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

Brown bowel syndrome is a rare condition characterized by deposition of lipofuscin in the smooth muscle cells of the gastrointestinal tract. The number of reported cases is small, but all are associated with malabsorptive states. Despite these small numbers, there is considerable evidence that vitamin E deficiency is important etiologically. We report here the case of a severely malnourished [body mass index 11.7 kg/m (2): normal range 20-25 kg/m (2)] 31-yr-old black male with a longstanding history of alcohol abuse, who was on anti-tuberculosis therapy. The patient presented with an acute abdomen and was found, at operation, to have a mid-ileal intussusception. Histological examination of the resected specimen demonstrated lipofuscin accumulation consistent with brown bowel syndrome, but no tumor. Subsequent investigations revealed no significant quantities of vitamin E in the blood and pancreatic steatorrhea. However, deficiency of other fat-soluble (vitamin A and D) and water-soluble vitamins (vitamin C and thiamine) also were detected. This report supports the association of brown bowel syndrome with vitamin E deficiency but cannot exclude the compounding effects of protein calorie malnutrition, multiple vitamin deficiencies, and chronic alcohol toxicity.
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PMID:Small bowel intussusception and brown bowel syndrome in association with severe malnutrition. 867 14

CT has become the primary imaging modality for the evaluation of the patient with clinical symptoms of an acute abdomen and a confusing clinical picture. Because these patients may have a range of various pathologies, CT has been used successfully to define the presence of disease and localize it to a specific organ or organ system. In this article, we review the various processes that resulted in acute abdomen focusing on the small bowel and colon. Specific entities discussed include appendicitis, diverticulitis, Crohn disease, and ulcerative colitis. Other less common processes, including pseudomembranous colitis, intussusception, and bowel ischemia are also discussed. The specific role of CT scanning and specific CT signs are discussed and addressed. The value of CT in relationship to other modalities and clinical evaluation is discussed and key statistics provided.
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PMID:CT evaluation of the acute abdomen: bowel pathology spectrum of disease. 887 9

When to operate immediately, when to observe, and when not to operate at all represent major challenges in the management of a child with an acute abdomen. This article is an overview of the subject from symptom to diagnosis, evaluation, and preparation for the surgical intervention. Tables provide examples of conditions requiring prompt surgical intervention and relative surgical urgency; pathologies suitable for (initial) nonsurgical management; and clinical pictures where surgical intervention is not indicated. Factors that influence the timing of operation are provided, as is the differential diagnosis between intestinal strangulation and obstruction. Brief notes highlight four important causes of acute abdomen in children acute appendicitis, malrotation with volvulus, Meckel's diverticulum, and intussusception. These as well as other intraabdominal pathologies are illustrated by means of surgical photographs. The acute abdomen is a clinical diagnosis. Other diagnostic modalities have merely supporting roles. The decision to operate is based primarily on the results of a good history and thorough physical examination(s).
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PMID:Acute abdomen. When to operate immediately and when to observe. 915 57

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

A child is said to have an 'acute abdomen' in case of severe abdominal pain of sudden onset. Further investigations are necessary if the pain is very bad, persists for longer than 3-4 hours or is accompanied by vomiting. Failure to make the correct diagnosis may result in severe complications. The principal cause in an older child is acute appendicitis. This diagnosis is to be based on the anamnesis, physical examination and laboratory tests. If one of these is typical, active observation is indicated; if two or three are typical, appendectomy is indicated. Differential diagnoses can only be made during laparotomy. Intussusception occurs more frequently in toddlers. In a child with possible intussusception, observation is not justified: the diagnosis should be excluded by a contrast colonic X-ray, or operation should be performed either immediately or, if the symptoms persist, after the X-ray. Rest and patience, careful and child-adapted approach, and correct evaluation of aberrant symptoms may minimize unnecessary intervention.
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PMID:['Acute abdomen' in children]. 1008 38

BACKGROUND: Although unusual, but not rare, obstruction in the vicinity of the jejunojejunostomy in Roux-Y gastric bypass (RYGBP) can progress in a very short period of time to a life-threatening situation. METHODS: Over a 10-year period in 1,174 RYGBPs, we have seen seven instances of acute and subacute partial to complete small bowel obstructions in the vicinity of the jejunojejunostomy, which can lead to acute gastric dilatation due to obstruction of the bilio-pancreatic limb. Signs and symptoms of the obstruction may include tachycardia, oliguria, hypotension, severe epigastric pain with or without a palpable mass in the epigastrium, chronic bile regurgitation and bilious vomiting, and a possible increase in serum amylase. Laboratory data otherwise has not been helpful, and although a palpable abdominal mass may be diagnostic, the best tools have been radiologic, i.e. the acute abdomen series, limited upper GI series in the patients that appear to be only partially obstructed, abdominal ultrasound and probably most importantly, CT of the abdomen. RESULTS: In the seven cases presented, diagnoses included internal hernia, adhesions, an idiopathic spontaneous hematoma of the bowel wall and retrograde intussusception at the jejunojejunostomy. CONCLUSIONS: Since many surgeons who perform bariatric surgery are alone in their community, they should train their non-bariatric surgical colleagues and associates to be aware of these potential deadly problems.
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PMID:Biliopancreatic Limb Obstruction in Gastric Bypass at or Proximal to the Jejunojejunostomy: A Potentially Deadly, Catastrophic Event. 1072 97

Duplications of the alimentary tract are rare congenital anomalies that may occur at any level from mouth to anus. While the oesophagus and the ileum are the most common sites, duplications of the colon are rare. Two cases of ileocolic intussusceptions in 8-month-old girl and 6-month-old boy who were admitted to our hospital with acute abdomen findings are presented. Intraoperatively, cecal cystic duplications leading intussusception were revealed. Intussusception is one of the most important surgical emergence in infancy and typically, it does not involve a lead point in childhood. Although duplication cyst may act as lead point, the review of literature reveals its rarity.
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PMID:Cecal duplications: a rare cause for secondary intussusception. 1083 80

Over the last twenty years, ultrasound has progressively become the primary modality used to assess the acute pediatric abdomen. The lack of radiation exposure and the high diagnostic efficacy of US have contributed to broaden the use of US. During his career, any radiologist may be involved in the evaluation of an acute abdomen in a child. He has to be familiar with the sonographic findings and the age-related symptoms which allow diagnosis of intussusception, hypertrophic pyloric stenosis, midgut volvulus, and appendicitis. He also has to be familiar with the findings which help to exclude these diseases. For experienced radiologists the accuracy in detecting appendicitis and intussusception are respectively close to 95% and 100%. In this chapter, we will also discuss the differential diagnoses of the most frequent causes of acute pediatric abdomen and the technical limitations of US. The learning objectives will be
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PMID:[Role of ultrasound in children with emergency gastrointestinal diseases]. 1144 95

To determine the morbidity and mortality of Meckel's diverticulum (MD) as a cause of acute abdominal disorders and to evaluate the relationship between patient age, MD complications, and postoperative complications. We reviewed 74 patients who underwent surgery between 1990 and 2000 for an acute abdominal syndrome with a MD diagnosed intraoperatively. Forty children were treated before 1995 and reviewed retrospectively, while the remaining 34 were reviewed prospectively. The average age was 4.8 years; the male/female ratio was 2.5/1; 34 (46%) were less than 2 years old, 32 were between 2 and 8 years, and 8 were older than 8 years. None of the symptoms was suggestive of the diagnosis of MD. Thirty-nine MDs were asymptomatic (21 intussusception, 18 volvulus), but all were the secondary cause of the acute abdomen. The remaining 35 children had a symptomatic MD (diverticulitis in 14, diverticular bleeding in 11, diverticular perforation in 10). The risk of complications due to a MD occurring in children under 2 years and between 2 and 8 years of age was significantly higher compared to children older than 8 years (P = 0.02). Postoperative complications occurred more commonly in children between 2 and 8 years of age compared to other patients. There is thus an increased risk of morbidity in a symptomatic MD in patients less than 2 and between 2 and 8 years of age, and there is no predictive factor for the development of diverticular complications. Resection of the MD is recommended in all children younger than 8 years, including asymptomatic ones, in the absence of absolute contraindications.
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PMID:When to resect and when not to resect an asymptomatic Meckel's diverticulum: an ongoing challenge. 1272 25

We report the case of a patient with von Recklinghausen's disease, who was admitted with a diagnosis of acute abdomen due to small bowel neurofibromatosis. The patient was submitted to an abdominal CT scan that showed a homogeneous round lesion, with a regular margin, probably belonging to the small bowel and with the appearance of a benign lesion that probably caused an intestinal intussusception. The patient was submitted to a surgical procedure that mainly consisted in multiple small bowel resections. The histopathological examination confirmed the benign nature of the lesions. About one third of patients affected by von Recklinghausen's disease present involvement of the bowel, but only 5% of them are symptomatic. The intestinal tumours are usually neurofibromas and are mainly localized in the jejunum. However, there have also been reports of stromal, nervous and endocrine tumours and even other tumours not belonging to these categories, including adenocarcinoma. The overall incidence of intestinal malignancy in patients with von Reckilnghausen's disease is about 10%. The surgical operation, as well as the histopathological and immunochemical examination of the intestinal lesions are of crucial importance for the treatment of the complications of intestinal neurofibromatosis and for the treatment and diagnosis of malignancy.
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PMID:[Von Recklinghausen's disease and intestinal neurofibromatosis: a case report]. 1274 3


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