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Quadrant Pain (quadrant + pain)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Quadrant Pain

  • right upper quadrant pain
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  • upper quadrant pain
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    Selected Abstracts

    Routine versus Selective Abdominal Computed Tomography Scan in the Evaluation of Right Lower Quadrant Pain: A Randomized Controlled Trial

    ACADEMIC EMERGENCY MEDICINE, Issue 2 2007
    Christopher C. Lee MD
    Objectives To determine the role of abdominal computed tomography (CT) imaging in patients with right lower quadrant (RLQ) pain. The authors hypothesized that selective use of abdominal CT would reduce imaging without increasing the rates of negative appendectomy and perforated appendicitis. Methods A prospective randomized clinical trial was conducted in a community teaching emergency department. Adult patients with acute RLQ abdominal pain with suspected acute appendicitis were included. Patients were randomized to mandatory (all patients) or selective (based on clinical evaluation) abdominal CT imaging. The primary outcome was the negative appendectomy rate. Results A total of 152 patients were randomized to selective (n= 80) and mandatory (n= 72) intervention groups. The mean (±SD) age was 34.1 (±3.5) years, and 48% were female. CT imaging was performed in 54 of 80 patients (68%; 95% confidence interval [CI] = 56% to 78%) in the selective group and in 70 of 72 patients (97%; 95% CI = 90% to 100%) in the mandatory group. There was a trend to a decreased rate of negative appendectomy in the mandatory group (1/39 [2.6%]; 95% CI = 0.5% to 13.2%) as compared with the selective group (6/43 [13.9%]; 95% CI = 6.6% to 27.3%), with a difference in prevalence rates of 11.3% (95% CI =,3.5% to 26.3%). There was also a trend to a decreased perforated appendix rate in the mandatory group (4/39 [10.3%]) as compared with the selective group (7/38 [18.4%]), with a difference in prevalence rates of 8.2% (95% CI =,8.0% to 24.4%). Conclusions In this small sample of adult patients with RLQ abdominal pain and suspected acute appendicitis, CT imaging was performed less frequently in the selective group and there was a trend with mandatory CT imaging to reduced rates of negative appendectomy and perforated appendices. [source]

    Disseminated bony metastases following incidental gallbladder cancer detected after laparoscopic cholecystectomy

    HPB, Issue 4 2003
    F Youssef
    Background In patients with gallbladder cancer bony metastases are usually a late feature. Case outline A 47-year-old woman presented with a 2-month history of right upper quadrant pain. Ultrasound scan showed gallstones and a thick-walled gallbladder. Laparoscopic cholecystectomy was performed. Histopathology showed poorly differentiated adenocarcinoma infiltrating the muscular layer and vascular invasion. She was referred for further surgery. Staging CT scan of the abdomen showed no local residual disease. However Tc-99 bone scan suggested disseminated bony metastases, which were confirmed by bone trephine biopsy. The cancer progressed rapidly and the patient died 4 months after the diagnosis. Discussion Bone metastases can occur with early gallbladder cancer and a radioisotope bone scan can avoid unnecessary extensive liver surgery. [source]

    Multiple hepatic nodules: Rare manifestation of clonorchiasis

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2006
    Wei-Chih Liao
    Abstract A 38-year-old man was admitted due to intermittent right upper quadrant pain for 1 month. Leukocytosis with marked eosionphilia and elevated serum alkaline phosphatase were noted. Stool examinations revealed no parasites or ova. Ultrasonography and computed tomography disclosed multiple hepatic tumors. Biopsy of the hepatic tumor was performed due to non-conclusive imaging studies and revealed eosinophil infiltration in portal areas only. Endoscopic retrograde cholangiography showed mild dilatation with irregularity of bilateral intrahepatic ducts, compatible with chronic cholangitis. Bile was aspirated and biliary lavage with normal saline was performed during endoscopy-guided biliary cannulation. Microscopic examination of the aspirate showed the characteristic ova of Clonorchis sinensis. The patient received Praziquantel therapy for 1 day. Abdominal pain reduced in intensity gradually. Eosinophilia and multiple hepatic lesions resolved after adequate treatment of Clonorchis sinensis. The rare manifestation of multiple hepatic tumors in Clonorchis sinensis should be differentiated from other primary or metastatic neoplasms, while biliary lavage for parasite ova is a valuable diagnostic tool when stool examination is negative. [source]

    Case of mucinous adenocarcinoma with porcelain gallbladder

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2003
    YOUNG-EUN JOO
    Abstract Histologically, the majority of gallbladder cancers are adenocarcinomas. Among the adenocarcinomas, the mucinous adenocarcinoma is relatively uncommon. Porcelain gallbladder is a rare finding and the risk of gallbladder cancer is significantly increased in porcelain gallbladder. We describe a rare case of mucinous adenocarcinoma with porcelain gallbladder. A 46-year-old man was admitted to Chonnam National University Hospital with a 2-week history of right upper quadrant pain. Three and 2 years previously, he had two episodes of cholecystitis with gallstones. An abdominal computed tomography revealed a contracted gallbladder with circumferential mural calcification, and the possibility of gallbladder cancer and porcelain gallbladder were considered. At laparotomy, cholecystectomy, liver wedge resection, and radical lymph node dissection were performed. The resected gallbladder showed thickened wall, luminal narrowing and mucosal irregularity. A histological examination of the resected gallbladder showed a mucinous adenocarcinoma composed of poorly differentiated glandular cells with mucin lakes. Porcelain gallbladder may be an end result of a chronic inflammatory reaction, and this change is associated with the development of gallbladder cancer. [source]

    Hepatobiliary and pancreatic: Recurrent right upper quadrant pain

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2000
    Article first published online: 25 DEC 200
    No abstract is available for this article. [source]

    A case of choledochocele mimicking choledocholithiasis on MR cholangiography: A new differential diagnosis of pseudo-filling defect

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2007
    Masashi Izumiya MD
    Abstract We present the case of a 79-year-old female with acute cholangitis and cholecystitis who presented with right upper quadrant pain. Thin-collimation MR cholangiogram showed a filling defect measuring 1 cm, which was less prominent on single-slab images. Endoscopy showed dynamic ballooning and collapsing of the ampulla of Vater, and a cholangiogram showed characteristic bulging at the distal common bile duct, which led to the diagnosis of choledochocele. It is important to differentiate choledochocele as a cause of filling defect of the lower common bile duct on the MR cholangiogram. J. Magn. Reson. Imaging 2007;26:1097,1100. © 2007 Wiley-Liss, Inc. [source]

    Uterus-like mass: MRI appearance of a very rare entity

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2007
    Kirsten A. Menn BA
    Abstract We describe a 37-year-old patient who presented with right lower quadrant pain and intermenstrual bleeding. MRI demonstrated a 5 × 5 cm lobulated mass centered in the right uterine wall interpreted as suspicious for malignancy. A total hysterectomy was performed, and the gross and histologic features were consistent with the diagnosis of a uterus-like mass. Uterus-like mass is a benign entity that can be found in a variety of organs, and is characterized by endometrium surrounded by smooth muscle. It is an extremely rare lesion with only approximately 15 cases reported in the current literature. There is a lack of imaging literature on this entity, which is primarily described in the pathology literature. Its histogenesis is uncertain, but is theorized to be metaplastic change, congenital anomaly, and/or heterotopia. However, given the MRI appearance in this case, we feel that uterus-like mass could be prospectively diagnosed or listed in a differential diagnosis. J. Magn. Reson. Imaging 2007;26:162,164. © 2007 Wiley-Liss, Inc. [source]

    Coexistent gallbladder carcinoma in Mirizzi syndrome

    JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2003
    Quee Li Chiam
    Summary A 52-year-old woman presented with right upper quadrant pain and obstructive jaundice. Computed tomographic scan showed Mirizzi syndrome type 1 and a thickened and calcified gallbladder wall, raising the possibility of coexistent gallbladder carcinoma that was later confirmed on histology post-cholecystectomy. [source]

    Limy bile syndrome: review of seven cases

    ANZ JOURNAL OF SURGERY, Issue 9 2005
    Konstantinos D. Ballas
    Background: Milk of calcium bile or limy bile is a rare disorder in which the gall bladder is filled with a thick, paste-like, radiopaque material. Methods: Seven patients with limy bile syndrome were treated in our department from 1980 to 2003. There were five women and two men, and their age ranged from 30 to 64 years. A retrospective analysis of clinical symptoms, diagnostic work-up, treatment approach and operative findings was performed. Results: All patients presented with intermittent right upper abdominal quadrant pain. Three of the seven patients (42.85%) presented with complications like acute cholecystitis (two of seven patients) and obstructive jaundice (one of seven patients). Diagnosis was based on clinical findings, plain abdominal X-rays, ultrasonography and computed tomography scanning. Surgery was the treatment of choice and cholecystectomy alone or in combination with common bile duct exploration and drainage (if needed) was performed. Conclusion: The clinical aspect of the disease is similar to that of biliary lithiasis and the diagnosis is easily made by the characteristic spontaneous opacification of the gall bladder on plain abdominal X-rays. Complications such as acute cholecystitis, pancreatitis or obstructive jaundice can also be present. Although some cases of conservative pharmaceutical treatment as well as cases of spontaneous disappearance of limy bile have been reported, surgical treatment remains the treatment of choice. [source]

    Laparoscopic treatment of primary omental torsion: Case report and literature review

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2010
    GR. Portillo
    Abstract Omental torsion is a rare cause of acute abdominal pain. The diagnosis is rarely made preoperatively. The treatment has been classically open. We present a case of omental torsion laparoscopically. A 63-year-old man was admitted to the emergency department. The patient had a right upper quadrant pain that started 3 d before his admission. The omentum was freed in a blunt fashion by identifying a point of torsion in the base of the mass. Partial omentectomy was performed with the assistance of a harmonic scalpel. The specimen was retrieved in a bag through a 3 cm left flank incision extended from a 10 mm port site. The pathology evaluation revealed an infarcted omentum. The patient had instant relief of pain, and the recovery was uneventful, with the patient beings discharged 2 d postoperative. The laparoscopic treatment of omental torsion is a safe, feasible and effective alternative. [source]

    CASE REPORT Giant congenital melanocytic naevus and symptomatic thoracic arachnoid cyst

    AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2001
    Gary Holmes
    SUMMARY A 43-year-old female with multiple congenital naevi presented with a 5-year history of right upper quadrant pain. Magnetic resonance imaging demonstrated a large epidural thoracic arachnoid cyst. This case highlights the need to consider that the management of patients with giant congenital melanocytic naevus is variable depending on the age of the patient, the location of lesions and the presence of complications such as neurocutaneous melanosis. The value of magnetic resonance scanning as a screening device is discussed. [source]