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

The authors present the case of a 31 year old woman admitted with abdominal pain, fever, weight loss and malignant hypertension. The ultrasonographic examination showed an image suggesting chronic nephropathy. On the 3rd day of hospitalization an exploratory laparotomy was performed with the diagnosis of acute abdomen. There was purulent peritonitis and a segment of ileum with multiple perforations, which was resected. The anatomopathologic finding of the surgical specimen revealed polyarteritis nodosa. The patient developed multiple organ failure and evolved to death. The difficulty in establishing the diagnosis is commented and, the authors according with some studies suggest treatment with plasmapheresis because the conventional therapy with methylprednisolone and cyclophosphamide proved to be insufficient in severe cases.
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PMID:[Acute abdomen in a patient with polyarteritis nodosa: report of a case]. 257 64

Two cases of acute abdomen operated on twice and biopsy specimens confirmed are presented. The diagnosis of a systemic necrotizing vasculitis group of polyarteritis nodosa was established. The syndrome affects predominantly males between the second and forth decade of life. The gastrointestinal tract is involved in approximately 50% of the cases. While a negative laparotomy may be considered as a surgical pit-fall, nevertheless, it is the only way of establishing the diagnosis and treating the complications of the disease in some of the cases.
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PMID:Polyarteritis nodosa. An unusual cause of acute abdomen. 257 2

The records of 106 consecutive patients referred to the University of Colorado Medical Center (UCMC) vasculitis study group during a 5-yr period were evaluated for gastrointestinal (GI) manifestations attributable to vasculitis. There were 3 groups: 18 with leukocytoclastic vasculitis (LCV) on skin biopsy younger than 16 yr of age; 75 with LCV older than 16 yr of age; and 13 with polyarteritis nodosa (PAN). Significant GI manifestations at presentation or exacerbation of vasculitis occurred in 38 of 106 (36%) patients. These were more frequent in LCV patients younger than 16 yr (66%), than older LCV patients (26%) or PAN patients (46%). The commonest complaint was abdominal pain (79%), followed by nausea (63%), vomiting (37%) and diarrhea (23%). GI bleeding was present in 52% and acute abdomen in 21% of patients. No consistent radiologic findings were noted. Duodenal and peritoneal biopsies suggested vasculitis in 6 LCV patients. Seven exploratory laparotomies were performed in 4 LCV and 3 PAN patients. Intestinal infarction was found in 3 patients with PAN, but in one of the LCV patients. Two patients with LCV with an acute abdomen were not explored and responded promptly to iv corticosteroids. Thus, systemic vasculitis frequently involves the GI tract. In patients with LCV, recognition of this association and treatment with corticosteroids can avoid surgery. In our patients with PAN, however, acute abdominal signs indicated infarction requiring surgery and resection.
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PMID:Gastrointestinal involvement in leukocytoclastic vasculitis and polyarteritis nodosa. 610 71

A presentation is made of abdominal vasculitis in the course of systemic lupus erythematosus (SLE) and polyarteritis nodosa (PAN). The disease is not yet completely known and therefore it is often incorrectly diagnosed as acute abdomen requiring surgery. An accurate diagnosis of this disease is essential for the choice of the correct therapeutic attitude. Some theoretical aspects of the disease are discussed and the personal experience of the authors resulting from the study of some cases hospitalized in the Institute of Internal Medicine, are discussed.
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PMID:Acute abdomen in systemic vasculitides. 790 12

Muscle symptoms, especially myalgias, appear to be common in patients with polyarteritis nodosa (PAN). We describe a patient who presented with a generalized myopathy and elevated creatine kinase (CK) suggestive of polymyositis. However, subsequent exploratory surgery for an acute abdomen revealed colonic perforation on the basis of PAN. A review of the literature suggests that generalized myopathy and elevated CK are uncommon features of PAN. A muscle biopsy can be a helpful procedure to secure the diagnosis in patients with PAN especially those with myopathies. Strategies for optimizing the choice of biopsy site are discussed.
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PMID:Muscle involvement in polyarteritis nodosa: report of a patient presenting clinically as polymyositis and review of the literature. 791 24

A 78-year-old female was admitted to our hospital with acute abdomen (abdominal pain and bloody stool). Abdominal examination revealed mild rebound tenderness on the right side. The laboratory data revealed severe inflammation (WBC: 33100/microliters, CRP:35.5 mg/dl). Panperitonitis was suspected because of diffuse and severe abdominal pain and rebound tenderness on the next day. X-ray examination by gastrografin showed mucosal irregularity and tubular narrowing of the tubular narrowing of the ascending colon which indicated ischemic colitis, and an emergency operation was performed. Histological examination of the pathologic specimens revealed fibrinoid necrosis and destruction of the internal lamina in small and medium-size arteries. We report a case diagnosed as ischemic colitis due to polyarteritis nodosa by the findings of its pathologic specimens.
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PMID:[A case of ischemic colitis due to polyarteritis nodosa]. 791 64

A 20-year old female patient with systemic lupus erythematosus with butterfly-erythema, arthritis, high positive ANA and anti-ds-DNA titres has to have laparatomy because of an acute abdomen. Histological diagnosis is a necrotizing vasculitis of the appendix. In systemic lupus erythematosus an intestinal vasculitis can be found which might be as severe as in polyarteritis nodosa.
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PMID:[Necrotizing vasculitis of the appendix and cecum in systemic lupus erythematosus]. 896 88

A case of an acute abdomen caused by a massive intrahepatic hemorrhage in a 77-year old man is presented. The hemorrhage was the first manifestation of an underlying polyarteritis nodosa which had not been diagnosed prior to the event. The diagnosis was suspected after a preoperatively performed angiography, surgical treatment was required to control the bleeding. This case demonstrates the differential diagnosis of acute intrahepatic hemorrhage which includes rare causes of vasculitis.
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PMID:Massive intrahepatic hemorrhage as first manifestation of polyarteritis nodosa. 905 34

Polyarteritis nodosa (PAN) is a rare vasculitic syndrome in childhood. There are few reported cases of ischaemic necrosis of the intestine and even fewer survivors in adults. We report the case of a 10-year-old boy with PAN and an acute abdomen that required operative intervention. Evidence was found of mesenteric arteritis with large ischaemic segments resulting in infarction and perforation.
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PMID:Fatal polyarteritis nodosa with massive mesenteric necrosis in a child. 1008 62

A 37-year-old Chinese male presented with an acute abdomen. Surgical exploration revealed duodenal perforation, extensive small bowel infarction and peritonitis. Histopathology of the resected bowel showed characteristic features of classic polyarteritis nodosa. The latter also involved mesenteric arteries in the form of tiny aneurysms. Steroids could not be started due to: (i) overwhelming microbial infections and (ii) fear of more perforations in other areas of the bowel. Such a presentation of polyarteritis nodosa is uncommon. Its recognition prior to surgery, management and prognosis is discussed.
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PMID:Massive small bowel infarction and duodenal perforation due to abdominal polyarteritis nodosa: a case report. 1632 80


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