Scipediacontent: Scipediacontent moved page Draft Content 317826585 to Lin Chiu 2015a

2017-05-15T11:00:03Z

Scipediacontent moved page Draft Content 317826585 to Lin Chiu 2015a

Scipediacontent: Created page with "==Question== A 77-year-old man with a history of benign prostate hypertrophy and ischemic heart disease was referred to our emergency department because of progressive abdomi..."

2017-05-15T10:51:54Z

Created page with "==Question== A 77-year-old man with a history of benign prostate hypertrophy and ischemic heart disease was referred to our emergency department because of progressive abdomi..."

New page

==Question==

A 77-year-old man with a history of benign prostate hypertrophy and ischemic heart disease was referred to our emergency department because of progressive abdominal distension, constipation, and leg edema for 1 week. There was no abdominal pain, fever, nausea, vomiting, body weight loss, or dyspnea. The patient had poor appetite and decreased urine output in the past week. On physical examination, the body temperature was 36.6°C. The bowel sound was hyperactive. Distended abdomen without tenderness was detected. Digital examination revealed an enlarged prostate. A kidney ureter bladder radiograph ([[#fig1|Fig. 1]] ) revealed a large radiopaque lesion with markedly dilated colon loops at the transverse segment, and the hepatic and splenic flexures.



{| style="text-align: center; border: 1px solid #BBB; margin: 1em auto; max-width: 100%;"
|-
|

[[Image:draft_Content_317826585-1-s2.0-S2351979715000286-gr1.jpg|center|350px|Kidney ureter bladder radiograph.]]

|-
| 

Figure 1.

Kidney ureter bladder radiograph.


|}

What is your impression for this patient?
* Lower abdominal soft tissue tumor
* Subacute urine retention with Chilaiditi syndrome
* Vovulus
* Colon cancer with obstruction

==Answer==

Sagittal reformatted contrast enhanced abdominal computed tomography ([[#fig2|Fig. 2]] ) showed the Chilaiditi’s sign (small arrow) and enlarged prostate gland, causing urine retention and exaggerative vesical distension (large arrow). A Foley catheter was inserted and 1850 mL clear urine was drained out. The clinical symptoms improved. Because this patient had severe congestive heart failure, he underwent long-term Foley catheter insertion instead of transurethral prostatectomy. Hepato-diaphragmatic interposition of the bowel, known as Chilaiditi’s sign, is a rare and an often asymptomatic anomaly. When this discovery is accompanied by gastrointestinal symptoms, such as constipation, abdominal pain, distension, and vomiting, it is known as Chilaiditi syndrome.



{| style="text-align: center; border: 1px solid #BBB; margin: 1em auto; max-width: 100%;"
|-
|

[[Image:draft_Content_317826585-1-s2.0-S2351979715000286-gr2.jpg|center|267px|Sagittal reformatted contrast enhanced abdominal computed tomography shows the ...]]

|-
| 

Figure 2.

Sagittal reformatted contrast enhanced abdominal computed tomography shows the Chilaiditi’s sign (small arrow) and enlarged prostate gland, causing urine retention and exaggerative vesical distension (large arrow).


|}

==Conflict of interest==

All authors declare no conflicts of interest.

← Older revision	Revision as of 11:00, 15 May 2017
(No difference)

Lin Chiu 2015a - Revision history

Scipediacontent: Scipediacontent moved page Draft Content 317826585 to Lin Chiu 2015a

Scipediacontent: Created page with "==Question== A 77-year-old man with a history of benign prostate hypertrophy and ischemic heart disease was referred to our emergency department because of progressive abdomi..."