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The most common diagnoses of pelvic/supra-pubic pain are related to uterine, gonadal, renal, and bladder complications. Hydrocele of the canal of Nuck is a rare cause of inguinal swelling in women, which occurs due to a patent processus vaginalis. The canal of Nuck typically closes in infancy, however, in some women, the canal of Nuck remains patent, allowing for the development of canal of Nuck cysts or indirect inguinal hernias. Until now, about 400 cases of this illness have been reported worldwide. Clinically, these cysts are usually fluctuant, painless, or may present locally painful masses in the labia or inguinal regions which are not reducible; we report the case of a young female which was characterized by persistent suprapubic pain in which the diagnosis initially made by ultrasonography was further confirmed by contrast-enhanced computed tomography, surgery and pathological examination. [ABSTRACT FROM AUTHOR]

Primary type small bowel volvulus is observed mainly in children and young adults, whereas the secondary type is usually found between the ages of 40 and 90 years and is mainly due to adhesions after previous surgery: tumors and mesenteric lymph nodes can also be responsible for the secondary type. Diagnosis is difficult and the computed tomography scan is the most relevant imaging modality. For this reason we believe that the case presented in which diagnosis was primary made by abdominal ultrasonography and then confirmed first by computed tomography scan and definitively by surgical exploration is worth reporting. [ABSTRACT FROM AUTHOR]

Heyde's syndrome (HS) is a triade constituted by aortic stenosis, gastrointestinal angiodysplasia and deficiency of high-molecular-weight von Willebrand factor multimers. Until now few cases of HS has been reported and we believe of interest to add a new patient having this disorder. We report a case of HS in an 86-year-old female patient admitted for the second episode of melena in the last 4 months. A colonoscopy revealed a bleeding due to angiodysplasia in the ascending colon and an endoscopic argon laser photocoagulation of the colonic angiodysplasia was successfully carried out. Physicians should be aware of the possibilities of acquired von Willebrand disease and gastrointestinal bleeding from angiodysplasia in patients with aortic valve stenosis because a right diagnosis affects the management of these patients, especially in emergency situations. [ABSTRACT FROM AUTHOR]

It has been reported that prolonged strenuous exercise increases cardiac biomarkers probably due to transient strain, ischemia, inflammation, or metabolic causes. However, in emergency situation the possible increase of troponin serum concentrations in a young runner may lead to a suspicion of an acute myocardial damage. We report a case of elevated high-sensitive troponin T (hs-cTnT) in a half-marathon runner who had a transient loss of consciousness after a race associated with an increased serum levels of hscTnT without cardiac damage. Physicians must be able to interpret hs-cTnT serum concentrations using clinical expertise especially in an emergency situation. [ABSTRACT FROM AUTHOR]

Primary aortoenteric fistula (PAEF) is a rare condition of intestinal hemorrhage. We herein report a case of this condition initially suspected by ultrasonographic evaluation and subsequently confirmed by computed tomography. PAEF should be considered a possible cause in patients with gastrointestinal bleeding of uncertain etiology and especially in patients with known aortic aneurysms. The rapid recognition of this condition may save the life of these patients because in untreated subjects the mortality is 100%, frequently due to hypovolemic shock. [ABSTRACT FROM AUTHOR]

Spontaneous bladder rupture is a rare condition that can be followed by an acute alcohol intoxication and can be associated with significant morbidity and mortality. We report a case diagnosed in a alcoholic young male who was admitted to our emergency room for epigastric pain. The case demonstrates the difficulties with diagnosis and the need for physicians who work in an emergency room to be aware of this condition. [ABSTRACT FROM AUTHOR]

The article presents a case report on ultra-sonographic diagnosis of appendiceal mucocele, a rare disease triggered by mucus accumulation inside the appendix. It mentions that a preoperative diagnosis is executed with abdominal ultra-sonography (US) and computed tomography (CT) scan. It notes that the common symptom is pain in the abdomen's lower part.

Background/aims: To explore the possibility that the preventive effect of gabexate mesilate on endoscopic retrograde cholangiopancreatography-related acute pancreatitis may be mediated by its modulation of acute phase proteins., Methodology: Thirty consecutive patients who underwent endoscopic retrograde cholangiopancreatography were randomly assigned to receive 1g of gabexate mesilate (13 patients) or a placebo (17 patients) by continuous i.v. infusion starting 30 minutes before the endoscopy session and continuing for 12 hours afterward. In all patients, C-reactive protein, serum amyloid A and interleukin 6 serum concentrations were determined before endoscopy and 4, 8, 12 and 24 hours afterward., Results: Interleukin 6 basal serum concentrations were not statistically different between patients who had been treated with gabexate mesilate and those who had received the placebo (P = 0.279), whereas C-reactive protein (P = 0.033) and serum amyloid A (P = 0.022) basal values were significantly lower in the gabexate mesilate group than in the placebo group. Compared to basal values, serum interleukin 6 concentrations significantly increased at 4 (P = 0.048) and at 8 (P = 0.025) hours; the increase of serum interleukin 6 concentrations was not significant at 12 (P = 0.092), but became significant at 24 (P = 0.025) hours. C-reactive protein and serum amyloid A serum concentrations increased significantly only at 12 (P = 0.001, P = 0.012, respectively) and 24 (P < 0.001, P = 0.013, respectively) hours. The modifications of serum concentrations of interleukin 6, C-reactive protein and serum amyloid A were not significantly different between the gabexate mesilate and the placebo groups., Conclusions: Gabexate mesilate does not affect serum concentrations of acute phase proteins after endoscopic retrograde cholangiopancreatography examination and it is able to prevent acute pancreatitis related to endoscopic retrograde cholangiopancreatography via a different mechanism than that explored in this study.

Background: There is a lack of data concerning pancreatic involvement during shock., Aim: To evaluate possible pancreatic alterations in the early phase of shock., Setting: Twelve consecutive patients with shock were studied within 2 hours from the onset of illness. Seven patients died during the hospital stay: 3 within 4 hours from admission, 3 within 4-8 hours and 1 within 12 hours., Main Outcome Measures: Amylase, lipase, C-reactive protein, amyloid A, interleukin 6, procalcitonin and vascular cell adhesion molecule-1 serum concentrations were determined on admission and 4, 8, and 12 hours afterward. All patients underwent imaging studies of the pancreas., Results: None of the patients developed clinical signs or morphological alterations compatible with acute pancreatitis. Serum amylase levels were above the upper reference limit in 7 patients (58.3%) and serum lipase levels in 2 patients (16.7%; P=0.062). There were no significant differences found between survivors and non-survivors in the serum concentrations of all the proteins studied., Conclusions: In patients with shock, amylase seems to be more frequently elevated than lipase. None of the patients showed pancreatic alterations at imaging techniques.