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Chest x-ray. A): Large hiatal hernia with a probably ectopic paragastric air bubble (black arrow). Left pleural effusion. CT: coronal (B) and axial (C) views: paraesophageal gastric herniation with organoaxial volvulus. Intrathoracic disposition of the fundus and body with normal location of the gastroduodenal junction. The herniated gastric walls present with concentric thickening due to edema and there is little contrast uptake due to ischemic damage. Multiple ectopic gas bubbles (white arrow) and fluid in the hernial sac due to visceral perforation are visible.
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Context 1
... no peritoneal irritation data. A strictured lesion in the cecum was encountered through colonoscopy. Biopsies were taken that only revealed nonspecific chronic inflam- mation. An abdominal tomography scan identified a 5 cm tumor at the level of the cecum with thickening of the wall in the terminal ileum and the cecum, along with adenopathies ( fig. 1). Because there was clinical suspicion of neoplasia, the patient underwent a laparoscopic right hemicolectomy. The intraoperative finding was peritumoral adenomegalies larger than 1 cm. During macroscopic exami- nation, a cecal appendix measuring 5 x 1.5 cm was observed with thickened walls and fibroadipose obliteration of the lumen, ...Context 2
... are the characteristics that make it necessary to consider inflammatory bowel disease, inflammatory pelvic disease, and tuberculosis in the differential diagnosis. The infec- tion can simulate malignancy due to its capacity to invade adjacent tissue and form masses. 4---6 Up to 80% of the cases occur in women and 60% are associated with the Figure 1 Abdominal tomography scan using contrast medium showing a tumor, 5 cm in diameter, at the level of the cecum, with thickening of the wall in the terminal ileum and the cecum; adenopathies are also identified. ...Similar publications
La hernia de Spiegel supone alrededor del 1 % de todas las hernias de pared abdominal. La presencia de una apendicitis por incarceración apendicular en una hernia de Spiegel es un caso excepcional.
Citations
Aim. To demonstrate a clinical case of acute gastric volvulus and to give a brief literary review of the disease. Materials and methods. A 12-year-old child who has applied for acute abdominal pain, repeated vomiting, with typical signs of obstruction of the upper gastrointestinal tract.Results. After the clinical and instrumental examination, the child was urgently operated. With laparotomy, the patient was diagnosed with acute secondary gastric volvulus with necrosis and perforation, against the background of a true left-sided diaphragmatic hernia, severe pancreatic lesions. The patient had a suturing of the stomach defect, diaphragm plastic, thorough sanitation and drainage of the abdominal cavity. The postoperative period was very difficult, due to complications of the underlying disease. As a result of the treatment, the patient was discharged in satisfactory condition.Conclusion. The clinical case confirms the severity of this nosology, accompanied by serious consequences. In our case, the patient recovered, but diagnostic errors and developing complications in acute gastric lavage often lead to death.
Gastric volvulus is a rare entity defined as an abnormal rotation of the stomach around itself. Itis a diagnosis of exclusion; the clinical index of suspicion is always low and is mostly diagnosedon imaging or on the surgery table. When it occurs, it is an emergency due to the risk ofstrangulation and consequent gangrene of the stomach. Mesentero-axial (MA) gastric volvuliconstitute one-third of all cases. Here, we are present an interesting case of acute MA gastricvolvulus diagnosed with imaging and treated subsequently.
