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

An acute abdomen in pregnancy can be caused by pregnancy itself, be predisposed to by pregnancy or be the result of a purely incidental cause. These various conditions are discussed. The obstetrician often has a difficult task in diagnosing and managing the acute abdomen in pregnancy. The clinical evaluation is generally confounded by the various anatomical and physiological changes occurring in pregnancy itself. Clinical examination is further hampered by the gravid uterus. The general reluctance to use conventional X-rays because of the pregnancy should be set aside when faced with the seriously ill mother. A reluctance to operate during pregnancy adds unnecessary delay, which increases morbidity for both mother and fetus. Such mistakes should be avoided as prompt diagnosis and appropriate therapy are crucial. A general approach to acute abdominal conditions in pregnancy is to manage these problems regardless of the pregnancy.
Baillieres Best Pract Res Clin Obstet Gynaecol 2000 Feb
PMID:The acute abdomen and the obstetrician. 1078 62

Familial Mediterranean fever is a hereditary syndrome characterised by recurrent episodes of fever and serositis, resulting in pain in the abdomen, chest, joints and muscles. It is primarily diagnosed in people of Jewish, Arabic, Turkish or Armenian ancestry and is caused by mutations in the gene encoding for pyrin. Abdominal FMF attacks resemble the clinical presentation of 'acute abdomen', with severe abdominal pain and rigidity, but in FMF symptoms always resolve spontaneously. It is important to distinguish these regular pain episodes from small bowel obstruction due to adhesions to prevent life-threatening bowel strangulation. In most cases, colchicine will prevent new painful attacks. This seminar also discusses other causes of abdominal pain in FMF patients.
Best Pract Res Clin Gastroenterol 2005 Apr
PMID:Familial Mediterranean fever--a not so unusual cause of abdominal pain. 1583 88

Although fibroids constitute the most common tumour in women of reproductive age, it is remarkable how very rarely they cause acute complications. However, when they do occur, the acute complications can cause significant morbidity (very occasionally, mortality), profoundly affecting a woman's quality of life. The complications include thrombo-embolism, acute torsion of subserosal pedunculated leiomyomata, acute urinary retention and renal failure, acute pain caused by red degeneration during pregnancy, acute vaginal or intra-peritoneal haemorrhage, mesenteric vein thrombosis and intestinal gangrene. The obstetrician will be most familiar with red degeneration and acute urinary retention, both of which tend to occur in association with pregnancy. It is difficult to quote an incidence rate for these acute complications as they are rare, and most are reported as cases or case series in the literature. The majority (except red degeneration, acute urinary retention and thrombo-embolism) presents as an acute abdomen and requires urgent exploratory surgery. The differential diagnosis would include twisted adnexa, ruptured ectopic pregnancy, haemorrhagic corpus luteum or follicular cyst, whilst that of the pelvic mass would be ovarian or endometrial carcinoma, uterine sarcoma or leiomyoma and, rarely, ovarian fibroma. Deep vein thrombosis is usually due to pelvic venous compression, and while some have advocated that its occurrence in association with a fibroid mass should be an absolute indication for hysterectomy, sophisticated use of radiological adjuncts at surgery, such as 'umbrellas' and haematological support with appropriate anticoagulation, could enable uterine-preserving surgery. The diagnosis of fibroids as a cause of acute urinary retention should be one of exclusion. The treatment of the acute fibroid in pregnancy is of course conservative, definitive treatment being postponed until postpartum.
Best Pract Res Clin Obstet Gynaecol 2009 Oct
PMID:Acute complications of fibroids. 1926 55

Acute mesenteric ischemia (AMI) is generally thought to be a rare disease, but in fact, it is more common cause of acute abdomen than appendicitis or ruptured abdominal aortic aneurysm in patients over 75 years of age. In occlusive AMI, surgical treatment without revascularization is associated with as high as 80% overall mortality. It has been shown that early diagnosis with contrast-enhanced computed tomography and revascularization can reduce the overall mortality in AMI by up to 50%. However, only a minority of patients with AMI are being treated actively with revascularization in the United States, and the situation is very likely similar in Europe as well. What can we do to improve diagnostic performance, so that more patients get proper treatment? The diagnosis is a collaborative effort of emergency department surgeons, gastrointestinal and vascular surgeons, and radiologists. The etiological categorization of AMI should be practical and guide the therapy. Furthermore, the limitations of the diagnostic examinations need to be understood with special emphasis on computed tomography findings on patients with slowly progressing "acute-on-chronic" mesenteric ischemia.
Best Pract Res Clin Gastroenterol 2017 Feb
PMID:Acute mesenteric ischemia (part I) - Incidence, etiologies, and how to improve early diagnosis. 2839 84