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*

An inflammation of an epiploic appendage is a relatively rare cause of acute abdominal pain. It can be clinically misdiagnosed as either acute appendicitis or diverticulitis. Judicious interpretation of imaging with ultrasound or computed tomography may lead to an early diagnosis and prevent unnecessary surgical or medical treatment. Conservative treatment of symptoms is usually sufficient. We have experienced a case of epiploic appendagitis treated by conservative management and report this case with the review of the literature.
Abdomen* ; Abdominal Pain ; Appendicitis ; Diverticulitis ; Early Diagnosis ; Inflammation ; Ultrasonography

Epiploic appendagitis is a relatively rare cause of acute abdominal pain. Usually, epiploic appendagitis is a benign and self-limited condition, but it can be clinically misdiagnosed as acute appendicitis or diverticulitis, so an inaccurate diagnosis may lead to unnecessary treatment. We recently managed 7 cases of epiploic appendagitis during 1 year and review these cases with an emphasis on the clinical diagnostic features. The main pathophysiologic mechanism underlying epiploic appendagitis is thought to be triggered by appendageal torsion and caused by a subsequent blood flow disturbance. This medical condition must be kept in mind when a patient with acute abdominal pain has well-localized pain which is characteristically sharp in nature and a mild systemic inflammatory response compared to the severity of the pain.
Abdomen, Acute ; Abdominal Pain ; Appendicitis ; Diagnosis, Differential ; Diverticulitis ; Humans

PURPOSE: With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. METHODS: From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. RESULTS: The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. CONCLUSION: Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children.
Abdominal Pain* ; Appendicitis ; Child* ; Classification* ; Diagnosis ; Humans ; Retrospective Studies ; Ulcer

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