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Tropical Colorectal Surgery
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Meheshinder Singh, Kemal I. Deen
This is the most common variety of abdominal tuberculosis found in the tropics and may be associated with lymphadenopathy in other locations, although a pulmonary lesion is notable by its absence.25 The illness begins insidiously, with weight loss, intermittent low-grade fever and general malaise. As the disease progresses, abdominal swelling occurs, due both to accumulation of fluid within the abdominal cavity and to the often massively enlarged lymph nodes. If the disease is allowed to progress, anaemia, hypoalbuminaemia and peripheral oedema, often with lymphoedema, become evident. Massive caseation of mesenteric lymph nodes occurs. Node rupture is a major complication of this form of abdominal tuberculosis with dissemination of bacilli throughout the abdominal cavity, causing tuberculous peritonitis with multiple tubercles throughout the peritoneal surface.
Gynaecology
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The most common solid tumours in young women are cystic teratomas (known more commonly as dermoid cysts), which typically contain a variety of tissues including hair, teeth and bone. Benign ovarian tumours are often asymptomatic and may present incidentally, for example when an abdominal radiograph reveals the appearance of a tooth in the abdomen or pelvis. Conversely, they may present with pain, abdominal swelling and pressure-type symptoms. The pain may result from torsion or bleeding into the cysts. Management will depend on the age of the woman and the characteristics of the cyst. In older women, a conservative approach is reasonable only if the risk of malignancy is low (refer to Ovarian cancer below). In perimenopausal women, the cyst can be followed by serial ultrasound scanning as many will regress. If there is uncontrollable pain, haemodynamic compromise, suspicion of torsion or the cyst does not regress, then surgical management is advised. In most cases this would involve a laparoscopic ovarian cystectomy with conservation of ovarian tissue as the treatment of choice. As the vast majority of oocytes lie within 5 mm of the surface of the ovary, a carefully carried out cystectomy can leave a normally functioning ovary (Figure81.14).
Antenatal obstetric complications
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
Polyhydramnios is the term given to an excess of amniotic fluid (i.e. AFI >95th centile for gestation on ultrasound estimation). It may present as severe abdominal swelling and discomfort. On examination, the abdomen will appear distended out of proportion to the woman’s gestation (increased SFH). Furthermore, the abdomen may be tense and tender and the fetal poles will be hard to palpate. The condition may be caused by maternal, placental or fetal conditions.
A retrospective evaluation of the presentation, prognostic factors and outcomes of neuroblastoma in Ugandan children
Published in Pediatric Hematology and Oncology, 2023
Irene Nanyanga, Gideon Kurigamba Kwikiriza, Barnabas Atwiine, Ruth Namazzi, Victor Musiime, Joyce Balagadde Kambugu, Jaques van Heerden
The most common presenting symptoms were fever (both on history and examination) and weight loss (both n = 56, 74.7%) and excessive night sweats (n = 29, 38.7%). Abdominal swelling and abdominal pain were present in 49 (65.3%) and 39 (52%) patients respectively. Hypertension (>95th centile for age) or elevated blood pressure (90th-95th centile for age) were diagnosed in 43 (57.3%) and 10 (13.3%) patients respectively. Twenty (26.7%) patients presented with tumor-related emergencies and/or complications, most presenting with respiratory distress (n = 11, 55%), superior vena cava obstruction (SVCO) in (n = 4, 20%) and spinal cord compression (n = 2, 10%). Horner syndrome, Opsoclonus myoclonus and intestinal obstruction were present in one (5%) patient each. The median duration of symptoms at diagnosis was 12 months (IQR 4 -24 months).
Complete response of recurrent malignant struma ovarii followed by 131I therapy
Published in Journal of Obstetrics and Gynaecology, 2021
Junhua Tang, Pan Hao, Wei Zhu, Jun Hu, Hongwu Wen
A 27-year-old female who complained of acute abdominal swelling and pain was admitted on the March 5, 1985. A pelvic ultrasound revealed a 20 cm diameter, right solid, cystic ovarian mass. Four days post-admission, the patient received scheduled fertility preservation surgery involving a right adnexectomy, a left ovarian wedge resection, and a peritoneal biopsy as intraoperative frozen sections revealed benign SO. Upon exploration, the right ovary was enlarged (21 × 11 × 3 cm), an irregular solid cyst with multiple raised growths was observed, a 3 mm-diameter breach was noted, and a yellow liquid discharge occurred. The left ovary contained multiple follicles protuberant and a 5 mm-diameter pink nodule. Diffuse, pink, firm nodules of 1 mm diameter were visible at the fundus uteri and the peritoneum. Postoperative histologic sections showed right ovarian struma-derived follicular thyroid carcinoma with contralateral ovaries and peritoneal focal metastasis (Figure 1(A)). Three weeks later, total abdominal hysterectomy, left adnexectomy, omentectomy, and appendectomy were performed. The patient was finally diagnosed as MSO (FIGO Stage IIIA). A dose of 10 mCi P-32 was administered intraperitoneally during the first post-surgical week.
Typhoid ileal perforation in a semi-urban tertiary health institution in north-eastern Nigeria
Published in South African Family Practice, 2018
BA Grema, I Aliyu, GC Michael, A Musa, AG Fikin, BM Abubakar, S Olusegun
Abdominal pain, anorexia, fever and abdominal swelling were the most common symptoms reported by the subjects. Common signs elicited were abnormality in the pulses, among these 26 (78.8%) had tachycardia while 7 (21.2%) had bradycardia. Tachypnoea was the next most common abnormal sign elicited, while jaundice and hepatomegaly were the least (Table 2) reported.