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

Clindamycin (7-chloro-7-deoxylincomycin) may induce mild or severe colitis. In 28 months, clindamycin-associated diarrhea was encountered in 8 patients who had received oral therapy. Severe, acute colitis was seen in 4 older patients, 3 of whom had acute pseudomembranous colitis and one who had an adynamic ileus mimicking an acute abdomen. Mild colitis with protracted diarrhea occurred in 4 younger patients who had mild, nonspecific inflammation in the rectum which responded to symptomatic treatment. The mechanism and true incidence of diarrhea as a sequel of clindamycin therapy are unknown. In all 8 patients, the use of clindamycin was arbitrary. Because of potentially serious gastrointestinal disturbance, including acute pseudomembranous colitis, clindamycin should be reserved for anaerobic and other serious infections.
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PMID:Colitis associated with clindamycin therapy. 120 37

Reference to the literature dealing with idiopathic rectocolitis and its complications, with particular attention to megacolon, is followed by the presentation of two cases of ulcerous colitis complicated by toxic megacolon and a picture of acute abdomen. Emphasis is placed on the clinical features of such complications and the surgical treatment required in accordance with the degree of seriousness of the case.
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PMID:[Toxic megacolon]. 122 36

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

Eosinophilic gastroenteritis (EGE) is an etiologically obscure and rare inflammation which can affect all sections of the gastrointestinal tract from esophagus to rectum in a diffuse or segmentary manner. An infiltrate of eosinophilic granulocytes is found to varying degrees in all wall layers. The clinical symptoms depend on the site and extent of organ involvement. Diagnosis can only be established histologically. Peripheral eosinophilia is inconsistent and not diagnostic. ESR, leukocyte count, serum IgE, and RAST tests in foodstuffs may be normal or elevated. Two women patients are described with tumorous eosinophilic colitis of the cecum and colon ascendens, who underwent surgery for clinical acute abdomen. A further woman patient was hospitalized with bloody diarrhea and marked eosinophilia in the blood findings. Eosinophilic colitis was likewise found histologically in the mucosa which appeared with reddened patches in sigmoidoscopy. Eosinophilic colitis associated with eosinophilic gastroenteritis is rather rare and may therefore be overlooked. Our literature review contains only 64 such cases, in only 6 of which was the tumorous form found. Counting our own patients as well, eosinophilic colitis occurs somewhat more frequently in women (27 = 56%) than in men (21 = 44%). The clinical symptoms, possible causes and therapeutic approaches are discussed in the light of the literature.
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PMID:[Eosinophilic colitis--an unusual cause of acute abdomen. Case report and literature review]. 141 98

Acute abdomen was the presenting manifestation of pseudomembranous colitis in six men who had previously been treated with antibiotics and presented with abdominal distention, pain, fever, and leukocytosis with absent or mild diarrhea. Plain abdominal radiographs revealed megacolon in two, combined small and large bowel dilation in three, with one of them showing volvuluslike pattern, and isolated small bowel ileus in one. Emergency colonoscopy was performed successfully in all patients and revealed pseudomembranes in five and nonspecific colitis in one. All patients had positive latex test results for Clostridium difficile, and two tested positive for cytotoxicity. All patients were treated with IV metronidazole, resulting in resolution of symptoms and abdominal findings. In addition, two patients underwent colonoscopic decompression with improvement. Endoscopically, complete resolution of the pseudomembranes occurred at 4 weeks in all cases. No patient had a recurrence. It is concluded that (a) pseudomembranous colitis may present as abdominal distention mimicking small bowel ileus. Ogilvie's syndrome, volvulus, or ischemia; (b) in such cases, emergency colonoscopy is safe and useful for diagnosis and therapeutic decompression and may obviate the need for surgery; and (c) treatment with IV metronidazole is effective. Colitis due to C. difficile should be considered in the differential diagnosis of acute abdomen in patients previously treated with antibiotics.
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PMID:Acute abdomen as the first presentation of pseudomembranous colitis. 161 51

We report a case of toxic megacolon manifesting in cytomegalovirus (CMV) colitis in a 55-yr-old man with steroid-dependent chronic obstructive pulmonary disease. He presented to the hospital with increasing dyspnea and low-grade fever. His hospital course was characterized by the poor response of his symptoms to treatment, and by the subsequent development of intermittent hematochezia and, eventually, acute abdomen. The surgical specimen showed dilatation of the cecum and ascending colon with a solitary mucosal ulcer in the latter. The major histologic changes were limited to the area of ulceration. In addition to classical CMV inclusions. vasculitis manifested in two forms, namely, leukocytoclastic type and fibrinoid necrosis. The patient died shortly thereafter, due to multi-organ system failure. To our knowledge, this represents the first reported case of toxic megacolon due to CMV infection without underlying inflammatory bowel disease. The pathogenesis of toxic colonic dilatation remains unknown.
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PMID:Toxic megacolon in cytomegalovirus colitis. 254 94

Cytomegalovirus disease is an opportunistic infection that is seen in patients with inmunodeficiencies. The group most commonly affected are AIDS and transplanted patients. Only a few cases of cytomegalovirus disease in non-immunocompromised patients have been reported. In localized disease, the gastrointestinal tract is the most frequently affected. We report two cases of acute abdomen caused by cytomegalovirus enteritis and colitis (histopathological diagnosis) without any underlying immune disorder. The role that the cytomegalovirus infection might play in the development of the clinical manifestations in these two cases is discussed. Without an established immunodeficiency we must be careful to attribute to cytomegalovirus infection the direct responsibility of the lesions. In the reported cases, the existence of intestinal ischemia is more than just a clinical hypothesis and pathological examination is inconclusive. The absence of an immunocompromised state, the presentation as an acute abdomen and the clinical course forwards intestinal occlusion in the first case are not characteristic of cytomegalovirus enteritis and colitis. We conclude that the two reported cases are in fact an ischemic enteritis upon which cytomegalovirus enteritis and colitis was superimposed, an association that has not been reported before.
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PMID:[Cytomegalovirus enteritis and colitis in nonimmunodepressed patients, a primary disease or superinfection?]. 798 12

A 20 year old woman with anorexia nervosa and severe weight loss developed extensive necrotizing colitis after being admitted to hospital for stabilization of her weight. Necrotizing colitis with anorexia nervosa has been reported previously. We report a second case. We believe necrotizing colitis is a true complication of anorexia nervosa and should be considered in the differential diagnosis in patients with primary anorexia who develop an acute abdomen.
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PMID:Anorexia nervosa and necrotizing colitis: case report and review of the literature. 801 11

Two cases of ischaemic necrosis of the sigmoid colon (necrotizing colitis) are reported in 2 brothers aged 7 and 4 years, diagnosed within a 10 d interval. The children had bathed in streams suspected to be contaminated by Schistosoma mansoni about 50-60 d before the onset of acute disease. Both patients had been previously exposed to schistosome-infected streams without showing signs or symptoms of infection. Before admission, S. mansoni eggs had not been found in the stool. Both patients presented with an apparently identical, relatively symptomatic clinical course with rapid evolution to an acute abdomen. Laparotomy disclosed, in both patients, extensive necrosis (ischaemic necrotizing colitis of schistosomal aetiology) of about 20 cm in the first child and 8 cm in the second, extending from part of the descending colon to the sigmoid. The patients were successfully operated upon (hemicolectomy plus colostomy). The histopathological findings were similar in both patients. Ischaemic necrosis with complete destruction of the mucosa and part of the submucosa was detected in the first case; in the necrotic areas a few eggs of S. mansoni were seen, with no granulomatous reaction, but surrounded by cell shadows, pycnotic nuclei and amorphous material. Necrosis extended to the muscular layer and serosa, in which schistosome granulomas in the necrotic-exudative phase were seen, as well as diffuse granulocytic exudate and fibrin. Sections of tissue from both patients contained numerous eggs and granulomas all in the same exudative phase in regional lymph nodes and near the thrombotic vessels. After surgery, the 2 patients progressed similarly. About 10 d after hospital discharge, the patients received anti-schistosomal treatment with oxamniquine. No further sign of infection was detected at subsequent recall visits.
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PMID:Ischaemic colitis (necrotizing colitis, pseudomembranous colitis) in acute schistosomiasis mansoni: report of two cases. 824 77

Pseudomembranous colitis associated with Clostridium difficile rarely manifests as an acute abdomen and even more rarely as an acute abdomen without abnormal radiologic studies. The following is a case report of a 52-year-old white man who had an acute abdomen without abnormal radiologic studies, and was given a final diagnosis of C difficile colitis. Surgery was averted only by the ability to do an expeditious flexible sigmoidoscopy with the visualization of pseudomembranes. Diagnosis was later confirmed by a positive toxin assay and culture of C difficile. Treatment for C difficile colitis is usually medical, with oral vancomycin the preferred agent. Surgery may be needed when there is an acute abdomen with other systemic signs (fever or leukocytosis) or abnormal radiologic studies.
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PMID:Clostridium difficile colitis presenting as an acute abdomen: case report and review of the literature. 901 Mar 77


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