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

Hantaviruses, the causative agents of HFRS, have become more widely recognized. Epidemiologic evidence indicates that these pathogens are distributed worldwide. People who come into close contact with infected rodents in urban, rural and laboratory environments are at particular risk. Transmission to man occurs mainly via the respiratory tract. The epidemiology of the hantaviruses is intimately linked to the ecology of their principal vertebrate hosts. Four distinct viruses are now recognized within the hantavirus genus and that number is likely to increase to six very soon; however, further investigations are necessary. Much more work is still needed before we fully understand the wide spectrum of clinical signs and symptoms of HFRS as well as the pathogenicity of the different viruses in the hantavirus genus of the Bunyaviridae family. HFRS is difficult to diagnose on clinical grounds alone and serological evidence is often needed. A fourfold rise in IgG antibody titer in a 1-week interval, and the presence of the IgM type of antibodies against hantaviruses are good evidence for an acute hantavirus infection. Physicians should be alert for HFRS each time they deal with patients with acute febrile flu-like illness, renal failure of unknown origin and sometimes hepatic dysfunction. Especially the mild form of HFRS is difficult to diagnose. Acute onset, headache, fever, increased serum creatinine, proteinuria and polyuria are signs and symptoms compatible with a mild form of HFRS. Differential diagnosis should be considered for the following diseases in the endemic areas of HFRS: acute renal failure, hemorrhagic scarlet fever, acute abdomen, leptospirosis, scrub typhus, murine typhus, spotted fevers, non-A, non-B hepatitis, Colorado tick fever, septicemia, dengue, heartstroke and DIC. Treatment of HFRS is mainly supportive. Recently, however, treatment of HFRS patients with ribavirin in China and Korea, within 7 days after onset of fever, resulted in a reduced mortality as well as shortened course of illness.
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PMID:Hemorrhagic fever with renal syndrome. 257 14

In a 26-year-old patient admitted to the emergency ward with acute abdomen, all the symptoms--nausea, vomiting, indeterminate abdominal pain, constipation, renal failure, polyuria and polydipsia--could be explained by calcium intoxication syndrome. Investigation revealed generalized sarcoidosis. Under medical treatment with prednisone all the pathologic findings rapidly regressed. The pathogenesis of hypercalcemia in sarcoidosis, and particularly the disorder of vitamin D metabolism with raised levels of 1,25-dihydroxycholecalciferol, are discussed.
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PMID:[Acute hypercalcemia syndrome in sarcoidosis]. 384 Sep 13

Necrosis of the cecum occurs in various settings, including low-flow states. Cecal necrosis in two dialysis patients with documented, sustained hypotension is presented. Spontaneous left colon perforations, which have been previously reported in renal failure patients, were considered secondary to distention from constipation. The cecum may be more susceptible to ischemia than the remainder of the colon. Maximal distention develops at this point. With an associated low-flow state, in a possible watershed area, necrosis can occur. The diagnosis of cecal necrosis and perforation should be entertained in any dialysis patient with an acute abdomen. Early exploration may be necessary.
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PMID:Cecal necrosis in the dialysis-dependent patient. 406 55

Nephropathia epidemica (NE) is an infectious disease caused by hantavirus of the Bunyavirus family and carried by little rodents, in Denmark presumably by the bank vole (Clethrionomys glareolus). The disease usually presents with self-limiting renal failure, thrombocytopenia, fever, lower back and/or abdominal pain. As such it might be confused with for example acute abdomen as shown by the two cases given. Final diagnosis is based upon demonstrating antibody formation against hantavirus.
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PMID:[Nephropathia epidemica. Hantavirus nephritis--a differential diagnosis in acute abdomen]. 781 17

Seven cases of abdominal complications necessitated laparotomies within 30 days after open heart surgery are presented. They consist of five cases of mesenteric infarction, one acalculous cholecystitis and one hemorrhagic ulcer of the rectum. The incidence is 0.9 percent at our institute. They also had a very complex course after their cardiac surgery such as cardiogenic shock, respiratory failure and renal failure prior to the development of their acute surgical abdomen. It is proposed that the cause of acute abdomen is attributed basically to the low cardiac output state. Surgery must be performed without delay because unnecessary passage of time is accompanied by unacceptable mortality rate.
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PMID:[Gastrointestinal complication after open cardiac operation]. 825 17

Patients with intra-abdominal processes that require prompt surgical intervention, including appendicitis, perforated viscus, ischemic bowel, volvulus, and bowel obstruction, often present with signs and symptoms of an acute abdomen. Several medical problems can mimic an acute abdomen. Overwhelming postsplenectomy infection is a life-threatening condition that can present with acute abdominal symptoms. The incidence of overwhelming postsplenectomy infection ranges from 1% to 25%, and is caused by Streptococcus pneumoniae in 50% of cases. Capnocytophaga canimorsus, a bacteria commonly found in dog saliva, accounts for less than 1% of cases. Overwhelming postsplenectomy infection has a rapidly deteriorating course that progresses to respiratory and renal failure, cardiovascular collapse, and death. The mortality associated with overwhelming postsplenectomy infection is 60% to 80%. Early diagnosis and institution of appropriate antibiotic therapy and supportive care is essential to improve patient outcome. A previously healthy woman who had undergone splenectomy secondary to trauma 11 years earlier presented with symptoms of an acute abdomen. A diagnosis of overwhelming postsplenectomy infection due to C canimorsus was made based on her peripheral blood smear and blood culture findings. Early aggressive care and antibiotic treatment resulted in a successful outcome for this patient with no long-term morbidity. This patient's clinical course demonstrates the importance of early diagnosis and treatment of overwhelming postsplenectomy infection.
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PMID:Postsplenectomy Capnocytophaga canimorsus sepsis presenting as an acute abdomen. 986 57

Primary hyperoxaluria is a rare genetic disorder characterised by calcium oxalate nephrolithiasis and nephrocalcinosis leading to renal failure, often with extra-renal oxalate deposition (systemic oxalosis). Although ischaemic complications of crystal deposition in vessel walls are well recognised clinically, these usually take the form of peripheral limb or cutaneous ischaemia. This paper documents the first reported case of fatal intestinal infarction in a 49 year old woman with systemic oxalosis and advocates its consideration in the differential diagnosis of an acute abdomen in such patients.
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PMID:Small intestinal infarction: a fatal complication of systemic oxalosis. 1104 Oct 66

We report on 4 cases of severe icteric leptospirosis. Three patients developed renal failure requiring haemodialysis and one required mechanic ventilation for 10 days. On entry all patients presented with severe myalgia, particularly in the calves, jaundice, oligo-anuria and severe thrombocytopenia. In one case an acute abdomen-like presentation led to exploratory laparotomy. We believe that the abdominal pain was mainly due to rhabdomyolysis of the abdominal wall. The outcome was favorable in all cases and recovery of renal function was observed after a few days to several weeks. Three out of 4 patients were infected in southern Switzerland. This observation underscores the importance of wild and domestic animals as a leptospira reservoir. Patients presenting with acute renal failure and jaundice, but only mild-to-moderate elevation of transaminases, are suspect for leptospirosis regardless of travel to a tropical or subtropical country.
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PMID:[Endemic and imported severe leptospirosis (Weil's disease) in southern Switzerland]. 1107 13

Patients with systemic rheumatic diseases may be admitted to the ICU because of worsening of or development of a new manifestation of the rheumatic disease, infections caused by immunosuppression, or adverse effects of drugs used to treat rheumatic diseases. Sometimes an unrelated, acute disorder may become life threatening because of the underlying rheumatic disorder. Rheumatoid arthritis is the most common rheumatic disease seen in ICU patients, followed by systemic lupus erythematosus and scleroderma. These three conditions together account for up to 75% of rheumatic cases admitted to the ICU. The respiratory system is the organ system most commonly affected in the acute process, followed by the renal, gastrointestinal, and nervous systems. More than 50% of admissions result from infections, and 25% to 35% result from exacerbation of the underlying rheumatic condition. In about 20% of patients, the rheumatic disorder may be diagnosed for the first time in the ICU. An aggressive approach should be pursued to establish the diagnosis of either disease exacerbation or infection. Delay in instituting appropriate immunosuppressive or antimicrobial therapy may result in multiple organ system failure and a poor outcome. The mortality rate in patients with rheumatic disease exceeds that predicted by the APACHE II or SAPS II scores and is higher than that in nonrheumatologic ICU admissions. The mortality may exceed 50% in patients admitted for infection; the prognosis is comparatively better for patients with exacerbations of disease activity. Renal failure, coma, and acute abdomen are predictors of poor outcome. Early recognition of abdominal complications requiring surgical intervention may help reduce mortality.
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PMID:Rheumatologic diseases in the intensive care unit: epidemiology, clinical approach, management, and outcome. 1241 38

Presented is material of 277 patients, who were treated due to acute abdomen illness in Intensive Therapy Unit at 2nd Department General Surgery Collegium Medicum Jagiellonian University during the time: from 01.07.1997 till 30.06.2002. This material regards only geriatric patients (patients > 65 years old). Patients analysis was divided into two main groups: patients with haemorrhagic shock caused by gastrointestinal bleeding (49 patients--group A) and by ruptured abdominal aneurysm (16 patients--group B), patients with hypovolemic and/or septic shock owing to diffuse peritonitis (150 patients--group C), and intestinal obstruction (62 patients--group D). The other principles of therapeutic procedures were described for every main group. In every illness group was showed: multiorgan dysfunction (acute myocardial ischemia with enzymatic and/or electrocardiographic changes, pulmonary oedema as acute left ventricular failure, respiratory and renal failure and metabolic dysfunction), actual punctuation into two scoring systems: APACHE II (28.8 points) and TISS-28 (44.5 points), time of hospitalization in the intensive therapy unit (mean 7.1 days), hospital's time of treatment (mean 17.5 days), mortality (for all patients 57.8%). These dates compared with dates from publications.
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PMID:[Treatment results in geriatric patients with acute abdomen in the intensive care unit]. 1467 91


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