No abstract available.
Abdominal Pain* ; Child* ; Diagnosis* ; Humans

No abstract available.
Abdominal Pain* ; Child* ; Diagnosis* ; Humans

PURPOSE: To present a diagnostic sign on MRI and US in patients with ovarian torsion. MATERIALS AND METHODS: We present characteristic imaging findings in eight patients with surgically-proven ovarian torsion. MRI was performed in four patients, CT in six and US in all patients; the procedures including eight transabdominal US(TAS) and three transvaginal US(TVS). In each study, imaging findings were analyzed for the appearance of twisted pedicle and the presence of a "whirling sign". RESULTS: The pedicle which indicates ovarian torsion was detected on MRI in all 4 patients, on TAS in 4/7, on TVS in 3/3, and on CT in 4/6. A specific "whirling sign" was detected on MRI in 2/4 patients, on TAS in 2/4, and on TVS in all three. On CT a "whirling sign" was not detected. CONCLUSION: The "whirling sign" on both MRI & US is a characteristic finding of ovarian torsion; in a patient with adnexal mass and complaining of lower abdominal pain, the presence of this sign is very useful for the diagnosis of ovarian torsion.
Abdominal Pain ; Diagnosis ; Humans ; Magnetic Resonance Imaging

PURPOSE: To present a diagnostic sign on MRI and US in patients with ovarian torsion. MATERIALS AND METHODS: We present characteristic imaging findings in eight patients with surgically-proven ovarian torsion. MRI was performed in four patients, CT in six and US in all patients; the procedures including eight transabdominal US(TAS) and three transvaginal US(TVS). In each study, imaging findings were analyzed for the appearance of twisted pedicle and the presence of a "whirling sign". RESULTS: The pedicle which indicates ovarian torsion was detected on MRI in all 4 patients, on TAS in 4/7, on TVS in 3/3, and on CT in 4/6. A specific "whirling sign" was detected on MRI in 2/4 patients, on TAS in 2/4, and on TVS in all three. On CT a "whirling sign" was not detected. CONCLUSION: The "whirling sign" on both MRI & US is a characteristic finding of ovarian torsion; in a patient with adnexal mass and complaining of lower abdominal pain, the presence of this sign is very useful for the diagnosis of ovarian torsion.
Abdominal Pain ; Diagnosis ; Humans ; Magnetic Resonance Imaging

An omental cyst is an uncommon intra-abdominal tumor. The pathogenesis of omental cysts are unknown, as the majority are asymptomatic and if found at all are discovered incidentally during abdominal exploration or radiologic examination. A correct preoperative diagnosis of an omental cyst is very difficult as the information provided by CT and ultrasound imaging is often insufficient to support a differential diagnosis. However, with the increasing availability of ultrasound and CT, preoperative diagnoses of omental cysts are being made more frequently. An exception to this occurs in children, in whom abdominal pain secondary to the cyst may be dominant, necessitating surgical intervention. The most common symptoms and physical findings are abdominal pain and a smooth, non-tender, mobile, palpable mass. Recently, we encountered a case of an omental cyst in a surgically removed omentum. This case is reported with a review of the literature.
Abdominal Pain ; Child ; Diagnosis ; Diagnosis, Differential ; Humans ; Omentum ; Ultrasonography

Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time.
Abdominal Muscles ; Abdominal Pain ; Abdominal Wall ; Anatomic Landmarks ; Chronic Pain ; Diagnosis ; Humans ; Nerve Block ; Nerve Compression Syndromes* ; Ultrasonography*

BACKGROUND: Abdominal pain is a common complaint seen at emergency centers. Various diseases can cause abdomin al pain making it difficult to make a correct diagnosis. In the elderly, however, the consequences of an incorrect or delayed diagnosis can be more critical. We investigated the accuracy of initial diagnoses in the emergency center and analyzed the associations among medical factors including age. METHODS: We compared the ICD 10 codes of initial diagnoses to the codes of final diagnoses, defined the 'degree of agreement' using a 5 point scale, and classified patients into 'high degree of agreement' or 'low degree of agreement' groups. According to the severity of illness, we classified patients as 'admission' or 'out patient follow up'. According to their illness, we classified them as 'surgical' or 'medical'. According to age, we classified them as 'elderly' or 'adult'. Finally, we analyzed the statistical significance of each association. RESULTS: Overall, admitted patients and surgical diagnoses had higher degrees of agreement. 'Elderly' patients had no significant difference in 'degree of agreement' from 'adult' patients. CONCLUSION: Among patients presenting with acute abdominal pain to the emergency center, the degree of agreement between initial diagnosis and final diagnosis is dependent on the diagnostic characteristics of the disease, and not on the age of the patients. Further studies on the diagnostic accuracy of individual diseases are needed. Additional diagnosis associated variables, for example comorbidity and prognosis, needs to be studied regarding relationship to diagnostic accuracy.
Abdominal Pain ; Aged ; Comorbidity ; Delayed Diagnosis ; Emergencies ; Humans ; Prognosis

PURPOSE: We wanted to determine the usefulness of computed tomography (CT) for patients with clinically-suspected but equivocal acute appendicitis, and we wanted to evaluate the differences of the sensitivity and specificity of CT according to the period of time from onset of the signs and symptoms to the performance of CT. METHODS: A retrospective study was done on 273 patients who visited our hospital for acute abdominal pain from Jan. 2003 to Dec. 2005, and they could not be excluded as suffering from acute appendicitis by their symptoms nor signs. RESULTS: Forty-three (15.8%) of the 273 patients did not undergo operation because their condition was not diagnosed as acute appendicitis and 190 patients were diagnosed as acute appendicitis by CT. The other 40 patients underwent diagnostic laparotomy because acute appendicitis could not be confirmed and any other diagnosis could not be made. The patients were classified into 6 groups according to the period of time from the onset of symptoms and signs to the performance of CT. The sensitivity of CT after 48 hours was statistically significantly increased as compared to performing CT before 48 hours (92.3% vs. 75.8%, respectively; P=0.023). CONCLUSION: Forty-three (15.8%) of the patients with clinically- suspected but equivocal acute appendicitis avoided unnecessary laparotomy by undergoing CT. The sensitivity was increased for diagnosing acute appendicitis by CT when it was performed after 48 hours from the onset of symptoms and signs, but caution may be needed during interpretation because of the false positives (2 patients;4.7%) could due to secondary change of other diseases
Abdominal Pain ; Appendicitis* ; Diagnosis ; Humans ; Laparotomy ; Retrospective Studies ; Sensitivity and Specificity

Angiosarcoma is a very rare form of neoplasm derived from soft tissue. It is reported even more rarely in hepatobiliary system. Because of its nonspecific symptoms and difficulty in diagnosis, angiosarcoma is often presented in a progressed state and often results in poor prognosis. To our best knowledge, there has been no report regarding angiosarcoma in common bile duct worldwide. We report a case of 77-year-old-woman presented with right upper abdominal pain diagnosed as angiosarcoma in common bile duct.
Abdominal Pain ; Common Bile Duct* ; Diagnosis ; Hemangiosarcoma* ; Prognosis

Struma Ovarii is a teratoma with thyroid tissue as the predominant (>50%) constituent. It is rare, representing about 2% of all teratomas, and its malignant transformation, less than 5% of struma ovarii. Presenting symptoms are not specific, therefore pre-operative diagnosis of malignant struma ovarii is difficult and most diagnosis of malignant struma ovaii is determined by post-operative histologic findings. Because of the rarity of malignant struma ovarii, there is considerable confusion concerning diagnosis and management. A postmenopausal woman presented with pelvic mass and lower abdominal pain and explo-laparotomy was performed. Then, pathologic report was identified as malignant struma ovarii. We report a case of malignant struma ovarii with brief review of literature
Abdominal Pain ; Diagnosis ; Female ; Humans ; Struma Ovarii* ; Teratoma ; Thyroid Gland