Acute Aortic Thrombus Presenting as Cauda Equina Syndrome

Mayo, Emily; Herdman, Gareth

doi:10.1016/j.jemermed.2020.03.011

Cited by 4 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The final studies included were case reports or series. Eighteen reports referred to abdominal conditions that mimic spinal diseases ( Table 1 ), 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 among them a patient with cyclic lumbar back pain who received a lumbar spinal fusion who, after persisting symptoms led to further diagnostic procedures, was ultimately diagnosed with endometriosis. 15 Spinal symptoms included paraplegia and urinary incontinence as results of acute aortic pathologies.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Lumbar Spondylodiscitis Mimicking Cholecystitis: A Case Report and Review of Literature

Mirbagheri

Etminan

Schölch

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Background and Objective: Lower back pain is a frequent cause of Emergency Department visits and one of the leading causes of the disease burden worldwide. The purpose of this case report and literature review was to discuss atypical abdominal entities mimicking spinal diseases typically presenting with lower back pain. Patient and Methods: A 79-year-old male presented with lower back pain and urinary incontinence after receiving a non-image-guided lumbar infiltration treatment four weeks prior to admission. The MRI highlighted multi-segmental hyperintensities in the intervertebral disc spaces of the lumbar spine indicative for spondylodiscitis. Antibiotic treatment over a week did not lead to significant clinical improvement. Blood cultures, cardiologic, otorhinolaryngologic and dental examinations turned out negative for a focus of infection. A CT-guided biopsy was indicated after discontinuation of antibiotic treatment for less than 24 hours. Rapid clinical deterioration with concomitant onset of abdominal pain resulted in the diagnosis of cholecystitis, which required cholecystectomy. We performed a systematic literature review using the Pubmed database for the key words “spondylodiscitis”, “spine”, “abdominal” and “cholecystitis”, to identify abdominal diseases that mimic spine pathologies and spinal diseases that mimic abdominal pathologies. Results: No other report in English literature of cholecystitis associated with initial onset of lower back pain was identified. Eighteen reports referred to abdominal conditions that mimic spinal diseases among them a patient with cyclic lumbar back pain who received a lumbar spinal fusion who, after persisting symptoms led to further diagnostic procedures, was ultimately diagnosed with endometriosis. Spinal symptoms included paraplegia and urinary incontinence as results of acute aortic pathologies. Eleven reports presented spinal pain mimicking abdominal conditions including abdominal pain and diarrhea as well as have had surgical procedures such as an appendectomy before the spinal condition was discovered. Conclusion: Clinical symptoms of the spine such as lower back pain can be unspecific and lead to false conclusions in the presence of concomitant pathologies in MRI. Only clinical deterioration in our case patient prompted correction of the diagnosis on day seven. Initial workup for alternative common infectious foci such as lung and urinary tract was performed, but further abdominal workup despite the absence of abdominal symptoms may have led to an earlier diagnosis. Our literature review found several cases of misdiagnosed spinal and abdominal conditions, respectively. Some had undergone unnecessary invasive surgical procedures before the right diagnosis was concluded. Because of the high incidence of symptoms such as lumbar back pain as well as abdominal pain, considering optimal patient care as well as economic aspects it would be essential to conduct an interdisciplinary clinical management to avoid errors in the early stage of diagnostics.

show abstract

Section: Literature Review and Discussionmentioning

confidence: 99%

Lumbar Spondylodiscitis Mimicking Cholecystitis: A Case Report and Review of Literature

Mirbagheri

Etminan

Schölch

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

show abstract

“…cervicothoracic compression, discitis or malignancy) or to consider non-spinal causes (e.g. acute aortic syndrome or primary urological causes of urinary retention or incontinence) [22].…”

Section: How Should Patients Be Evaluated?mentioning

confidence: 99%

Diagnosis of cauda equina syndrome in the emergency department

Metcalfe,

Hoeritzauer,

Angus

et al. 2023

Emerg Med J

View full text Add to dashboard Cite

Cauda equina syndrome (CES) is a spinal emergency that can be challenging to identify from among the many patients presenting to EDs with low back and/or radicular leg pain. This article presents a practical guide to the assessment and early management of patients with suspected CES as well as an up-to-date review of the most important studies in this area that should inform clinical practice in the ED.

show abstract

Acute onset low back pain leading to a diagnosis of cauda equina syndrome: a case study

Read¹,

Mortimore

2022

Practice Nursing

View full text Add to dashboard Cite

Cauda equina syndrome is rarely seen in primary care, but advanced practitioners must be aware of the possibility. Haley Read and Gerri Mortimore highlight a case study leading to a diagnosis of the condition One of the most common symptoms managed in primary care is lower back pain, which affects approximately 20% of the UK population at any one time ( National Collaborating Centre for Primary Care, 2009 ). There are many differential diagnoses for the cause of back pain, with one such potential diagnosis being cauda equina syndrome. In this instance, it is of paramount importance that the correct diagnosis is reached quickly with urgent referral into secondary care for the instigation of treatment to prevent paralysis. This case review will examine a patient presenting to primary care with lower back pain and diagnosed with cauda equina syndrome.

show abstract

Acute Aortic Thrombus Presenting as Cauda Equina Syndrome

Cited by 4 publications

References 14 publications

Lumbar Spondylodiscitis Mimicking Cholecystitis: A Case Report and Review of Literature

Lumbar Spondylodiscitis Mimicking Cholecystitis: A Case Report and Review of Literature

Diagnosis of cauda equina syndrome in the emergency department

Acute onset low back pain leading to a diagnosis of cauda equina syndrome: a case study

Contact Info

Product

Resources

About