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PubMed2006

Cystic lymphangioma of Retzius space manifested as acute abdomen.

The authors describe a rare pediatric case of cystic lymphangioma arising from the Retzius space. A 9-year-old boy underwent an appendectomy in a nearby hospital after a sudden onset of severe hypogastralgia. When laparotomy revealed a retroperitoneal mass, he was referred to our hospital. After diagnosis of a multicystic mass in the Retzius space, extirpation of the cystic lesion was performed. Histological evaluation of the resected specimens revealed cystic lymphangioma. The patient has been free of symptoms for 6 years since the operation.

Abdomen, Acute↗
PubMed1993

[Septic shock with acute abdomen in idiopathic hemochromatosis].

The case of a patient with abdominal crisis and shock without any discernible origin who died 36 hours after hospital admission despite maximal therapy is described. Gram-negative sepsis, peritonitis and haemochromatosis with hepatic siderosis was the post-mortem diagnosis. We consider spontaneous peritonitis arising from translocation of normal intestinal flora (E. coli) through the intact wall of the gut combined with the impaired ability of the reticulo-endothelial system to remove endotoxin to be the causative factors. It is unknown whether the adrenal insufficiency due to siderophilic adrenal hypophysis and adrenal glands contributed to the fulminant course of the disease. Undiagnosed liver cirrhosis and especially haemochromatosis should therefore be included in the differential diagnostic considerations in patients presenting with these symptoms, and in whom no obvious cause for a septic focus can be found.

Abdomen, Acute↗
PubMed1995

[The torsion of an accessory liver lobe as the rare cause of acute abdomen].

HISTORY AND CLINICAL FINDINGS: A 35-year-old woman was admitted because of cramp-like abdominal pain with nausea and vomiting since the previous evening. There was no history of previous abdominal symptoms of jaundice. Physical examination suggested atypical appendicitis with pain on palpation of the right mid-abdomen, localized paraumbilical guarding tension and diffuse pressure pain, more on the right, on rectal examination. Body temperature was 37.8 degrees C. EXAMINATIONS: There were leucocytosis (12000/microliters) and abnormally high liver function tests (GOT 95 U/l, GPT 110 U/l, LDH 368 U/l, alkaline phosphatase 335 U/l). Ultrasonography of the abdomen demonstrated free fluid in the Douglas pouch. TREATMENT AND COURSE: Laparotomy, performed because atypical appendicitis was suspected, revealed a torsioned pedicle of a severely bleeding accessory liver lobe positioned near the gall bladder bed. The accessory lobe was removed and the patient became symptom-free. This is the 15th reported case of clinical manifestations of an accessory liver lobe.

Abdomen, Acute↗
PubMed1990

Management of the acute abdomen. A test of judgement.

Most patients with abdominal pain do not need an operation, but identification of those who do is an important role for the primary care physician. A carefully performed physical examination in conjunction with selected laboratory tests usually establishes the general diagnosis and allows the physician to decide among management alternatives. These include early operation, observation, or further evaluation using special studies.

Abdomen, Acute↗