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

Two cases of spontaneous atheromatous embolization associated with unusual complications are presented. One is an 85-year-old man who developed an acute abdomen and underwent a surgical resection of totally infarcted left-sided colon. Histologically, multiple acute atheromatous emboli were found occluding the serosal and pericolic mesenteric arteries causing transmural necrosis of the involved portion of bowel. The other is an 80-year-old woman who had had a coronary heart disease, hypertension, and renal insufficiency, and terminally developed a rapid deterioration of renal function and melena. Postmortem examination showed a severely, ulcerated, aortic atherosclerosis and widespread, recurrent, atheromatous emboli in many abdominal organs with the resultant severe nephrosclerosis, gastrointestinal mucosal hemorrhagic necrosis, and multiple infarcts in the pancreas and spleen. In addition, there was focal cortical necrosis of the kidneys accompanied with glomerular capillary fibrin thrombi indicating disseminated intravascular coagulation (DIC). These findings seen in the present two cases were briefly discussed in light of the previous pertinent literature.
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PMID:Atheromatous embolization. Report of two cases with unusual complications. 650 92

We describe herein the unusual case of a 68-year-old Japanese man who underwent laparotomy for an acute abdomen caused by diffuse peritonitis, which revealed perforation of the gallbladder without any stones. A cholecystectomy was subsequently carried out, and histological examination showed marked atherosclerosis of the gallbladder associated with acute inflammatory changes. It is most likely that circulatory disturbance of the gallbladder wall due to the atherosclerosis played an important role in the events leading to perforation. Acute acalculous cholecystitis is an uncommon condition which is extremely difficult to diagnose preoperatively. The clinicopathological features of this patient are of particular interest and importance in terms of pathogenesis as well as treatment.
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PMID:Perforation of acalculous cholecystitis associated with localized atherosclerosis: report of a case. 908 55

In summary, we report two cases of mesenteric ischemia following cocaine abuse in young women. In such cases it is always difficult to prove a direct causal relationship between the abuse of cocaine and mesenteric ischemia. Both our patients were relatively young (in their thirties) and did not have any history of atherosclerosis, and their urine toxicity screens were positive for the use of cocaine. Cocaine-related hospital visits are on the increase. Mesenteric ischemia should be considered in the differential diagnosis when evaluating a young patient with a history of cocaine abuse presenting with an acute abdomen.
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PMID:Mesenteric ischemia secondary to cocaine abuse: case reports and literature review. 917 33

The mesenteric infarction is a rare but life threatening cause of acute abdomen. A 55-year-old woman was referred to the hospital because of acute mesenteric infarction and in the history claudication. In the absence of risk factors (atrial fibrillation, atherosclerosis, nicotin abusus) a postoperative work up was started to identify the cause of the arterial occlusions. A primary antiphospholipid-antibody syndrome was found. The patient is now receiving low-dose aspirin and anticoagulation therapy. The follow-up over now 14 months shows no further events.
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PMID:[Mesenteric infarct in primary antiphospholipid antibody syndrome]. 943 19

This is a detailed histological autopsy study of 47 cases of macroscopically recognisable flat intraendometrial haemorrhage into the atrophic lining of the uterine cavity. The average age of the studied women was 71 years. The majority of the deceased patients (61%) had suffered from various cardiovascular diseases or acute abdomen; the rest had disseminated carcinoma, chronic lung, kidney or liver diseases. The most common cause of death was cardiovascular failure (68%), followed by respiratory failure, cerebrovascular accident and renal or liver failure. We have observed serious vascular changes in other organs in 22 cases (46%), many of these affected the gastrointestinal tract. The histological examination has always showed congestion of the endometrium and myometrium. In 38 cases there was also marked haemorrhage into the endometrial stroma which occasionally extended into the myometrium. The intensity of the bleeding resembled a haemorrhagic infarction in several instances. The myometrial arteries exhibited a variable degree of atherosclerosis with narrowing of their lumen. In our opinion, apoplexia uteri is caused by the state of permanent hypoperfusion leading to passive hyperaemia, and it is related to the degree of the arterial stenosis.
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PMID:[Apoplexia uteri--a postmenopausal bleeding into atrophic endometrium during terminal stress]. 1564 51

Abdominal apoplexy, the spontaneous hemorrhage into the peritoneal cavity, is usually caused by a rupture of visceral vessels such as short gastric arteries. Several factors such as pregnancy, hypertension and atherosclerosis have been described in association with abdominal apoplexy. Blunt trauma, inflammatory conditions, aneurysm rupture and rarely vomiting are some predisposing conditions. We report a very unusual case of a patient who had a spontaneous short gastric artery acute hemoperitoneum caused by forceful gagging during teeth brushing. The patient was treated with blood transfusion, fluids resuscitation, laparotomy, and suture ligation of the bleeder vessel. We also review the medical literature of abdominal apoplexy, a rare etiology of acute abdomen that should be recognized early in the Emergency Department.
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PMID:Short gastric artery apoplexy after gagging. 2319 60

Thoracic aortic disease is an important contributor to arterial disease and therefore, mortality in the UK. It has close associations with hypertension, atherosclerosis and genetic conditions such as Marfan syndrome. The cardiovascular consequences of acute aortic dissection or the rupture of a thoracic aneurysm are life threatening with a 1% increase in mortality per hour with a type A aortic dissection and a high 30-day mortality rate. The clinical diagnosis can be difficult for the general physician as the symptoms can mimic more common conditions such as acute coronary syndrome, pulmonary embolism or acute abdomen. The investigations that carry the highest sensitivity and specificity, CT, transoesophageal echocardiography and MRI are not usually first-line investigations in most patients so a high index of clinical suspicion is key. The management of acute aortic syndromes involves good initial resuscitation and early discussion with the cardiothoracic surgeons. Given the serious consequences of acute aortic syndromes, it is important for all military doctors to be aware of these presentations and to appreciate the difficulties that can be encountered when trying to accurately diagnose them. Routine medicals, particularly entrance medicals, present a unique clinical opportunity to recognise the clinical features that would warrant further investigation and specialist advice.
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PMID:Thoracic aortopathies in the military patient. 2624 6