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

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

Eosinophilic Gastroenteritis (EG) is a poorly understood disorder defined by eosinophilic infiltration of the bowel wall, eosinophilia and gastrointestinal symptoms. The disease's aetiology, course and treatment are not well known. We report two atypical cases of EG: one involving the mucosal layer and another involving the serosal and muscularis layer. The first shows how EG may present with a long history of episodes of intestinal obstruction and malabsorption and how the disease could take a severe course and may be unresponsive to treatment. The second case shows EG presenting as acute abdomen and which subsequently became asymptomatic without therapy, regardless of the fact that peripheral eosinophilia remained present. This case raises the problem of how to treat an asymptomatic patient, what parameters should be considered in order to assess the progress of the disease and the indications for treatment.
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PMID:Eosinophilic gastroenteritis: report of two atypical cases. 174 9

A retrospective study was done to determine the presence of abdominal angiostrongyliasis in Nicaragua. Twelve cases of this parasitic disease were found among 48 visceral specimens: small intestine, liver and testes. The patients with intestinal lesions presented symptoms of an acute abdomen, and in some instances, a tumor-like mass was palpated in the lower right quadrant. A thickening of the intestinal wall accompanied by necrosis and perforation were the most important macroscopic findings. One patient with hepatic localisation of Angiostrongylus costaricencis displayed a clinical picture of visceral larva migrans-like syndrome. The chief laboratory findings were leukocytosis and eosinophilia. The histopathological examination showed granulomas and heavy eosinophilic infiltration around the eggs and larvae of A. costaricencis. Also, an adult worm was seen in one biopsy.
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PMID:Abdominal angiostrongyliasis in Nicaragua: a clinico-pathological study on a series of 12 cases reports. 182 56

A 29-year-old patient was admitted with acute abdomen in the 17th week of pregnancy. History revealed two episodes of colic in the right hypochondriac area during the previous six months, but no other abdominal complaints. Clinically the picture was that of acute cholecystitis. Laboratory findings included an elevated white cell count, a slight elevation of serum transaminases and a marked increase of serum alkaline phosphatase and bilirubin. Echographically there were dilated intra- and extrahepatic bile ducts containing two hyperechogenic elements without casting an acoustic shadow. A hydrops of the gallbladder with sludge and a thickening of the wall could also been seen. Because of pregnancy an ERCP could not be performed due to the need for X-ray, so we had to resort to open surgery. Under tocolytic and antibiotic shielding we carried out open cholecystectomy and choledochoscopic exploration of the common bile duct. Using a Fogarty balloon catheter we extracted two live, adult liver flukes and placed a T-tube in the duct. Because of positive fecal probes for fasciola eggs the T-tube had to be left in place until childbirth. Afterwards we performed a pre-cut-papillotomy by ERCP and took the T-tube out, having confirmed a clear duct on a T-tube-cholangiogram. With negative fecal probes and the eosinophilia on the white cell count returning to normal, we decided against the planned chemotherapy and assumed self-healing of the disease. The patient has been well since.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fasciola hepatica--a unusual cause of acute cholecystitis with cholestatic jaundice]. 748 18

Strongyloides stercoralis is an intestinal nematode that is widely distributed throughout the tropics and subtropics. Immigration patterns, travel, and poor hygiene can place patients in the United States at an increased risk. Endemic regions in the southeastern United States have been identified. The infected host may be asymptomatic or present with a wide variety of complaints. Abdominal findings may mimic an acute abdomen or intestinal obstruction, which may lead to an avoidable laparotomy. A massive infection of the gastrointestinal tract and lungs is termed hyperinfection syndrome. Disseminated strongyloides occurs when other organs are involved. This can be life-threatening. A prominent predisposing factor to severe infection is a patient's status as an immunocomprised host. Asymptomatic infected hosts can become symptomatic after the initiation of corticosteroid therapy or other immunosuppressive medications. Strongyloidiasis should be considered in patients with transient pulmonary infiltrates and gastrointestinal complaints. A recent travel history, poor hygiene, cutaneous manifestations, or blood eosinophilia may point to the diagnosis. Negative stool cultures do not rule out the diagnosis, and esphogogastroduodonoscopy with aspiration cultures and mucosal biopsy greatly increase the diagnostic yield. A high index of suspicion is necessary to establish the diagnosis, and unnecessary laparotomies can be avoided.
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PMID:Intestinal ileus secondary to Strongyloides stercoralis infection: case report and review of the literature. 789 10

The authors describe a case of acute abdomen operated in emergency for obstruction in a patient with eosinophilic gastritis. This is very unusual pathology characterized by eosinophilic infiltration of the gastric antral wall combined with peripheric eosinophilia. This particular case was operated for a small bowel obstruction but in those rare cases, when we can reach a diagnosis with endoscopic biopsy, a prudential attitude becomes inevitable as this pathology is very responsive to medical treatment with corticosteroids.
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PMID:[Acute abdomen caused by eosinophilic gastritis]. 799 Dec 8

A 39 year old man had been suffering from chronic bowel symptoms of changing intensity. At the age of 37 the diagnosis of nontropical sprue was made. After institution of a gluten free diet the patient improved, but soon diarrhea started again. In the examination of peripheral blood smear, bone marrow and small intestinal mucosal biopsies a dominant eosinophilia was found. Since several attacks of abdominal colics and finally an acute abdomen occurred, a laparotomy was indicated. This operative intervention showed a perforation of the intestine and tumors in the bowel wall as well as numerous lymphomas spread over the whole mesentery. The histological examination of both the small intestine resect and the lymphomas proved the diagnosis of a highly malignant Non Hodgkin lymphoma (middle and large cell pleomorphic T-cell lymphoma with transition into a large cell anaplastic lymphoma [ki-1 lymphoma]). The patient received a chemotherapy with COEP but died 4 weeks after the surgery.
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PMID:[Eosinophilia as the leading symptom of highly malignant enteropathy-associated T-cell lymphoma]. 829 Dec 79

We present the first, probably autocton, case of abdominal angiostrongyliasis in Rio de Janeiro State. The patient presented initially with fever of unknown origin and severe eosinophilia developing acute abdomen due to small bowel perfuration, peritonitis, hepatic necrosis and sepsis. At the laparotomy a segment of small bowel was ressected and a liver biopsy was performed. Histopatology revealed the presence of an intra-arterial nematode, eosinophilic arteritis and granuloma. It is discussed the clinicopathological aspects of this rare and potentially severe disease that has not an established drug treatment since oral anti-helmintics are contra-indicated. The authors emphasize the importance of avoiding indiscriminate use of oral anti-helmintic drugs based only in blood eosinophilia.
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PMID:[Abdominal angiostrongyliasis: report of a potential autochthonous case from Rio de Janeiro]. 971 15

The records of 100 children with hydatid disease were reviewed retrospectively from 1978 to 1997; 43 were girls and 57 were boys. The mean age was 9.14 years; 61 patients had 124 hepatic cysts. Presenting symptoms were asymptomatic abdominal masses, found masses incidentally during ultrasonography (US), or acute abdomen. Plain X-ray films, US, or computerized tomography (CT) are sufficient for diagnostic evaluation in endemic areas. In the differential diagnosis, laboratory investigations such as the Casoni and Weinberg tests, indirect hemagglutination, eosinophilia, and ELISA were also used. These tests may give negative results, however, in some patients with hydatid disease. The mean follow-up time was 10.5 years (range 1-18 years), the mean duration of hospitalization 7 days. The complication rate was 3.6%. Mortality was 3.27% and occurred after the administration of formaldehyde and hypertonic scolicidal agents. Hydatid disease of the liver can be treated medically in selected patients; conservative surgical approaches that save as much parenchyma as possible, such as partial cystectomy and capitonnage, are indicated in the other cases.
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PMID:Hydatid disease of the liver in childhood. 1037 27

Ancylostoma caninum is responsible for cases with eosinophilic enteritis (EE) and unexplained abdominal pain with peripheral eosinophilia in man. Ninety-five patients with obscure acute or recurrent abdominal pain and ten asymptomatic healthy parasite free were subjected to thorough history taking, clinical examination, sonography, routine laboratory investigations and serotesting by IgG ELISA to detect antibodies to excretory/secretory (ES) antigens of adult A. caninum and by IgG and IgG4 Western blot (W.B.) to detect antibodies to Ac68 antigen. Eleven male patients (11.6%) (5 with acute abdomen, 3 diagnosed as appendicitis and 3 had recurrent mild to moderate abdominal pain) fulfilled the criteria of case definition of human enteric infection with A. caninum (G.I). The study also detected human hookworm infection in 14 patients (G.IIb) other parasites in 34 patients (GIIc) and 36 patients had no parasites (G.IIa). Although 3 patients from group I were diagnosed as appendicitis and were dealt with surgically, the pain recurred and mebendazole only put an end to the patient's complaints. The obtained appendices of these operated cases showed marked eosinophilic infiltration but no adult canine hookworms were detected. IgG ELISA was positive in 72.7%, 8.3%, 100%, 23.5% and 0% in groups and control respectively. IgG and IgG4 W.B. did not increase the sensitivity but IgG4 W.B. elevated specificity to 100% excluding those with HH infection (Group Iib) who showed 100% cross-reactions. Stool analysis was the only differentiation between these two types of hookworms. These findings confirmed the presence of human enteric infection with A. caninum as clinical entity in the study community and referred to its value in differential diagnosis of the obscure abdominal pain.
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PMID:Evaluation of the role of Ancylostoma caninum in humans as a cause of acute and recurrent abdominal pain. 1256 26


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