فهرست مطالب anita zarghami

 Fibrous obliteration or appendiceal neuroma is a rare type of appendiceal tumor that causes appendiceal obstruction and then presents as appendicitis. This neural tumor has no specific presentation and, after appendectomy, is diagnosed by the pathologist accidentally. Fibrous obliteration is described as a proliferative lesion. The pathogenesis of this lesion is unknown, but it is mentioned that the etiology of this problem is secondary to recurrent inflammation processes. These processes cause neuroendocrine cell hyperplasia in the submucosa and lamina propria of the wall of the appendix. The repetitive occurrence of these sub-clinical inflammatory processes causes fibrosis.

Cases Report: 

We presented a 55-year-old woman who was referred to our clinic with persistent pain in the right lower quadrant for five days in this report. The pain mimicked appendicitis presentation, and it suddenly started from the periumbilical area and then shifted to the right lower quadrant of the abdomen. Her laboratory study showed a 9600/microliter white blood cell count with 70% neutrophils. An increase in the appendix loop with 9 millimeters diameter was reported in the ultrasound. There was also severe fat haziness around the tissues and visceral inflammation of the terminal ileum in the sonogram. She underwent an appendectomy after the diagnosis of appendicitis, and the pathologist diagnosed fibrous obliteration or appendiceal neuroma.

 It is concluded that fibrous obliteration or appendiceal neuroma mimics acute appendicitis, and in patients with this presentation, appendectomy is the best choice for treatment. The main diagnostic method is pathologic assessment, and it is important for the differentiation of this tumor from other malignant tumors of the appendix because fibrous obliteration is a benign tumor.

Hepatic spontaneous sub-capsular hematoma is uncommon. This is a life-threatening condition because the rupture of this hematoma is accompanied by uncontrolled intra-abdominal hemorrhage.

Cases Report: 

We presented a 71-year-old man with a huge hepatic sub-capsular hematoma without any history of trauma or coagulopathy. The patient received heparin due to a neglected myocardial infarction. Blood pressure and hemoglobin levels decreased. The drug was discontinued, an abdominal computed tomography (CT) scan was done for him, and a huge hepatic sub-capsular hematoma was detected.

Spontaneous liver subcapsular hematoma may be found in patients with a history of surgery on the liver site and those with a history of COVID-19. In these patients, hemodynamic instability should increase the doubt of physicians about a rupture of hepatic hematoma.

 varicose veins are common and can make some complaints about patients such as cosmetic problems and pain. This disorder has some risk factors such as long time standing, high body mass index, pregnancy. In this study, we aimed to investigate the relationship between clinical presentations on varicose veins and patient's risk factors and also, this relationship with sonographic findings.

 in this cross-sectional study, all patients who came to Shohad-e –Tajrish hospital (Tehran-Iran) with varicose vein presentation were evaluated. Age, sex, standing time, smoking, multi-gravidity, and symptoms were recorded. A color Doppler sonography was taken from the veins of the involved legs.

finally, 158 patients were evaluated and based on CEAP classification, 15.2% of patients had grade C0, 20.9% had grade C1, 24.1% had grade C2, 19.6% had grade C3, 7% had grade C4, 8.2% had grade C5, and 5.1% had grade C6. There was no relationship between symptoms of varicose veins and varicose veins severity. There was a relationship between the severity of varicose veins with age, sex, smoking, obesity, multi gravidity, and standing time. Also, there was a relationship between sonographic findings of venous valves insufficiencies and severity of varicose veins.

 symptoms of varicose veins have no relationship with varicose vein severity but venous valve insufficiency, age, sex, smoking, obesity, multi gravidity, and standing time have an association with varicose vein severity.