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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Delayed spontaneous rupture of the urinary bladder following augmentation enterocystoplasty is a serious life-threatening complication of uncertain etiology. Multiple factors are believed to contribute to the mechanism of bladder perforation. Ruptured augmented bladders share a common urodynamic pattern of high leak point pressure of the urethra, with sensory and mechanical tolerance of high filling pressure. This combination seems to be the main predisposing factor for spontaneous perforation. Other risk factors, including catheter trauma during intermittent self-catheterization, urinary retention due to mucus retention or noncompliance with the catheterization protocol, chronic infection, and decreased sensation of bladder filling, may play roles in the mechanism of rupture. Clinically, patients present with sepsis, abdominal pain and distension, ileus, fever, oliguria and peritoneal irritation. The diagnosis is made on low pressure cystography, although failure of cystography to demonstrate extravasation is not unusual. Aggressive surgical treatment consists of immediate exploration, primary repair of the perforation, drainage of the perivesical space, suprapubic cystostomy and broad-spectrum antibiotics. Longterm management includes a strict intermittent catheterization schedule, anticholinergic therapy and urodynamic evaluation. Failure to achieve a low pressure storage reservoir by conservative means entails an increased risk of recurrent perforation. In such cases further surgical intervention should be considered. We present a 21-year-old paraplegic man 5 months after augmentation enterocystoplasty who required operation because of spontaneous rupture of the augmented bladder. Spontaneous delayed rupture of the bladder should be considered in the differential diagnosis of acute abdomen in patients after augmentation enterocystoplasty. Early surgical treatment and subsequent monitoring of the low pressure reservoir are recommended.
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PMID:[Delayed spontaneous rupture of the bladder following augmentation enterocystoplasty]. 222 70

Acute appendicitis remains an up to date issue, being the most frequent cause of surgical acute abdomen round the globe. The complications that occurs creates important therapeutically difficulties. The study, based on 114 cases, had analyzed not only the pathogen flora (type, association, frequency of certain germs, the relation between them and different pathological lesion), but also the immune response of the organism to septic aggression. The microbiological tests from the lumen and bont of the appendix and also from peritoneal cavity showed monobacterial infection (11%) and pluribacterial infection (89%). Association between aerobes and anaerobes germs was identified in 85%. The most frequent germs identified were E. coli (87%) and Bacteroides (55%). We didn't identify germs with particular pathogenesis and the immune response had no malfunction. We can conclude that time factor is the main element in constituting of complications during acute appendicitis. A late diagnosis and also a late surgical intervention are the bases for the gravity of the pathogenic process.
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PMID:[Immunologic and bacteriologic study of severe acute appendicitis. Diagnostics and therapeutic considerations]. 1768 54

The ovarian fibroma is a rare benign tumor originating from the connective tissue of the ovarian cortex. On occasion, the general surgeon may encounter ovarian fibroma while operating an acute abdomen. We present a series of 15 ovarian fibromas encountered in 13 patients over 11 years experience in our general surgical ward. Only four cases required emergency operations due to either tumors or adnexal torsion. High-resolution ultrasound scan with color Doppler suggested an ovarian fibroma in only ten cases, while CT and MRI were suggestive for the diagnosis in three other cases. Surgical treatment consisted of five ovarectomies, three adnexal resections and five total hysterectomies with bilateral salpingo-oophorectomy. Seven patients underwent laparoscopic surgery, four of them for an ovarian resection and in three for an adnexectomy. Laparoscopic approach has significant advantages by limiting parietal aggression with better cosmetic results, short hospital admission, lower costs, few postoperative adhesions and rapid recovery.
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PMID:Ovarian fibroma in the era of laparoscopic surgery: a general surgeon's experience. 1827 81

Emphysematous gastritis is a rapidly fatal and rare type of infectious gastritis. It may lead to involvement of esophagus, and organ necrosis, in its severe form. A 16-year-old, previously healthy, boy presenting with acute abdomen was diagnosed to have emphysematous gastritis on CT scan. During laparotomy, there was complete necrosis of the stomach, with patchy esophageal involvement. Aggressive management in the form of total gastrectomy, and later, transthoracic esophagectomy was done. However, it failed to alter the course of the illness, and the patient succumbed to the illness. Emphysematous gastritis is rare in young patients without known risk factors. Also, only two previous cases have been reported with esophageal involvement. We have presented this case with a brief review of literature.
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PMID:Emphysematous gastritis causing gastric and esophageal necrosis in a young boy. 1990 71

The paper presents a case of entero-mesenteric venous infarct, occurred in a man of 34 years, discovered intraoperator, when to intervene surgically in emergency surgery for acute abdomen of peritonitic type. The etiology of this venous infarct was posttraumatic, the patient underwent an abdominal aggression with seven days prior to onset of symptoms. In literature, the posttraumatic etiology is found in a small number compared to the large number of abdominal contusion, intimal lesional factor beeing associated with blood thickness. Paraclinical investigations were not significant in terms of preoperator diagnosis, surgical intervention (backward and forward thrombectomy of superior mesenteric vein with Fogarty probe and venosuture) having a favorable evolution. This intervention is practiced as an exception on the basis of the idea that venous thrombosis spreads to mezenteric vein and its collaterals followed by extensive arterial thrombosis and total compromise of intestinal viability.
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PMID:[Post traumatic entero-mesenteric venous infarct]. 2072 12

The term "chronic periaortitis" (CP), proposed by Mitchinson in 1984, comprises 3 main entities: idiopathic retroperitoneal fibrosis (IRF), inflammatory abdominal aortic aneurysms (IAAAs), and perianeurysmal retroperitoneal fibrosis (PRF).The presence of constitutional symptoms, high acute-phase reactants, positive autoantibodies, and associated autoimmune diseases suggests a systemic inflammatory process. Histopathologic findings show vasculitis with fibrinoid necrosis involving the aortic vasa vasorum as well as the small and medium retroperitoneal vessels.We reviewed the medical records of 608 patients with a diagnosis of vasculitis involving the gastrointestinal (GI) tract at the Mayo Clinic between January 1996 and December 2007. Only patients with biopsy-proven or typical angiographic findings of vasculitis localized to the GI tract were included.Five patients were identified with evidence of CP (1 patient with PRF, 1 with IRF, and 3 with IAAAs). Three patients were men, and the median age at diagnosis was 49 years. The diagnosis of GI vasculitis and CP was made simultaneously in 4 patients. At the time of onset, all patients had abdominal pain and constitutional manifestations; the median erythrocyte sedimentation rate was 62.5 mm/1 h (range, 20-86 mm/1 h). All patients had evidence of mesenteric vasculitis at angiography. Three patients also had associated renal artery stenoses. Abdominal computed tomography showed spleen infarcts in 2 patients, bowel wall thickening in 1, and liver infarction in 1. Two patients underwent surgical intervention for acute abdomen; there was histologic evidence of small bowel infarcts and infarction of the spleen and liver in 1. Oral prednisone was administered to all 5 patients (median starting dose, 60 mg/d; range, 25-80 mg/d). Three patients also received immunosuppressive agents, 1 tamoxifen, and 1 anti-tumor necrosis factor therapy. All patients had at least 1 relapse or recurrence of vasculitis, but at last visit, GI vasculitis and CP were in remission in all 5 patients.This study provides evidence that GI manifestations due to mesenteric vasculitis may be associated with CP. Vasculitic involvement of the renal arteries is also frequently present in these patients. Aggressive immunosuppressive treatment should be promptly initiated to forestall abdominal complications. These findings reinforce the hypothesis that a vasculitic process plays an important role in the pathogenesis of CP.
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PMID:Vasculitis of the gastrointestinal tract in chronic periaortitis. 2120 Jan 84