ABSTRACT
A 26-year-old man who was previously well presented to the emergency in septic shock. He had a preceding history of fever, right upper abdominal pain and jaundice. On examination, there was tenderness over the right hypochondrium and epigastrium, without features of generalised peritonitis. His blood tests were suggestive of sepsis with deranged liver function tests. CT scan of the abdomen showed multiples abscesses in various segments of the liver and a thrombus in the inferior venacava, without any other intraabdominal focus of infection. The abscess was aspirated under sonographic guidance, and the cultures grew Streptococcus constellatus species of S. milleri group (SMG). He received crystalline penicillin, based on culture sensitivity and underwent drainage of the abscess. There was a clinical improvement and he was subsequently discharged in a stable condition. On 3 months follow-up, there was a complete resolution of the liver abscess and normalisation of the liver function tests.
Subject(s)
Liver Abscess, Pyogenic/diagnosis , Streptococcal Infections/diagnosis , Streptococcus constellatus/isolation & purification , Abdominal Pain/etiology , Adult , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Diagnosis, Differential , Drainage , Fever/etiology , Humans , Jaundice/etiology , Liver Abscess, Pyogenic/complications , Liver Abscess, Pyogenic/diagnostic imaging , Liver Abscess, Pyogenic/therapy , Male , Streptococcal Infections/complications , Streptococcal Infections/diagnostic imaging , Streptococcal Infections/therapy , Tomography, X-Ray ComputedSubject(s)
Chondrosarcoma, Mesenchymal/diagnosis , Iliac Vein/diagnostic imaging , Iliac Vein/pathology , Vascular Neoplasms/diagnosis , Adult , Chondrosarcoma, Mesenchymal/drug therapy , Diagnosis, Differential , Fatal Outcome , Female , Humans , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Vascular Neoplasms/drug therapyABSTRACT
Rectourethral fistula is an uncommon but devastating condition. Traumatic rectourethral fistula is still uncommon and repair of traumatic rectourethral fistula involves a complex procedure. Most of the urologists would prefer to repair the fistula through perineal route especially when urethral reconstruction is also required. The repaired ends of the fistula are separated with various interposition flaps and grafts in order to prevent recurrence. Gracilis interposition muscle flap is commonly used. We describe the first case of traumatic rectourethral fistula repair in a 45-year-old man using interposition of a porcine small intestinal submucosal (Biodesign™ (Surgisis(®)) graft.
ABSTRACT
Ectopic pancreas rarely produces symptoms and often goes undetected. We report a 28-year-old man with ectopic pancreas presenting with symptoms and radiological findings mimicking superior mesenteric artery syndrome. Excision of the lesion and duodeno-jejunostomy led to relief.