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

Overwhelming Clostridium septicum infection is a rare occurrence in children. It is seen almost exclusively as a complication of acute leukemia. A high index of suspicion in the leukemic child with an acute abdomen is the key to early diagnosis and improved survival. A case in a 13-year-old girl with acute myelogenous leukemia is reported and six pediatric cases in the literature were reviewed.
Cancer 1977 Aug
PMID:Clostridium septicum infection in childhood leukemia: report of a case and review of the literature. 26 32

An unusual case of lymphoma is presented in which small bowel intussusception due to a lymphomatous nodule caused an acute abdomen, requiring small bowel resection. Four weeks later a second intussusception caused intestinal obstruction, necessitating a second laparotomy and bowel resection. The high incidence of malignant tumor in adult cases leads us to recommend primary resection without manual reduction in all but rectosigmoid and selected small bowel cases.
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PMID:Adult intussusception; case report of recurrent intussusception and review of the literature. 93 58

With the increase in remission and survival in children with acute leukemia, the complication of acute abdomen has become increasingly important in the total care of these children. A total of 286 children with acute leukemia was treated at Memorial Hospital between 1966 and 1971. Sixteen or 5.6% of these children developed an acute abdomen during the course of their disease. During the same period, many other children developed symptoms and signs mimicking an acute abdomen. Of the 9 children treated surgically, 5 were long-term survivors. Two children treated conservatively died, and 5 patients were diagnosed at autopsy. Prognosis was better in those patients in remission at the time of surgery, and where remission was maintained by immediately restarting antileukemic chemotherapy. A more aggressive surgical approach to the acute abdomen, combined with careful supportive measures, is further adding to the numbers of long-term survivors in childhood leukemia.
Cancer 1975 Mar
PMID:Management of the acute abdomen in children with leukemia. 105 39

Fourteen cases of primary colonic non-Hodgkin lymphomas (NHL) with a mean age of 51.5 yrs and 64.3% of them female, are reported. While diagnoses were only obtained by cytologic or histopathologic means, 35.5% of the cases were in Stage 1e (S1e) and a further 42.6% in Stage 2e (S2e) and 7.1% in Stage 3e (S3e) according to the modified Manchester classification. 63.9% were of immunoblastic and 21.3% lymphoblastic type according to the Kiel classification. 85.2% of the tumours were located at the caecum. While acute abdomen required surgery in two patients, 85.2% of the series underwent radical interventions. 14.2% were able to receive chemotherapy with a subsequent total morbidity and mortality figures of 21.3% each. It is the authors' argument that prognosis is not solely dependent on the age, sex or the malignancy state of the tumour but more on its infiltrative stage and on the advent of treatment, whether by radical surgery and/or medical means.
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PMID:Primary colonic non-Hodgkin lymphomas: a retrospective clinicopathologic study of 14 cases. 139 68

Isolated, small bowel metastases from lung carcinoma are extremely rare; only 34 cases have been previously reported. Rarer still is the presentation of lung carcinoma with a lesion metastatic to the small bowel. These 34 cases and 3 recent ones from Easton Hospital (Easton, PA) were analyzed to clarify the clinical and pathologic features of the disease. The majority of patients had a history of abdominal pain (86%), melena (23%), or nausea and vomiting (26%). Few had weight loss (16%). Twenty-one patients (57%) came to the hospital with perforation and peritonitis, including 9 in whom lung carcinoma was undiagnosed before laparotomy. Thirteen patients (34%) underwent laparotomy because of small bowel obstruction, 2 (6%) for bleeding and 1 (3%) for a mass found during work-up. Squamous cell (49%) and large cell (22%) were the most common cell types, and the jejunum was the most common site of the metastases (79%). Survival time was dismal (mean 51 days) and was unaffected by therapy to the primary site of the cancer or its metastases. The authors conclude that small bowel metastases from lung carcinoma are not uncommon and may be seen more frequently as patients live longer after their diagnosis of cancer. Small bowel metastases must be considered in any patient with both lung carcinoma and abdominal pain, and should be expected in patients with both lung carcinoma and an acute abdomen.
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PMID:Small bowel metastases from primary lung carcinoma: a rarity waiting to be found? 148 99

The records of 101 patients with primary small intestinal malignant tumor at NTUH, collected from 1960 to 1989, were reviewed. These patients represented 1.2% of the patients with gastrointestinal cancer at NTUH over the same period. Fourty-two (41.6%) of the cancer patients had lymphomas, 30(29.7%) had adenocarcinomas, 26 (25.7%) had leiomyosarcomas, and 3(3.0%) had carcinoid tumors. The average age at cancer presentation was 47.5 years (range from 3 to 96). The lymphoma patients had an average age of 35.1 years, while adenocarcinoma patients averaged 60.4 years of age. Leiomyosarcoma and carcinoid tumors averaged 51.2 years and 59 years, respectively. There were 65 male patients and 36 female patients, and there was a male predominance in all groups except for the leiomyosarcoma group which had an equal sex ratio. Generally speaking, the incidence rate for the areas involved were similar in the duodenum, jejunum and ileum. However, adenocarcinomas were more common in the duodenum (53%) and 45% of lymphomas were found in the ileum, as were the carcinoid tumors (66%). The most common presenting symptom was abdominal pain (62%), with bleeding second (32%). Obstruction and palpable mass together were present in 29% of the cases. Body weight loss was found in 25% of patients, and 14% of the patients presented with acute abdomen due to intestinal perforation. Laparotomy was the most common diagnostic procedure (60%). Preoperative diagnoses were possible in cases of duodenal and upper intestinal malignancies, but were rarely possible in patients with lower intestinal malignancies. Sixty-eight patients (68%) underwent tumor resection for palliation or cure. The operation mortality was 4%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Primary malignant tumor of the small intestine. 168 72

Evaluating an elderly patient with an acute abdomen is a challenging clinical problem. THe diagnosis is more difficult to secure in this age group, because it is difficult to obtain an accurate history, and physical findings are more subtle. The major factors that increase mortality include associated medical diseases, emergent operations, and delay in recognition and treatment of the problem. Patients with widespread malignancy and generalized peritonitis fare poorly, but operative mortality in the geriatric group has improved significantly because of more prompt diagnosis, aggressive resuscitation, precise monitoring, and expedient but definitive procedures. As the proportion of elderly patients in the population continues to rise, it becomes increasingly important to evaluate and manage this problem expediently.
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PMID:The acute abdomen in the geriatric patient. 232 16

Nine major hepatic resections for hepatocellular carcinoma were performed during a period of 2 years and 4 months. HBsAg was positive in six patients, preoperative serum alpha-fetoprotein was more than 20 ng/ml in 5 patients, and liver cirrhosis was present in four patients. Two patients presented with spontaneous rupture of hepatocellular carcinoma. The great value of ultrasonography is stressed as an emergency diagnostic tool in any patient with an acute abdomen without obvious cause. There was no operative mortality or morbidity among this series of patients. All but one patient with a ruptured hepatoma are alive without evidence of disease 3-31 months after liver resection. These encouraging operative results made the authors willing to adopt an aggressive policy toward the surgical treatment of hepatocellular carcinoma.
Cancer Chemother Pharmacol 1989
PMID:Experience with major hepatic resections for hepatocellular carcinoma. 253 54

Peritoneoscopy is an invasive procedure. With attention to detail and a degree of dexterity which is inherent to surgery the procedure has been found safe in over 2,500 cases. Peritoneoscopy must always be a sequel to careful clinical examination. The greatest advantage of peritoneoscopy over all other diagnostic modalities is that peritoneoscopic diagnosis is a final histological diagnosis and has no element of shadow, image or conjecture. Peritoneoscopy has its greatest value in the diagnosis of liver pathology, in ascites, jaundice, malignancy and tuberculosis especially if non-invasive scanning techniques are not available. When used with discretion, it has some value in the management of the acute abdomen. Surgeons will be gratified to find the extent to which the peritoneoscope can help arrive at an early histological diagnosis, plan surgery, reduce morbidity by avoiding unnecessary surgery and shorten hospitalisation.
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PMID:Peritoneoscopy for surgeons. 294 93

The authors report 2 cases of hepatocellular tumour in children treated with anabolic androgens for aplastic anemia. In both cases, the presentation was by a picture of acute abdomen due to hemoperitoneum caused by tumour rupture. In the first case, there was multiple hepatic adenomas necessitating right hepatic lobectomy. The second infant had a single tumour of segment IV treated by simple excision of the tumour. It was a hepatocellular-carcinoma. Follow-up for one year after the initial operation showed no signs of recurrence in both infants. The review of the literature permitted us to find 48 other cases of hepatocellular tumour secondary to androgen therapy. In order of frequency, the hepatocellular-carcinoma is the most frequent and it is usually single; followed by the adenoma which is usually multiple. The other types of tumours are rare: focal nodular hyperplasia, angiosarcoma and cholangiocarcinoma. The hepatocellular-carcinoma and adenoma have some characteristic features: spontaneous regression may occur after withdrawing of androgens; the risk of rupture is important; their evolution is almost always favorable despite of a severe histopathological picture; the alpha-foeto-protein is nearly always negative; and the metastasis are exceptional. The hepatocellular-carcinomas associated with androgen therapy are probably just adenomas with marked dysplasia, but their long term malignant potential remain unknown. Except in case of rupture, surgical intervention should be postponed until the effect of discontinuing the hormonal therapy is assessed, because of the potential for spontaneous regression. The administration of antineoplastic chemotherapeutic agents should be reserved for the tumours showing evidence of malignancy.
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PMID:[Tumors of the liver secondary to androgen therapy. Apropos of 2 cases in children]. 304 Feb 81


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