[Epiploic appendagitis: a rare cause of acute abdomen]. / Appendagite épiploïque: cause rare d'abdomen aigu.

Epiploic appendagitis is a rare cause of acute abdomen. It can mimic other inflammatory processes such as diverticulitis or appendicitis. Diagnosis is based on CT scan. Medical management is the approach of choice in the absence of complications.

Things Are Not Always What They Seem: Two Cases of Child Maltreatment Presenting With Common Pediatric Chief Complaints.

We describe 2 cases of child maltreatment who presented as common pediatric conditions: preseptal cellulitis and gastroenteritis. The first case is an 8-year-old girl who presented with progressive right eye pain, swelling, and discharge. She was initially treated for preseptal cellulitis, but eye cultures ultimately grew Neisseria gonorrhoeae. Further investigation revealed sexual abuse by a male family member. The second case is a 2-year-old previously healthy girl who presented with 6 hours of emesis, lethargy, and abdominal pain. Initially attributed to viral gastroenteritis, her serum blood urea nitrogen and creatinine were above what was expected for her clinical course, and she later developed signs of peritonitis. She was ultimately found to have a large bladder wall defect secondary to inflicted blunt abdominal trauma. These cases are presented to emphasize the need for pediatricians to consider child abuse even when patients present with common pediatric complaints.

A 17-Year-Old Boy With High-Functioning Autism, Gastrointestinal Illness, and Seizures.

A healthy 17-year-old boy with a high-functioning pervasive developmental disorder presented to the emergency department after having a 4-minute episode of seizure-like activity in the setting of presumed viral gastroenteritis. Within an hour of emergency department arrival, he developed a forehead-sparing facial droop, right-sided ptosis, and expressive aphasia, prompting stroke team assessment and urgent neuroimaging. Laboratory results later revealed a serum sodium of 119 mmol/L. Neurologic deficits self-resolved, and a full physical examination revealed diffuse abdominal tenderness in the lower abdomen with rebound tenderness in the right-lower quadrant. The patient was admitted to the PICU for electrolyte management and monitoring. A computed tomography (CT) scan of the abdomen obtained the following morning revealed the patient's final diagnosis.

Intestinal necrosis due to norovirus enteritis.

Noroviruses cause epidemic and sporadic acute gastroenteritis in both children and adults. We report a rare case of intestinal necrosis due to norovirus gastroenteritis in a healthy adult. A 47-year-old man presented with worsening abdominal pain, diarrhea, vomiting, and abdominal fullness. Physical examination revealed abdominal distension and diffuse tenderness. Contrast-enhanced computed tomography revealed intestinal distention, pneumatosis, and portal venous gas, findings suggestive of intestinal necrosis. Norovirus genome was detected in his stools using the RT-PCR method. Upon laparotomy, a segment of necrotic bowel 170 cm from the ileocecal valve was identified, and the lesion was resected with an end ileostomy. The patient's recovery was uneventful, and he was transferred to another hospital on the 7th post-operative day. Ileostomy closure was performed one month after the first surgery at the transfer hospital. He had no recurrent episodes.

A common case of gastroenteritis in a child followed by an axial torsion of Meckel diverticulum: a rare and unusual complication.

A 1-year-old boy presented at our hospital with common gastroenteritis symptoms such as fever, vomiting and diarrhoea. Clinical and laboratory findings were normal. An emergency ultrasound examination was performed and excluded abdominal complications. After 2 days of complete regression of symptoms, the patient began to vomit again, diarrhoea stopped with a sudden worsening of clinical conditions. Laboratory and radiological findings showed signs of an acute abdomen with differential diagnosis between an infectious and an obstructive cause. Owing to the rapid and progressive toxic condition, an emergency laparoscopy was performed. An axial torsion of a swollen and gangrenous Meckel's diverticulum was detected.

Diferentes formas de presentación de una misma entidad clínica: gastroenteritis eosinofílica / Distinct clinical presentations of a single medical entity: eosinophilic enteritis

La enteritis eosinofílica es una rara enfermedad caracterizada por la infiltración de cualquier tramo del tracto gastrointestinal, desde el esófago hasta el recto, por células eosinófilas, aunque el estómago y el intestino delgado son las estructuras más frecuentemente afectadas. Su etiopatogenia se desconoce, y en muchas ocasiones se relaciona con antecedentes personales o familiares de atopia. Las manifestaciones clínicas varían en función de las capas afectadas; así, la presentación como síndrome de malabsorción digestiva, estenosis intestinal o ascitis dependerá de si la eosinofilia predomina en la mucosa, muscular o serosa, respectivamente. Se presentan 3 casos clínicos con diferentes formas de presentación de gastroenteritis eosinofílica

Eosinophilic enteritis is a rare disease characterized by eosinophilic infiltration of different wall layers of the gastrointestinal tract, from the esophagus to the rectum, by eosinophilic cells. The most frequently affected structures are the stomach and small intestine. The pathogenesis of eosinophilic enteritis is not well understood and is often related to a personal or familial history of atopy. Clinical symptoms depend on the affected layers. Thus malabsorptive syndrome, intestinal strictures or ascites depend on a mucosal, muscular or serosa layer infiltration, respectively. We present three cases of eosinophilic gastroenteritis with distinct clinical presentations

Eosinophilic gastroenteritis presenting as acute abdomen.

Many causes of acute abdomen are diagnosed on computed tomography (CT). We present two cases of eosinophilic gastroenteritis that showed mural thickening of the stomach, duodenum, and/or proximal jejunum on CT. The correct diagnosis was made by checking the eosinophil count, and, in one case, unnecessary surgery was avoided.

Recurrent acute pancreatitis due to eosinophilic gastroenteritis. Case report and literature review.

CONTEXT: Eosinophilic gastroenteritis is characterized by eosinophilic infiltration of any gastrointestinal segment from the esophagus to the rectum, most commonly, the stomach and the duodenum. Clinical manifestations range from non-specific gastrointestinal complaints to more specific symptoms such as protein-losing enteropathy, malabsorption, luminal obstruction and eosinophilic ascites. CASE REPORT: We report the case of a 35-year-old woman with recurrent gastric outlet obstruction due to eosinophilic infiltration of the stomach and the duodenum. There was a history of two episodes of acute pancreatitis as well as eosinophilia of bone marrow and ascites. CONCLUSIONS: Although unusual, eosinophilic gastroenteritis may be complicated by symptomatic acute pancreatitis. Seven previous cases have been reported in the literature, and a comparison was made. The pancreatitis is probably due to duct obstruction, but some cases of eosinophilic gastroenteritis have pancreatic tissue eosinophilia. Most cases respond to medical treatment, and surgery is usually unnecessary.

[Clinical experience and current aspects of treatment of abdominal actinomycosis].

Actinomycosis is an uncommocn inflammatory entity caused by the universally distributed anaerobic bacterium, Actinomyces Israeli. The most common sites of the abdominal form of the disease are the transverse colon and the cecum with the appendix. Actinomycosis can mimic other abdominal diseases as diverticulitis, abscesses, inflammatory bowel disease and malignant tumors, presenting a diagnostic challenge. In most cases surgical intervention is performed. Antibiotic administration should be a part of the complex treatment of the disease.

Eosinophilic gastroenteritis mimicking acute appendicitis.

Eosinophilic gastroenteritis is a rare entity that can be treated successfully with glucocorticoid therapy if the appropriate diagnosis is made. However, it may present with symptomatology mimicking acute surgical conditions. We present the case of a 26-year-old man who presented with diffuse epigastric pain, nausea, vomiting, and diarrhea. Extensive workup including upper endoscopy and imaging study revealed gastritis with ulcer and ascites. The patient developed right lower quadrant pain with localized peritonitis and leukocytosis. He underwent appendectomy and small bowel biopsy. Pathology revealed eosinophilic cellular infiltrate of both the appendiceal and small intestinal wall. The unique features of this condition are reviewed and surgical approaches are discussed.

Eosinophilic gastroenteritis presenting as an obstructing cecal mass--a case report and review of the literature.

The causes of colonic obstruction are protean. Less common is the diagnosis of eosinophilic gastroenteritis (EGE). EGE is more common as a cause of more proximal bowel obstruction. To our knowledge, this case represents one of the only reported cases of such a lesion causing obstruction in the cecum.

[Hypersensitivity vasculitis causing an acute abdomen]. / Hypersensitivitätsvaskulitis als Ursache eines akuten Abdomens.

The members of a family of four persons suffered acute gastroenteritis after eating a meal consisting of chicken. While three of them recovered rapidly, the 18-year old son developed an acute abdomen which had to be treated surgically and led to a complicated stay at the intensive care unit. Intraoperatively, a mild insignificantly inflamed appendix and an obscure segmental inflammatory process of the small bowel with local peritonitis were seen; this required an appendectomy and a peritoneal lavage. The development of bacterial peritonitis with multiple organ dysfunction required several surgical revisions with an open abdominal toilet treatment. Histological examination of the resected appendix specimen showed a severe primary fibrinoid necrotizing vasculitis with epitheloid-granulomatous reaction. Diseases such as Panenteritis nodosa, Wegener's disease and Churg-Strauss's syndrome were excluded by negative serology. By a process of exclusion, a hypersensitivity vasculitis was diagnosed and treated successfully with a high-dose cortisone regime.

[Eosinophilic gastroenteritis. A report of a clinical case]. / Gastroenterite da eosinofili. Descrizione di un caso clinico.

Eosinophilic gastroenteritis is an inflammatory pathology with an unknown etiology characterised by the presence of an eosinophil infiltrate on the intestinal wall. The symptoms (bleeding, occlusion, fistulae, etc.) may lead to surgery even if the best treatment is medical. Endoscopic examination with specific multiple biopsies is indispensable for the diagnosis of the pathology. The authors report the case of a 2-month-old baby suffering from intermittent pyloric obstruction secondary to eosinophilic gastroenteritis which was wrongly interpreted as hypertrophic stenosis of the pylorus.

Eosinophilic gastroenteritis: diagnostic laparoscopy.

We report a case of eosinophilic gastroenteritis. The initial diagnosis was made by laparoscopic inspection of the lesion during exploration of the abdomen. We immediately carried out an extracorporeal resection using a laparoscopic surgical technique. Pathological examination confirmed our diagnosis. Eosinophilic gastroenteritis is an infrequent condition, and this definitive description of a lesion as seen in the magnified field of the laparoscope demonstrates the effectiveness of laparoscopy as a diagnostic tool to diagnose the cause of ill-defined abdominal discomfort with inconclusive laboratory findings that formerly would have needed a more surgically aggressive laparotomy to resolve.