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

A case of obstructive colitis associated with rectal carcinoma in a 56 year old Japanese man is reported herein. He presented to Shinkokura Hospital with severe abdominal pain following a one month history of anal bleeding and mild abdominal pain. On palpation, muscle guarding was observed in the left lower quadrant and the white blood cell count was 14,200/mm3. An exploratory laparotomy was performed under the provisional diagnosis of acute abdomen, which revealed localized peritonitis 8 cm oral to an area of rectal carcinoma. An anterior resection of the lesion was therefore performed together with a descendo-proctostomy. The histopathologic diagnosis revealed adenocarcinoma and obstructive colitis involving the entire thickness of the sigmoid colon and resultant fibrino-purulent peritonitis. His post-operative course was uneventful and he was continuing to do well on the 30th postoperative day, at the time of writing. The clinical significance of this combination of obstructive colitis with rectal carcinoma is briefly discussed following the presentation of this case.
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PMID:A case of localized peritonitis caused by obstructive colitis proximal to rectal carcinoma: a rare manifestation of obstructive colitis. 139 36

We evaluated the clinical accuracy of an automated turbidimetric assay for serum lipase determination in order to screen for acute pancreatic damage. Seventy patients with pancreatic and thirty with nonpancreatic digestive diseases were studied. Fifty-two healthy subjects were also studied as controls. Serum lipase concentrations were abnormally high in all patients with acute pancreatitis and in 3 (10%) in the group of 30 patients with nonpancreatic acute abdomen. In the 35 patients with chronic pancreatitis studied during clinical remission, serum lipase levels were abnormally high in 8 (23%), and abnormally low in 3 (9%). In the 9 patients with pancreatic cancer, 4 (44%) had abnormally elevated serum lipase values and 1 (11%) abnormally low. The results indicate that serum lipase determination is useful in the emergency diagnosis of acute pancreatic damage because of its high sensitivity and specificity. In patients with chronic pancreatitis and in patients with pancreatic carcinoma serum lipase determination is of limited value.
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PMID:Serum lipase assay. A test of choice in acute pancreatitis. 158 55

We present a case of a cirrhotic patient suffering an intradiverticular squamous carcinoma with perforation to the peritoneal cavity, diagnosed after performance of an emergency laparotomy due to acute abdomen with infaust evolution. The rarity of the entity and the differential diagnosis imposed are the reasons for our presenting it. A series of diagnostic, prognostic and preventive aspects are considered.
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PMID:[Intra-diverticular neoplasms of the bladder. Apropos of a squamous carcinoma]. 211 77

Sudden unexpected death of apparent healthy young males due to malignant tumours are extremely rare in forensic autopsy material. We report on three such cases dying of pulmonary embolism caused by metastazing tumour of the testis. In each subject the tumour was localized to the right testis and consisted of two types of tumour tissue: Seminoma and embryonic carcinoma, the latter of which was always the metastazing one. Each of the cases represent different aspects of forensic medicine. In the first subject the tumour had remained undiagnosed in a recent medical examination. The second one underwent surgery because of acute abdomen and died intraoperatively and the third one died suddenly during antibiotic treatment, because the tumour had been mistakenly diagnosed as orchitis.
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PMID:[Sudden death caused by malignant testicular tumors]. 217 Dec 45

Epithelial carcinoma of the ovary, a rare complication of pregnancy, was diagnosed at 16 weeks' gestation after presentation as an acute abdomen. Exploration with conservative surgery was done, and cis-platinum-based combination chemotherapy was administered for the remainder of the pregnancy. Induction and vaginal delivery resulted in a successful outcome for mother and fetus. Postpartum laparotomy was negative.
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PMID:Cis-platinum combination chemotherapy during pregnancy for advanced epithelial ovarian carcinoma. 230 34

Cecal diverticulitis is an uncommon entity. Its operative treatment represents 0.2% of procedures performed for an acute abdomen. The clinical presentation is often indistinguishable from acute appendicitis. At operation, it may be confused with cecal carcinoma. The surgeon must be aware of this condition and be prepared to choose the most appropriate treatment. Local excision has been advocated as the treatment of choice. The authors review 18 cases seen over a 10-year period. In no case was the correct diagnosis made preoperatively. Intraoperatively, a correct diagnosis was made in 12 of the 18. Carcinoma was the next most frequent intraoperative diagnosis (four cases). Twelve of the 18 patients were treated by standard or limited right hemicolectomy. One patient died early in the series of sepsis caused by a perforated diverticulum and one patient had a life-threatening complication. Right hemicolectomy appears to be a safe and effective treatment option for cecal diverticulitis.
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PMID:Cecal diverticulitis. 273 55

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

A 65-year-old man, in hospital for treatment for bladder carcinoma, was by chance found also to have a so far asymptomatic obstructive jaundice with hydrops of the gallbladder. Endoscopic retrograde cholangiography revealed, in addition to a papilla distorted by tumour, a clearly obstructed choledochal duct with dilated intrahepatic bile ducts, caused by a 2-3 cm prepapillary intraductal choledochus tumour, which in the biopsy specimen corresponded to papillomatous structures with occasional medium-grade epithelial dysplasias. The patients, who initially declined operation, was five weeks later re-admitted with the clinical picture of an acute abdomen. In view of the history the surgeon performed a partial duodenopancreatectomy despite the acute emergency. Histology revealed a highly differentiated adenocarcinoma within a villous adenoma of the choledochal duct near the papilla.
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PMID:[Highly differentiated adenocarcinoma in a villous adenoma of the common bile duct near the papilla]. 331 54

Between 1974 and 1978 we saw nine patients with acute gastro-duodenal ulcers. Morphologically these were characterised by their unusual extent without deep penetration, by sharp bizarre contours, and with symmetrical findings in the gastric antrum. Spasm and submucous inflammatory reactions may obscure the niche of an antral ulcer and lead to stenosis and rigidity; in the differential diagnosis an infiltrating carcinoma must be excluded. This is possible by double contrast demonstration of the ulcer en face. The clinical picture is one of sudden, severe upper abdominal pain with features of an acute abdomen, often with a previous history of stress or of gastric distension with vomiting.
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PMID:[Acute gastro-duodenal ulceration--lesions without a niche (author's transl)]. 645 96

During 1970-1976, 459 cases of primary carcinoma of the liver were admitted to the Department of Medicine, Siriraj Hospital, Thailand. Three hundred and two cases (66%) had associated cirrhosis. Fifty-five cases or 12 per cent presented with hemoperitoneum from ruptured carcinomatous nodules. In most of these, the presenting symptom were not dramatic and might be indistinguishable from other uncomplicated carcinoma of the liver. Only 2 cases presented as acute abdomen and 5 cases had severe abdominal pain for short duration prior to admission. Peritonoscopy were performed routinely in all cases with hemoperitoneum except the two cases which presented as acute abdomen. Fifty cases or 91 per cent had associated cirrhosis and the site of the rupture were visualized in 6 cases or 11.32 per cent. Fourteen patients were treated conservatively with the mortality rate of 100 per cent. Eight patients who presumably bled from coagulation defect were also treated conservatively with only 50 per cent mortality. Hepatic artery ligation was employed in 23 cases with 52 per cent mortality and bleeding stopped in 95 per cent, as compare with other conventional surgical measure such as packing, suture and cauterization to control the hemorrhage with 90 per cent mortality. Judging from our experience, hepatic artery ligation is of definite value for palliative treatment particularly in patient with hemoperitoneum from ruptured carcinoma of the liver.
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PMID:Intraperitoneal hemorrhage due to spontaneous rupture of primary liver cancer with particular reference to hepatic artery ligation. 742 31


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