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

Intussusception is one of the leading causes of bowel obstruction in early infancy and childhood. From 1984-1989, 67 patients under 2 years of age with intussusception were diagnosed and treated in our institution. There were 48 boys and 19 girls ranging in age from 2 months to 2 years with a mean of 7.4 months. Presenting symptoms and signs included abdominal pain (96%), vomiting (93%), rectal bleeding (60%) and a palpable mass (67%). Symptoms and signs were present for less than 24 hours in about 80% of cases. Most of the intussusceptions were of the ileocolic type (75%). The overall success rate of hydrostatic barium enema reduction was 49%. The highest rate of reduction by enema was among patients between 9 and 16 months of age (83%). The success rate of barium enema reduction was negligible after 24 hours of cardinal symptoms. Five children underwent surgical exploration without contrast studies because of delayed presentation and signs of an acute abdomen. A pathological lead point was found in only four cases, the commonest being Meckel's diverticulum. The average length of hospitalization was 2.57 days after barium enema reduction and 7.55 days after surgical reduction. There were no deaths. There was no case of perforation during enema reduction. Three children had recurrence within 3 months of initial presentation. The best outcome is associated with early diagnosis and barium enema reduction, or selected surgical intervention when indicated.
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PMID:Intussusception in children under 2 years of age in the State of Qatar : analysis of 67 cases. 137 79

Congenital and acquired diverticula of the jejunum and ileum in the adult are unusual and occur in approximately 1 percent to 2 percent of the population. They are pulsion diverticula thought to be the result of intestinal dyskinesia. These lesions can produce a significant diagnostic and therapeutic dilemma. They are multiple in the jejunum and solitary distally and are characteristically found in 60- or 70-year-old males. The diagnosis may be confirmed with contrast studies of the small intestine, arteriography, or nuclear scan. Consider these disorders in patients with 1) unexplained gastrointestinal bleeding, 2) unexplained intestinal obstruction, 3) an unexpected cause of acute abdomen, 4) chronic abdominal pain, 5) anemia, or 6) malabsorption. Medical therapy is helpful in controlling diarrhea and anemia, while surgical therapy is reserved for hemorrhage, obstruction, perforation, or failure of medical management. Asymptomatic diverticula discovered on routine contrast studies need not be resected. At surgery, incidental diverticula should be removed when evidence of dilated, hypertrophied loops of small bowel with large diverticula is found. Intraoperative air distention will aid in diagnosis. Resection and primary anastomosis is the preferred treatment for non-Meckelian diverticula. Diverticulectomy is reserved for a Meckel's diverticulum without evidence of ulceration. An incidental Meckel's diverticulum should be removed in the presence of mesodiverticular bands or ectopic tissue. Removal of a Meckel's diverticulum is not advised in the patient with Crohn's disease but may be performed in the patient undergoing restorative proctocolectomy for ulcerative colitis.
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PMID:Clinical implications of jejunoileal diverticular disease. 158 62

A case of perforated leiomyosarcoma of Meckel's diverticulum causing acute abdomen is described. In the available literature only 58 cases of leiomyosarcoma at this site have been reported, with three perforations.
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PMID:Perforated leiomyosarcoma of Meckel's diverticulum. Case report. 167 86

The authors describe two case-histories of acute abdomen which developed as a result of perforation of Meckel's diverticulum by a foreign body. They draw attention to diagnostic difficulties by a foreign body. They draw attention to diagnostic difficulties and the frequent diagnosis of acute appendicitis.
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PMID:[Perforation of Meckel's diverticulum by a foreign body]. 189 96

The most common cause of acute abdomen in a child is acute appendicitis followed by mesenteric lymphadenitis, invagination, strangulation-ileus as a result of volvulus and more rarely perforated Meckel's diverticulum. However even with a child, from a differential diagnosis' aspect, a gynaecological cause should be taken in account too. From time to time one comes across a polycystic-alterated, with twisted lig. ovarii, haemorrhagic and infarctioned ovary without any endocrinological or other pathological irregularities which produces these complaints and symptoms. In the following casuistic such an instance is described.
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PMID:[Pedicle torsion, hemorrhagic ovarian infarct. A rare cause of pediatric acute abdomen]. 192 84

In 1978-1988 operations were performed on 92 children: 35 with diverticulitis, 7 with intestinal intussusception, 5 with hemorrhage from an ulcer of the diverticulum, 13 with strangulation or mechanical ileus, 2 with strangulated Littre's hernia, one with torsion of the omentum, 22 with secondary diverticulitis, and in 7 children Meckel's diverticulum was a chance finding during other operations in the cavities. Boys accounted for 60.9' (56) of cases. There were 12 children under one year of age, nine from 1 to 3 years, 17 from 3 to 5 years, 17 from 5 to 7 years, and 12 children aged from 7 to 10 years. The clinical manifestations depended on the pathological changes developing in Meckel's diverticulum. A clinical picture of acute appendicitis developed in diverticulitis, six children had a typical picture of intussusception, and one child had a picture of acute abdomen. Anemia and a stool with dark blood were encountered in hemorrhage from a diverticular ulcer. Seven out of 13 children with ileus had a pronounced clinical picture, in the remaining 5 it was unclear and resembled that of acute appendicitis. Meckel's diverticulum was suspected before the operation in 17 (9.95%) patients. The Volkovich-Dyakonov laparotomy approach was used in 64 children, a pararectal incision in 9, a transrectal incision in 15, a median incision in one patient, hernio-laparotomy was conducted in one and Shpizi's operation in 2 children. Diverticulectomy was accomplished by the oblique-transverse method in 79 children, by the wedge techniques in 5, by the purse-string method in 2 patients, and resection of the intestine with the diverticulum was conducted in 5 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Meckel's diverticulum in children]. 767 99

Laparoscopy in the emergency setting is a logical extension of this technique. Open laparoscopy is particularly useful in the management of the acute abdomen. In our institution, after a sequential work-out that includes physical examination, laboratory data, plain abdominal roentgenograms and ultrasonography, diagnostic laparoscopy is advocated. We present the laparoscopic treatment of an intestinal obstruction caused by a volvulus around Meckel's diverticulum. The efficacy and safety of the diagnostic and/or therapeutic laparoscopic procedures in the emergency setting are discussed.
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PMID:Laparoscopic management of volvulated Meckel's diverticulum. 773 47

In two autopsy prospective studies, at the Prosectures of the Departmental Hospital and of the Pediatric Hospital in Cluj, we found an incidence of Meckel's diverticulum of 1.16%, 1.46% respectively. Besides, we have retrospectively followed the incidence of the ileal diverticulum during the laparatomies performed at the Pediatric Hospital in Cluj between 1981 and 1990 on an acute abdomen of a supposed appendicular cause. Consulting the pathological bulletins which registered 8,385 laparatomies we found 200 Meckel's diverticula. Of the 200 diverticula, 64 exhibited a pathological process and 136 were trophic, and we suppose that they were found incidentally (incidence of 1.63%, corrected incidence of 1.38%). Up to the age of 16, 4.5% of the diverticula were excised. In the 64 symptomatic cases of ileal diverticulum, 50 presented inflammatory complications, 10 were ulcero-hemorrhagic, two were obstructive, one diverticulum presented an entero-umbilical fistula and one displayed a hemorrhagic infarction. Seventeen of the 200 diverticula presented heterotopic tissues; 12 of the 17 cases were symptomatic; in 64.7% of the cases the heterotopic tissue was the gastric mucous coat. Out of 8,385 laparatomies performed on an acute abdomen of a supposed appendicular cause, in 64 cases the symptomatology was generated by a meckelian pathological process (0.76%). An acute appendicitis was concomitantly present in 22 of the 64 cases.
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PMID:The ileal diverticulum. Morpho-clinical and epidemiological study. 803 19

Acute appendicitis is the first cause of emergency surgery in children. Actually, emergency abdominal sonography has evolved in differential diagnosis of acute appendicitis in children to differentiate it from other causes of acute abdomen as mesenteric lymphoadenitis, acute right pyelonephritis, acute diverticulitis in Meckel's diverticulum, intestinal intussusception, regional enterits, primary peritonitis, anaphylactoid purpura of Henoch-Schonlein. The aim of this study is the evaluation of the usefulness of abdominal sonography in diagnosing acute appendicitis in our current series of pediatric patients. We have operated 102 patients afflicted by appendicitis admitted to the pediatric department of Ospedale San Raffaele, Milano in a period of 5 years and operated on for appendectomy. In the last 2 years 36 patients were evaluated with abdominal sonography. This diagnostic tool showed in 34 (94.4%) a liquid effusion, sometimes thick of the right iliac fossa. In 2 patients the appendix had thickened layers, was edematous and the lumen was clearly filled with debris. Abdominal sonography has given a clear cut picture of the acute inflammatory process of the appendix. None of these patients has suffered from septic or obstructive complications. Mean duration of hospital stay was 6.35 days (3-15 days). Differential diagnosis of acute appendicitis can be extremely variable, from simple, paradigmatic situations to the most intriguing ones. This concept is well emphasized by William Silen when he says that "differential diagnosis of acute appendicits is an encyclopedic compendium of every abdominal disease that causes pain" in the 11th edition of Harrison's Principles of Internal Medicine.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current diagnostic-therapeutic trends in treatment of pediatric appendicitis]. 803 58

Laparoscopy in the emergency setting is a logical extension of this technique. Open laparoscopy is particularly useful in the management of acute abdomen. In fact, after a sequential work-out that includes physical examination, laboratory data, plain abdominal x-rays and ultrasonography, diagnostic laparoscopy is advocated. The Authors herein report a case of intestinal obstruction (volvulus due to Meckel's diverticulum) treated with laparoscopy. The efficacy and safety of the diagnostic and/or therapeutic laparoscopic procedure in the emergency setting are discussed.
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PMID:[Laparoscopic diverticulectomy for ileal volvulus on Meckel's diverticulum]. 806 Jul 82


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