General surgery
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan in Essential Notes for Medical and Surgical Finals, 2021
On examination, there is tenderness of the abdomen with or without abdominal distension, guarding and decreased or absent bowel sounds. Pathologically: luminal obstruction due to lymphoid hyperplasia following a viral infection or obstruction due to a faecolith. Often a history of previous similar episodes and risk factors for vascular disease. Predisposing factors are obesity, immobility, caffeine and alcohol intake, cigarette smoking, polycystic kidney disease, and mixed connective tissue disorders. Rectosigmoid junction involved in 80% of cases; small bowel can also be affected. Neoplastic polyps can be morphologically classified as either sessile or pedunculated; three histological types: Tubular adenoma, Villous adenoma and Tubulovillous adenoma. The inguinal canal extends from the deep inguinal ring (midpoint of the inguinal ligament) to the superficial ring (at the pubic tubercle). Infection of the soft tissue surrounding the anal canal, often associated with a fistulous tract.
Abdominal swelling
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson in Care of the Cancer Patient, 2018
This chapter considers all the patient's symptoms and all the information available to doctors and assesses the symptoms, signs and information given using this to choose the appropriate remedies for the problem, and offers extra information where available and appropriate. The healthy adult has about 50 ml of fluid in the abdominal cavity, with a turnover of about 5 ml per hour. The protein content is about 25% of that in the plasma. There are a number of questions that should be asked in order to determine the cause and the impact of the abdominal distension on the patient's quality of life. If patients have ankle swelling as well as abdominal swelling, offer a diuretic in preference to paracentesis. Consider the value of complementary therapies to improve comfort, and do not forget about how body image and sexuality may be affected by having ascites.
Noninfectious Pulmonary Manifestations of Renal Disease In Children
Lourdes R. Laraya-Cuasay, Walter T. Hughes in Interstitial Lung Diseases in Children, 2019
Pulmonary disease with renal failure includes pulmonary edema, pleural effusion, uremic pneumonia, pleuritis, pulmonary calcification, hemosiderosis, and fibrosis. In acute renal failure, the degree of uremic pulmonary edema is related to the degree of azotemia. In chronic renal failure the severity of uremic pulmonary edema is not directly associated with the degree of azotemia as one sees hyalinization of alveolar septa, casts of bronchioles, and interstitial fibrosis. The primary pulmonary findings in the nephrotic syndrome are pulmonary edema and pleural effusion. All the pulmonary changes of acute and chronic renal failure may be seen in the patient who is on peritoneal dialysis. Pulmonary problems during peritoneal dialysis may be the result of abdominal distention during dialysis with elevation of the diaphragm and pressure on the lower lobes of the lung. Any subacute or chronic lung infiltrate in renal disease, especially in those who have had immunosuppression could represent a malignancy.
Splenic Hemangiomatosis: An Uncommon Vascular Lesion in an Infant
Published in Fetal and Pediatric Pathology, 2018
Gargi Kapatia, Suvradeep Mitra, Kirti Gupta, Prema Menon, K. L. N. Rao
Background: Vascular tumors of spleen represent a wide spectrum of lesions, ranging from benign to highly aggressive neoplasms. Among the benign tumors, localized hemangiomas are the most frequently encountered. Splenic hemangiomatosis is seldom seen especially in the pediatric population with anecdotal cases described in the literature. Case report: We present of 6-month-old child presenting with abdominal distention. The resected spleen was totally replaced with a hemangiomatous lesion. There were no other hemangiomatous foci outside the spleen. Conclusions: Hemangiomatosis limited to the spleen can occur in a child, and the present case demonstrates its characteristic histological features.
A case of multiple bone fractures due to the use of topical corticosteroid therapy for psoriasis
Published in Journal of Dermatological Treatment, 2015
A 45-year-old man who had psoriasis had applied topical clobetasol 17 propionate ointment on his whole body 2–3 times a week after the bath for 20 years. Physical examination showed abdominal distension, atrophy all over the skin, psoriatic plaques on the trunk, and extremities and multiple striae on the shoulders and legs. Morning plasma cortisol level and ACTH stimulation test confirmed the diagnosis of hypothalamic insufficiency. Bone mineral densitometry showed severe osteoporosis. Multiple bone fractures in the vertebrae and costa were detected on lumbar magnetic resonance imaging, the 99Tc MDP whole-body bone scan, and thoracoabdominal computerized tomography imaging. Topical corticosteroid therapies have possible local and/or systemic side effects such as atrophy, telangiectasia, hypertricosis, and suppression of pituitary-adrenal axis. We present an interesting case with multiple bone fractures caused by long-time topical corticosteroid use.
Giant Ovarian Lymphangioma: Case Report and Review of the Literature
Published in Fetal and Pediatric Pathology, 2018
Elisa Pani, Alessandra Martin, Annamaria Buccoliero, Marco Ghionzoli, Antonio Messineo
Introduction: Lymphangiomas are benign tumors/malformations, characterized by proliferation of the lymphatic vessels. They may arise anywhere, although the most common localizations are the head–neck region and the axilla. To date, only 21 cases of lymphangioma of the ovary in a 60-year literature survey have been reported. Case report: A 16-year-old female patient with long standing abdominal distension had 40 cm × 15 cm × 29 cm ovarian lymphangioma. Conclusions: Our case highlights that lymphangiomas can occur in the adolescent population and should be added to the differential diagnosis of ovarian masses in this age group.