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

Emphysematous cholecystitis is a rare form of acute cholecystitis, characterized radiographically by the presence of gas within the gallbladder. We report of a patient, who was admitted to the hospital with the diagnosis of acute abdomen. This patient had an emphysematous cholecystitis caused by Clostridium perfringens. We found the wall of the gallbladder emphysematous and gangrenous, the gallbladder was distended and contained purulent material, but no stones. However, in addition, the films of abdomen showed gas in the ducts. Diagnosis, pathogenesis and the aetiological and therapeutical aspects will be discussed.
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PMID:[Acute emphysematous cholecystitis]. 22 5

One hundred cases of acute abdomen in patients over 70 years of age were studied. Mechanical occlusion was the most common cause among these patients, as opposed to acute appendicitis, which is the primary cause of the same condition among young people and adults. Irreducible hernias and visceral neoplasias were the most frequent etiologies among cases of mechanical occlusion. Cholecystitis took second place in our series. Visceral peforations were more often due to localized infections or visceral neoplasias than to gastric or duodenal ulcers. Overall mortality among these patients was 29 percent. Patients with visceral perforations due to localized infections or visceral neoplasias and all of the patients with vascular diseases had a negative prognosis.
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PMID:[Acute abdomen in the elderly: etiology, complications, and prognosis. A review of 100 cases (author's transl)]. 52 28

Cholescintigraphy was performed in 113 patients of whom 38 had normal gallbladders, 37 had acute cholecystitis and 38 had chronic cholecystitis. The radiopharmaceuticals used in the study were either 99mTc-dimethyl acetanilide iminodiacetic acid or 99mTc-paraisopropyl acetanilide iminodiacetic acid, both of which performed equally well. All patients with non-visualized gallbladders had cholecystitis, but visualization did not exclude disease. The rapidity of obtaining the results (within one hour), the complete absence of untoward reactions to the radiopharmaceuticals, the much lower frequency of subtle or indeterminate results, the ability to render useful information in the presence of moderate jaundice and the lack of interference from overlying intestinal contents establishes these radionuclide agents as superior to both radiographic oral and intravenous cholangiography in the investigation of the acute abdomen.
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PMID:Assessment of the utility of gallbladder imaging with 99mTc-IDA. 72 28

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

In a prospective study 152 consecutive patients presenting with acute abdominal pain were assessed clinically and an ultrasonographic examination was performed immediately. Of these, 16 (11 per cent) patients would normally have had an immediate ultrasonographic scan requested; routine (within 24 h of admission) ultrasonographic examination would have been requested in a further 66 (43 per cent) patients. In 70 (46 per cent) patients an ultrasonographic examination would not have been requested. Ultrasonography altered the diagnosis in one patient from probable appendicitis to cholecystitis. Ultrasonography missed one abdominal aortic aneurysm and one empyema of the gallbladder. Ultrasonography had a sensitivity of 96 per cent, a specificity of 94 per cent, a positive predictive value of 96 per cent, a negative predictive value of 94 per cent and an accuracy of 95 per cent in diagnosing appendicitis. Exactly the same values were found for the clinical diagnosis of appendicitis. The study shows that routine immediate ultrasonographic examination of the acute abdomen is rarely helpful, with the possible exception of appendicitis. Where an urgent ultrasonographic scan is necessary on clinical grounds the expertise of a radiologist is probably required, whereas in specific areas, for example in the diagnosis of right iliac fossa pain, there may be a place for training the surgical trainee.
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PMID:Ultrasonography in the acute abdomen. 195 78

Disseminated cytomegalovirus (CMV) infection occurs predominantly in immunocompromised hosts. Symptomatic CMV cholecystitis and pancreatitis are quite rare, and, to our knowledge, there are no reports of these occurring simultaneously. We describe a patient with a history of chronic myelogenous leukemia (treated with chemotherapy) who presented with recurrent unexplained fevers and an acute abdomen. At surgery, cholecystitis and pancreatitis were found, and a cholecystectomy was performed. The patient developed disseminated intravascular coagulation, eventual sepsis, and multiorgan failure. At autopsy, widespread disseminated CMV infection was found, with CMV-associated foci of acute inflammation and necrosis in the pancreas and in the surgically resected gallbladder. A review of our autopsy files revealed only one renal transplant patient with CMV inclusions and chronic pancreatitis. No pancreatitis was seen in 27 patients with acquired immunodeficiency syndrome. Cytomegalovirus should be considered as a possible cause of pancreatitis and cholecystitis in immunocompromised patients.
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PMID:Disseminated cytomegalovirus infection presenting with acalculous cholecystitis and acute pancreatitis. 255 45

The authors describe a case of acute gangrenous cholecystitis in a 17-month-old boy manifested by symptoms of an inflammatory acute abdomen after several days of a febrile condition associated with diarrhoea. Cholecystectomy was performed and after antibiotic and infusion therapy a noncomplicated postoperative development followed. Five years after operation the boy has no subjective complaints. In the discussion the authors analyze the incidence, aetiopathogenesis, clinical, laboratory and X-ray findings of this rare disease. For the therapy of advanced cholecystitis the authors recommend cholecystectomy.
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PMID:[Acalculous gangrenous cholecystitis in a toddler]. 281 3

In our Country through the acquired experience, we have reached the 10 more frequent diagnostics in laparoscopies of urgency. 1) Our 10 more frequent diagnosis in laparoscopy were: Salpingitis 27.5%; Appendicitis 18%; Ovarian cyst 18%; Inflammatory localized processes 8.5%; Ectopic pregnancy 4.5%; Peritonitis 4%; Piosalpinx 3.5%; Cholecystitis 3%; Hemoperitoneum 3%; Metritis 2%. 2) That acute abdomen conditions should be diagnosed as early as possible. 3) That the maximum time employed to this diagnostic must not depass of six hours from the onset of the symptomatology. 4) That if at that time a diagnostic has not been established by all resources at the hands of the physician, an emergency laparoscopy shall be indicated. 5) That, this laparoscopy of urgency ought to be performed immediately at an Specialized Service and by a qualified endoscopist. 6) That, a qualified endoscopist shall be able to issue a laparoscopic diagnostic of the pathologies of the different abdominal organs, digestives and gynecological, in adults and children.
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PMID:[Emergency laparoscopy in the diagnosis of acute abdomen]. 295 85

Acute cholecystitis is a common cause of the acute abdomen. The diagnosis has been distinctly improved with the development of ultrasonography and hepatobiliary scanning over the past 20 years. The treatment is cholecystectomy, with early as opposed to delayed operation gaining increasing popularity nationwide. Acute acalculous cholecystitis and emphysematous cholecystitis are special features of acute cholecystitis occurring in more complicated cases and requiring diligence in diagnosis and great care in treatment.
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PMID:Acute cholecystitis. 327 46

From 1972 through 1984, 7140 cardiac operations were performed at one university teaching hospital; they were reviewed to elucidate common factors in patients developing an acute surgical abdomen after cardiac surgery and extracorporeal circulation. Twenty-one patients (0.29%) developed an acute surgical abdomen in the period following cardiac surgery. The abdominal surgical complications were, in general, due to complications of peptic ulcer disease, decreased intestinal blood flow, and cholecystitis. There was no correlation between preoperative history, physical examination, cardiac function, laboratory data, and the subsequent development of an acute abdomen. Mortality rate, 24% after abdominal surgery, was increased with emergency cardiac operations, combined cardiac procedures, complications of cardiac surgery, unnecessary delay of abdominal surgery, and abdominal wound complications. Major abdominal wound complications were seen in 38%. Patients undergoing cardiac surgery may develop a variety of common abdominal surgical disorders. Patients so inclined cannot be identified prior to cardiac surgery. Ulcer prophylaxis, wound management, prompt resuscitation, and timely surgery are critical.
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PMID:The acute surgical abdomen after cardiac surgery involving extracorporeal circulation. 334 18


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