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Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report

RATIONALE: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare. PATIENT CONCERNS: The present patient was an 18-year-old female w...

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Autores principales: Li, Jian, Xu, Run, Hu, Deng-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336540/
https://www.ncbi.nlm.nih.gov/pubmed/30633226
http://dx.doi.org/10.1097/MD.0000000000014115
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author Li, Jian
Xu, Run
Hu, Deng-Min
author_facet Li, Jian
Xu, Run
Hu, Deng-Min
author_sort Li, Jian
collection PubMed
description RATIONALE: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare. PATIENT CONCERNS: The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission. DIAGNOSES: A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor. INTERVENTIONS: The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively. OUTCOMES: The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence. LESSONS: Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence.
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spelling pubmed-63365402019-01-24 Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report Li, Jian Xu, Run Hu, Deng-Min Medicine (Baltimore) Research Article RATIONALE: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare. PATIENT CONCERNS: The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission. DIAGNOSES: A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor. INTERVENTIONS: The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively. OUTCOMES: The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence. LESSONS: Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence. Wolters Kluwer Health 2019-01-11 /pmc/articles/PMC6336540/ /pubmed/30633226 http://dx.doi.org/10.1097/MD.0000000000014115 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Li, Jian
Xu, Run
Hu, Deng-Min
Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report
title Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report
title_full Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report
title_fullStr Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report
title_full_unstemmed Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report
title_short Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report
title_sort rare acute abdominal condition caused by mesenteric fibromatosis perforation: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336540/
https://www.ncbi.nlm.nih.gov/pubmed/30633226
http://dx.doi.org/10.1097/MD.0000000000014115
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