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

A staging classification is proposed by CT findings in 27 patients with acute abdomen, caused by inflammatory colonic non-parasitic pathology. Of the 17 patients with diverticular disease, 4 were stage A (edema/ischemia on thickness of the abdominal wall), 2 were stage B (partial intramural infarction on the abdominal wall) and 3 were stage C (abscess/peritonitis and obstruction/vascular strangulation). None of the patients in the series were stage D (ischemia/infarction of the colonic wall with dilatation). Of the 4 patients with ulcerative colitis, 3 were stage A and 1 in stage C. Of the 3 patients with Crohn's disease, 2 were stage A and 1 was in stage C. Classified as stage D were 1 pseudomembranous colitis, 1 volvulus and 1 idiopathic megacolon. Clinical severity was in parallel with CT stages that gave better information on the progression of the pathology. Staging by CT in acute abdomen caused by inflammatory colonic non-parasitic pathology could be useful in therapeutics.
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PMID:Acute abdomen caused by inflammatory colonic non-parasitic pathology: staging by CT. 1042 Oct 16

Paraesophageal herniation of the stomach is a rare complication following laparoscopic Nissen fundoplication. We retrospectively reviewed our experience with 720 patients undergoing laparoscopic Nissen fundoplications. Seven patients were found to have postoperative paraesophageal hernias requiring reoperation. The clinical presentation, diagnostic workup, operative treatment, and outcome were evaluated. There were no deaths or procedure-related complications. Clinical presentation was recurrent dysphagia in four, nonspecific abdominal symptoms in one, and acute abdomen in one. One additional patient was asymptomatic. Preoperatively the correct diagnosis was able to be confirmed in four of six patients by barium esophagogram. Four patients underwent successful laparoscopic repair. Two patients had a thoracotomy including one conversion from laparoscopy to thoracotomy. One patient had a lap-arotomy to reduce an intrathoracic gastric volvulus. At a mean follow-up of 2.5 months no patient had further complications. Paraesophageal herniation is a rare complication following laparoscopic Nissen fundoplication and a definitive diagnosis is often difficult to establish. Early dysphagia after surgery should alert the surgeon to this complication. Redo laparoscopic surgery is feasible but an open procedure may be necessary.
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PMID:Paraesophageal herniation as a complication following laparoscopic antireflux surgery. 1045 30

A case history of a fatal neonatal infection caused by Salmonella enteritidis group D is reported. The baby deteriorated rapidly at 24 hours after birth with clinical signs and symptoms of an acute abdomen. Bloody diarrhea led to a tentative diagnosis of midgut volvulus or necrotizing enterocolitis. Autopsy and bacteriologic investigation revealed sepsis by S. enteritidis group D. The same organism was found in cultures taken from stool and vaginal swabs from the mother. This clearly confirmed transmission of the infection during delivery.
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PMID:Fatal neonatal Salmonella enteritidis sepsis. 1069 1

A retrospective analysis was undertaken on 229 cases of acute surgical abdomen surgically managed at Yirgalem hospital from January to December 1997. Small intestinal obstruction ranked the first and it was mainly due to small intestinal volvulus. Acute appendicitis was the second in the rank. Large intestinal obstruction was the third and it was mainly due to sigmoid volvulus. Typhoid perforation, primary peritonitis, perforated gastroduodenal ulcer, abdominal tuberculosis and empyema of the gallbladder in that order were the other observed causes of acute surgical abdomen. Analysis based on the specific causes of acute abdomen is of great value for early diagnosis and prompt treatment in clinical practice.
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PMID:Pattern of acute abdomen in Yirgalem Hospital, southern Ethiopia. 1112 97

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

Caring for children of adolescent parents presents unique challenges. Because adolescent parents may lack parenting skills and knowledge of medical terminology, symptoms of life-threatening illnesses may be misinterpreted. We present two cases of unexpected acute abdomen in young infants with adolescent mothers. The first case involves midgut volvulus, which was discovered during a routine newborn visit. The second case, involving pyloric stenosis, presented a clinical management challenge when the adolescent mother refused diagnostic studies.
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PMID:Acute abdomen in infants of adolescent mothers: diagnostic challenges. 1175

In many poor countries of the world the need for surgical treatment of acute abdominal emergencies is largely unmet. In some cases this service is provided by physicians with little postgraduate surgical training, and there is a paucity of published data on the outcomes of this service. This series of sequential cases of acute abdominal surgical emergencies from a hospital in rural Sierra Leone illustrates the causes, outcomes, and challenges in this setting. All patients with an acute abdomen from September 1992 until September 1994 who required surgery were identified by review of theater records, ward books, and patients' notes. Altogether, 173 cases were identified. Operative diagnoses included ectopic pregnancy (n = 43), strangulated hernia (n = 45) 15 of which required bowel resection, appendicitis (n = 15), normal appendix (n = 4), uterine rupture (n = 9), perforated ulcer (n = 8), tubal or pelvic abscess (n = 7), volvulus (n = 6), and others. Ninety percent survived to discharge after a median postoperative stay of 9.2 days (range 7-127 days). Of the 18 deaths, 83% occurred during the first 3 days. Factors associated with poor outcome were ileal perforation due to typhoid fever and resection of bowel after a strangulated hernia. These results show that acute abdominal surgery can be done at the district level in poor countries using limited facilities by staff without extensive surgical training. The outcomes are comparable to those from larger centers.
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PMID:Case series of acute abdominal surgery in rural Sierra Leone. 1191 Apr 89

The era of videoendoscopic surgery in emergency surgery practice has facilitated a wide range of endoscopic operative procedures. In our unit the diagnosis of acute abdomen is made after sequential clinical and laboratory examination, and diagnostic laparoscopy is advocated. Laparoscopy-assisted resection of complicated Meckel's diverticulum in two adult patients was performed, and the results are discussed. Between December 1996 and June 2000, 98 patients underwent diagnostic laparoscopy at the Cerrahpasa Medical Faculty Emergency Surgery Unit of Istanbul University because of signs and symptoms of acute abdomen. Among these, we have diagnosed one case of intestinal obstruction due to a volvulus around Meckel's diverticulum and one of acute abdomen masquerading as acute appendicitis but actually involving omphalomesenteric duct cyst torsion. Both of these patients underwent diagnostic laparoscopy and laparoscopy-assisted Meckel's diverticulectomy. Diagnostic laparoscopies were performed on 46 male (47%) and 52 female (53%) patients. In all cases, laparoscopy successfully confirmed the diagnosis. Although in 27 patients the interventions were converted to open procedures, the operations were completed laparoscopically in 71 patients. Two of these patients underwent laparoscopy-assisted Meckel's diverticulectomy and their postoperative periods were uneventful. Both patients were discharged from the hospital on their fourth postoperative day. Diagnostic laparoscopy is a safe and effective method for diagnosis of acute abdomen. In emergency surgery practices in developing countries, advanced laparoscopy should be performed to reduce expenses. Laparoscopy-assisted Meckel's diverticulectomy is a safe and economic procedure and can be performed in adults for treatment of complicated cases without staplers.
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PMID:Laparoscopy-assisted resection of complicated Meckel's diverticulum in adults. 1249 56

Para-oesophageal hiatus hernia, a condition in which the fundus and part of the body of the stomach wrapped in a peritoneal sac herniate into the mediastinum, is a relatively uncommon entity. It tends to grow progressively and may become so large as to lead to symptoms of intrathoracic organ compression. In some exceptional cases, the entire stomach together with other abdominal viscera might herniate through the hiatus into the thorax. Paraesophageal hiatus hernias are characterised clinically by vague symptomatology, absent gastro-oesophageal reflux, and possible onset of gastric volvulus, generally without consequent incarceration of the portion of the herniated organ. Such an event is uncommon but dangerous and life-threatening. These cases often require resection of the incarcerated viscera, followed by hiatoplasty and Nissen fundoplication. The authors report on the case of a patient presenting with acute abdomen as a result of incarcerated and perforated para-oesophageal hiatus hernia.
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PMID:[Acute abdomen due to a strangulated and perforated para-esophageal hernia. A case report]. 1223 70

This is a case report of a 23 year old multiparous woman who presented with intestinal obstruction and a right hypochondrial mass. Laparatomy revealed an infarcted 1.4 Kg spleen in the right lumbar region compressing the ascending colon. There was also ileal volvulus around the splenic pedicle. This is probably the first documented case of wandering spleen in the right hypochondrium, presenting as right large bowel obstruction, to be reported in our region. Wandering spleen is a rare condition, often asymptomatic, but may present as an acute abdomen. Pre-operative diagnosis is difficult and rarely made. Laboratory tests are seldom useful, but imaging studies do assist. Up to 1971 only 350 cases had been reported in the western literature. Review of English literature from 1900 to 1991 reported only 51 cases in children. In our region 11 cases were reported in Uganda between 1968 and 1971. No other literature is available from our region. Clinical presentation, aetiology, investigation, and management of wandering spleen is discussed.
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PMID:Wandering spleen presenting as a right hypochondrial mass and intestinal obstruction. 1263 49


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