The authors report a rare case of retroperitoneal ganglioneuroma discovered incidentally in a 47-year-old male during abdominal computed tomogaphy(CT) evaluation. The clinical features and findings of the complementary examinations, which included radiological assessment, abdomen CT and lumbar spine magnetic resonance image with contrast enhancement are presented, as well as the pathology findings. The tumor, 10x10x6cm in size, was well encapsulated and total removal was made. Histopathological diagnosis of retroperitoneal ganglioneuroma was confirmed.
Abdomen ; Diagnosis ; Ganglioneuroma* ; Humans ; Male ; Middle Aged ; Pathology ; Spine

Acute scrotal pain is a common urologic presentation and critical pathology due to the possibility of organ loss in the emergency department. Referred pain in the lower quadrant of the abdomen may accompany testicular torsion. Of 58 patients with testicular torsion between January 2001 and March 2011, three visited the emergency department with abdominal pain alone. The median age of the patients was 16 years (range, 13-19). Median duration of abdominal pain to first medical examination and proper diagnosis by an urologist was 14 hours (range, 2-168) and 77 hours (range, 57-240), respectively. All patients underwent orchiectomy. Due to symptomatic variations for testicular torsion, all clinicians providing emergency care to patients who have referred pain in the lower abdomen without scrotal pain should consider the constellation of symptoms in order to avoid superfluous diagnostic delay.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Diagnosis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Orchiectomy ; Pain, Referred ; Pathology ; Spermatic Cord Torsion*

Acute scrotal pain is a common urologic presentation and critical pathology due to the possibility of organ loss in the emergency department. Referred pain in the lower quadrant of the abdomen may accompany testicular torsion. Of 58 patients with testicular torsion between January 2001 and March 2011, three visited the emergency department with abdominal pain alone. The median age of the patients was 16 years (range, 13-19). Median duration of abdominal pain to first medical examination and proper diagnosis by an urologist was 14 hours (range, 2-168) and 77 hours (range, 57-240), respectively. All patients underwent orchiectomy. Due to symptomatic variations for testicular torsion, all clinicians providing emergency care to patients who have referred pain in the lower abdomen without scrotal pain should consider the constellation of symptoms in order to avoid superfluous diagnostic delay.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Diagnosis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Orchiectomy ; Pain, Referred ; Pathology ; Spermatic Cord Torsion*

Abdomen, Acute ; diagnosis ; pathology ; Adult ; Hemorrhagic Fever, Ebola ; diagnosis ; pathology ; Humans ; Male

A 63-year-old female was admitted to our hospital with a tender abdominal wall mass about 15 cm in diameter, which she had for 1 month. About 1 week earlier, the patient had also perceived a mass in the neck area. Computed tomography revealed huge thyroid and periumbilical masses. The thyroid hormone levels were consistent with a hyperthyroid state. Pathological examination of the thyroid mass was compatible with anaplastic thyroid carcinoma (ATC) and the abdominal cutaneous mass was shown to be metastatic ATC. Despite palliative radiotherapy and chemotherapy, the patient died of respiratory failure on her 63rd day of hospitalization. This case demonstrates that abdominal cutaneous metastasis and hyperthyroidism can occur as initial manifestations of ATC. To our knowledge, this is the first reported case.
Abdomen ; Female ; Humans ; Hyperthyroidism/*etiology ; Middle Aged ; Skin Neoplasms/*secondary ; Thyroid Neoplasms/pathology

Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period.
Tomography, X-Ray Computed ; Radiography, Abdominal ; Middle Aged ; Humans ; Female ; Esophageal Cyst/*diagnosis/pathology/*surgery ; *Abdomen

OBJECTIVEAbdominal distention is a common disorder in newborns, which can be life-threatening in severe cases. Currently, little literature is available regarding early identification of the etiology of this disorder in newborn babies, which is imperative to reducing the likelihood of serious consequences. This retrospective study was conducted to analyze the clinical characteristics of early newborns with abdominal distention, aiming at identifying the underlying etiologic factors.

METHODSMedical records of 201 (65 premature and 136 full-term) early newborns with abdominal distention between January 2011 and December 2012 were retrieved.

RESULTSCongenital malformations (including congenital megacolon, anal atresia, malrotation, intestinal atresia, intestinal duplication and posterior urethral valves) occurred in 44.6% of the premature newborns with abdominal distention and 61.8% of the full-term newborns with the disorder. Congenital megacolon was the number one cause of abdominal distention in the full-term group (33.8%) and the number two cause in the preterm group (13.8%). As far as other individual abnormalities were concerned, sepsis was the number one cause of abdominal distention in the preterm group (35.4%) and the number two cause in the full-term group (21.3%). Vomiting was a main symptom associated with abdominal distension, occurring in 64.0% of the full-term newborns and 44.6% of the preterm newborns. The most pronounced X-ray manifestation was bowel distention with an air-fluid level in the preterm group (47.7%) but was bowel distention without a fluid level in the full-term group (57.3%). Eliological and symptomatic treatment was effective in 86.2% of the premature cases and 88.2% in the full-term cases (P>0.05).

CONCLUSIONSCongenital malformations may be the major cause of abdominal distension in early newborns. Sepsis and congenital megacolon are the single disease most frequently associated with abdominal distention in preterm and full-term newborns respectively. Vomiting is a main accompanying symptom in early newborns with abdominal distention. X-ray manifestations seem to be more severe in preterm newborns than in full term newborns. A satisfactory outcome can be achieved after treatment in both preterm and full-term newborns with this disorder.

Abdomen ; pathology ; Dilatation, Pathologic ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; diagnosis ; Male ; Radiography, Abdominal

OBJECTIVETo summarize the clinical management of abdominal compartment syndrome (ACS) in burn patients with severe burn injury.

METHODSTwelve serious burn patients with abdominal compartment syndrome hospitalized in our center from January 2001 to April 2005 were enrolled in the study. Among them 3 patients were treated with conservative method, 4 with escharectomy of abdominal wall, 5 with laparotomy for decompression. The clinical results were analyzed statistically. Bladder pressure, central venous pressure, systolic blood pressure and arterial blood oxygen partial pressure (PaO2 ) were measured and compared before and after operation.

RESULTSAmong these 12 patients, 5 died with the overall mortality of 41.67%. But only 3 died among 9 patients undergone operation. Most of patients were oliguric,with abnormal bladder pressure, central venous pressure, and systolic blood pressure 24 hours before operation. But these parameters were significantly improved after operation ( P <0. 01).

CONCLUSIONEarly abdominal escharectomy and timely abdominal decompression are vital for the management of ACS in burn patients.

Abdomen ; pathology ; Adult ; Aged ; Burns ; complications ; therapy ; Compartment Syndromes ; etiology ; surgery ; Female ; Humans ; Male ; Middle Aged

Castleman's disease (CD) is a rare lymphoproliferative disorder that can involve single or multiple lymph nodes in the body. Especially, the localized form of CD is known to be well-controlled by using a surgical resection. On occasion, the surgeon may confront an abdominal and retroperitoneal mass of unknown origin. Thus, we present this case in which we treated a 16-year-old female patient for CD and investigated how to evaluate and manage the situation from the standpoint of CD. Also, we give a review of the pathology, clinical manifestation, diagnosis, and treatment of CD.
Abdomen* ; Adolescent ; Diagnosis ; Female ; Giant Lymph Node Hyperplasia* ; Humans ; Lymph Nodes ; Lymphoproliferative Disorders ; Pathology, Clinical

Enigmatic chronic pelvic pain is the persistence of unexplained pain in the low abdomen and pelvic lesions without evidence of active disease. One of the most frequent causes is the nonvisceral pain such as myofascial and postsurgical incisional origin. We evaluated the trigger point injection of bupivacaine hydrochloride as a treatment option for chronic nonvisceral pelvic pain. From March, 1995 to May, 1996, 35 female patients (16 to 68 years old, mean 43.7 years ) with localized chronic pelvic pain for 6 months to 10 years were managed by trigger point injection. After confirming the absence of intraabdominal pathology by physical examination and Carnett`s test, 3 to 5 ml of 0.25% bupivacaine hydrochloride was injected to the most hyperpathic foci with 22 gauge, one and half inch needle percutaneously. The mean followup time was 9.7 months. The results were assessed by Visual Analogue Scale(VAS) and subjective symptoms. Twenty six patients had nonincisional pain and 9 had incisional pain. Twenty two patients were treated by only one session while others needed two or more sessions(maximum 4 sessions). The sites of pain were hypogastrium, suprapubic area and iliac fossa in the order of frequency. The mean VAS value at the time of last followup was reduced to 1.7 cm(0 - 5.7 cm) from 6.7 cm(4.9 - 9.1 cm). The improvement of pain occurred mostly within 1 week after treatment and was maintained thereafter. Eighty percent of patients expressed more than 50% reduction of pain by VAS. Sixteen patients(45.7%) responded ""pain free"", 10(28.6%) ""occasional"", 6(17.1%)"" present but better"", and 3(8.6%) ""no change"". The successful responses were noted in 74.3%. No significant complications were identified. These results demonstrated that the trigger point injection is an easy, safe and effective treatment option for chronic nonvisceral pelvic pain.
Abdomen ; Aged ; Bupivacaine* ; Female ; Follow-Up Studies ; Humans ; Needles ; Pathology ; Pelvic Pain* ; Physical Examination ; Trigger Points*