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

Acute appendicitis was once thought to be rare among rural blacks. It is now known that appendicitis is relatively common among Africans and in Africa. At the University College Hospital, Ibadan, Nigeria, appendicitis is the most common cause of acute abdomen on the surgical service.One hundred and eighty-one cases of appendicitis were operated on in a two-year period from June 1975 to June 1977. A retrospective analysis of 47 fully documented cases showed that wrong diagnosis occurred more often in females than in males. There was a high incidence of perforation (31.9 percent) in this series. Deaths occurred in perforated cases and cases complicated by typhoid perforation of the terminal ileum. Parasites and their ova were often present in the lumen of some appendices.The age group most affected was 16 to 20 years. This disease affected low, middle and upper income groups in our society. Chronic, recurrent appendicitis was frequently diagnosed (31.9 percent) and history of recurrent right lower quadrant pain as far back as three months was often elicited from these patients.
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PMID:Appendicitis in a tropical African population. 53 24

A study was performed to determine the value of peritoneal lavage in the acute abdomen not related to trauma. Lavage was performed in 33 patients in the evaluation of abdominal pain of sufficient degree to warrant consideration for surgical intervention. Peritoneal lavage was truly positive or truly negative in 64% of the cases. It showed false negative results in 28% and false positive results in 8%. The lavage was most accurate in the evaluation of appendicitis, colonic disease, and intra abdominal bleeding. It was highly inaccurate in the evaluation of cholecystitis and peptic ulcer disease. It was concluded that the peritoneal lavage can be a useful adjunct in the evaluation of patients with abdominal pain and should be considered in difficult diagnostic problems but not routinely employed.
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PMID:Diagnostic peritoneal lavage in evaluating acute abdominal pain. 113 36

A 49 years old female patient entered the surgical department because of epigastric and ileocoecal pains with the symptoms of acute abdomen. A surgical intervention was performed because of supposed appendicitis, but it was not verified. During the surgical observation the patient was confused and negativistic so she was transferred to the psychiatric department. Because of loss of 20 kg weight, high blood sedimentation and anaemia she was sent to our department with the suspicion of an organic disease. A moderate exophthalmos, glittering eyes and Graefe's sign was noted, therefore hyperthyroidism was diagnosed, which was proved by Kocher's blood picture, low serum cholesterol, extremely high T3 and T4 level, and iodine storage diagram. The antithyreotic treatment resulted a dramatic improvement in the extremely serious moreover hopeless case and after a long-term treatment the patient became symptom-free without complaints. Later because of regression of hyperthyreoidism and the growing nodular goitre the patient was treated on two occasions with radioactive iodine. At present the patient is in remission.
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PMID:[Successful treatment of hyperthyroidism simulating acute abdomen and psychosis]. 137 58

The application of laparoscopy for diagnosis and treatment of the acute abdomen, appendicitis, and in the management of small and large bowel diseases is a natural step for the general surgeon. Acute appendicitis is a common general surgical problem that can be difficult to diagnose. Laparoscopy is an excellent aid in diagnosis and laparoscopic appendectomy can be performed easily. The controversy of incidental appendectomy and recommendations for management are discussed. Small and large bowel diseases and their surgical treatment now can be managed laparoscopically thus decreasing morbidity and mortality. The uses and limitations of these techniques are discussed as well as future trends in treatment.
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PMID:Laparoscopic management of the acute abdomen, appendix, and small and large bowel. 138 4

Disseminated cytomegalovirus infection occurs predominantly in immunocompromised hosts. Involvement of the gastrointestinal tract in the acquired immunodeficiency syndrome is frequent, but to our knowledge there is only one report of involvement of the appendix. In this study, a patient with a history of the acquired immunodeficiency syndrome who presented with fever and an acute abdomen is described. At surgery, appendicitis was found. In the surgical specimen, appendicitis and cytomegalovirus infection were found. Cytomegalovirus should be considered as a possible cause of appendicitis in the acquired immunodeficiency syndrome.
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PMID:Cytomegalovirus infection of the appendix in patient with the acquired immunodeficiency syndrome. 130 61

The Authors present and discuss a personal case of perforated acute neonatal appendicitis. After a brief review of literature, they delineate the elements that are responsible of rareness of this affection and the causes of frequency of perforation and mortality. Diagnosis is difficult in newborns because clinical and laboratory signs are not specific. They conclude affirming that acute abdomen is an indication for operation even if pre-operating diagnosis of acute neonatal appendicitis is not possible.
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PMID:[Acute perforated appendicitis in newborns]. 178 17

Mesenteric cysts are rare intraabdominal lesions of childhood that may vary in presentation from an asymptomatic mass to an acute abdomen. From 1970 to 1990, 15 children were diagnosed and treated for mesenteric cysts at Ste Justine Hospital in Montreal. The ages ranged from birth to 18 years (average age, 6 years). There were 9 boys and 6 girls. Ten patients required emergency surgery and five underwent elective surgery. The main presenting symptom was abdominal pain. Ten patients had preoperative ultrasounds that were diagnostic for a cystic mass in all patients. The second most frequent preoperative diagnosis was appendicitis. The cysts were located in the small bowel mesentery in 5 cases, the base of the mesentery with retroperitoneal extension in 4 cases, the transverse mesocolon in 4 cases, and the gastrocolic ligament in 2 cases. Operative procedures performed included complete cyst excision (9 patients), complete excision with intestinal resection (5 patients), and drainage of the cyst (1 patient). The only recurrence in this series occurred after drainage. One other patient had recurrence of a mesenteric cyst following resection performed elsewhere. Mesenteric cysts are rare in children, are usually symptomatic, and are most commonly misdiagnosed as acute appendicitis. Accurate preoperative diagnosis is possible with current ultrasonographic imaging techniques. Complete cyst resection is the procedure of choice and results in an excellent outcome.
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PMID:Mesenteric cysts in children. 181 63

The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of volvulus of the small intestine, a stress ulcer, gangrenous appendicitis, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute abdomen as a postoperative complication]. 182 40

The ability to improve surgical decision-making in the acute abdomen using selective laparoscopy is now established. When the decision to operate is uncertain laparoscopy not only identifies those patients who do not require laparotomy, but also reveals those who need surgery which might otherwise have been delayed. Furthermore, the high error rates in diagnosing acute appendicitis in young women provides overwhelming support to the current view that all women with suspected appendicitis should undergo laparoscopy before appendicectomy, irrespective of clinical 'certainty'. Improvements in the management of the acute abdomen can also be achieved by other techniques such as computer-assisted diagnosis (McAdam et al, 1990) and peritoneal cytology (Stewart et al, 1988), and a combination of these with selective laparotomy would be appropriate. Initial patient assessment using a structured proforma would appear to be one of the most significant factors in the improvement of diagnostic accuracy associated with the use of computers (Gunn, 1976), and their combination with a policy of selective laparoscopy has been shown to be beneficial (Paterson-Brown et al, 1989). The ability to detect which patients are likely to benefit from laparoscopy by performing peritoneal cytology first (Vipond et al, 1990) has been shown to be helpful in reducing the number of patients who undergo a 'negative laparoscopy' (Baigrie et al, 1990). It is now time for laparoscopy to return to the bosom of general surgery from where it was conceived almost a century ago. When it does, as the developments in laparoscopic cholecystectomy would predict it will, so surgeons in training must take the earliest opportunity to become as familiar and proficient with the technique as their gynaecological colleagues have done, even if this means attending the gynaecological operating lists to do so. It is only then that the undoubted benefits of laparoscopy will be spread more widely in general surgery and particularly for the patient with acute abdominal pain.
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PMID:The acute abdomen: the role of laparoscopy. 183 86

Cystic lymphangioma is an uncommon tumor of the small bowel. A case in the ileum in a 3 years old boy is described. The clinical picture was with 10 months of progression with constipation, abdominal pain associated with meals and finally an acute abdomen suggestive of appendicitis. A conservative surgical treatment with segmental intestinal resection and termino-terminal anastomosis was curative. The anatomopathological findings are described and a revision of the literature is done.
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PMID:[Cystic lymphangioma of the ileum. A case report]. 186 48


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