Haemorrhagic cholecystitis (HC) is a rare cause of cholecystitis that can be fatal if management is delayed. HC could present in the setting of trauma, malignancy and bleeding diathesis, such as renal failure, cirrhosis and anticoagulation. Its symptoms are easily confused with acute calculous or acalculous cholecystitis and might include haemobilia or hematemesis as blood drains from the gallbladder into the gastrointestinal tract. Imaging of HC can be misleading unless the possibility of this diagnosis is considered. In this report, we present an interesting case of HC in a patient with none of the above comorbidities and the patient who was not on anticoagulation neither anti platelets. The case includes relevant imaging and a review of the literature on this rare subject.
Mixed serous and mucinous retroperitoneal cyst adenoma is an extremely rare condition as most of the reported cases in the literature are primary retroperitoneal mucinous cystadenomas and primary retroperitoneal serous cystadenomas. They are initially asymptomatic and become symptomatic gradually depending on their size and anatomical extension and location. We report a 49-year-old woman with a history of right-side abdomen pain for a few years. Diagnostic images revealed a large retroperitoneal cystic lesion. A laparoscopic resection was performed without spillage. The patient was discharged without complication postoperatively and no recurrence on follow-up. Surgical excision, either open/or laparoscopic without any spillage, remains the most effective and appropriate treatment for this lesion.
Aim To evaluate the management of Blunt Splenic Trauma (BST) management in multi-injured trauma patients at The Canberra Hospital (TCH). Non operative management (NOM) for hemodynamically stable patients & operative management (OM) for unstable patients. The aim was how to further reduce failed NOM. Method Retrospective data collected from of all multi trauma patients with BST from June 2008 - June 2013 at TCH. Data review included patients’ admission notes, CT results, management technique, and clinical outcome. Results A total of 161 patients included in the study. All paediatric patients treated with NOM with success rate of 100%. Seventy-three per cent of adults managed NOM with success rate of 97.8%. Twenty-six per cent managed operatively. ICU admissions were 54.4 % and splenic angioembolisation 2.9%. Mortality was 3.7 % with multiple injury patients zero with isolated splenic injury Conclusions As per our study NOM is the standard of care for all hemodynamically stable patients with success rate of 97.8% acceptable rate as per evidence more than 96%. All hemodynamically unstable patients with diffuse peritonitis require urgent laparotomy. The query to answer that AE should be considered for all patients with (AAST) grade 4–5 who are hemodynamically stable as adjunct to NOM to reduce rate of fail NOM. Further randomised controlled studies are needed.
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