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

We report two cases of spontaneous colonic perforation associated with cystic fibrosis (CF) in the neonatal period. Both presented with an acute abdomen soon after birth and required laparotomy and stoma formation. Colonic perforation as an initial presentation of CF is reviewed and management options are discussed.
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PMID:Neonatal spontaneous colonic perforation due to cystic fibrosis. 1843 72

A 44-year-old man with cystic fibrosis with an acute abdomen was hospitalized via the emergency care unit. Additional investigations revealed ileus of the small intestine and an enlarged appendix which suggested acute appendicitis. However, the clinical picture did not fit the diagnosis of appendicitis and therefore the patient was provisionally diagnosed as having a 'distal intestinal obstruction syndrome'. The patient was conservatively treated on this basis and recovered, being discharged in good condition from hospital after four days. An enlarged appendix occurs frequently in patients with cystic fibrosis, so that the appearance of this part of the intestine contributes little to the diagnosis.
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PMID:[Acute abdomen in cystic fibrosis]. 2097 14

Duodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.
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PMID:Duodenal perforation: an unusual complication of sickle cell anemia. 2542 92

Appendicitis is the most frequent surgical disease in childhood, but it is very uncommon in the neonatal period. In this period of life, a delay in diagnosis (frequently due to the rareness of this pathology and lack of clinical suspicion) and consequently in therapeutic approach, frequently results in appendicular perforation and a subsequently poor evolution of this pathology. We present the case of a neonate with a history of Down's syndrome and Fallot's tetralogy. Due to her basal cardiopathy, she required surgical intervention to create a systemic-pulmonary fistula, as a temporary bridge until definitive cardiac surgery could be performed. In the postoperative period of this surgery she presented fever, acute abdomen and abdominal radiography compatible with pneumoperitoneum. An emergency laparotomy was performed, which revealed peritonitis secondary to a cecal gangrenous appendix with perforation in its middle third. Neonatal appendicitis is usually associated with diseases such as cystic fibrosis, necrotizing enterocolitis, or Hirschsprung's disease, as in the case of our patient. In neonates with acute abdomen and presence of pneumoperitoneum, appendicitis must be part of the differential diagnosis and requires urgent surgical intervention. Despite this, it presents a high rate of morbidity and mortality. Once the definitive diagnosis is made, any basal pathology that justifies its presence should be discarded.
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PMID:[Appendicitis, an unusual cause of acute abdomen in neonatal patients. A case report]. 2994 58

Although infants with meconium ileus usually present with apparent symptoms shortly after birth, the diagnosis of meconium ileus and cystic fibrosis (CF) may be delayed, awaiting newborn screening (NBS) results. We present the case of an 11-day-old term girl with delayed passage of meconium at 48 hours who had 2 subsequent small meconium stools over the following week. There was a normal feeding history and no signs of abdominal distension or distress. She then presented with an acute abdomen, decompensated shock, bowel perforation, and peritonitis, requiring multiple intestinal surgeries. Her NBS for CF was positive, and CF was ultimately confirmed with mutation analysis. Her course was complicated by prolonged parenteral feedings and mechanical ventilation via tracheostomy. The infant was managed with soy oil, medium chain triglycerides, olive oil, fish oil lipids and experienced only transaminitis without cholestasis and no chronic liver sequelae, with subsequent normalization of her transaminases without treatment. Because her only symptom was decreased stool output and NBS results were unavailable, the CF diagnosis was delayed until she presented in extremis. Delayed meconium passage and decreased stool output during the first week of life should lead to suspicion and additional evaluation for CF while awaiting NBS results. Careful monitoring is indicated to prevent serious, life-threatening complications. The use of soy oil, medium chain triglycerides, olive oil, fish oil lipids for infants requiring prolonged parenteral nutrition may also be considered proactively to prevent cholestasis, particularly for high risk groups.
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PMID:Delayed Presentation of Meconium Ileus in an Infant With Cystic Fibrosis. 3297 95