Clinical, laboratory and ultrasonography features of proven human fascioliasis.
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Abstract:
Examination of twenty parasitologically proven human cases of fascioliasis showed the following clinical, laboratory and ultrasonography results: (1) Both sexes are susceptible to fascioliasis. The smallest one was a child 3-year old. (2) The most important clinical manifestations are: a- abdominal distention and flatulence (30%), b- right upper quadrant pains (25%), colicky abdominal pains (25%), d- pallor (25%), and etympanitic abdomen (25%). Nevertheless, 15% of the patients showed no symptoms. (3) The most significant items in the CBC and liver function tests are: a- significantly high eosinophilia, b-high alkaline phosphatase, and c- low haemoglobin. Besides, two fascioliasis patients had high serum bilirubin. (4) Ultrasonography diagnosed only nine fascioliasis patients (45%). The result was critically discussed.Keywords:
Pallor
Abdominal ultrasonography
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Examination of twenty parasitologically proven human cases of fascioliasis showed the following clinical, laboratory and ultrasonography results: (1) Both sexes are susceptible to fascioliasis. The smallest one was a child 3-year old. (2) The most important clinical manifestations are: a- abdominal distention and flatulence (30%), b- right upper quadrant pains (25%), colicky abdominal pains (25%), d- pallor (25%), and etympanitic abdomen (25%). Nevertheless, 15% of the patients showed no symptoms. (3) The most significant items in the CBC and liver function tests are: a- significantly high eosinophilia, b-high alkaline phosphatase, and c- low haemoglobin. Besides, two fascioliasis patients had high serum bilirubin. (4) Ultrasonography diagnosed only nine fascioliasis patients (45%). The result was critically discussed.
Pallor
Abdominal ultrasonography
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Objective.
—To determine the ability of ultrasonography to detect appendicitis and to identify other conditions responsible for symptoms in children with acute abdominal pain.Design.
—Cohort study. The accuracy of ultrasonographic results was assessed in relation to final diagnoses established by surgery or by composite clinical data and follow-up.Setting.
—Metropolitan, pediatric hospital; ambulatory and hospitalized patients.Patients.
—Consecutive sample of 178 pediatric patients who were referred for ultrasonography because of suspected acute appendicitis, but in whom the diagnosis could not be definitively established by clinical criteria.Results.
—Appendicitis was proven at surgery in 38 patients. Ultrasonography demonstrated the findings of appendicitis (noncompressible appendix with or without concomitant periappendiceal fluid collection or appendicolith) in 31 (82%) of these patients. Among the 140 children without appendicitis, other specific diagnoses were established by clinical, laboratory, and radiologic findings in 58 patients (including gynecologic diseases in 25, gastrointestinal tract abnormalities in 17, renal diseases in six, and extra-abdominal disease in 10). Ultrasonography aided in the diagnosis of other conditions in 34 (59%) of these 58 patients. No definitive clinical diagnosis was established in the remaining 82 patients. There were no false-positive results of ultrasonography.Conclusion.
—Approximately half of children referred for suspected appendicitis will have a final diagnosis of abdominal pain of unknown origin. In the remainder, ultrasonography is useful, both to establish the diagnosis of appendicitis and to aid in diagnosing other causes of acute abdominal pain. (JAMA. 1991;266:1987-1989)Abdominal ultrasonography
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Introduction: Ultrasonography has established itself as an invaluable tool in surgery. In surgical practice, abdominal pain is perhaps the most common symptom encountered and almost in every case of abdominal pain surgeon prefers to use the ultrasound to confirm the diagnosis. Although physical examination of the patient is the most important part in proper diagnosis many a time some positive help is required in the form of investigations especially ultrasonography. Methods: This was a study of hundred patients carried out at a tertiary care hospital admitted with complaints of severe abdominal pain except those with a history of trauma or with a history of chronic abdominal pain. Clinical history, physical examination, ultrasonography, per operative findings and histo-pathological examination were used to come to a final conclusion. Result: In this study ultrasonography was diagnostic in 78% of patients. Two patients were misdiagnosed and in 20 patients other investigations were required for the confirmation of diagnosis. The sensitivity and specificity of ultrasound in diagnosing acute appendicitis, renal calculus, liver abscess, mesenteric lymphadenitis, acute pancreatitis and ovarian cyst was 100% and in calculus cholecystitis it was 93.75% and 100% respectively. Conclusion: Ultrasonography is superior in organ system imaging. It helps in showing organ specific lesions and its accurate measurement which is helpful in follow up and response to treatment. Ultrasonography is also helpful in diagnosing alternative disease and to reduce negative laparotomy rate.
Acute abdomen
Abdominal ultrasonography
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The medical records were reviewed for 109 children (0-15 years) who were investigated by abdominal ultrasonography as part of the evaluation of recurrent abdominal pain. We characterised this group of children in an attempt to localise the characteristics that would predict abnormal findings by abdominal ultrasonography. We conclude that neither location, frequency or duration of pain, nor sex nor age have any predictive value. All abnormal findings seen by abdominal ultrasonography could have been revealed by a carefully taken history, thorough clinical examination and commonly performed laboratory tests, such as urine analysis. We recommend that abdominal ultrasonography should only be used in the evaluation of recurrent abdominal pain in children if there are other characteristics, such as a history of cystitis.
Abdominal ultrasonography
Medical History
Medical record
Abdominal ultrasound
Clinical history
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A geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain and the interval development of epigastric and left upper quadrant abdominal pain. He was admitted to the hospital for evaluation and serial examinations. Mild diffuse abdominal tenderness developed overnight, and computed tomography of the abdomen revealed a perforated appendix with suppuration. An appendectomy was done immediately. The diagnosis of appendicitis in the geriatric patient is occasionally difficult because of atypical and sometimes misleading physical findings.
Epigastric pain
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An unusual case of hepatic hydatid cyst in a 27-year old female is reported. The patient had abdominal distention of 10-year duration, pain, pallor of mucous membranes, and was grossly wasted. Ultrasonography revealed a large hydatid cyst that covered most of the abdomen. A successful surgical intervention was performed and 24 litres of hydatid fluid drained.
Pallor
Hydatid cyst
Abdominal ultrasonography
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Triclabendazole
Abdominal ultrasonography
Fasciola
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Introduction: Abdominal Ultrasonography (USG) is the most commonly used method for diagnosing acute appendicitis the most common surgical cause of acute abdomen. In this study, we observed the reliability of USG for diagnosing acute appendicitis. Objectives: To evaluate the role of ultrasonography in the diagnosis of acute appendicitis. Methods: In this study, we performed abdominal USG of 100 patients admitted with lower right abdominal pain and diagnosed as acute surgical abdomen according to the physical examination and laboratory findings. These patients were surgically treated by appendecectomy, and excised specimens were sent for histopathological examination. Results: One hundred patients were assessed in this study. Out of them 82.0% patients had acute appendicitis and diameter of their appendices were more or equal to 6 mm. Twenty nine percent of the patients were below 21 years of age. Intraluminal fluid was present in 81% of patients and peri-appendicular fluid was present in 66.7% of patients. Leucocytosis was present in 49% of the cases and neutrophilia in 84% of the cases. All of the patients presented with lower abdominal pain with migration of pain in 52% cases and they had right iliac fossa tenderness. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy rate of ultrasonography was 76.8%, 88.9%, 96.9%, 45.7% and 79.0%, respectively. 45 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: Acute appendicitis is a common indication for emergency abdominal surgery. Proper clinical assessment is the mainstay of diagnosis in acute appendicitis and addition of routine abdominal ultrasound by graded compression technique can improve the diagnostic accuracy and adverse outcome. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22904 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014
Iliac fossa
Abdominal ultrasonography
Acute abdomen
Neutrophilia
Palpation
Alvarado score
Acute abdominal pain
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A case of CAA in a 68-year-old male patient is reported. The patient had vague abdominal pain for 1 year. Physical examination revealed a pulsatile abdominal mass on the epigastrium. Abdominal ultrasonography and visceral arteriography confirmed the diagnosis of CAA. Aneurysmectomy with direct implantation was performed transabdominally.
Pulsatile flow
Abdominal mass
Abdominal ultrasonography
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