RESUMO
The falciform ligament is a peritoneal double layer that anatomically divides the right and left hepatic lobes. Abnormality of the falciform ligament is rare - less than 20 cases of torsion of the falciform ligament have been reported to date in adults. The pathophysiology of these entities is similar to intra-abdominal focal fat infarction. The clinical of the patient with torsion of the falciform ligament is abdominal pain of sudden onset and focal location. Laboratory tests can lead to diagnostic confusion with cholecystitis. Ultrasonography is usually the initial evaluation test, but the gold standard diagnosis is computed tomography. We report the case of a 30-year-old female patient reporting sudden abdominal pain that radiates to the dorsal region associated with nausea and vomiting diagnosed with torsion of the falciform ligament with ultrasonography and confirmed with computed tomography. She was treated conservatively without the need for surgical treatment, being discharged after one week hospitalization.
Assuntos
Parede Abdominal , Ligamentos , Adulto , Feminino , Humanos , Ligamentos/diagnóstico por imagem , Ligamentos/cirurgia , Dor Abdominal/complicações , Infarto/etiologia , Tomografia Computadorizada por Raios X/efeitos adversosRESUMO
INTRODUCTION: Omental infarction describes ischemic torsion of the distal portion of the omentum and constitutes an infrequent cause of acute abdominal pain in childhood of which few cases are known. Objec tive: To analyze through a clinical case the characteristics and management of this pathology, to consider this entity in the differential diagnosis of acute abdominal pain. CLINICAL CASE: An 11-year- old child consulted the emergency department due to a 48-hour history of continuous abdominal pain, which had progressively increased. On the physical examination, the patient presented pain in the right side of the abdomen and the epigastric area, with no signs of peritoneal irritation, and was overweight (BMI 91st percentile). Biochemical analysis showed a slight increase in c-reactive protein (CRP) 41.31 mg/L (reference value < 3.0 mg/L) without leukocytosis and normal ultrasound study, without visualization of the appendix. Due to persistent pain, increased CRP, and absence of appen dix visualization in the ultrasound, the study was completed with an abdomen and pelvis CT scan which showed trabeculation of the fat of the anterior right subhepatic space, thus diagnosing omental infarction. The patient was hospitalized for conservative management with analgesia, anti-inflamma tory drugs, and fluid therapy, presenting good evolution in the first 48 hours. CONCLUSION: Omental infarction is an infrequent cause of acute abdominal pain in childhood. Imaging studies play a funda mental role in the differential diagnosis of this entity with other clinical conditions of similar course, thus avoiding unnecessary surgical interventions.
Assuntos
Abdome Agudo , Doenças Peritoneais , Doenças Vasculares , Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Abdome Agudo/cirurgia , Dor Abdominal/complicações , Dor Abdominal/patologia , Criança , Humanos , Infarto/diagnóstico , Infarto/etiologia , Infarto/patologia , Omento/patologia , Omento/cirurgia , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/patologia , Doenças Peritoneais/cirurgia , Doenças Vasculares/complicações , Doenças Vasculares/patologiaRESUMO
Kidney transplant is the established treatment for patients with chronic kidney disease but is associated with complications due to the complexity of the procedure. Calyceal fistulas are rare urological complications in transplants caused by arterial occlusion with segmental infarction of the graft. Treatment is based on the extension of the affected area and the clinical status of the patient. For extensive infarctions treated surgically, a total nephrectomy of the transplanted kidney is generally performed. We present a case of a transplanted kidney with polar necrosis and calyceal fistula treated with partial nephrectomy of the affected area, maintaining the graft and preserving kidney function.
Assuntos
Transplante de Rim , Insuficiência Renal Crônica , Fístula Urinária , Humanos , Rim , Nefrectomia/efeitos adversos , Transplante de Rim/efeitos adversos , Fístula Urinária/diagnóstico por imagem , Fístula Urinária/etiologia , Fístula Urinária/cirurgia , Infarto/etiologia , Insuficiência Renal Crônica/complicaçõesRESUMO
Meckel's diverticulum is a congenital anomaly, resulting from incomplete obliteration of the most proximal portion of the omphalomesenteric duct. It generally remains silent, but life-threatening complications may arise in 4-6% of the patients. We present a case of a 16-year-old male, who arrived at the emergency room with crampy abdominal pain, nausea, and vomiting, suggestive of acute appendicitis. Surgical exploration revealed 150 cm of infarcted small bowel, secondary to a mesodiverticular band of a Meckel's diverticulum at the site of obstruction. The ischemic small bowel with Meckel's diverticulum was resected, and an ileo-ileal anastomosis was carried out. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. He was seen 12 months after his initial surgery, with a favorable outcome.
Assuntos
Infarto/etiologia , Intestino Delgado/irrigação sanguínea , Divertículo Ileal/complicações , Adolescente , Humanos , Infarto/diagnóstico por imagem , Infarto/cirurgia , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/cirurgia , Masculino , Radiografia AbdominalRESUMO
BACKGROUND: Renal infarction is a rare and usually underdiagnosed entity. AIM: To study the etiology of renal infarction in published series. MATERIAL AND METHODS: A systematic review was carried out selecting 28 series that included 1582 patients. RESULTS: The proposed cause was cardiac or aortic embolism in 718 cases (45%), an arterial injury in 253 (16%), prothrombotic factors in 146 (9%) and other causes in 79 (5%). 291 cases were classified as idiopathic (18.4%). Atrial fibrillation was present in 542 of the 718 patients with cardiac or aortic embolism. CONCLUSIONS: The main cause of renal infarction is cardiac or aortic embolism and among this group, most cases are due to atrial fibrillation. One out of five cases is labeled as idiopathic.
Assuntos
Infarto/etiologia , Nefropatias/etiologia , Rim/irrigação sanguínea , Humanos , Rim/patologiaRESUMO
Background: Renal infarction is a rare and usually underdiagnosed entity. Aim: To study the etiology of renal infarction in published series. Material and Methods: A systematic review was carried out selecting 28 series that included 1582 patients. Results: The proposed cause was cardiac or aortic embolism in 718 cases (45%), an arterial injury in 253 (16%), prothrombotic factors in 146 (9%) and other causes in 79 (5%). 291 cases were classified as idiopathic (18.4%). Atrial fibrillation was present in 542 of the 718 patients with cardiac or aortic embolism. Conclusions: The main cause of renal infarction is cardiac or aortic embolism and among this group, most cases are due to atrial fibrillation. One out of five cases is labeled as idiopathic.
Assuntos
Humanos , Infarto/etiologia , Rim/irrigação sanguínea , Nefropatias/etiologia , Rim/patologiaAssuntos
Artrite/etiologia , Cotovelo/diagnóstico por imagem , Úmero/irrigação sanguínea , Infarto/etiologia , Linfoma de Células B/complicações , Idoso , Artrite/diagnóstico , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/etiologia , Feminino , Humanos , Infarto/diagnóstico por imagem , Linfoma de Células B/diagnóstico por imagem , Imageamento por Ressonância Magnética , Tomografia Computadorizada EspiralAssuntos
Quimioembolização Terapêutica/efeitos adversos , Artéria Hepática , Infarto/etiologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Tumores Neuroendócrinos/patologia , Omento/irrigação sanguínea , Angiografia Digital , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
We report a 68-year-old woman presenting with pain and swelling in her left elbow. An elbow magnetic resonance with gadolinium evidenced bone marrow infiltration and a bone infarct. Given these findings, a body CT scan was performed which showed multiple mesenteric adenopathies and a large retroperitoneal mass. A lymph node biopsy confirmed a B cell lymphoma. Monoarthritis with no systemic manifestations represents a highly uncommon form of presentation of lymphoma. Moreover it usually affects inferior limbs, particularly in the presence of bone infarction.