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

Cases of neutropenic enterocolitis associated with Clostridium septicum infection have been reported with increasing frequency in the past decade. We report two such cases involving unusual hosts and briefly discuss possible pathogenetic mechanisms such as ischemia, mucosal damage related to chemotherapy and neutropenia, and immunosuppression. One case involved a young man with chronic Epstein-Barr infection who developed extensive gas gangrene of the right side of his trunk and thigh and who died within 12 hours of presentation to the emergency department. Diagnosis was only made at postmortem examination. The second, middle-aged patient was admitted with an acute abdomen shortly after he completed chemotherapy for pleural mesothelioma. A right hemicolectomy was performed, but the patient developed antibiotic-associated pseudomembranous colitis and died. These cases indicate that neutropenic enterocolitis may arise in a variety of underlying conditions and that prompt diagnosis and therapy will be required to salvage more patients with this disorder.
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PMID:Neutropenic enterocolitis. Two unusual cases with review of the literature. 848 43

In the period 1990 through 1995, one-hundred patients operated for acute abdomen or admitted on a routine basis, presenting evidence of anaerobic infection, undergo treatment in the clinic of emergency surgery. Septic shock develops in 10/100 patients (10 per cent). In six of the latter the outcome is fatal--three with infection caused by spore-forming anaerobes (gas gangrene of the inguinal region--of Fournier, and anterior abdominal wall--anus praeternaturalis--two), and three with infection caused by non-spore-forming anaerobes (mixed anaerobic-aerobic infection). Anaerobic surgical infection and septic shock specificity is discussed, with an algorithm of therapeutic approach, based on clinical experience had with 100 patients, being proposed in either of them. Special emphasis is laid on antibiotic prophylaxis against anaerobic surgical infection. Its implementation in the concrete clinical conditions in this country demands a clearcut hospital drug policy (adoption of the "Drug Formularies" system), and elaboration of a new economical approach to the choice of antibacterial agents (using some of the forms of pharmaco-economical analysis, practicable with a view to the Bulgarian health-care model).
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PMID:[Anaerobic surgical infection and septic shock]. 917 69

Anaerobic infections with Clostridium perfringens (CP) occur rarely but are associated with considerable maternal mortality. We report the case of a patient who developed uterine gas gangrene postpartum and discuss the management of this infection. A 28-year-old patient, GII, PII with history of Caesarean in 2002, delivered a healthy girl per vacuum extraction. Postpartally she presented with an acute abdomen and a laparotomy was performed. The uterotomy suture was intact but a parametrane tear had to be resutured. 36 hours later the patient's condition worsened quickly. Cellulitis was diagnosed and after receiving the results of the wound swabs (CP positive) from the uterus and haematoma, tazobactam and clindamycin were administered. Her condition continued to deteriorate and gaseous gangrene was seen with unilateral extension to the abdomen reaching as far as the axilla cranially and to the thigh caudally. Due to the extensive infection it was necessary to perform a hysterectomy, necrosis removal and splitting of the fascia followed by several debridements and leaving the wound open in order to avoid anaerobic conditions. The patient was discharged after 21 days. She developed a post-traumatic syndrome with severe depression. Clostridium perfringens is ubiquitous and is found vaginally in ca. 1 - 10 % of healthy women and usually does not cause a serious infection. Under the right conditions it can cause an endometritis leading to sepsis. Early recognition and interdisciplinary treatment are of extreme importance. In this case the surgical treatment through hysterectomy combined with targeted antibiotic therapy, ultimately saved the patient's life.
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PMID:[Uterine gas gangrene through clostridium perfringens sepsis after uterus rupture postpartum]. 1631 27

Clostridium perfiringens may cause myonecrosis (i.e. gas gangrene), acute food poisoning or necrotic enteritis (e.g. enteritis necroticans or Pig Bel). We describe a case of enteritis necroticans in a 33 year old man with acute myeloid leukaemia. He presented with an acute abdomen, diarrhoea and pancytopaenia and extensive accumulation of gas in the intrahepatic and extrahepatic portal veins. Despite urgent resuscitation he died shortly after arrival in the Intensive Care Unit. Treatment of enteritis necroticans requires urgent surgery to remove dead bowel and in adults intravenous penicillin (1g 2-hourly) and metronidazole (500 mg 8-hourly) or clindamycin (600 mg 6-hourly). While antibiotics may also reduce toxin formation, beta toxoid has not been found to be of benefit in established disease.
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PMID:Proximal small bowel infarction associated with portal venous gas. 1660 2