3 It accounts for only 5 to 10% of all diverticulitis in the large intestine. 2ĭiverticular disease in the transverse colon or hepatic flexure, first described in 1944 by Thompson and Fox, is extremely infrequent. 1 Three main factors are known to cause diverticular disease: disordered intestinal motility, a low-fiber diet, and intestinal wall abnormalities. The present case is a rare variant of diverticular disease, given that the most commonly affected site is the sigmoid colon in white patients and the right colon in Asians. The patient was asymptomatic at one month, then at 12 months, after his original symptoms. Six weeks later, a control CAT scan was performed that showed complete resolution of the perivesicular and pericolonic inflammation. The patient improved and was released under oral treatment with the same antibiotics for another 7 days. Initial management was conservative, with bowel rest, analgesics, and double-regimen antibiotic therapy with ciprofloxacin and metronidazole for 7 days. Whether the CAT images were caused by colonic pathology or by gallbladder pathology could not be accurately determined. Because the pain continued, a computed axial tomography (CAT) scan with intravenous contrast medium was carried out ( Fig. An upper abdominal ultrasound study identified a distended gallbladder with biliary sludge and a 3 mm wall, a bile duct diameter of 5.5 mm, and the remaining parameters within normal limits. The patient’s hemoglobin level was 12.4 g/dl, platelets 336,000 cells/mm 3, leukocytes 16,400 cells/mm 3, and unaltered liver function tests. Physical examination revealed reduced peristalsis, abdominal distension due to bloating, pain in the right hypochondrium upon palpation, and a positive Murphy’s sign. The pain had no aggravating factors and partially improved with antispasmodics. He did not present with vomiting, fever, or jaundice. It began insidiously, with an intensity of 8/10, and was accompanied by abdominal bloating, hyporexia, and nausea.
![hepatic flexture ultrasound hepatic flexture ultrasound](https://www.mussenhealth.us/ultrasound-anatomy/images/1901_9_418-adrenal-gland-transverse-ultrasound.jpg)
We present herein the case of a 56-year-old man, with an unremarkable past medical history, who came to the emergency room complaining of abdominal pain of 3-day progression in the right hypochondrium. The journal accepts original articles, scientific letters, review articles, clinical guidelines, consensuses, editorials, letters to the Editors, brief communications, and clinical images in Gastroenterology in Spanish and English for their publication. The scientific works include the areas of Clinical, Endoscopic, Surgical, and Pediatric Gastroenterology, along with related disciplines. The principal aim of the journal is to publish original work in the broad field of Gastroenterology, as well as to provide information on the specialty and related areas that is up-to-date and relevant. Its pages are open to the members of the Association, as well as to all members of the medical community interested in using this forum to publish their articles in accordance with the journal editorial policies. From MEDLINE®/PubMed®, a database of the U.S.The Revista de Gastroenterología de México (Mexican Journal of Gastroenterology) is the official publication of the Asociación Mexicana de Gastroenterología (Mexican Association of Gastroenterology). No commercial use is permitted unless otherwise expressly granted. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. Medical treatment here was successful and avoided extensive surgery. Maternal mortality rate with abdominal pregnancy is 20% due to the risk of massive haemorrhage from placental separation or invasion of bowel vasculature. The decision to manage with methotrexate was balanced against reported cases of bowel perforation and the possibility that a section of bowel may need removal if the pregnancy showed signs of invasion. The patient received two doses of methotrexate and monitored until the beta human chorionic gonadotropin reduced. At laparoscopy, an ectopic pregnancy was identified at the hepatic flexure.
#Hepatic flexture ultrasound free#
An ultrasound scan revealed an empty uterus with free fluid in both adnexa and a 31×21 mm heterogenous mass adjacent to the right ovary. This case involves a woman admitted at 6 weeks gestation with right iliac fossa and shoulder tip pain.
![hepatic flexture ultrasound hepatic flexture ultrasound](https://www.ultrasoundcases.info/clients/ultrasoundcases/uploads/lbox_52624-Afbeelding8.jpg)
A literature search of six cases involving bowel ectopic pregnancies provided anecdotal treatment options. Abdominal pregnancies represent 1.4% of extrauterine pregnancies.