conclusions the addition of ketamine to intravenous fentanyl plus acetaminophen pca had not extra effects in relieving post abdominal surgery pain. results there were no significant demographic differences between two groups. pain scores (at rest, while moving and coughing) during the first 48 hours were not significantly different between two groups (p values = 0.361, 0.367 and 0.204, respecti...

intra-abdominal hernias are rare conditions usually secondary to congenital defects, with pericecal hernias accounting for a minority of them. they can be difficult to diagnose due to non-specific presentations but may lead to strangulation and thus require early management. we herein report a rare case of pericecal hernia with gangrenous appendicitis in an 88 year-old lady presenting with feat...

pneumatic rectosigmoid rapture is usually occurred following the inappropriate fun by direct entering a high volume of the air through the pneumatic device to the anus. such an event was reported for the first time in 1904 by stone. diagnosis and treatment of such injuries are often delayed because of some social limitations and preventing the patient form explaining the event. colon sigmoid ru...

aggressive fibromatosis or desmoid tumors, histologically indicated by small bundles of spindle cells in a fibrous background, are uncommon benign tumors without metastasis. they are recurrent and aggressive and their recurrence and severity is exacerbated following surgical operation. based on previous reports, these tumors rarely present as intra-abdominal abscesses. herein, a 54-year-old wom...

conclusions it is important to keep in mind that even peritoneal involvement may be seen despite intact hepatic cysts. careful excision of these cysts is the treatment of choice. case presentation a 40-year-old man was referred to the emergency department with dull and intermittent periumbilical pain in the left and right lower quadrant regions accompanied by moderate tenderness and rebound wit...

The term 'acute abdomen' represents a rapid onset of severe symptoms that may indicate lifethreatening intra-abdominal pathology. Pain is usually a feature but is not always the case. A pain-free acute abdomen is more likely in the elderly, in children and in the third trimester of pregnancy. [1] The differential diagnosis is extremely wide and definitive diagnosis is often difficult, particula...