We present such a rare case of acute pancreatitis presenting as anterior abdominal abscess and epididymo-orchitis. :: Case Report A 52-year-old male patient presented with history of pain and fullness in lower abdomen since 3 weeks. [jpgmonline.com]

Perfect for radiologists who need a comprehensive reference while working on difficult cases, it presents a complete yet concise overview of imaging applications, findings, and interpretation in every anatomic area. [books.google.de]

A high fever is present in the initial stages but in severe peritonitis there may be hypothermia. Tachycardia is usually present. The classic abdominal signs are tenderness on palpation, guarding and rebound tenderness. [patient.info]

That is why the clinical presentation of posterior gastric perforation is less dramatic than that of the more common anterior perforations and is characterized by late presentation. [ejs.eg.net]

Presents numerous recesses into which pus from an abscess may be drained. Subphrenic (suprahepatic) recess Is a peritoneal pocket between the diaphragm and the anterior and superior part of the liver. [wikiradiography.net]

• Fever

  Abstract A 76-year-old man was emergently seen at the hospital because of upper abdominal pain and fever. Abdominal CT scan showed a low density mass measuring 14 cm in maximum diameater in the peritoneal cavity. [jstage.jst.go.jp]

  No fever of leukocytosis. [aast.org]

  With generalised peritonitis, the patient is very unwell, with marked fever, tachycardia and dehydration. There is diffuse abdominal pain, exacerbated by even the slightest movement. [surgwiki.com]

  Symptoms may include fever, pain anywhere in the abdomen, diarrhoea or ileus. A subphrenic abscess can cause chest pain and also shoulder pain. Psoas muscle abscesses may lead to flank pain which radiates to the groin. [patient.info]

  The patient did not have fever. The collection underwent successful percutaneous drainage, which showed clear fluid with high amylase and subsequently resolved along with the patient's symptoms. [radiologyassistant.nl]

• Lymphadenopathy

  Other findings included lymphadenopathy (46.9% mainly of diffuse nature, bowel wall thickening (38%) and solid organ involvement (20.4%). [bmcmedimaging.biomedcentral.com]

  Cystic components and lymphadenopathy may develop. • Biopsy is necessary for diagnosis, especially to differentiate from carcinoid and other tumors. • Definition: Increased attenuation of small bowel mesentery at CT • Mesenteric Panniculitis: characterized [learningradiology.com]

  […] circumscribed fluid collection within breast tissue, not involving nipple/ areola complex Acute inflammation limited to breast tissue III Complex abscess Large abscess with multiple loculations, multiple abscesses, or abscess involving nipple/areola complex; lymphadenopathy [aast.org]

  […] carcinoma and hypernephroma Term Dilation of the intrahepatic bile ducts maybe seen with all the following except A) Intrahepatic mass in area of the portal hepatis B) Polyp in the fundus of the gallbladder C) Obstructive stone in the cystic duct D) Lymphadenopathy [flashcardmachine.com]

• Swelling

  For the scrotal swelling, support bandage was given. Fluid amylase was 40000 IU. As pigtail started draining, pain and swelling subsided within 2 days. Thereafter patient's recovery was uneventful. [jpgmonline.com]

  […] abscess Fever; perineal pain; diffuse swelling; pain with defecation; palpable fluctuant area on digital examination Endorectal ultrasound localization; CT may localize collection but MRI preferable Drainage of localized pus Culture of abscess positive [aast.org]

  The epididymitis is infection of the epididymis, represents the most common cause of acute scrotal pain and swelling in adults. [flashcardmachine.com]

  A 35-year-old man with a history of Crohn disease presented with pain and swelling in the right abdomen. Figure A shows a thickened loop of terminal ileum adherent to the right anterior abdominal wall. [emedicine.medscape.com]

• Malaise

  TUBERCULOUSPERITONITIS■ Acute and chronic forms■ Abdominal pain, sweats, malaise and weight loss arefrequent■ Caseating peritoneal nodules are common – distinguishfrom metastatic carcinoma and fat necrosis of pancreatitis■ Ascites common, may be loculated [slideshare.net]

  Pain usually begins as para-umbilical discomfort, accompanied by malaise, and diarrhoea or constipation. [bmb.leeds.ac.uk]

• Internal Bleeding

  Other causes include; malignancies of the GI tract, malnutrition, heart failure, and mechanical injuries which result in internal bleeding. [teachmeanatomy.info]

• Abdominal Pain

  Univadis - a service form MSD app catalog Search Log in 7 Noncontrast CT in a patient with abdominal pain. Oral contrast was administered and demonstrates opacification of the stomach. There is a large fluid collection,,... [univadis.com.sg]

  Esophageal Perforation AAST Grade Description Clinical Criteria Imaging and/or endoscopic criteria Operative Criteria Pathologic criteria I Mucosal tear Dysphagia; chest pain, upper abdominal pain or back pain; breathing problems No abnormality or possible [aast.org]

  Abstract A 76-year-old man was emergently seen at the hospital because of upper abdominal pain and fever. Abdominal CT scan showed a low density mass measuring 14 cm in maximum diameater in the peritoneal cavity. [jstage.jst.go.jp]

  Journal of Clinical Gastroenterology: June 1981 Clinical Studies: PDF Only Abstract In a 45-year-old woman with abdominal pain and vomiting, plain films and barium studies showed a gas and fluid collection displacing the stomach anteriorly and to the [journals.lww.com]

  […] changed the epidemiology of abdominal pain in HIV/AIDS patients. ( 22 ) Presentation with acute abdominal pain occurs in 12-48% of HIV patients. [ptolemy.ca]

• Acute Abdomen

  CONCLUSION: The early diagnosis of acute intestinal obstruction and immediate indication for laparotomy is the main task of the surgeon when faced with a case of acute abdomen with a hypothesis of internal hernia, so as to minimize severe postoperative [ingentaconnect.com]

  Diagnosis – the acute abdomen Abdominal pain is the most common reason for admission to hospital in the USA and correct diagnosis of the acute abdomen remains a challenge for physicians. ( 18 ) Acute abdominal pain is defined as acute undiagnosed pain [ptolemy.ca]

  Depending upon severity of acute pancreatitis patient may presents with minimal symptoms to more severe signs of acute abdomen like generalized guarding and rigidity. [jpgmonline.com]

• Epigastric Mass

  Physical examination revealed a firm, epigastric mass that did not move with respiration. Her computed tomography (CT) scan report showed a lobulated, cystic mass lesion in the lesser sac of size 10 cm × 9 cm × 8 cm ( [Figure 1] ). [journalofmas.com]

• Peritoneal Disease

  (Mesentry, omental and peritoneal disease): 38 (77.5%) Lymph nodes: 23 (46.9%) G.I.T: 19 (38.7%) Solid organ involvement: 10 (20.4%) Table 3 CT features of Peritoneal TB (n = 38; wet = 21; dry = 17) Free Loculated Free Loculated LV SV LV SV LV SV LV [bmcmedimaging.biomedcentral.com]

• Abdominal Bloating

  Materials and Methods: A 74-year-old female was admitted to our clinic with complaints of abdominal bloating and impossible food and fluid intake. She had undergone a previous conservative treatment for acute pancreatitis in a therapeutic ward. [press.mu-varna.bg]

• Thrombosis

  Sometime patients with acute pancreatitis may be found to have inferior vena cava thrombosis which is very rare and spinal artery thrombosis leading to paraplegia due to systemic hypercoagubility induced by pancreatitis. [7], [9] Possible mechanism for [jpgmonline.com]

  Septicemia NOS intra-abdominal K65.1 ICD-10-CM Codes Adjacent To K65.1 K64.0 First degree hemorrhoids K64.1 Second degree hemorrhoids K64.2 Third degree hemorrhoids K64.3 Fourth degree hemorrhoids K64.4 Residual hemorrhoidal skin tags K64.5 Perianal venous thrombosis [icd10data.com]

  […] leading to pneumo and pyo pericardium and cardiac temponade.[ 8 ] Spontaneous pneumoperitonium secondary to penetrating benign gastric ulcer is rarely seen.[ 9 ] In our patient there was free perforation of gastric ulcer in to the lesser sac resulting in thrombosis [tropicalgastro.com]

  […] attenuation of small bowel mesentery at CT • Mesenteric Panniculitis: characterized by “ fat ring ” sign and “ tumoral pseudocapsule ” • Other causes: Edema, malignancy, inflammation/fibrosis Radiology 2003;226:86 AJR 1996;167:61 Mesenteric and Portal Thrombosis [learningradiology.com]

  Renal vascular thrombosis C. Glomerulonephritis D. Renal ischemia Definition B – Renal vascular thrombosis would be prerenal Term The gallbladder contains 4 layers. [flashcardmachine.com]

• Tachycardia

  With generalised peritonitis, the patient is very unwell, with marked fever, tachycardia and dehydration. There is diffuse abdominal pain, exacerbated by even the slightest movement. [surgwiki.com]

  Tachycardia is usually present. The classic abdominal signs are tenderness on palpation, guarding and rebound tenderness. The tenderness will be maximal over the area of pathology. [patient.info]

  At 3 weeks after initial episode of pancreatitis, he was readmitted for fevers and tachycardia. [pancreas.imedpub.com]

  Hernia visible on CT Abdominal wall defect present with abdominal contents lodged in defect; healthy appearing viscera N/A III Incarcerated with bowel ischemic but viable Local tenderness with non-reducible palpable hernia; may be associated with fever, tachycardia [aast.org]

• Sweating

  TUBERCULOUSPERITONITIS■ Acute and chronic forms■ Abdominal pain, sweats, malaise and weight loss arefrequent■ Caseating peritoneal nodules are common – distinguishfrom metastatic carcinoma and fat necrosis of pancreatitis■ Ascites common, may be loculated [slideshare.net]

• Flushing

  […] spread to mesentery directly or through local lymphatics • Distal ileum is most frequent primary location • Mesenteric mass is often detected first • With hepatic metastases, may present with carcinoid syndrome caused by release of vasoactive substances (flushing [learningradiology.com]

• Erythema

  Breast Infections AAST Grade Description Clinical Criteria Imaging Criteria (US or CT findings) Operative Criteria Pathologic Criteria I Breast cellulitis Erythema, induration, edema, pain, tenderness Inflammation without fluid collection N/A N/A II Simple [aast.org]

• Irritability

  With a pelvic abscess, there may be urinary frequency, dysuria, diarrhoea or tenesmus due to irritation of the anatomically related organs. [surgwiki.com]

  […] peritoneum develop from thesomatopleural and splanchnopleural layers respectively oflateral plate mesodermSomatic nerves that innervate the parietal peritoneum alsosupply the corresponding segmental areas of skin andmuscles; when the parietal peritoneum is irritated [slideshare.net]

  Rebound tenderness is a useful sign for localized peritoneal irritation. Generalized tenderness and boardlike rigidity are pathgnomonic of generalized peritonitis. [ptolemy.ca]

  Inflammatory Disease AAST Grade Description Clinical Criteria Imaging Criteria (CT or US findings) Operative Criteria Pathologic Criteria I Inflammation of the cervix None N/A N/A N/A II Purulent cervical drainage None OR vaginal discharge, vaginal irritation [aast.org]

• Renal Injury

  injury, from surgical intervention, or it may arise spontaneously secondary to an obstructing lesion The most common primary sites of peritoneal metastases are the _________, __________, and ________ Ovaries, stomach and colon The __________ sign of [brainscape.com]

(See Workup, Computed Tomography.) Sequential, multiple organ failure is the main cause of death. [emedicine.medscape.com]

• Pneumoperitoneum

  This page provides an overview of the plain film diagnosis of pneumoperitoneum. Why is Pneumoperitoneum Important? Pneumoperitoneum is most often caused by perforated abdominal viscus and can present an acute medical emergency. [wikiradiography.com]

  Chest radiography revealed pneumoperitoneum and a decision was made to explore the patient. [ejs.eg.net]

  The pneumoperitoneum was created with a veress needle (ETHICON US, LLC, part of the Johnson & Johnson family of companies). [journalofmas.com]

  There was no free pneumoperitoneum nor free intraperitoneal fluid. A review of the first CT scan revealed a huge air-fluid collection in the subphrenic space (Figures 1 and 2). The diagnosis of right subphrenic abscess was made. Figure 1. [oatext.com]

  […] wall enhancement; intramural, portal, or mesenteric pneumatosis Transmural necrosis without perforation Transmural necrosis without perforation IV Segmental transmural bowel infarction with perforation Abdominal pain and tenderness with peritonitis Pneumoperitoneum [aast.org]

• Leukocytosis

  No fever of leukocytosis. [aast.org]

  Clinical symptoms vary from none to fever, leukocytosis, and flank pain The most common abdominal pathologic process is _____________ which requires immediate surgery A mass or lesion within the mesentery and omentum may have solid or cystic characteristics [brainscape.com]

  FBC - there is usually a leukocytosis. U&Es and creatinine - dehydration may be present. LFTs, amylase and lipase - particularly if pancreatitis is suspected. Blood cultures - aerobic and anaerobic to exclude blood sepsis. [patient.info]

  Few patients have significant abdominal symptoms although they will exhibit fever and leukocytosis. Thus imaging, particularly with CT scan plays an important role in detection. [ptolemy.ca]

  After 2 weeks, she had fever with abdominal pain and leukocytosis. CT showed a increased fluid collection in superior recess of lesser sac and EUS-guided drainage was performed. The symptoms resolved without any complication after drainage. [kjpbt.org]

She had undergone a previous conservative treatment for acute pancreatitis in a therapeutic ward. [press.mu-varna.bg]

Treatment The recurring themes of treatment in peritonitis are: a) resuscitation, b) antibiotics, c) peritoneal lavage, and d) source control 4.2.1. [ptolemy.ca]

The treatment of subphrenic abscess is that of any intra-abdominal abscesses. The treatment of sealed perforated ulcer is non operative. [oatext.com]

A summary of the advantages and disadvantages of the various treatment strategies discussed is included in Table 1. [pancreas.imedpub.com]

Delayed diagnosis and treatment can also lead to increased mortality; therefore, the economic impact of delaying treatment is significant. [emedicine.medscape.com]

Prognosis Abscess The prognosis has improved considerably with the advent of drainage under CT scanning. Deaths are generally due to the underlying disease process or unsuspected foci of infection. [patient.info]

The prognosis of the affected batch depends on how often and how severe is the condition. [marcosgodoy.com]

Prognosis The introduction of computed tomography (CT) for the diagnosis and drainage of intra-abdominal abscesses has led to a dramatic reduction in mortality. (See Workup, Computed Tomography.) [emedicine.medscape.com]

Helicobacter pylori is not the predominant etiology for peptic ulcers requiring operation. Am Surg 2011; 77:1054-1060. 2. Bertleff MJ, Lange JF. Perforated peptic ulcer disease: a review of history and treatment. Dig Surg 2010; 27:161-169. 3. [ejs.eg.net]

Etiology Although multiple causes of intra-abdominal abscesses exist, the following are the most common: Perforation of viscus, which includes peptic ulcer perforation [2] Perforated appendicitis and diverticulitis Gangrenous cholecystitis Mesenteric [emedicine.medscape.com]

[…] the disease and further complications of advanced chronic pancreatitis. [10] So here we would like to conclude that when a patient presents with inguinoscrotal swelling or lower abdomen abscess, acute pancreatitis should be kept in mind as a possible etiology [jpgmonline.com]

The retrospective/prospectiv e study was analyzed by etiological forms with speci fic therapeutic management, and timing of surgery was analyzed with the benchmark of 21 day according to the studies of Fernández del Cas- tillo [8] and recommendations [file.scirp.org]

The etiology of chronic active hepatitis is usually idiopathic but may be viral or immunological. [flashcardmachine.com]

Time-trends in the epidemiology of peptic ulcer bleeding. Scand J Gastroenterol. 2005; 40 :914–20. 3. Sharma SS, Mamtani MR, Sharma MS, Kulkarni H. [tropicalgastro.com]

Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality. Digestion 2011; 84:102-113. 4. Williams N, Bullstrode C, Connell RO. [ejs.eg.net]

Epidemiology The incidence depends on the cause. In a hospital setting the prevalence of SBP is around 10%. [ 3 ] Three studies of patients with perforated appendicitis found an incidence of postoperative abscess formation of 20%. [patient.info]

Epidemiology and pathophysiology of intraabdominal infections (IAI). [Review] [26 refs]. Infection 26(5):329-34, 1998;-Oct. (15) Laroche M, Harding G. Primary and secondary peritonitis: an update. [Review] [79 refs]. [ptolemy.ca]

Radiology 226: 556–557 PubMed CrossRef Google Scholar Van Breda Vriesman AC, Lohle PNM, Coerkamp EG, Puylaert JBCM (1999) Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. [link.springer.com]

The pathophysiological basis of surgical diseases is discussed in relation to their management, acting as a bridge between basic medical sciences and clinical problems. [books.google.de]

Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization. [emedicine.medscape.com]

Pathophysiology Peritonitis is an inflammatory response to peritoneal injury. [ptolemy.ca]

Foley Catheter Enterostomy First, the proper size of the ballooning could obstruct the leakage site, and it is easy to prevent local fluid collection. Also, it is possible to form the fistula tract faster than in a simple procedure. [apscvir.com]

Actual passage of infectious material into the peritoneum, however, is rare due to the presence of a mucous plug in the external os (opening) of the uterus which prevents the passage of pathogens but allows sperm to enter the uterus. [teachmeanatomy.info]

In abdominal wounds the omentum may protrude, block up the opening, and so prevent the escape of blood. Fig. 24.- Diagram of Peritoneum, its Sacs and Folds. Lesser sac is shaded. Arrow through foramen of Winslow. [bookdome.com]

Review article: spontaneous bacterial peritonitis--diagnosis, treatment and prevention. [Review] [70 refs]. [ptolemy.ca]

We use these foils 5-6 days after surgical intervention when the wounds begin to granulate to prevent suppura- tive complications of the abdominal wall. [file.scirp.org]