stuck in the ileocecal area of a young man with right lower abdominal pain who was misdiagnosed as acute appendicitis. However, an abdominal computed tomography scan showed an elongated foreign body stuck in the ileocecal area. The elongated foreign body was identified as a wooden toothpick, which was then grasped with a foreign body forceps and successfully removed through colonoscopy. The patient's abdominal pain was significantly relieved within 2 days following treatment. On the basis of the case report, we suggest the importance of abdominal computed tomography scans for the differential diagnosis of acute abdominal pain and highlight the need for extra vigilance in excluding the diagnosis of foreign bodies in the gastrointestinal tract of patients with acute abdominal pain.


Asunto(s)
Apendicitis , Cuerpos Extraños , Perforación Intestinal , Dolor Abdominal/etiología , Enfermedad Aguda , Apendicitis/complicaciones , Apendicitis/diagnóstico , Errores Diagnósticos/efectos adversos , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/diagnóstico por imagen , Humanos , Perforación Intestinal/complicaciones , Perforación Intestinal/diagnóstico , Masculino
8.
Scanning ; 2022: 8356256, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35950090

RESUMEN

In order to relieve the pain of incision after cesarean section, a method of foot and hand massage for abdominal pain of cesarean section incision under ultrasound guidance was proposed in this paper. In this paper, the experimental control method and retrospective analysis were used to relax the patients through massage, so that the pregnant women could focus on the reaction caused by hand and foot massage, distract their attention, and reduce the pain. The results showed that 60 cases of puerpera after cesarean section were divided into two groups with 30 cases in each group. The control group was only given routine care. The intervention group received 20 min hand and foot massage on the basis of routine care. The visual analog scale (VAS) of pain before, immediately after, 30 min after, and 60 min after massage in the intervention group was evaluated and recorded, and the VAS scores of the control group at the corresponding time points were recorded. The VAS score of the intervention group at each time point after massage was significantly lower than that before massage (P < 0.05), and the VAS score of the intervention group at each time point was significantly lower than that of the control group (P < 0.01). Hand and foot massage can effectively relieve incision pain after cesarean section.


Asunto(s)
Cesárea , Masaje , Dolor Abdominal , Cesárea/efectos adversos , Femenino , Pie/cirugía , Humanos , Masaje/métodos , Embarazo , Estudios Retrospectivos
9.
Nihon Shokakibyo Gakkai Zasshi ; 119(8): 744-749, 2022.
Artículo en Japonés | MEDLINE | ID: mdl-35944992

RESUMEN

A female in her 60s was referred to our institution with epigastric pain and abdominal fullness persisting for one week. She was afebrile and mild abdominal tenderness was found on physical examination. Computed tomography (CT) revealed free air, and the dirty fat sign outside the duodenal wall. Her previous CT had not shown causative findings such as duodenal diverticula. A slightly high-attenuated linear structure penetrating the duodenal wall at the second portion was suspected after review of present CT images. Based on the history of her current illness, the possibility of mackerel bone ingestion was considered. Esophagogastroduodenoscopy (EGD) revealed a fishbone sticking out of the duodenal wall, which was extracted with biopsy forceps. Although antibiotic treatment under fasting was continued, the formation of retroperitoneal abscess was detected by CT on the 6th postprocedural day. Given that she also developed a high fever, surgical drainage was performed. The patient was discharged on the 15th postoperative day. Thus, in cases of duodenal perforations, a fishbone should be taken into account as a possible cause. Even if endoscopic removal was initially selected, careful observation is mandatory and an additional treatment should be considered depending on the clinical course.


Asunto(s)
Úlcera Duodenal , Perforación Intestinal , Dolor Abdominal/etiología , Absceso/complicaciones , Drenaje , Úlcera Duodenal/complicaciones , Duodeno/cirugía , Femenino , Humanos , Perforación Intestinal/diagnóstico por imagen , Perforación Intestinal/etiología , Perforación Intestinal/cirugía
10.
J Nepal Health Res Counc ; 20(1): 272-275, 2022 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-35945890

RESUMEN

Entrapment abdominal neuropathy is not a common diagnosis in our context. Chronic Abdominal wall pain is often mistaken for gastritis, gynecological issue, thoracic spinal radiculopathy, rectus sheath hematoma, abdominal muscle injury or psychiatric disorder. Anterior cutaneous nerve entrapment syndrome is one of the frequent causes of abdominal wall pain occurring due to trapped thoracic intercostal nerves between abdominal muscles. History and bedside Carnett's sign can elicit the diagnosis. Injection of the local anesthetics with steroids in the junction between the rectus sheath and abdominal muscle under ultrasound guidance can provide sustained pain relief. We should consider Anterior cutaneous nerve entrapment syndrome as a differential diagnosis while evaluating the abdominal wall pain. Keywords: ACENE; carnett's test; chronic abdominal pain; entrapment neuropathy; hydrodissection.


Asunto(s)
Bloqueo Nervioso , Síndromes de Compresión Nerviosa , Dolor Abdominal/etiología , Humanos , Nepal , Síndromes de Compresión Nerviosa/complicaciones , Síndromes de Compresión Nerviosa/diagnóstico por imagen , Ultrasonografía Intervencional
11.
Comput Math Methods Med ; 2022: 5203166, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35941895

RESUMEN

Objective: This study is aimed at constructing and evaluating a prediction model of severe abdominal pain post-transcatheter arterial chemoembolization in patients with HBV-related primary liver cancer. Methods: Patients with HBV-associated primary liver cancer who received transarterial chemoembolization (TACE) from March 2019 to March 2022 in the Interventional Therapy Department of our hospital were selected as the subjects, and the included 160 patients were randomly divided into modeling group (n = 120) and validation group (n = 40) in a ratio of 3 : 1. Visual analog scale (VAS) was used to assess pain severity. 120 patients in the modeling group were divided into no/mild abdominal pain group and severe abdominal pain group. The clinical data of the patients, including gender, age, TACE treatment history, vascular invasion, maximum diameter of tumor, infarction degree, preoperative Eastern Oncology Collaboration Group (ECOG) score, and Lipiodol dosage, were analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the prediction model for severe abdominal pain post-TACE. Results: A total of 116 patients (72.50%) had severe abdominal pain after TACE. Univariate analysis showed that severe abdominal pain after TACE in the modeling group was associated with TACE treatment history, maximum tumor diameter, infarction degree, and preoperative ECOG score (all P < 0.05), but not related to gender, age, vascular invasion, and Lipiodol dosage (all P > 0.05). Logistic regression analysis showed that TACE treatment history, maximum tumor diameter, infarction degree, and preoperative ECOG score were all independent influencing factors for acute abdominal pain post-TACE in HBV-HCC patients (all P < 0.05). The prediction model equation was Y = -3.673 + 1.722 × TACE treatment history + 1.175 × tumor maximum diameter + 2.064 × infarction degree + 1.555 × preoperative ECOG score. Goodness-of-fit test results showed no significant difference between the established prediction model and the observed value (χ 2 = 1.645, P = 0.560) and R 2 = 0.821, suggesting that the prediction ability of the model was relatively accurate. ROC analysis results showed that the area under the curve (AUC) of severe abdominal pain after TACE was 0.916 (0.862~0.970) and 0.902 (95% CI: 0.841~0.963) in the modeling group and the verification group, respectively. Conclusion: TACE treatment history, tumor maximum diameter, infarction degree, and preoperative ECOG score are independent influencing factors for severe abdominal pain post-TACE in patients with HBV-HCC, and the prediction model established on this basis has good application value.


Asunto(s)
Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Dolor Abdominal/etiología , Dolor Abdominal/terapia , Carcinoma Hepatocelular/terapia , Quimioembolización Terapéutica/efectos adversos , Quimioembolización Terapéutica/métodos , Aceite Etiodizado , Virus de la Hepatitis B , Humanos , Infarto/terapia , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/terapia , Estudios Retrospectivos , Resultado del Tratamiento
12.
Eur J Gastroenterol Hepatol ; 34(9): 925-932, 2022 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-35913778

RESUMEN

INTRODUCTION: Post-coronavirus disease (post-COVID) symptoms arise mostly from impaired function of respiratory tract although in many patients, the dysfunction of gastrointestinal tract and liver among other organ systems may persist. METHODS: Primary data collection was based on a short gastrointestinal symptom questionnaire at the initial screening. A brief telephone survey within the patient and control group was performed 5-8 months after the initial screening. R ver. 4.0.5 and imbalanced RandomForest (RF) machine-learning algorithm were used for data explorations and analyses. RESULTS: A total of 590 patients were included in the study. The general presence of gastrointestinal symptoms 208.2 days (153-230 days) after the initial acute severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection was 19% in patients with moderate-to-serious course of the disease and 7.3% in patients with mild course compared with 3.0% in SARS-CoV-2 negative controls (P < 0.001). Diarrhea and abdominal pain are the most prevalent post-COVID gastrointestinal symptoms. RF machine-learning algorithm identified acute diarrhea and antibiotics administration as the strongest predictors for gastrointestinal sequelae with area under curve of 0.68. Variable importance for acute diarrhea is 0.066 and 0.058 for antibiotics administration. CONCLUSION: The presence of gastrointestinal sequelae 7 months after the initial SARS-CoV-2 infection is significantly higher in patients with moderate-to-severe course of the acute COVID-19 compared with asymptomatic patients or those with mild course of the disease. The most prevalent post-COVID gastrointestinal symptoms are diarrhea and abdominal pain. The strongest predictors for persistence of these symptoms are antibiotics administration and acute diarrhea during the initial infection.


Asunto(s)
COVID-19 , Enfermedades Gastrointestinales , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Antibacterianos/uso terapéutico , COVID-19/complicaciones , COVID-19/diagnóstico , Diarrea/diagnóstico , Diarrea/etiología , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/etiología , Humanos , Estudios Prospectivos , SARS-CoV-2
14.
Comput Math Methods Med ; 2022: 1557861, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35928975

RESUMEN

Objective: To study the effects of modified Lamaze breathing on abdominal pain experienced during colonoscopy. Methods: Eighty-five patients who underwent common colonoscopy at our hospital between March 2021 and May 2021 were selected and randomly divided into the Lamaze group (n = 40) and a control group (n = 45). Their basic clinical information was collected, and the bowel cleanliness, the time for the endoscope to reach the ileocecal junction, and the degree of abdominal pain of the two groups were compared. Results: No significant difference was observed in age, gender, bowel cleanliness, and time of endoscope to reach the ileocecal junction between the two groups. However, the degree of abdominal pain (anal region, descending sigmoid colon junction, splenic flexure, and hepatic flexure) was significantly lower in the Lamaze group compared with the control group. Conclusion: Modified Lamaze breathing demonstrated promising effectiveness in reducing abdominal pain during colonoscopy and improving the quality of the examination.


Asunto(s)
Dolor Abdominal , Ejercicios Respiratorios , Colonoscopía , Dolor Abdominal/etiología , Dolor Abdominal/prevención & control , Humanos
15.
MMW Fortschr Med ; 164(14): 70, 2022 08.
Artículo en Alemán | MEDLINE | ID: mdl-35941457
16.
Rom J Ophthalmol ; 66(2): 198-208, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35935086

RESUMEN

The diagnosis of bilateral panuveitis was made in a 9-year-old girl who was referred to our hospital for blurred vision accompanied by periorbital and abdominal pain. Endothelial dusting, vitreous haze and optic nerve edema were deemed as signs of involvement of all segments of the eye. The bloodwork results were suggestive of infectious uveitis, with elevated inflammatory markers and the patient was treated with IV antibiotics. Cerebral-CT was normal, screening for common infectious causes of uveitis and cultures were negative. There was no history of autoimmune disease, and autoimmune antibody tests were negative. Pediatric inflammatory multisystem syndrome induced panuveitis, secondary to SARS-CoV-2 (PIMS), was suspected by the infectious disease consultant. The syndrome commonly affects school-age children and represents a generalized inflammatory response in the body that appears about one month after the initial infection with the SARS-CoV-2 virus. Initial symptoms include fever, abdominal pain, eye redness, rashes, dizziness, accompanied by laboratory evidence of inflammation unexplained by any other plausible cause. The patient's coronavirus IgG titer was positive, while the RT-PCR for SARS-CoV-2 virus, taken from the nasopharyngeal swab, was negative. As all the other investigations turned out negative, COVID-19 was the only presumptive cause for the pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS). A diagnosis of probable COVID-19 induced uveitis was made and the patient started IV Dexamethasone, followed by oral steroids that were gradually tapered and made a full recovery. The aim of this report was to shed light and enrich the scarce literature available on Uveitis as a sign of pediatric inflammatory syndrome following COVID-19 infection. Abbreviations: ACE2 = Angiotensin converting enzyme 2, ANA = Antinuclear antibodies, c-ANCA, p-ANCA = Cytoplasmic and perinuclear anti-neutrophil cytoplasm antibodies, BCVA = Best corrected visual acuity, CMV = Cytomegalovirus, COVID-19 = coronavirus disease 2019, CRE = Carbapenem-resistant Enterobacteriaceae, CRP = C-Reactive Protein, EBV = Epstein Barr virus, ESBL = Extended spectrum beta-lactamase, ESR = Erythrocyte Sedimentation Rate, FCoV = Feline coronavirus, MDR = Multidrug resistant, MRSA = methicillin-resistant Staphylococcus aureus, MHV = mouse hepatitis virus, MIS-C = multisystem inflammatory syndrome in children, NSAID = Nonsteroidal anti-inflammatory drug, NT pro BNP = precursor natriuretic brain peptide, PIMS-TS = Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2, RNFL = Retinal nerve fiber layer, SARS CoV-2 = severe acute respiratory syndrome coronavirus 2, SD-OCT = Spectral domain optical coherence tomography, VRE = Vancomycin-resistant Enterococci.


Asunto(s)
COVID-19 , Infecciones por Virus de Epstein-Barr , Staphylococcus aureus Resistente a Meticilina , Oftalmólogos , Panuveítis , Dolor Abdominal , COVID-19/complicaciones , COVID-19/diagnóstico , Herpesvirus Humano 4 , Humanos , Panuveítis/diagnóstico , Panuveítis/etiología , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria Sistémica
17.
J Environ Public Health ; 2022: 1211499, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35910757

RESUMEN

Objective: Peptic ulcer disease (PUD) in children is an uncommon disorder. An estimated 1.3 percent to 20 percent of people die from perforated peptic ulcers (PPU), a PUD consequence. Using a database, we assess the prevalence and prognosis of PPU in patients. We also do radiological and laparoscopic operations for PPU in young patients. In pediatric patients, sufficient accumulation of knowledge about laparoscopic repair is at the level of case reports. This study aims to assess the results in pediatric cases operated for PUP by open or laparoscopic surgery and determine the role of computed tomography (CT) in diagnosing PUP. Methods: Data was collected from the Department of Pediatric Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Turkey, from 2015 to 2020. Patients under 18 years of age who were operated on for PUP between 2015 and 2020 were divided into two groups. Group 1 involved those patients operated by laparoscopic surgery, whereas Group 2 involved those used by open surgery. Both groups were retrospectively evaluated in terms of demographic data, clinical findings, preoperative-intraoperative findings and surgical methods (open or laparoscopic), duration of surgery, duration of nasogastric intubation, time of return to oral feeding, length of hospital stay, and postoperative complications. Results: 18 patients consisting of 15 boys and 3 girls were included in the study. Group 1 involved 10 patients, whereas Group 2 involved 8 patients. In Group 1, the symptom onset period was 1.6 ± 1.9 days, and in Group 2, it was 6.6 ± 6.1 days. In the erect abdominal radiographs (AXR) of 10 (58.8%) patients, the air was under the diaphragm. Six patients whose erect AXRs showed no attitude under the diaphragm but had abdominal pain and acute abdominal manifestation were given abdominal computed tomography (CT) scanning. In all patients with PUP, laparoscopic/open surgery involves primary suturing and repair by omentoplasty (Graham patch). The mean operative time was 87.0 ± 26.3 minutes in Group 1 and 122.5 ± 57.6 minutes in Group 2. The mean length of hospital stay was 3.9 ± 1.3 days in Group 1 and 5.8 ± 2.1 days in Group 2. Neither group developed any major surgical complications. Conclusions: Adolescents with a history of sudden onset and severe abdominal pain may present with peptic ulcer perforation even if there is no known diagnosis of peptic ulcer or predisposing factor. In cases suspected of PUP, it is vital to order and carefully examine erect AXR, which is an easy and inexpensive method. Computed tomography should be the first choice in patients without free air in ADBG but whose anamnesis and findings match peptic ulcer perforation.


Asunto(s)
Laparoscopía , Úlcera Péptica Perforada , Úlcera Péptica , Radiología , Dolor Abdominal/complicaciones , Dolor Abdominal/cirugía , Adolescente , Niño , Femenino , Humanos , Laparoscopía/efectos adversos , Laparoscopía/métodos , Masculino , Úlcera Péptica/complicaciones , Úlcera Péptica/cirugía , Úlcera Péptica Perforada/diagnóstico por imagen , Úlcera Péptica Perforada/epidemiología , Úlcera Péptica Perforada/etiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del Tratamiento
18.
BMJ Case Rep ; 15(8)2022 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-35961689

RESUMEN

An acute ectopic pregnancy is one of the most common gynaecological emergencies in clinical practice. The diagnosis is usually established by a combination of clinical examination findings, correlated with sonographic and laboratory results. However, a chronic ectopic pregnancy (CEP) may occur when the ectopically implanted gestation, mostly in the fallopian tubes, invades the underlying structures, causing protracted destruction at the site of implantation. Individuals may present with subacute or chronic abdominal pain, abnormal vaginal bleeding, amenorrhoea and a low bHCG. The correct diagnosis is often only established following laparoscopy or even histologically after the operation. The authors present the case of a woman in her 30 s presenting with severe right sided abdominal pain and a failing pregnancy at 10 weeks gestation. Her urine pregnancy test was negative, but her serum bHCG was 18 IU/L. A transvaginal ultrasound scan confirmed a ruptured right tubal ectopic pregnancy. A laparoscopic salpingectomy was performed. This case provides an important reminder that a CEP should always be considered in the differential diagnosis of women of reproductive age presenting with acute lower abdominal pain, despite a negative urine pregnancy test.


Asunto(s)
Laparoscopía , Pruebas de Embarazo , Embarazo Ectópico , Embarazo Tubario , Dolor Abdominal/cirugía , Femenino , Humanos , Laparoscopía/efectos adversos , Embarazo , Embarazo Ectópico/diagnóstico , Embarazo Ectópico/etiología , Embarazo Ectópico/cirugía , Embarazo Tubario/diagnóstico por imagen , Embarazo Tubario/cirugía , Salpingectomía/efectos adversos
19.
Wiad Lek ; 75(6): 1801-1804, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35962702

RESUMEN

In this case we used CBC and biochemical tests, ECG, ultrasound of the abdominal cavity and heart, CT scan with and without IV contrast. Women with complains on recurrent severe abdominal pain in epigastric region and right part of the abdomen radiating to the back, nausea, vomiting. Making laboratory and instrumental tests for confirmation of the diagnosis. Surgical treatment of DS was performed and after one year of the follow up there were no complications. DS may mimic other medical conditions such as gallbladder diseases, gastritis/peptic ulcer, appendicitis, colorectal malignancy, hepatitis, atherosclerotic diseases etc. That is why DS is a diagnosis of exclusion. This case illustrates pathway to find correct diagnosis and improve management tactic.


Asunto(s)
Síndrome del Ligamento Arcuato Medio , Dolor Abdominal/etiología , Adulto , Arteria Celíaca/patología , Arteria Celíaca/cirugía , Femenino , Humanos , Síndrome del Ligamento Arcuato Medio/complicaciones , Síndrome del Ligamento Arcuato Medio/diagnóstico , Síndrome del Ligamento Arcuato Medio/cirugía , Náusea , Vómitos
20.
Indian J Med Microbiol ; 40(3): 449-450, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35933240

RESUMEN

Fascioliasis has been reported from many countries across the globe. Acute phase of liver fluke is characterised by fever, abdominal pain and peripheral blood eosinophilia while the chronic phase is marked by chronic inflammation involving biliary tract. It is commonly diagnosed by a radiologist due to characteristic branching abscesses seen on CT scan, highly suggestive of liver fluke. Diagnosis is made by demonstration of eggs on direct microscopic examination of duodenal aspirate or bile. Screening of family members is recommended once diagnosis is has been made. Triclabendazole is the drug of choice for treatment.


Asunto(s)
Antihelmínticos , Eosinofilia , Fasciola hepatica , Fascioliasis , Dolor Abdominal/tratamiento farmacológico , Dolor Abdominal/etiología , Animales , Antihelmínticos/uso terapéutico , Eosinofilia/diagnóstico , Eosinofilia/tratamiento farmacológico , Fascioliasis/diagnóstico , Fascioliasis/tratamiento farmacológico , Femenino , Fiebre/tratamiento farmacológico , Fiebre/etiología , Humanos , Triclabendazol/uso terapéutico
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