Perforated Meckel's diverticulitis presenting as a mesenteric abscess: case report

Only 2% of patients with Meckel's diverticulae (MD) will manifest clinical problems. Diverticulitis occurs in approximately 10-20% of patients with symptomatic MD and more often in the elderly population. We report a case of Meckels diverticulitis presenting with perforation and mesenteric abscess in a young African man. The authors present information on diagnostic pitfalls and advise a lower threshold for consideration of MD as a differential diagnosis of acute right iliac fossa pain especially when the CT scan denotes a normal appendix in a male patient.     

1例阑尾炎术后阑尾周围脓肿的护理干预分析

目的探讨阑尾炎术后阑尾周围脓肿的临床特点和护理方式。方法严密观察1例急性阑炎术后阑尾周围脓肿患者的病情变化,及时采取科学化、人性化的护理方式。结果有效地配合了医生的诊断和治疗,促进了病人的康复。结论术后实施全面系统的护理,可对患者病情变化的早诊断、早治疗提供支持。     

Epidural abscess after multiple lumbar punctures for labour epidural catheter placement

Epidural catheterization is routinely used by anaesthesiologists to provide labour and post-operative analgesia. In most cases, catheter placement is without serious side effects and uneventful. However, epidural abscess is a rare complication that may result in severe morbidity. We present a case of epidural abscess after labour epidural catheter placement in a healthy 36-year-old female who presented on post-partum d 10 with complaints of fever and back pain. She was treated with intravenous antibiotics and fully recovered.     

Adenosquamous carcinoma presenting as liver abscess

Adenosquamous carcinoma (ASC) has a nonspecific presentation. We report a patient with ASC who presented with fever and epigastric pain. Computed tomographic findings and clinical features were suggestive of a liver abscess, while ultrasonography showed a complex space-occupying lesion. Biopsy revealed a lesion with malignant glandular and squamous components, a finding that was compatible with ASC. Complex space-occupying lesions should raise the suspicion of a mass lesion. Subtle imaging clues of a metastatic disease were reviewed retrospectively.     

Endometriosis of the appendix presenting as acute appendicitis

While endometriosis is fairly common, endometriosis of the appendix is a very rare occurrence. Correct pre-operative diagnosis is uncommon and definitive diagnosis is established by histology of the appendix. We present a case of endometriosis of the appendix that manifested as acute appendicitis in a 40-year-old woman.     

Perforated ileal duplication cyst presenting with right iliac fossa pain mimicking perforated appendicitis

Enteric duplication is an uncommon malformation of the gastrointestinal tract which is either asymptomatic or presents with vague symptoms mimicking other more common pathology. It is most commonly diagnosed when complications such as bleeding, intestinal obstruction or perforation occurs. This is a case report of a patient with this condition presenting with right iliac fossa pain and localised peritonitis mimicking acute appendicitis.     

13例小儿急性阑尾炎穿孔误诊分析

目的分析小儿急性阑尾炎穿孔误诊原因,以降低小儿急性阑尾炎穿孔的误诊率,减少术后并发症及阑尾炎穿孔误诊的发生,增加医患之间信任度,减少医患矛盾。方法回顾本院近3年收治的87例急性阑尾炎患儿中13例误诊病例的临床资料,对病史、体征、相关检查结果、手术所见,进行回顾性统计研究,分析误诊原因。结果在13例误诊病例中,入院疑似诊断为阑尾炎5例、后经手术证实为阑尾穿孔;入院诊断为其他疾病,经过治疗无好转,从而行必要的手术探查证实为阑尾穿孔8例。结论对小儿急性阑尾炎穿孔的临床症状、特点,缺乏足够的认识,腹部体征的掌握不准确及过多依赖辅助检查是误诊的主要原因。     

Hepatic hydatid cyst presenting as cutaneous abscess

Hydatidosis is a parasitic zoonotic echinococcal infection that affects both humans and other mammals. These diseases are common worldwide but particularly common in sheep and cattle farming regions. Anaphylaxis mediated by IgE is a serious complication of surgery or trauma which necessitates more aware of its clinical features, diagnosis and management. It is important to make a preoperative diagnosis based on the typical image findings, so that particular precaution can be taken not to rupture the lesion. A woman presented with a right upper quadrant cutaneous abscess. USG reveals multiple cystic lesions in the liver arranged in cartwheel appearance, CT disclosed a cystic lesions having daughter cysts, marginal calcifications, marginal enhancement and contiguous abdominal wall abscess, which led to a diagnosis of complicated hepatic hydatid cysts with abdominal wall abscess formation. FNAC showed scolices surrounded by chronic inflammatory cells. Abdominal wall abscess may be a presentation of hydatid liver disease.     

阑尾周围脓肿误诊为卵巢肿瘤行手术治疗的经验教训

目的提高对阑尾周围脓肿的诊断与鉴别诊断水平。方法回顾分析26例阑尾周围脓肿误诊为卵巢肿瘤行手术治疗的原因及预防措施。结果26例患者术前均误诊为卵巢肿瘤行手术治疗,术中发现为阑尾周围脓肿行脓肿引流或阑尾切除治愈,其中4例患者术中损伤肠管行肠修补、局部引流而治愈（1例并发肠瘘）。结论阑尾周围脓肿误诊为卵巢肿瘤而手术,易导致严重并发症。术前仔细询问病史,细致体格检查,全面分析辅助检查结果,认真做好诊断和鉴别诊断,能减少或避免阑尾周围脓肿的误诊误治。     

Giant urethral diverticulum calculus presenting as scrotal abscess

We report herein a patient with a urethral calculus associated with urethral diverticulum. A 39-year-old man presented with scrotal swelling and acute retention of urine. Computed tomography of the pelvis and cystoscopy demonstrated a giant calculus in the proximal penile urethra. Emergency in-situ lithotripsy was performed. Complete stone clearance was achieved and a large urethral diverticulum was encountered. The rare occurrence of urethral diverticulum and associated stone disease were discussed.     

腰椎不稳合并椎间盘突出的临床分析

目的观察腰椎不稳合并椎间盘突出的手术疗效。方法对23例腰椎不稳合并椎间盘突出患者行椎弓根内固定、髓核摘除、椎间植骨手术治疗。结果23例患者术后骨性融合率97．2％,临床症状采用日本矫形外科学会（JOA）下腰痛评分标准评价,临床优良率89．2％,1例出现神经根激惹。本组无内固定松动、断裂。结论腰椎不稳合并椎间盘突出行椎弓根内固定、髓核摘除、椎间植骨有良好近期疗效,远期疗效有待进一步观察。     

Covert lung abscess as a cause of atrial arrhythmia: case report

Atrial arrhythmia is common in clinic. Recently, it, was revealed that ectopic impulses originating in sleeve muscles around the orifices of pulmonary veins (PVs) were deemed to be one of the most important reasons that trigger or drive atrial arrhythmia, which was called myocardial sleeve related arrhythmia. Electrical isolation by radiofrequency ablation is becoming highlight and proved to be an effective method for the arrhythmia.     

Amyand's hernia with scrotal abscess presenting as acute scrotum

Amyand's hernia is a rare form of inguinal hernia in which an inflamed appendix is incarcerated in a hernial sac. The clinical presentation of Amyand's hernia varies, depending on the extent of inflammation involved in the hernial sac and the presence or absence of a scrotal abscess. If a scrotal abscess is present, this usually indicates that the appendix in the hernial sac is perforated. However, without the availability of computed tomography (CT) scans, the condition is often preoperatively misdiagnosed as a strangulated inguinal hernia. We describe a rare case of a 64-year-old man who presented at our emergency room complaining of scrotal swelling and pain. Diagnosis of Amyand's hernia with a scrotal abscess was confirmed preoperatively by CT scan.     

Retroperitoneal fungal abscess presenting as superior mesenteric artery syndrome.

We report a patient two years post-cholecystectomy for gallstone pancreatitis presenting with superior mesenteric artery syndrome due to a retroperitoneal fungal abscess.     

Atrial septal defect presenting as recurrent primary amoebic lung abscess

A middle-aged female with an atrial septal defect (secundum type) presented with a primary pulmonary amoebic abscess. She was successfully treated with antiamoebic therapy. One year later she presented with a similar lung abscess which again responded to antiamboebic treatment. Attention is drawn to the fact that a patient with a left to right shunt can present with a recurrent rare primary parasitic infection of the lung.