Mycetoma on a background of tuberculosis with incidental gastric mesenteroaxial volvulus

Case contributed by Dr Amro Omar

Presentation

Acute abdominal pain

Patient Data

Age: 60
Gender: Male

Mycetoma on a background of tuberculosis with incidental gastric mesenteroaxial volvulus

Case Discussion

Aspergilloma (Mycetoma, Fungus Ball)

Represents a saprophytic infection in preexisting structural lung disease (cavitary or bulla from TB,end-stage sarcoid,emphysema).Commonly in upper lobes, solitarylesions. The fungus grows in the cavity, creating a “fungus ball” consisting of fungus,mucus, and inflammatory cells. Treatment is with surgical resection and intracavitary administration of amphotericin.

In mesentericoaxial gastric Volvulus. Stomach rotates around  its short axis (perpendicular to long axis) , 

Fundus is caudal to antrum .

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