Infected duplication cyst of ileum masquerading as an adnexal abscess—ultrasonographic features
✍ Scribed by Benjamin Caspi; Morey Schachter; Moshe Lancet
- Book ID
- 102330683
- Publisher
- John Wiley and Sons
- Year
- 1989
- Tongue
- English
- Weight
- 272 KB
- Volume
- 17
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Diagnosis of a duplication cyst of the bowel is difficult due t o its varying clinical manifestations. It is doubly difficult when the clinical picture includes signs of peritonitis. We report a case of an abscess of an ileal duplication cyst mistakenly diagnosed preoperatively as a tuboovarian abscess.
REPORT OF A CASE
A 15-year-old girl, usually in excellent health, presented with right lower abdominal pain of six hours duration and, initially, no fever. Her menstrual periods were regular, the previous period four weeks before. Within 24 hours of observation, nausea, sporadic vomiting, and fever of 39°C appeared. Physical findings at this time included a pale, ill-appearing girl, a sensitive abdomen, rebound tenderness, and rigidity, especially in the right lower quadrant. Rectal examination disclosed a pelvic mass on the right side of uncertain dimensions, quite sensitive to palpation. Laboratory tests demonstrated a leukocyte count of 8600 with slight shift to the left. Hemoglobin concentration and all biochemical parameters were normal. Ultrasonography of the lower abdomen demonstrated a normally appearing uterus, cervix, and left adnexa. The right ovary was not clearly seen. To the right and behind the uterus, an elongated cystic mass, 46 mm x 25 mm x 69 mm, with poorly defined borders, and a thickened capsule was noted (Figures 1 and2). Right tubo-ovarian abscess was presumptively diagnosed and laparoscopy undertaken. On laparoscopic examination the right From the