Synchronous presentation of acute acalculous cholecystitis and appendicitis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute acalculous cholecystitis is traditionally associated with elderly or critically ill patients.</p> <p>Case presentation</p> <p>We present the case of an otherwise healthy 23-year-old Caucasian man who presented with acute right-sided abdominal pain. An ultrasound examination revealed evidence of acute acalculous cholecystitis. A laparoscopy was undertaken and the dual pathologies of acute acalculous cholecystitis and acute appendicitis were discovered and a laparoscopic cholecystectomy and appendectomy were performed.</p> <p>Conclusion</p> <p>Acute acalculous cholecystitis is a rare clinical entity in young, healthy patients and this report describes the unusual association of acute acalculous cholecystitis and appendicitis. A single stage combined laparoscopic appendectomy and cholecystectomy is an effective treatment modality.</p

A Case of Primary Paraganglioma that Arose in the Pancreas: the Color Doppler Ultrasonography and Dynamic CT Features

Paragangliomas rarely originate from the pancreas and they are characterized on imaging studies as well-marginated, hypervascular masses with cystic areas. We herein report on a case report of pancreatic paraganglioma in a 57-year-old woman, which was confirmed on pathology. Color Doppler ultrasonography and dynamic CT demonstrated a well-demarcated, extremely hypervascular mass with prominent intratumoral vessels and early contrast filling of the draining veins from the mass. Endoscopic retrograde cholangiopancreatography showed that the main pancreatic duct was displaced and mildly dilated

Acute acalculous cholecystitis during the course of primary Epstein-Barr virus infection: a new case and a review of the literature

OBJECTIVE: The aim of this study was to describe a case of acute acalculous cholecystitis occurring in the course of primary Epstein-Barr virus (EBV) infection. METHODS: The clinical features of the case were analyzed and compared to those of three other similar cases reported in the international literature. RESULTS: All cases occurred in European females with cholestatic hepatitis, presented with gallbladder wall thickening, and recovered uneventfully without the need for surgical intervention. CONCLUSIONS: Acute acalculous cholecystitis may occur during the course of acute EBV infection, especially in patients with cholestatic hepatitis. Clinicians should be aware of the possible involvement of the gallbladder during EBV infection to avoid unnecessary invasive procedures or the overuse of antibiotics

Case Report: De Garengeot’s hernia. Appendicitis within femoral hernia. Diagnosis and surgical management

Introduction: Abdominal wall hernias remain as one of the most common problems that the general surgeon has to treat. Although usually straightforward and easy to diagnose by the experienced hands, obstacles appear when contents of the hernia sac include organs. The presence of the appendix inside a femoral hernia (De Garengeot’s hernia) is a rare entity which represents multiple challenges, both diagnostic and therapeutic. Case presentation: We present a case of a 36-year-old female patient who originally presented to the ED with abdominal/groin pain and a new onset of right inguinal swelling. Discussion: Contrary to the usual presentation, where an appendix is incidentally found during hernia repair, we were able to make the diagnosis by CT scan before surgery. This placed us on an ideal standpoint to plan the surgical management. We approached our case laparoscopic first, where a distally gangrenous appendix was reduced intraabdominally. As purulent exudates were present on hernial sac, femoral hernia repair was achieved with McVay techniche. Conclusion: Although rare, the finding of a strangulated appendix within a femoral hernia represents a challenge. Here we present a case that may guide the surgeon who faces a similar case in the future