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

While diagnostic laparoscopy is a well established tool, therapeutic laparoscopy for acute abdominal disorders has recently been made possible by video-endoscopic techniques. From July 1989 to April 1992, 243 laparoscopic interventions were carried out in patients with an acute abdomen. After a pilot phase, patients with acute appendicitis were entered into a randomized trial, those with acute cholecystitis were operated within the next day list. Among the 243 operations were 202 appendectomies, 12 closures of perforated peptic ulcers, 4 successful interventions for intestinal obstruction, 4 irrigations for intraabdominal abscesses and 35 further operations, some of which had to be finished as laparotomies. Laparoscopic appendectomy was less painful but technically more difficult. In cases which needed bowel resection for ischemic necrosis or diverticular disease, conversion to open surgery had to be performed. Laparoscopic treatment of acute abdominal disorders including peritonitis can be effective and beneficial in one out of two patients. Adequate surgical training, expertise and respect to the safety of the patient are mandatory. The application of endoscopic suture devices will further enlarge the spectrum of laparoscopic treatment options for the acute abdomen.
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PMID:[Value of laparoscopy in diagnosis and therapy of the acute abdomen]. 814 45

The authors describe in their case-study the history of a 25 years old woman, having the signs of acute abdomen. The patient underwent surgery, with the suspicion of acute appendicitis. It turned out, that the symptoms were due to the isolated actinomycosis of the greater omentum. The authors review the pathogenesis, the phenomenology, diagnosis and the therapy of this uncommon disease. They recommend to consider this special disease of the omentum, in the differential diagnosis of the appendicitis.
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PMID:[Isolated actinomycosis of the omentum simulating appendicitis]. 819 Apr 93

A case of abdominal mycobacterial infection mimicking acute appendicitis in a human immunodeficiency virus (HIV) infected patient is reported. The case illustrates the unusual aetiology of an acute abdomen in this population and the report reviews the aetiology of surgical abdominal pain in HIV infection and discusses the management of abdominal mycobacterial infections.
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PMID:Abdominal mycobacterial infection mimicking acute appendicitis in an AIDS patient. 831 83

Primary torsion of the greater omentum is an uncommon cause of acute abdomen and frequently it is misunderstood. In fact, from the analysis of the literature the authors can evict that the preoperative diagnosis is generally wrong. The authors write about the subject and they describe four cases come to their observation and all mistaken for acute appendicitis.
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PMID:[Acute torsion of the greater omentum]. 832 60

Diverticulosis of the vermiform appendix, either single or multiple, congenital or acquired, is rather infrequent and usually asymptomatic. However, it may be complicated by flogosis configuring an acute abdomen hardly recognizable from an acute appendicitis not related to the diverticular disease. The Authors report a case of acute appendicular diverticulitis surgically treated. A brief review of the literature is also reported.
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PMID:[Diverticulitis of the appendix: a rare cause of acute abdomen]. 839 20

The clinical course of patients with hematological disease, especially after treatment, is often complicated by gastrointestinal infections. Between 1986 and 1990 a total of 18 patients affected with hematologic disease and presenting with an acute abdomen were admitted to the surgery department at the University of Rome "La Sapienza". Most patients were affected with acute or chronic myeloid leukemia (61%) and lymphoma. Five patients with acute appendicitis, three with necrotizing enterocolitis, three with spontaneous hemoperitoneum, three with cholecystitis, two splenic infarctions and two intestinal occlusions were diagnosed. Symptoms were often vague and non specific and blood counts revealed neutropenia in all but two patients, while anemia was characteristic in spontaneous hemoperitoneum and in neutropenic enterocolitis. Fungemia occurred in only two cases while bacteremia was present in seven. The most critical patients were those affected by neutropenic enterocolitis and acute cholecystitis. Sonography was meaningful in the diagnosis of hemoperitoneum, splenic infarct and acute cholecystitis. All patients underwent surgical procedures within 48 hours of admission to the department. In all cases peritoneal washing was performed and at least one peritoneal drainage was left. In all cases of necrotizing enterocolitis, intestinal resections, either ileal or colonic, were followed by an immediate anastomosis in two layers. Intensive hematological and antibiotic post surgical care was performed in all patients. Seven patients presented minor complications (38.8%), and only one died (5.5%). Emergency surgical treatment may be safely carried out in patients with hematological diseases presenting with an acute abdomen. Intensive postsurgical care is mandatory for the recovery of patients and the patient's critical condition should not be a deterrent to surgical intervention.
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PMID:The surgical choice in neutropenic patients with hematological disorders and acute abdominal complications. 847 83

The acute abdomen continues to demand a large proportion of the general surgeon's workload. Recent studies have demonstrated that management errors can be significantly reduced using selective laparoscopy and this should now become routine practice. The continuing advances in laparoscopic surgery that permit many emergency procedures to be performed by this route provide increased impetus for a combined approach using diagnostic and therapeutic laparoscopy for the management of the acute abdomen. Results of current studies must be awaited before the exact role of emergency laparoscopic surgery can be defined, but early reports suggest several advantages in using laparoscopy to manage conditions such as acute appendicitis, perforated peptic ulcer and gynaecological emergencies.
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PMID:Emergency laparoscopic surgery. 840 34

Acute appendicitis is believed to be one of the commonest causes of the acute abdomen in tropical Africa. Negative appendicectomy rates are usually above 20%, which is now considered unacceptably high because of increased risk to patients and the availability of diagnostic facilities to aid clinical decision-making. Our negative appendicectomy rate over a 4-year retrospective period was 29.7% in males, and 47% in females. These reduced to 11% and 10%, respectively, after the introduction of laparoscopy for doubtful cases of acute abdominal pain.
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PMID:Another look at acute appendicitis in tropical Africa: and the value of laparoscopy in diagnosis. 848 83

The acute abdomen in childhood is in most cases caused by an acute appendicitis and rarely it is secondary to other diseases. It is for that reason, that we present two cases extremely rare of acute abdomen: the first one was an abdominal Actinomycosis secondary to acute appendicitis that looked like a tumor and the second that was an acute omentitis due to pinworms.
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PMID:[Acute abdomen of unusual cause in children]. 849 39

The purpose of this prospective study was to elucidate the characteristics of adult patients with acute abdomen admitted to a Finnish university hospital. A total of 639 patients entered the study. The most common cause of acute abdomen was non-specific abdominal pain (NSAP) (33.0%) followed by acute appendicitis (23.3%) and acute biliary disease (8.8%). The male:female ratio was 47:53 in the whole study population, but there were differences in the age and sex distributions when studied by diagnosis. NSAP was mainly presented in young women, but also in patients over 75 years of age. Acute appendicitis was most frequently found in young men, and biliary disease was most common in elderly women. A male predominance was noted in cases of alcoholic pancreatitis and gastritis, renal stones and peptic ulcer. Young women and elderly patients were slightly over-represented in the study population when compared with the whole population residing within the study area. 43% of the patients were operated on, and surgery was most common in patients aged 55-64 years and 15-24 years. Altogether 15% of the patients were discharged without hospitalisation. Twelve patients (1.9%) died of various causes, the most common of which was malignancy (four patients). In conclusion, a considerably large proportion (one third) of cases with acute abdomen remained without any specific explanation. Further, age and gender seem to be important factors when the most probable cause of acute abdomen is to be considered. Operative treatment is necessary in almost half of cases, and mortality for acute abdomen is low.
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PMID:Acute abdominal pain in adults. 873 26


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