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

Although fibroids constitute the most common tumour in women of reproductive age, it is remarkable how very rarely they cause acute complications. However, when they do occur, the acute complications can cause significant morbidity (very occasionally, mortality), profoundly affecting a woman's quality of life. The complications include thrombo-embolism, acute torsion of subserosal pedunculated leiomyomata, acute urinary retention and renal failure, acute pain caused by red degeneration during pregnancy, acute vaginal or intra-peritoneal haemorrhage, mesenteric vein thrombosis and intestinal gangrene. The obstetrician will be most familiar with red degeneration and acute urinary retention, both of which tend to occur in association with pregnancy. It is difficult to quote an incidence rate for these acute complications as they are rare, and most are reported as cases or case series in the literature. The majority (except red degeneration, acute urinary retention and thrombo-embolism) presents as an acute abdomen and requires urgent exploratory surgery. The differential diagnosis would include twisted adnexa, ruptured ectopic pregnancy, haemorrhagic corpus luteum or follicular cyst, whilst that of the pelvic mass would be ovarian or endometrial carcinoma, uterine sarcoma or leiomyoma and, rarely, ovarian fibroma. Deep vein thrombosis is usually due to pelvic venous compression, and while some have advocated that its occurrence in association with a fibroid mass should be an absolute indication for hysterectomy, sophisticated use of radiological adjuncts at surgery, such as 'umbrellas' and haematological support with appropriate anticoagulation, could enable uterine-preserving surgery. The diagnosis of fibroids as a cause of acute urinary retention should be one of exclusion. The treatment of the acute fibroid in pregnancy is of course conservative, definitive treatment being postponed until postpartum.
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PMID:Acute complications of fibroids. 1926 55

A 19-year-old woman presented to the emergency department with intermittent and progressively worsening abdominal pain, nausea, and vomiting. A computed tomographic scan revealed findings consistent with distal small bowel obstruction of unknown etiology. In the operating room, a torsed and gangrenous Meckel's diverticulum with extension of ischemia to adjacent small bowel was discovered and immediately resected. Pathology confirmed the diagnosis of gangrenous Meckel's diverticulum. Torsion and gangrene of a Meckel's diverticulum is a rare complication and often presents with vague and poorly localized signs and symptoms. The preoperative diagnosis is often difficult and presumed to be appendicitis or small bowel obstruction of unclear etiology. Complications of Meckel's diverticulum should be considered in patients with lower abdominal pain and acute abdomen.
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PMID:Torsion and gangrene of a Meckel's diverticulum. 1927 65

Acute mesenteric ischemia (AMI) is a catastrophic disorder of the gastrointestinal tract with high mortality. Few data on the characteristics of this disease in Iran are available. Patient records of public and private hospitals in Shiraz, southern Iran, with impression of acute abdomen, bowel gangrene or abdominal pain, and patients with risk factors for this disease, who were admitted between March 1989 and March 2005, were reviewed. Among the 10,000 patient records studied, 105 patients (mean age 57 years) with AMI were identified. The mortality rate was 50.4%. The most common symptom was abdominal pain (98.1%). Heart diseases were seen in 44.7% of cases. The mortality rate was lower in patients undergoing mesenteric angiography (p=0.014). In those patients in whom the site of lesion was identified, venous thrombosis was the most common type (41.9%). AMI is a common cause of acute abdomen especially in elderly patients, with venous thrombosis being the most common type.
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PMID:Acute mesenteric ischemia: causes and mortality rates over sixteen years in southern Iran. 1940 57

Ascaris infestation in the gastrointestinal tract is well known in Asian countries. It can be asymptomatic or can present with symptoms of acute abdomen. Perforation and torsion with gangrene are its very rare fatal complications but an important cause of mortality in children. Although ascariasis is very rare in developed countries, clinicians should consider this potentially dangerous, yet treatable, infection in the differential diagnosis of acute abdomen. We herein report a series of five cases of intestinal gangrene secondary to extensive infestation by Ascaris lumbricoides in children aged 1-4 years.
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PMID:Gangrene intestine caused by Ascaris lumbricoides; report of 5 cases in children. 1994 30

Vascular disturbances of the omentum, described variously as acute epiploitis, primary omental torsion, idiopathic segmental infarction, etc., is an infrequent cause of acute abdomen, often mimicking acute appendicitis, cholecystitis, or pancreatitis. In this retrospective article, we share our experiences about the incidence, diagnostic dilemma, and management of patients with omental torsion or infarction and discuss the diagnostic and therapeutic role of laparoscopy. From January 2003 to December 2008, 9 patients (7 men and 2 women; median age, 26 years; range, 5-71) with omental gangrene, including omental torsion and infarction, were operated on at our institute. Of these, 8 patients had a preoperative provisional diagnosis of acute appendicitis and 1 patient of acute calculus cholecystitis. During this period, a total of 1502 patients were diagnosed and operated on laparoscopically for acute appendicitis and acute cholecystitis. Of them, 2 patients were intraoperatively diagnosed to have omental torsion and 7 patients had segmental omental infarction. Incidences of omental gangrene presenting as acute cholecystitis and acute appendicitis were 0.11 and 1.1%, respectively. The suspected preoperative pathology was grossly normal, and histopathology of the same was noncontributory to the cause of acute abdomen. All 9 cases were managed laparoscopically, with the gangrenous omentum excised along with appendectomy in 8 patients and cholecystectomy in 1 patient. In conclusion, inspection of the omentum should be a routine part of exploration in suspected acute appendicitis.
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PMID:Omental torsion and infarction: a diagnostic dilemma and its laparoscopic management. 2018 Jun 56

Gangrenous cystitis is an extremely rare condition: only a total of 240 cases worldwide have been reported so far. Most of these cases have occurred in the preantibiotic era. After the advent and widespread use of antibiotics in clinical practice, only sporadic cases have been observed. We report a case of gangrenous cystitis in an 83-year-old woman who presented with symptoms of acute abdomen. The main causative factor was overdistension of the bladder due to urinary retention. The patient underwent total cystectomy and bilateral ureterocutaneostomy with a favorable outcome. The incidence, etiology, diagnosis, management and outcome of gangrenous cystitis are discussed.
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PMID:Gangrenous cystitis: report of a case and review of the literature. 2098 Jul 27

The aim of the study was to estimate the incidence and analyse the clinical profile and surgical outcome of the Meckel's diverticulum. This prospective study included 632 patients who were operated upon for acute abdomen during August 1999 to July 2004 in a single surgical unit. Pre-operative abdominal ultrasonography and plain x-ray abdomen erect were done depending on the necessity. These patients were subjected to laparotomy/appendicectomy depending on the case. A search for Meckel's diverticulum was done and if found, surgical resection and analysis by histopathological confirmation of the Meckel's diverticulum was performed. This study detected 9 patients (1.42%) with Meckel's diverticulum during the operation. In none of these cases pre-operative diagnosis of Meckel's diverticulitis was made. Out of 9 patients, 6 (66.6%) were males, 3 (33.4%) females. Four cases (44.4%) were symptomatic due to Meckel's diverticulum and 5 (55.6%) were asymptomatic. One patient presented with haematochezia, one with intestinal obstruction due to gangrene of the Meckel's diverticulum and one case of duplication of (double) Meckel's diverticulum. Histopathological examination of these specimens confirmed 2 cases with inflammation, one with gangrene and one ulcerated gastric mucosa in the Meckel's diverticulum. In 2 cases (22.2%) there was heterotopic epithelium (gastric-1, colonic-1). It is recommended that a search for Meckel's diverticulum in every case of appendicectomy, laparotomies for acute abdomen should be conducted and if found, Meckel's diverticulectomy/resection should be performed to avoid secondary complications arising from it.
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PMID:Clinical profile and surgical outcome of Meckel's diverticulum. 2231 42

The association of acute appendicitis with femoral hernia,strangulated or incarcerated, represents a rare but well documented pathology in the specialized medical literature,also known as Garengeot hernia. The development of an acute appendicitis in the femoral hernia sac becomes a surgical emergency of acute abdomen. The diagnosis is always mistaken for the one of incarcerated or strangled hernia, the correct diagnosis being established intraoperatively, occasion which exposes the cecal appendix by opening the herniary bag, found in different morphological stages of inflammation that can go as far as gangrene or even perforation. In this paper, we have reported the case of a 76 year-old female that presented with femoral tumours, incarcerated, painful and initially considered as an incarcerated femoral hernia, the final diagnosis being made intraoperatively. The treatment for these "hernias" is generally simple, when there are no complications of acute appendicitis as the presence of pus in the hernia sac, and consists in appendectomy and herniorrhaphy. The absence of symptoms for an acute appendicitis often delays the surgery which leads to frequent complications and increased rate of morbidity.
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PMID:A rare case of acute abdomen: Garengeot hernia. 2433 33

Omental gangrene is an infrequent cause of acute abdomen with unclear etiology. Hypercoagualable states like protein C or protein S deficiency have never been implicated in the etiology of omental gangrene. We present this case report of a patient having protein C and protein S deficiency presenting with omental gangrene and extensive porto mesenteric thrombosis.
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PMID:Omental gangrene and porto-mesenteric thrombosis in a patient of protein C and protein s deficiency. 2442 32

The ileosigmoid knot (ISK) is a rare cause of intestinal obstruction. ISK is a condition in which the ileum wraps around the base of the sigmoid colon and forms a knot, leading to high mortality with rapid progression to bowel gangrene. We herein report a rare case of ISK at week 13 of pregnancy. The ISK was diagnosed by computed tomography, and the patient underwent emergency surgery for acute abdomen. Laparotomy showed segmental gangrenous change in the sigmoid colon, which was twisted around the distal ileal loop. The gangrenous bowel was resected, and primary anastomosis was performed. To our knowledge, the present case involves the first and earliest pregnancy in which a preoperative diagnosis of ISK was made and successful treatment was performed with surgery. A radiologic approach should be undertaken for prompt diagnosis and optimal management, even in early pregnancy.
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PMID:Ileosigmoid knot at week 13 of pregnancy: report of a case. 2483 44


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