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

Familial Mediterranean fever is an inherited disease, occurring almost exclusively in Arabs, Jews and Turks. Cases are very rarely described in the USA, USSR, France, and patients are all natives to the Mediterranean area. This paper describes two cases of familial Mediterranean fever in brothers native to Campania, Italy. Both had complained of repeated episodes of fever, with acute abdomen, thoracalgia and arthralgia since the age of about 20. One of them had had pleuritis when he was 6 years old. In the period preceding our first observation, both underwent laparotomy to evaluate abdominal symptoms, with negative results. After ruling out other diseases with similar signs and symptoms, we raised the hypothesis of familial Mediterranean fever, despite the fact that the literature has described very few Italian natives affected by this disease. The diagnostic hypothesis was confirmed by the positivity of the metaraminol provocation test. At the same time we evaluated the presence of amyloidosis by rectal biopsy, with negative results. Treatment with colchicine 1 mg/day per os was established. Dramatic improvement of the symptoms was observed in both patients. The present paper stresses the importance of familial Mediterranean fever, its correct diagnosis in Italy and the fundamental role played by the metaraminol provocation test as a determinant diagnostic tool. It allows establishment of appropriate treatment as soon as possible, so that renal amyloidosis, the most severe complication and major prognostic determinant of familial Mediterranean fever, can be prevented. Inappropriate, useless and potentially harmful surgical diagnostic procedures are also avoided.
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PMID:[Familial Mediterranean fever: a report of 2 cases of Italian origin]. 146 26

On occasion of a laparotomy on account of an unclear acute abdomen in a 30-year-old patient the surprising diagnosis of a spontaneous rupture of the spleen in amyloidosis was made. The patient died already 3 months after the appearance of the first uncharacteristic symptoms acutely from heart failure due to amyloidosis of the myocardium of pericollagenic type of high degree.
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PMID:[Spontaneous splenic rupture as a leading symptom of primary amyloidosis]. 746 15

Familial mediterranean fever (FMF) is an hereditary disease transmitted in an autosomal recessive way and characterized by recurrent and brief episodes of fever and pain secondary to serositis. The pain is usually located in abdomen simulating an acute abdomen, and in thorax in the form of pleuritic pain. The most severe complication of the FMF is the development of amyloidosis being the main cause of death. This illness affects an specific ethnic group of the mediterranean area, but the prevalence in our area is low. We present the case of a 30 years old man with recurrent thoracic and abdominal pain, whose final diagnostic was FMF. Insisting on the difficulty that it was recognize this proper illness.
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PMID:[Fever and abdominal pain. A case of familial mediterranean fever]. 1562 54

Splenic rupture is frequently produced due to traumatic mechanisms, being referred to as spontaneous or pathological when there is no history of trauma or there is an underlying splenic disease. Spontaneous splenic rupture due to amyloid deposits is a very uncommon cause of surgical acute abdomen. The patient in this case is a woman admitted with acute abdomen secondary to spontaneous splenic rupture, whose final diagnosis was primary amyloidosis.
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PMID:[Spontaneous splenic rupture due to amyloidosis]. 1607 11

We report the case of a patient with systemic amyloidosis who developed a life-threatening spontaneous haemorrhage from an amyloid kidney. A review of the literature suggests that this is a rare complication of renal amyloidosis. However, the grossly abnormal renal angiography observed in our patient has previously been described in the literature. Therefore, spontaneous renal haemorrhage should be considered a risk in any systemic amyloid patient, especially in the differential diagnosis for those patients with the condition who present with an acute abdomen.
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PMID:Major spontaneous renal haemorrhage as an unusual complication of systemic amyloidosis. 2156 41

A 72-year-old woman, 157 cm in height and weighing 45 kg, was scheduled for emergency surgery for acute abdomen suggestive of gastrointestinal perforation. During the procedure, a triluminal central venous catheter (CVC) was inserted via the left internal jugular vein; venous blood could be aspirated separately through its lumens. On attempting blood transfusion, we noticed that the opening of one the CVC lumen tips was blocked and blood pumping was thus performed to achieve rapid transfusion. Colostomy was then performed and the transverse colon resection surgery was completed. Postoperative CT revealed right-sided hemothorax, a mediastinal hematoma located in the anterior region, and extravascular findings of CVC. The CT findings suggested a perforation of the left internal jugular vein due to the catheter tip. In the present case, the intraoperative pumping performed to enable rapid blood transfusion was believed to have caused blood vessel perforation. After the intraoperative blood vessel perforation, the condition may have been aggravated by steroid use, amyloidosis, and blood vessel fragility, ultimately presenting the extravascular findings observed on CT. We thus believe that in cases where CVC is inserted via the left internal jugular vein, blood pumping in particular is believed to be dangerous. Although the risks of blood vessel perforation when using CVC are relatively low, the possibility of unexpected complications should be borne in mind.
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PMID:[Case of large vein perforation caused by pumping using central venous catheter revealed by postoperative CT]. 2211 65

A 62 year-old woman who presented with an atraumatic acute abdomen was discovered to have haemoperitoneum with splenic rupture on urgent computed tomography and was immediately referred for life-saving emergency splenectomy. Histopathological examination revealed secondary splenic amyloidosis. The patient was later found to be suffering from infective endocarditis secondary to her permanent cardiac pacemaker. This report describes a patient who could have suffered from a long-standing infected vegetation on a permanent cardiac pacemaker, which led to splenic amyloidosis and spontaneous splenic rupture.
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PMID:Splenic amyloidosis: a rare cause of spontaneous splenic rupture. 2217 63

Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease, which is diagnosed especially in Mediterranean patients, but is a rare disorder in our geographical area. Due to its rarity and symptoms consisting mainly in recurrent episodes of fever and serositis, it may be mistaken with other, more frequent diseases, especially acute abdomen and systemic rheumatic diseases. The most important life-threatening complication is secondary amyloidosis, which usually affects kidneys, with proteinuria up to nephrotic syndrome and chronic kidney disease progressing to end-stage renal disease requiring dialysis or transplantation. In patients with suspected amyloidosis, kidney biopsy or submucosal rectal biopsy are the methods of choice for diagnosis. Kidney biopsy is also useful in patients with FMF who start to develop proteinuria, since other non-amyloid glomerular involvement may appear in FMF. Colchicine is now the gold standard for treatment, not only to reduce the frequency of attacks but also to improve renal prognosis. For this reason, the sooner the diagnosis is established the better the prognosis will be since the patient will benefit from the appropriate treatment with Colchicine. We present the case of a young female patient diagnosed through kidney biopsy with amyloid A (AA) amyloidosis after 30 years of evolution of FMF and we review the present knowledge regarding the pathogenesis and management of this rare genetic disease.
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PMID:Familial Mediterranean fever-associated renal amyloidosis: case report and review of the literature. 3223 8

Multiple myeloma is a rare malignancy that exhibits a wide range of possible clinical presentations. In recent years, with the advent of stem cell transplantation, the prognosis of patients with multiple myeloma has been increasing. We searched the literature for reports of atypical myeloma presentations to aid clinicians in formulating differential diagnoses and to increase the number of cases diagnosed early. There have been a number of reports of early ocular symptoms, including, but not limited to, proptosis, optic neuropathy, vision loss, retinal hemorrhage, and detachment. Neurological presentations included cranial nerve palsies, vertigo related to cerebellar involvement, and diabetes insipidus related to pituitary involvement. Among gastrointestinal manifestations, there are a number of reports of multiple myeloma presenting as acute and chronic pancreatitis. Mesenteric ischemia due to amyloidosis, acute abdomen, and hepatosplenomegaly were also among reported presentations. When it comes to renal involvement, while acute renal failure and proteinuria are typical, there are reports of patients presenting with both nephritic and nephrotic forms of glomerular disease, as well as end-stage renal disease requiring dialysis. We believe that it is essential for clinicians to keep reporting atypical multiple myeloma presentations and consider it as a possible diagnosis in a patient with serious, atypical symptoms.
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PMID:Uncommon Presentations of Multiple Myeloma. 3263 79