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Query: UMLS:C0000727 (
acute abdomen
)
3,084
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
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.
...
PMID:[Pedicle torsion, hemorrhagic ovarian infarct. A rare cause of pediatric acute abdomen]. 192 84
Eight cases of abdominal tuberculosis from the Department of Medicine, Singapore General Hospital are reported to illustrate the varied clinical manifestations of the disease. Presentation ranged from asymptomatic hepatomegaly to
acute abdomen
(intestinal obstruction/perforation). Chronic non-specific symptomatology (fever, weight loss, abdominal pain, diarrhoea, jaundice) was commonest. There were three patients with hepatic tuberculosis, two with tuberculous
mesenteric lymphadenitis
and three with intestinal tuberculosis, two of whom had concomitant tuberculous peritonitis. Only three patients had coexisting pulmonary tuberculosis. The diagnosis was unsuspected at presentation in four patients. Initial provisional diagnoses included typhoid, abdominal lymphoma, hepatic malignancy, chronic hepatitis and iatrogenic gut perforation. All patients responded totally to conventional antituberculous therapy.
...
PMID:The varied manifestations of abdominal tuberculosis. 343 16
Enteral yersiniosis is caused either by Y. enterocolitica 0-group I (syn. serotype 0:3) and 0-group V (syn. serotype 0:9) or Y. pseudotuberculosis type I-VI. The clinical symptoms are mostly like enteritis, enterocolitis,
acute abdomen
,
mesenteric lymphadenitis
, or ileitis terminalis. Post-infection reactions are possible like septicemia, arthritis and erythema nodosum. Only cultural and serological examinations confirm the diagnosis of enteral yersiniosis. In the judgement of serological results it is necessary to consider the cross-reactions of Y. enterocolitica 0-group V to Brucella abortus, Brucella melitensis and Brucella suis and also to the antigenic community of Y. pseudotuberculosis type II respectively IV to Salmonella group B respectively D. With exception of septicemia, it is not necessary to treat enteral yersiniosis with antibiotics.
...
PMID:[Enteral yersiniosis--a serious disease? Current knowledge of clinical aspects, diagnosis and therapy]. 709 94
During a twelve-month period, 416 children with acute abdominal pain required emergency admission to Southampton General Hospital; 46% had operations. Appendicitis was the commonest organic cause of acute abdominal pain identified (31%). Constipation (9%) can present as acute abdominal pain simulating appendicitis. All children should have a urine sample examined microscopically and the finding of significant pyuria is suggestive, but not diagnostic, of a urinary tract infection (7%).
Mesenteric adenitis
, which can only be diagnosed with certainty at laparotomy, was less common (4%). Despite careful clinical assessment and follow up, 45% of children in this series remained undiagnosed. Sedation but not analgesia may assist in the diagnosis of the
acute abdomen
in children.
...
PMID:Acute abdominal pain in children. 724 73
Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis.
Mesenteric lymphadenitis
associated with Salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with
acute abdomen
and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. Serology results showed that both patients' titers for BO ("B and O agglutinating [BO]") antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852.
...
PMID:Acute abdomen caused by Salmonella typhimurium infection in children. 1173 22
Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis,
mesenteric lymphadenitis
and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an
acute abdomen
. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing normal intrauterine pregnancy from threatened or spontaneous abortion, ectopic pregnancy and other complications that may occur in patients with positive pregnancy test. Incomplete abortion is visualized as thickened and irregular endometrial echo with certain amount of intracavitary fluid. If applied, color Doppler ultrasound reveals low vascular resistance signals in richly perfused intracavitary area. Transvaginal sonography has high sensitivity and specificity in visualization of uterine and adnexal signs of ectopic pregnancy. Color Doppler examination may aid in detection of the peritrophoblastic flow. Furthermore, it facilitates detection of ectopic living embryo, tubal ring or unspecific adnexal tumor. Corpus luteum cysts and leiomyomas are another cause of pelvic pain during pregnancy, which can be correctly diagnosed by ultrasound. Detection of uterine dehiscence and rupture in patients with history of prior surgical intervention on uterine wall relies exclusively on correct ultrasound diagnosis. In patients with placental abruption sonographer detects hypoechoic complex representing either retroplacental hematoma, subchorionic hematoma or subamniotic hemorrhage. In closing, ultrasound has already become important and easily available tool which can efficiently recognize patients with possibly threatening conditions of different origins.
...
PMID:[Ultrasonography in acute pelvic pain]. 1276 97
Although multislice, helical CT is increasingly replacing ultrasonography for the evaluation of patients with acute abdominal pain, ultrasound does have certain specific advantages over CT. This article discusses the advantages of ultrasound in imaging of the
acute abdomen
, exploring such areas as appendicitis, ileocecal Crohn's disease, infectious ileocolitis and infectious ileocecitis,
mesenteric lymphadenitis
, cecal carcinoma, sigmoid diverticulitis, right-sided colonic diverticulitis, and perforated peptic ulcer.
...
PMID:Ultrasonography of the acute abdomen: gastrointestinal conditions. 1466 68
Salmonella infections can manifest themselves as acute abdominal problems and lead to emergency surgery. Some examples are: salmonella-related intestinal perforations, gallbladder involments, salpingitis, and peritonitis.
Mesenteric lymphadenitis
associated with salmonella mimics acute appendicitis and it is often difficult to establish a timely and tempestive diagnosis in children with right lower abdominal pain. Because of the difficult diagnostic process, a significant number of patients with salmonella infections present
acute abdomen
and undergo needless operations. Instead, in our case of salmonella-related
acute abdomen
, laparotomy was the right therapeutic choice. The conclusion is drawn that, even if there is not a precise diagnosis, in salmonella-related
acute abdomen
the surgical approach is the right choice, considering the high morbidity and mortality associated with untreated appendicitis and intestinal perforations.
...
PMID:[Acute abdomen caused by Salmonella typhi acute appendicitis]. 1683 80
Varied clinical presentations of Penicillium marneffei, an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an
acute abdomen
. On radiologic imaging he had features of intestinal obstruction and
mesenteric lymphadenitis
. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P. Marneffei. He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with
acute abdomen
, more so in patients from a distinct geographic region--South-East Asia.
...
PMID:Acute abdomen: an unusual presentation of disseminated Penicillium marneffei infection. 1844 60
Abdominal pain as an initial symptom of meningococcemia is an infrequent entity, rarely described in literature. We present a case of a 4 year-old, male, previously healthy child with a 24 hour history of fever and abdominal pain. He is admitted in a surgical unit with a diagnosis of
acute abdomen
for surgical resolution. The clinical course turns unfavorably, and patient presents signs of severe sepsis. Urgent laparotomy is performed, observing little brownish fluid and
mesenteric adenitis
. He then exhibits palpable purpuric rapidly progressive lesions in lower extremities, progressing to septic shock. Later, Neisseria meningitidis serogroup B is isolated from blood cultures. The aim of this article is drawing attention to a nontypical form of manifestation of meningococcemia, as a delayed diagnosis and treatment has an impact on morbidity and mortality among the pediatric population.
...
PMID:[Acute abdomen as initial manifestation of meningococcemia]. 1869 40
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