Background Wandering spleen is a rare clinical entity with a less than 0.2% reporting incidence rate. In this case, the spleen is present abnormally in the abdominal or pelvic cavity instead of its normal anatomical location. The aetiology is either congenital or acquired. The condition is caused by the absence or maldevelopment of the spleen's suspensory ligaments, which holds the spleen static in the left hypochondrium. Case presentation A 27-year-old female patient presented to the emergency department with complaints of abdominal pain, fever, nausea, vomiting, and constipation for three days. A palpable movable mass was found during the physical examination, and torsion of the wandering spleen’s pedicle was confirmed by CT scan. Open splenectomy was performed, and the patient was recovered uneventfully. Conclusion Even though ectopic spleen is a rare disease, clinicians should be aware of its incidence. Early diagnosis in the case of an acute abdomen is vital for the preservation of the spleen. Patients presented with acute abdomen and absence of splenic shadow under left hemidiaphragm should be suspected, and further radiological investigation will confirm the diagnosis. Surgery is the gold standard for wandering spleen with either splenopexy or splenectomy, depending on the spleen's condition during surgery.
HighlightsTrichobezoar is a rare clinical entity in which a ball of hair amasses within the alimentary tract, mainly in stomach.Trichobezoars should be suspected in young females with long standing upper abdominal masses; as the possibility of malignancy is not very common in this age group.While ultrasound is inconclusive, trichobezoar can be accurately diagnosed with computed tomography.Convenient approach of treatment should be selected depending on the size and site of trichobezoars followed by psychiatric consultations in order to prevent its relapses.
Background Spontaneous biliary system perforation is a rare presentation in clinical practice especially in adults. It is rarely suspected and diagnosed preoperatively due to small number of cases, vague sign and symptoms, and ambiguous presentation. Case presentation We describe an interesting case of spontaneous perforation of the common bile duct in a 16 year-old female who presented a week after her first birth to the emergency department with complaints of diffuse abdominal pain, abdominal distention, fever, vomiting, and constipation. She was having generalized peritonitis but the etiology was unclear despite a thorough workup. She underwent exploratory laparotomy, and a perforation in the supra duodenal region of the common bile duct was found intraoperatively. The common bile duct was repaired over T-tube, and cholecystectomy was performed; the patient was recovered uneventfully. Conclusion Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy. Its delayed diagnoses and management can lead to a high morbidity and mortality. All physicians, especially surgeons, should be aware of this possibility and consider it a cause of peritonitis on differential diagnosis particularly when there is no apparent etiology available for presentation.
Background: Spontaneous biliary system perforation is a rare presentation in clinical practice. It is even rare in adult population than infants. The condition is rarely suspected and diagnosed preoperatively because of small number of cases, vague sign and symptoms and ambiguous presentation.Case presentation: we are presenting an interesting case of spontaneous perforation of common bile duct in a 16 years old lady presented a week after her first delivery to the emergency department with complain of diffuse abdominal pain, abdominal distention, fever, vomiting and constipation. She was having generalize peritonitis but the cause of peritonitis was unknown despite of all available investigations performed. She underwent exploratory laparotomy and a perforation in the supra duodenal region of common bile duct was found intraoperatively. Common bile duct repair over T-tube and cholecystectomy performed and patient recovered.Conclusion: Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy and its belated diagnoses and management is leading to high morbidity and mortality. All physicians especially surgeons should be aware of its possibility and consider it a cause of peritonitis on differential diagnosis especially when there is no apparent etiology available for the presentation.
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