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

Leukaemic and lymphomatous infiltration of the appendix is rare and even rarer is acute appendicitis as the initial manifestation. From our routine biopsy material we collected four cases of haematological malignancies presenting as acute appendicitis or acute abdomen, caused or accompanied by tumoral infiltration of the appendix. Appendicitis was the initial manifestation that allowed diagnosis of the underlying disease. The clinical histories and histological examinations of the appendices and of one autopsy are described. We report the first detailed description of acute myeloid leukaemia involving the appendix, and three cases of lymphomatous infiltration of the appendix presenting with appendicitis, and give an overview of the literature. In these days of budgetary cuts in national health services, where one may be tempted not to have seemingly commonplace cases of appendicitis histologically verified, our cases emphasize that careful histopathological examination of all appendectomy specimens should be mandatory. Despite the fact that leukaemia and lymphoma of the appendix are rare, our cases illustrate that these must be included in the differential diagnosis of acute appendicitis and that physicians and surgeons have to be aware of these conditions.
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PMID:Leukaemia and lymphoma of the appendix presenting as acute appendicitis or acute abdomen. Four case reports with a review of the literature. 939 90

The purpose of this work is to evaluate the degree of applicability of the diagnostic laparoscopy (DL) and therapeutic laparoscopy in the acute abdomen and trauma patients. The material of 109 cases of DL performed since 1983 has been evaluated retrospectively. 22 patients were operated by laparoscopy. The patients were assessed in the following groups: I-suspected acute appendicitis, II-acute abdomen of uncertain ethology, III-abdominal trauma. In the first group 60 patients were diagnosed, 13 of them were operated by laparoscopy, 28 by open access, 15 avoided the unnecessary laparotomy. In the second group 30 patients were diagnosed, 6 of them were operated by laparoscopy, 8 open interventions were noted, 16 avoided the non-therapeutic laparotomy. In the third group 19 patients were diagnosed, 13 underwent laparotomy, 6 avoided the unnecessary intervention. There has been one death, not associated with DL (acute bowel ischemia), morbidity was 1% (one case of bleeding from the mesenterial artery, treated by conversion to laparotomy), one DL was considered as falsely negative, one not sufficient to establish the diagnosis. Basing on our experience in DL as a diagnostic tool we can confirm the accuracy of the method in 99.08% with only 1% of morbidity. 20.1% of patients were operated by laparoscopy, without complications. In conclusions the authors consider the DL allows to establish a prompt and accurate diagnosis in the acute abdomen and trauma without a therapeutic delay and unnecessary hospital observation. The fault of the method and morbidity rate is acceptable. The treatment by the same laparoscopic access offers to these patients another benefit, the more the experience is increasing.
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PMID:[Diagnostic and therapeutic value of laparoscopy in acute abdomen]. 944 53

Intestinal injuries are pathologies frequently caused by toothpicks. In literature are reported serious damage to the cardiovascular system, lung and systemic fatal sepsis. In literature are also reported some deaths caused by delayed diagnosis. The authors report two cases of intestinal perforation by toothpick. Both patients had accidentally swallowed the toothpick. The clinical state was compatible with acute abdomen in a 59 year old psychopathic patient and acute appendicitis in a 27 year old patient. The aim of this paper is to emphasize the importance of a careful anamnesis for detecting the swallowing of a toothpick.
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PMID:[Intestinal perforation caused by a toothpick]. 961 21

The purpose of this retrospective study was to evaluate the results of the laparoscopic surgical treatment of abdominal emergencies. From May 1991 to September 1995, 200 patients operated by laparoscopy for an acute abdomen were included in this study. The decision to treat the patient by laparoscopy was taken by the surgeon on duty. There were 101 males and 99 females with a mean age of 41 +/- 20 years (range 11-90 years). The main indications for operation were: acute appendicitis (109 patients), acute cholecystitis (52 patients), small bowel obstruction (14 patients) and perforated duodenal ulcer (14 patients). There was no hospital mortality. One per cent of patients experienced an operative complication which was treated by laparotomy. Conversion to laparotomy was needed in 13% of cases. The morbidity rate was 9% and reoperation by laparotomy for acute generalized peritonitis secondary to small bowel perforation was necessary in two cases. Mean postoperative hospital stay ranged from 4 to 7 days. The authors conclude that surgical laparoscopic treatment of the common abdominal emergencies is safe. The conversion rate is low as is the complication rate. These conclusions should be confirmed by a prospective study.
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PMID:[Results of laparoscopic treatment of abdominal emergencies]. 975 49

The experience of operative treatment in 14 cases of acute abdomen complicated by malignant hemopathy was reported. Primary diseases consisted of AL, NHL, MM, MH and MDS-RA, 13 cases of them were at progressing stage. The acute abdominal conditions included acute appendicitis, acute pancreatitis, acute cholecystitis, peritonitis secondary to intestinal perforation, intestinal obstruction, primary peritonitis and ileocecal syndrome. The type of acute abdomen was related with primary desease and chemotherapy. 8 cases were operated and 2 of them died of complications after operation. Biopsy of excised tissue showed tumor cells in 2 cases. The rate of correllation between preoper active and postoperative diagnosis was 62.5%. These findings suggest that malignant infiltration in the viscera, duration of abdominal pain before operation and the change of blood picture are the major factors for determining operative indication and the postoperative prognosis.
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PMID:[An approach to operative treatment for acute abdomen complicated by malignant hemopathy]. 981 68

The appendicitis is the commonest cause of an acute abdomen in children older 1 year of age. Only 5% of children with appendicitis are younger than 2 years of age. There is a familial preponderance. The younger the child the faster the symptoms of the disease are increasing in intensity. The symptoms starts with unspecific periumbilical or epigastric pain, followed by nausea, vomiting and restlessness at night. Finally the pain moves to the position of the appendix. The position of the appendix shows a high variation in children thus the pain characteristic is not uniform. Laboratory tests are not reliable but ultrasonography is recommended to exclude other diseases and to try to confirm the diagnoses. With the technique of "Graded compression Sonography" the rate of non identified appendicitis has been reduced under 5%. Laparoscopy is another option. Its use just for diagnostic purposes is limited but is recommended widely for primary therapeutic treatment with laparoscopic performed appendectomy. Laparoscopy has a special advantage against conventional appendectomy in the diagnostic of recurrent unspecific abdominal pain in children and in cases with interval appendectomy. Finally in pseudoappendicitis and pseudoperitonitis in children with immunvasculitis and other extraabdominal diseases. Letality of the acute appendicitis is zero.
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PMID:[Acute appendicitis in the child]. 988 Aug 78

A child is said to have an 'acute abdomen' in case of severe abdominal pain of sudden onset. Further investigations are necessary if the pain is very bad, persists for longer than 3-4 hours or is accompanied by vomiting. Failure to make the correct diagnosis may result in severe complications. The principal cause in an older child is acute appendicitis. This diagnosis is to be based on the anamnesis, physical examination and laboratory tests. If one of these is typical, active observation is indicated; if two or three are typical, appendectomy is indicated. Differential diagnoses can only be made during laparotomy. Intussusception occurs more frequently in toddlers. In a child with possible intussusception, observation is not justified: the diagnosis should be excluded by a contrast colonic X-ray, or operation should be performed either immediately or, if the symptoms persist, after the X-ray. Rest and patience, careful and child-adapted approach, and correct evaluation of aberrant symptoms may minimize unnecessary intervention.
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PMID:['Acute abdomen' in children]. 1008 38

The presentation of acute abdominal pain in young women is not an unusual occurrence in casualty and gynaecology departments. Both acute appendicitis and ectopic pregnancy have to be considered and investigated, as these two conditions are accepted as the most common surgical causes of an acute abdomen. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case report presented here describes the extremely unusual occurrence of both these acute conditions happening simultaneously with the added complication of an ongoing twin pregnancy and it highlights the need to look beyond the most obvious diagnosis and always to expect the unexpected.
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PMID:Simultaneous rupturing heterotopic pregnancy and acute appendicitis in an in-vitro fertilization twin pregnancy. 1022 26

Visceral pain is caused by either distension or contraction of the visceral muscular wall or obstruction of hollow gastrointestinal organs. Unlike the somatic pain due to peritonitis, visceral pain is diffuse, epigastric, periumbilical and is often accompanied by nausea, vomiting and restlessness. We demonstrate the significance of visceral pain in the differential diagnosis of the acute abdomen presenting five cases of appendicitis and cholecystitis. A correct early diagnosis of the acute abdomen while signs of local peritonitis are still absent (appendicitis in atypical location, recurrent acute appendicitis, spontaneous reopening of an occlusion) is facilitated by the awareness for the characteristics and symptoms of visceral pain, and therefore careful taking of the patient's history. A history lacking visceral pain on the other hand represents an important clue for the diagnosis of other conditions (gynecological, diverticulititis, etc.) with acute pelvic peritonitis.
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PMID:[Visceral pain in acute abdomen]. 1032 Nov 25

In the absence of any pathological condition in the pelvis of children who present with acute abdomen, the observation of serosanguineous intraabdominal fluid should prompt the surgeon to investigate the omentum. A 6-year-old boy who was admitted with a clinical picture of acute appendicitis, and was later diagnosed during a laparotomy to have primary torsion of the omentum, is reported. Obesity, exercise, and the presence of a bifid omentum were confirmed to be the predisposing factors.
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PMID:Primary torsion of the omentum in a 6-year-old boy: report of a case. 1038 76


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