Cargando…
Spinal surgery for gallstones disease – Case report of a rare differential diagnosis
INTRODUCTION AND IMPORTANCE: Abdominal pain in the right upper quadrant is very common for patients to present in the emergency department. Finding the correct diagnosis seems straightforward in most cases but can be challenging. CASE PRESENTATION: We present the case of a 75-year-old male with a ra...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006330/ https://www.ncbi.nlm.nih.gov/pubmed/35405511 http://dx.doi.org/10.1016/j.ijscr.2022.106995 |
_version_ | 1784686643680116736 |
---|---|
author | Linke, K. Schoen, S. Fourie, L. Klasen, J.M. |
author_facet | Linke, K. Schoen, S. Fourie, L. Klasen, J.M. |
author_sort | Linke, K. |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Abdominal pain in the right upper quadrant is very common for patients to present in the emergency department. Finding the correct diagnosis seems straightforward in most cases but can be challenging. CASE PRESENTATION: We present the case of a 75-year-old male with a rare differential diagnosis for right upper quadrant and back pain, initially diagnosed as symptomatic cholelithiasis. After referral to an abdominal surgeon, detailed history taking prior to planned cholecystectomy revealed a record of back pain due to spinal degeneration and fusion surgery, as well as a bulb of the right abdominal wall with hypesthesia in a dermatomal area in the right upper quadrant. Considering these “new” facts, a spinal surgeon was consulted and a foraminal disc hernia of the thoracic vertebrae 11/12 was identified as the cause of symptoms. Instead of the initially planned cholecystectomy, a right-sided facetectomy Th11/12, sequestrectomy and unilateral transpedicular stabilization to decompress the nerve root was successfully performed. CLINICAL DISCUSSION: Although, symptomatic cholelithiasis is one of the most common diagnoses for patients presenting with right upper quadrant pain in the presence of gallstones, other differential diagnoses have to be considered. Thoracic disc herniations can present with atypical symptoms that mimic other non-spinal causes and may pose a diagnostic challenge, sometimes even leading to unnecessary surgery. CONCLUSION: This case highlights a rare differential diagnosis for one of the most common diseases seen by emergency physicians. It emphasizes the risk of working under time pressure, especially in an emergency setting, which may lead to premature diagnostic error and treatment, endangering patient's care and safety. |
format | Online Article Text |
id | pubmed-9006330 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-90063302022-04-14 Spinal surgery for gallstones disease – Case report of a rare differential diagnosis Linke, K. Schoen, S. Fourie, L. Klasen, J.M. Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Abdominal pain in the right upper quadrant is very common for patients to present in the emergency department. Finding the correct diagnosis seems straightforward in most cases but can be challenging. CASE PRESENTATION: We present the case of a 75-year-old male with a rare differential diagnosis for right upper quadrant and back pain, initially diagnosed as symptomatic cholelithiasis. After referral to an abdominal surgeon, detailed history taking prior to planned cholecystectomy revealed a record of back pain due to spinal degeneration and fusion surgery, as well as a bulb of the right abdominal wall with hypesthesia in a dermatomal area in the right upper quadrant. Considering these “new” facts, a spinal surgeon was consulted and a foraminal disc hernia of the thoracic vertebrae 11/12 was identified as the cause of symptoms. Instead of the initially planned cholecystectomy, a right-sided facetectomy Th11/12, sequestrectomy and unilateral transpedicular stabilization to decompress the nerve root was successfully performed. CLINICAL DISCUSSION: Although, symptomatic cholelithiasis is one of the most common diagnoses for patients presenting with right upper quadrant pain in the presence of gallstones, other differential diagnoses have to be considered. Thoracic disc herniations can present with atypical symptoms that mimic other non-spinal causes and may pose a diagnostic challenge, sometimes even leading to unnecessary surgery. CONCLUSION: This case highlights a rare differential diagnosis for one of the most common diseases seen by emergency physicians. It emphasizes the risk of working under time pressure, especially in an emergency setting, which may lead to premature diagnostic error and treatment, endangering patient's care and safety. Elsevier 2022-03-29 /pmc/articles/PMC9006330/ /pubmed/35405511 http://dx.doi.org/10.1016/j.ijscr.2022.106995 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Linke, K. Schoen, S. Fourie, L. Klasen, J.M. Spinal surgery for gallstones disease – Case report of a rare differential diagnosis |
title | Spinal surgery for gallstones disease – Case report of a rare differential diagnosis |
title_full | Spinal surgery for gallstones disease – Case report of a rare differential diagnosis |
title_fullStr | Spinal surgery for gallstones disease – Case report of a rare differential diagnosis |
title_full_unstemmed | Spinal surgery for gallstones disease – Case report of a rare differential diagnosis |
title_short | Spinal surgery for gallstones disease – Case report of a rare differential diagnosis |
title_sort | spinal surgery for gallstones disease – case report of a rare differential diagnosis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006330/ https://www.ncbi.nlm.nih.gov/pubmed/35405511 http://dx.doi.org/10.1016/j.ijscr.2022.106995 |
work_keys_str_mv | AT linkek spinalsurgeryforgallstonesdiseasecasereportofararedifferentialdiagnosis AT schoens spinalsurgeryforgallstonesdiseasecasereportofararedifferentialdiagnosis AT fouriel spinalsurgeryforgallstonesdiseasecasereportofararedifferentialdiagnosis AT klasenjm spinalsurgeryforgallstonesdiseasecasereportofararedifferentialdiagnosis |