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

Phlegmonous enteritis is a rare inflammatory bowel disease. A 52-yr-old man with a history of alcoholic abuse was admitted to the hospital for an acute abdomen and died of septicemia and its complications. Autopsy revealed phlegmonous inflammation of the ileum and severe fatty liver. Numerous Gram-negative rod bacilli were demonstrated in the ileal mucosa. Shortened villi and decreased lysozyme activity of Paneth cells in the small intestine might be results of chronic alcohol ingestion. The relationship between phlegmonous enteritis and alcoholic abuse was strongly suggested in this case.
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PMID:Phlegmonous enteritis in alcoholic fatty liver. 192 52

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

Huge dose ACTH therapy is used in some severely ill patients with inflammatory bowel disease. We report a teenage girl with Crohn's disease who developed an acute abdomen following ACTH therapy. CT revealed the mass to be a hemorrhagic adrenal gland; the opposite adrenal gland was hypertrophied but without signs of hemorrhage.
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PMID:Adrenal hemorrhage complicating ACTH therapy in Crohn's disease. 825 51

The outcome for children with common surgical conditions that cause an acute abdomen is discussed. These conditions include appendicitis, intussusception, malrotation, inflammatory bowel disease, intestinal obstructions, and nonorganic pain. Emphasis is placed on surgical intervention and disease processes that significantly affect outcome. The outcome of many of the diseases discussed is strongly influenced by the timing of diagnosis and treatment. These children should have prompt care and intervention to prevent morbidity and mortality. In addition, many children who present with common pediatric surgical emergencies have other medical conditions and are best treated in an environment that has a multidisciplinary team to handle their care and decrease the long-term complications.
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PMID:Acute abdomen. Outcomes. 915 62

Actinomyces israelii is a normal inhabitant in the gastrointestinal tract of humans, it rarely causes disease. Abdominal involvement occurs in only 20 percent of all cases and can mimic malignant diseases, tuberculosis and inflammatory bowel disease. A case of a 36 years old female patient with abdominal actinomycosis and review of the literature is reported. Symptoms was presented as an acute abdomen associated with painful epigastric and left subcostal mass. The pathologic process infiltrated the retroperitoneal space simulated sarcoma or lymphoma. Diagnosis was established only at the second laparotomy, when histologic examination of the removed lymph node disclosed actinomycosis. The patient is completely free of symptoms 6 month after the second operation.
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PMID:[Abdominal actinomycosis presenting as a malignant tumor--report of a case and review of the literature]. 1057 89

The aim of this prospective study was to elucidate the clinical features and natural history of Crohn's disease in Greece. One hundred and fifty-five Greek patients with definite diagnosis of Crohn's disease were followed-up for a mean period of 9.7 years and evaluated for clinical patterns and course of illness. The male/female ratio was 1.58:1. The peak incidence of the disease was observed between 20 and 30 years of age. The majority of patients were urban dwellers and of higher socio-economic level compared to the general population of Greece. In almost 50% of the patients symptoms of the disease started below the age of 30, although in almost one in every 5 cases, symptoms appeared after the age of 50. Familial clustering of inflammatory bowel disease was observed in 1. 3%. The pattern of anatomic involvement was: ileocolic 33.3%, colon 33.3% and small bowel 33.3%. The kind of predominant symptoms at the time of diagnosis was related to the anatomic location of the disease. At least one extraintestinal manifestation appeared in 42% of patients. Perianal disease was noticed in 21.3% with fistulae and abscesses being the most common manifestation. Fifty-one percent of patients were operated upon at least once during the follow-up period because of acute abdomen, bad response to conservative treatment and fistulae and abscesses. Emergency operation was required in 17.3% of the patients. Evolution to cancer was observed in 3 patients (2%). During the follow-up period of 9.7 +/- 6.5 years, 18 patients (11.6%) died. A considerable mortality was noticed in the surgically treated group of patients, while in the nonoperated group the disease was running with milder symptoms. It is concluded that some of the clinicoepidemiological characteristics of patients with Crohn's disease in Greece are in accordance with those reported from western as well as the neighboring Mediterranean countries. However, other parameters such as the higher incidence of the disease in males, the low incidence of familial clustering, and the low incidence of perianal disease, underline the importance of environmental, genetic and other factors on the evolution and behavior of the disease in different parts of the world.
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PMID:Clinical patterns of Crohn's disease in Greece: a follow-up study of 155 cases. 1070 76

A 37-year-old woman presented with an acute abdomen following the onset of watery diarrhea. Spontaneous peritonitis was detected, along with evidence of a focal sigmoid colon perforation. Subsequent postoperative colonoscopic studies revealed collagenous colitis with a focal, deep, nongranulomatous ulcer in the sigmoid colon. Although the literature suggests that collagenous colitis tends to have a relatively 'benign' clinical course characterized by chronic or episodic watery diarrhea. Potentially serious and life- threatening complications may occur in this microscopic form of inflammatory bowel disease.
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PMID:Spontaneous peritonitis from perforation of the colon in collagenous colitis. 1133 29

Eosinophilic gastroenteritis is an unusual entity that is rarely found in daily clinical practise. Its aetiology is unknown and diagnosis can be made microscopically with evidence of massive eosinophilic infiltration in patients with chronic gastrointestinal symptoms, excluding entities that may cause such findings (parasitic infestation, medical therapy, inflammatory bowel disease, and so on). Allergic processes are usually associated and these normally respond well to steroids. We present our last year's experience of four women with eosinophilic gastroenteritis with an extraordinary atypical clinical onset. Two of the women presented with an acute abdomen and two with isolated colonic involvement. The management of acute abdomen avoiding surgery and a complete response with azathioprine are the outstanding variables that make our recent cases of special interest. Demographic variables were similar to others reported from our medium, with the exception of a higher incidence of women. Our cases suggest the wide spectrum of clinical presentations and show the high suspicion index needed for a diagnosis that is made by pathologists.
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PMID:Eosinophilic gastroenteritis: our recent experience: one-year experience of atypical onset of an uncommon disease. 1222 80

Primary intestinal tuberculosis is unusual in European and North American countries today. Its diagnosis is often surprising and differentiation from inflammatory bowel diseases is difficult. The authors present a rare case of severe stercoral peritonitis caused by multiple intestinal perforations in a patient with primary ileocecal tuberculosis. Initial clinical and laboratory investigations led to the suspicion of inflammatory bowel disease. The subsequent diagnostic workup included colonoscopic examination of the cecal and terminal region of the ileum with multiple biopsies. After the pathologist had assessed the specimen as indicating Crohn's disease, appropriate therapy was initiated. Several days later, however, the patient was readmitted to a surgical intensive care unit with clinical signs of peritonitis and immediately operated on. The final diagnosis from a resection specimen confirmed the diagnosis of primary intestinal tuberculosis. The follow-up was complicated by a subhepatic abscess formation with the necessity for surgical drainage. The patient's recovery was uneventful, she underwent intensive antituberculotic therapy and is asymptomatic at present. Surgeons caring for patients with acute abdomen should be aware of tuberculous perforation peritonitis even in non-risk groups of patients.
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PMID:Perforation peritonitis in primary intestinal tuberculosis. 1179 99

Mesenteric inflammatory veno-occlusive disease (MIVOD) is a relatively recently known and not very often diagnosed form of ischemic bowel disease of low incidence und unknown etiology. We present the case of a patient who after presentation of inconclusive signs of epigastric pain and rectal bleeding suddenly developed right abdominal pain with local peritonism. Suspecting intestinal ischemia or perforated appendicitis we first performed laparoscopy, which showed an inflammable tumor of cecum, ascending colon and appendix with massive adhesions to the abdominal wall. We performed an open right hemicolectomy with primary anastomosis. The patient developed a deep vein thrombosis of the vena tibialis post. and vena saphena parva. After 12 months our patient is free of complaints and recurrence. Investigations carried out showed no evidence of hypercoagulopathy. The presentation of MIVOD can range from chronic inflammatory bowel disease with recurrent abdominal pain in combination with nausea, emesis and bloody diarrhea to acute abdomen. Therefore diagnostic misinterpretation and mistherapy as well as underdiagnosis is common. Histologic investigation shows a variable inflammatory infiltration of multiple veins of the intestinal wall and the mesentery as well as thrombotic vessel occlusion in different stages without involvement of the arteries. All forms of hypercoagulopathy, parasitic disease, sepsis and malignancy have to be excluded. Therapeutic success can only be achieved with surgical resection of the affected bowel, whereon in general no recurrence will occur.
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PMID:[Mesenteric inflammatory veno-occlusive disease (MIVOD)--a rare cause of intestinal ischemia]. 1639 91


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