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

A case of pelvic actinomycosis, now seen as a complication of intrauterine contraceptive devices, is reported. A 32-year old nulliparous women who had developed pain and irregular bleeding over the previous month presented initially for removal of a Dalkon shield IUD. For the previous 5 years the IUD had caused no symptoms. The Dalkon shield could not be removed, and vaginal examination revealed a tender mass in the pouch of Douglas. The patient was hospitalized for a laparoscopy and removal of the IUD under general anesthesia. Laparoscopy revealed an acute pelvic inflammatory disease (PID) with pus leaking from bilteral pyosalpinges. The IUD was removed, and the patient was treated with parenterally by administered penicillin and streptomycin for 5 days. 3 weeks later the patient was readmitted, complaining of nausea, vomiting and malaise. Clinically she was febrile, with signs of an acute abdomen. On vaginal examination, a large tender mass was palpable in the pouch of Douglas, and the blood film revealed a leukocytosis. When her condition failed to improve after treatment with penicillin and streptomycin, a laparotomy was performed. Gross PID was found with a large ruptured tubo-ovarian abscess on the right side. A total abdominal hysterectomy with bilteral salpingo-oophorectomy was performed. After the removal of the infected organs, her temperature dropped and her condition improved rapidly. Pathological findings are reported.
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PMID:Pelvic actinomycosis in association with an intrauterine contraceptive device. 29 10

Patients with traumatic or non-traumatic acute abdomen, often exhibit difficulties in the assessment of the real intra-abdominal visceral compromise. This study intends to compare laparoscopy and ultrasonography in patients with non-traumatic or traumatic acute abdomen, in whom there is a doubt on the actual visceral compromise. Forty-five patients were studied in this protocol. Both procedures were performed in 28 and in 17 patients with non-traumatic or traumatic acute abdomen, respectively. The laparoscopic examination was shown to be superior to the ultrasound even when one subtracts from the ultrasound data all pathologies that involved bowel transit and the bowel wall such as the acute appendicitis and cases of pelvic inflammatory disease. The laparoscopic and ultrasound accuracy were 97.8% and 53%, respectively.
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PMID:[Comparative analysis of the diagnostic value of ultrasonography and laparoscopy in acute abdomen]. 166 42

Pelvic inflammatory disease (PID) is considered to be rare or nonexistent following tubal sterilization. The purpose of this report is to describe three cases of surgically diagnosed acute PID in women previously sterilized by bilateral tubal ligation who presented over a one-year period. All three patients presented with an acute abdomen, fever and elevated white blood cell count. Our experience suggests that PID following tubal sterilization is more common than previously described and can present a diagnostic dilemma.
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PMID:Acute pelvic inflammatory disease after tubal sterilization. A report of three cases. 780 94

The role of laparoscopy in the management of patients presenting to one surgical firm with an acute abdomen is discussed. Sixty-seven laparoscopies have been performed over an 18 month period and it has altered the diagnosis in 19.4% of cases and the management in 13.4% of cases. At laparoscopy the diagnosis of appendicitis was made in 37 patients (81% had attempted laparoscopic appendicectomies); pelvic inflammatory disease in 15 patients; torted fimbrial cyst in two patients; and free pus in the right lower peritoneum as a result of a perforated appendix was seen in two patients. Normal laparoscopy was performed in five patients and four patients who presented with a perforated duodenal ulcer had the diagnosis confirmed at laparoscopy, in three cases the perforation was oversewn laparoscopically. Two laparoscopies were performed on trauma patients; one stabbing and one blunt trauma to the right hypochondrium. It has been demonstrated that diagnostic laparoscopy is a useful adjunct to the general surgeon's armamentarium. It is suggested that the skill of laparoscopy is passed on to junior trainee surgeons who can use this technique to help attain a diagnosis in patients presenting with an acute abdomen.
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PMID:The influence of diagnostic and therapeutic laparoscopy on patients presenting with an acute abdomen. 830 8

Although pelvic inflammatory disease (PID) is a common complaint in young, fertile women, it is quite rare during pregnancy. Clinically it is characterized by abdominal pain, sometimes presenting as an acute abdomen with fever. Since PID has no characteristic clinical or laboratory findings, and is rare during pregnancy, it is understandable why the diagnosis is missed in most cases, and the patient is treated as an abdominal emergency. Since surgery during pregnancy in the presence of an infection leads to abortion in most cases, accurate diagnosis and appropriate treatment is of the greatest importance. A case of PID during pregnancy is presented.
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PMID:[Pelvic inflammatory disease in pregnancy]. 843 4

A 45-year-old female with oophoritis (pelvic inflammatory disease) caused by Campylobacter fetus (C. fetus) is reported. She was admitted to the hospital because of high fever and an acute abdomen. On admission, severe inflammation was observed by the laboratory findings, and abdominal X-ray and CT scan revealed ileus with marked swelling of the right ovary. Laparotomy was performed with adonexooophrectomy due to the tubo-ovarian abscesses. C. fetus was isolated from the right ovary, salpinx and ascites. Erythromycin was administered after a sensitive test of C. fetus as the bacteria was isolated at operation. She was discharged on the 17th day after her admission. Indirect immunofluorescent test with hyperimmune rabbit sera to isolated C. fetus revealed a fine to coarse granular immunoreaction in the cytoplasm of the macrophages infiltrated in the tissue. This result was interpreted as the existence and growth of bacteria in the right ovarian tissue. Oophoritis due to C. fetus subspecies fetus is very rare. To our knowledge, this case is the second case reported in Japan.
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PMID:[A case report of Campylobacter fetus subspecies fetus oophoritis]. 1078 83

Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing normal intrauterine pregnancy from threatened or spontaneous abortion, ectopic pregnancy and other complications that may occur in patients with positive pregnancy test. Incomplete abortion is visualized as thickened and irregular endometrial echo with certain amount of intracavitary fluid. If applied, color Doppler ultrasound reveals low vascular resistance signals in richly perfused intracavitary area. Transvaginal sonography has high sensitivity and specificity in visualization of uterine and adnexal signs of ectopic pregnancy. Color Doppler examination may aid in detection of the peritrophoblastic flow. Furthermore, it facilitates detection of ectopic living embryo, tubal ring or unspecific adnexal tumor. Corpus luteum cysts and leiomyomas are another cause of pelvic pain during pregnancy, which can be correctly diagnosed by ultrasound. Detection of uterine dehiscence and rupture in patients with history of prior surgical intervention on uterine wall relies exclusively on correct ultrasound diagnosis. In patients with placental abruption sonographer detects hypoechoic complex representing either retroplacental hematoma, subchorionic hematoma or subamniotic hemorrhage. In closing, ultrasound has already become important and easily available tool which can efficiently recognize patients with possibly threatening conditions of different origins.
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PMID:[Ultrasonography in acute pelvic pain]. 1276 97

Gonococcal infection in the postantibiotic era continues to cause disseminated and severe disease in some patients. The differential diagnosis of pain in the lower abdomen in young women is difficult. Our case report described a 19-year-old patient who presented with acute abdomen as a result of Gonococcal infection, assessed as a local complication, pelveoperitonitis: pelvic inflammatory disease. The message of our case report is sexually transmitted infections should invariably be considered in young women and searched for accordingly.
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PMID:Gonococcal infection as a cause of acute abdomen. 1657 33

Clinical manifestations and computed tomography (CT) findings of Fitz-Hugh-Curtis syndrome (FHCS) are relatively well stabilized as right upper quadrant abdominal pain and hepatic capsular enhancement because of perihepatitis associated with pelvic inflammatory disease caused by N. gonorrhoeae and C. trachomatis. We encountered three patients with serial FHCS associated with pelvic inflammatory disease, who visited the emergency room with right upper quadrant abdominal pain. Abdominal CT revealed hepatic capsular or pericapsular enhancement along the anterior surface of the liver on the arterial phase. Recently, multi-detector CT has evolved as the first-line imaging modality of acute abdomen at the emergency room; we reemphasized the importance of the CT findings of this syndrome for differential diagnosis of right upper quadrant abdominal pain in sexually active young women. Physicians at the emergency room acknowledge the syndrome and should perform dynamic abdominopelvic CT including the arterial phase.
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PMID:Fitz-Hugh-Curtis syndrome: CT findings of three cases. 1758 37

Ovarian abscess in young sexually non-active girls can represent a diagnostic challenge. 15-years old girl was admitted to the Clinic for Gynaecology and Obstetrics under the suspicion of torsion of an ovarian cyst. Her clinical status deteriorated after the admission with development of acute abdomen. Laparoscopic exploration was performed and unilateral ovarian abscess was found without involvement of other pelvic structures. The surgical procedure was minimal invasive for a young girl and Salmonella staleyville was isolated from pus. Solitary ovarian abscess can be of hematogenous origin and the causative pathogens are different from pathogens usually involved in pelvic inflammatory disease. To avoid later fertility problems it is of great importance to treat infections in pelvic region correctly according to the isolated microorganism and that surgery is the least invasive.
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PMID:Salmonella ovarian abscess in young girl presented as acute abdomen--case report. 2166 76


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