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

Visceral pain is caused by either distension or contraction of the visceral muscular wall or obstruction of hollow gastrointestinal organs. Unlike the somatic pain due to peritonitis, visceral pain is diffuse, epigastric, periumbilical and is often accompanied by nausea, vomiting and restlessness. We demonstrate the significance of visceral pain in the differential diagnosis of the acute abdomen presenting five cases of appendicitis and cholecystitis. A correct early diagnosis of the acute abdomen while signs of local peritonitis are still absent (appendicitis in atypical location, recurrent acute appendicitis, spontaneous reopening of an occlusion) is facilitated by the awareness for the characteristics and symptoms of visceral pain, and therefore careful taking of the patient's history. A history lacking visceral pain on the other hand represents an important clue for the diagnosis of other conditions (gynecological, diverticulititis, etc.) with acute pelvic peritonitis.
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PMID:[Visceral pain in acute abdomen]. 1032 Nov 25

The incidence of abdominal pain in patients with systemic lupus erythematosus (SLE) is very high. Most patients do not require surgical treatment (serositis). Some cases such as appendicitis, perforated ulcer, cholecystitis or, rarely, intestinal infarction are surgical. Differential diagnosis is difficult, partly because noninvasive examinations do not provide enough evidence to rule out a diagnosis. On the other hand, in patients with SLE who have acute abdomen, it is dangerous to delay surgery by attempting conservative therapy. In fact, a better survival rate has been associated with early laparotomy. We report a case of acute abdomen in a patient affected by SLE, in which the diagnostic problem was solved by means of laparoscopy and the treatment was laparoscopically assisted. A 45-year-old woman with a 25-year history of SLE was admitted with abdominal pain and fever. Her physical examination revealed a painful right iliac fossa with rebound tenderness. Her WBC count was normal. Abdominal x-ray, ultrasonography, paracentesis, and peritoneal lavage did not provide a diagnosis. A diagnostic laparoscopy was performed, showing segmentary small bowel necrosis. The incision of the umbilical port site was enlarged to allow a small laparatomy, and a small bowel resection was performed. The histopathologic finding was "leucocytoclasic vasculitis, with infarction of the intestinal wall." The patient recovered uneventfully. In conclusion, this case report shows that emergency diagnostic laparoscopy is feasible and useful for acute abdomen in SLE. Currently, this diagnostic possibility could be considered the technique of choice in these cases, partly because, when necessary, it also can allow for mini-invasive treatment therapy.
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PMID:Laparoscopically assisted treatment of acute abdomen in systemic lupus erythematosus. 1128 87

The segmental infarction of the greater omentum is a rare cause of acute abdomen. Its etiology is uncertain although several predisposing factors have been underlined such as congenital venous anomalies, sudden change of position and substantial meal. The clinical picture simulates an appendicitis or cholecystitis, thus being difficult to make a preoperative diagnosis. However, ultrasonography or computed tomography scan can help us make this diagnosis and then we alternatively perform a conservative treatment, laparoscopic approach or resection by laparotomy. We present two cases, preoperatively diagnosed by ultrasonography and computed tomography scan that were treated by laparotomy resection. We also review the published cases in the medical literature.
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PMID:Idiopathic segmental infarction of the greater omentum as a cause of acute abdomen report of two cases and review of the literature. 1146 16

It is often speculated that an inflamed gallbladder weeps bile to produce bile peritonitis. This may be so, but more likely the problem is a peritoneal effusion in a jaundiced patient which thus resembles bile. So-called "spontaneous or idiopathic biliary peritonitis" in acute acalculous cholecystitis without a proven cause is a further example of this very rare condition. Spontaneous perforations of the extrahepatic biliary ductal system associated with acalculous cholecystitis are uncommon albeit reported in adults. Most patients present with an acute abdomen and are operated upon urgently without diagnostic iter. A recent experience with such a case prompted a thorough review of 27 similar cases previously reported.
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PMID:Spontaneous biliary peritonitis in acalculous cholecystitis: fact or misdiagnosis? 1149 Jul 84

An acute abdomen may result from various diseases, with appendicitis, cholecystitis, pancreatitis, and obstruction of the small and the large bowel as the leading causes. The quality of diagnostic imaging has been improved within the last years especially by recent developments of cross-sectional imaging modalities. Sonography is an efficient modality for detecting cholecystitis and appendicitis. Spiral computed tomography is the modality of choice in case of suspected bowel obstruction or pancreatitis.
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PMID:[Diagnostic imaging of the acute abdomen]. 1176 48

Torsions are rare acute abdominal conditions and are mistaken for other more frequent diseases. The present work draws attention to the most frequent diagnostic errors. The authors present three cases of torsions of intraabdominal organs and two cases of testicular torsion. All patients attended their doctor because of abdominal pain. In four of five cases the patients were first treated for an erroneous diagnosis of acute abdomen. In the first case the torsion of the omentum was mistaken for diverticulitis of the sigmoid, later for an intraperitoneal lipoma, in he second case for cholecystitis, in the third case a patient with torsion of a myoma was indicated for surgery on account of acute appendicitis. In the fourth case incomplete torsion of the testis was mistaken for irritation of the appendix. In the fifth case where abdominal symptomatology dominated the correct diagnosis of testicular torsion was made and atypically spontaneous detorsion of the testis occurred.
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PMID:[Organ torsion and abdominal symptoms--case reports]. 1188 Dec 84

The appropriate treatment for extrahepatic hepatic artery aneurysms remains controversial, with arguments for and against embolization. We describe a case of a giant true aneurysm of the common hepatic artery associated with obstructive jaundice of nonhemobilia origin. The patient, a 49-year-old previously healthy man, presented with upper midepigastric pain, jaundice, and low-grade fever. The diagnosis of the aneurysm was mainly based on computed tomography scan findings. The aneurysm was successfully embolized using wire coils, and the patient was operated on for acute abdomen. Necrotizing acalculus cholecystitis was found, and cholecystectomy followed by aneurysmectomy without hepatic artery reconstruction was performed. The jaundice subsided spontaneously, and the patient was discharged in good condition. Giant common hepatic artery aneurysms can be managed by either surgery or embolization. In the absence of liver ischemia there is no need for common hepatic artery reconstruction unless a bilioenteric bypass has to be performed to resolve the issue of jaundice. If the latter is required, reconstruction of the hepatic artery might be justifiable to maximize the blood supply to the bile duct.
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PMID:True giant common hepatic artery aneurysm associated with obstructive jaundice: a case report. 1240 87

A case of acute abdomen caused by a Brucella melitensis is reported. The patient presented with biliary involvement in the form of acute acalculous cholecystitis and developed acute appendicitis that resulted in his surgical treatment.
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PMID:Acute abdomen due to Brucella melitensis. 1275 20

A 77-year old man living in Kyunggi-Do, Korea was surgically treated at Seoul National University Hospital on April 1981, because of acute abdomen. At laparotomy, a 1.77m long adult Taenia saginata was found both in gallbladder and in common bile duct to cause acute gangrenous cholecystitis. The relevant literature were reviewed and possible mechanisms of the disease were discussed.
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PMID:A Case Of Taenia Saginata Infection Involving Gallbladder And Common Bile Duct. 1290 11

Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in areas of destructive inflammation. The macroscopic appearance generally mimics a gallbladder carcinoma. Twelve cases of xanthogranulomatous cholecystitis were identified from a retrospective analysis of the patient records of 770 cholecystectomy cases operated on in our department from January 1996 to October 2001. There were four men and eight women. Mean age of presentation was 52.5 years. Eleven patients had gallbladder stones. Seven patients had a history of acute cholecystitis and five patients of biliary colicky pain. Five cases were presented with obstructive jaundice and five with acute cholecystitis. Right upper quadrant mass was palpable in three patients. All patients underwent cholecystectomy. Open surgery was planned and performed in three patients. Laparoscopic cholecystectomy was planned in nine patients but converted to open surgery in three cases. Nine patients had an uneventful postoperative course. One patient developed wound infection and one patient a postoperative pulmonary infection. One patient developed acute abdomen in the 2nd postoperative day and was re-operated for bile peritonitis. No mortality was seen in the series.
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PMID:Xanthogranulomatous cholecystitis. Retrospective analysis of 12 cases. 1291 66


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