ABSTRACT
Chilaiditi sign and syndrome are uncommon conditions and often misdiagnosed. They are clinically significant, however, because they can result in a range of complications, including bowel volvulus, perforation and obstruction. When patients are symptomatic, treatment is usually conservative and surgery is rarely indicated unless there is a suspicion of ischaemia, or if conservative management does not resolve other signs and symptoms. This article describes Chilaiditi sign and syndrome, and presents four case studies to illustrate the relevant signs and symptoms.
Subject(s)
Chilaiditi Syndrome/diagnosis , Adult , Aged , Chilaiditi Syndrome/diagnostic imaging , Female , Humans , Male , Symptom Assessment , Young AdultABSTRACT
We present a case of a 55-year-old male with a history of urethroscopic calculus removal who later developed urinary tract infection (UTI), complicated by periurethral abscess formation with osteomyelitis of the inferior pubic ramus and a urethrocutaneous fistula after surgical drainage of the abscess. UTI with periurethral abscess and urethrocutaneous fistula (watering-can perineum) is a rare complication of UTI. A periurethral abscess with pubic osteomyelitis has not been previously reported.
Subject(s)
Abortion, Incomplete/diagnostic imaging , Decapitation/diagnostic imaging , Prenatal Injuries/diagnostic imaging , Ultrasonography, Prenatal/methods , Abortion, Incomplete/etiology , Decapitation/etiology , Diagnosis, Differential , Female , Humans , Middle Aged , Pregnancy , Prenatal Injuries/etiologyABSTRACT
BACKGROUND: Omental cyst and omental torsion both are uncommon but important causes of acute abdomen with a difficult clinical diagnosis due to nonspecific features. Here we report a case of an eight year old child with acute abdominal pain referred for USG and CT scan which revealed two cysts in greater omentum leading to secondary omental torsion. CASE REPORT: An eight year old male child presented to casualty with severe pain abdomen since 1 day. There was no history of vomiting or altered bowel habits. The patient was febrile with tachycardia on arrival. On examination rigidity and tenderness all over abdomen were present. Serum amylase was within normal range. USG and CECT abdomen were done subsequently. USG showed two well defined cystic lesions in lower abdomen with presence of some internal echogenic debris and calcified foci in their dependent part. There was also presence of omentum with a whirl of blood vessels seen along anterior abdominal wall leading to these lesions suggesting torsion. On colour Doppler the presence of blood flow within the whirl of vessels was seen. Mild amount of free fluid was also seen in the peritoneal cavity. On CECT abdomen the findings of omental cysts and torsion of greater omentum with free fluid in abdomen were confirmed. The cysts measured 60×55 and 65×55mm on CT. The patient was taken for an emergency laparotomy for indication of acute generalized peritonitis. Two large omental cysts were found in the pelvic cavity along with torsed greater omentum along with 150 ml of hemorrhagic fluid in peritoneal cavity. The cysts and twisted necrotic part of the greater omentum were excised at surgery. No postoperative complications were observed. Histopathologic examination was suggestive of lymphangioma of omentum. CONCLUSIONS: Lymphangioma of the omentum is an not very uncommon however acute presentation with omental torsion and infarction is an unusual entity. Optimal utilization of preoperative imaging with USG, Doppler and contrast enhanced CT scan can provide correct diagnosis.
