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

The type of first aid given to patients requiring emergency pediatric surgery is decisive for the prognosis in many cases. With this aspect in mind, individual disease pictures from the group of connatal deformities (esophageal atresia, intestinal atresia, gastroschisis, diaphragmatic hernia and defect, myelomeningocele), from emergency surgical situations beyond the neonatal stage (acute abdomen and ileus, esophageal varices, pneumothorax), and accident injuries (blunt abdominal trauma, cranio-cerebral trauma, burns) are selected and the most important first aid measures described. But for all diseases, the general rule for the treatment of all seriously ill children applies: provision of a safe venous access, readiness to intubate, adequate oxygenation and control of the acid-base, water and electrolyte balances.
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PMID:[First aid measures in emergency pediatric surgery (author's transl)]. 41 88

Spinal epidural abscess is seldom encountered in children and rarely occurs in the absence of spinal pain. A case is described in which a child with a thoracic epidural abscess presented with abdominal rather than spinal pain. Thoracolumbar radicular inflammation and visceroparietal reflexes initiated by a s'spinal ileus' probably produced the symptoms and signs of acute intra-abdominal disease. Consideration of intraspinal disease is advisable in all cases of acute abdomen which exhibit atypical features.
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PMID:Spinal epidural abscess presenting as acute abdomen in a child. 42 Sep 67

Two cases of lymphangiectasia of the small intestine in elderly women are presented. The condition manifested itself in one case by a sudden perforation of the jejunum; in the other case by ileus of the terminal ileum. In both cases the disease process pursued a relentless course that ultimately led to the death of the patients. Elective surgery in patients with lymphangiectasia has been performed before. Acute surgery of lymphangiectasia of the small intestine with complaints of acute abdomen, obstruction or perforation as presenting signs of the disease has not been described previously.
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PMID:Lymphangiectasia of the small intestine as an acute surgical problem. 70 84

Evidence is presented that many of the enteric and systemic manifestations after jejunoileal bypass can be related to an inflammatory process within the bypassed small bowel rather than to the surgically induced sequelae of a short bowel syndrome with malabsorption. Invasion of the excluded segment by fecal flora was associated with a histologically demonstrable inflammatory response of the mucosa. The disorder was of variable severity and duration and occurred in the majority of 28 bypass patients. Progression to a clinical syndrome resembling an acute abdomen occurred in about 15% of the patients. Small bowel ileus and, in some patients, obstruction of the colon were suggested by physical signs and x-ray findings. Surgical exploration in such instances demonstrated an inflammaotry process of the excluded small bowel loops with severe distention of this segment and of the colon, but not organic obstruction. Pneumatosis cystoides intestinalis was a sequal in two patients. Exudative protein loss was documented in the severe cases. Most of the systemic sequelae are comparable to those seen with inflammatory diseases of the bowel such as Crohn's disease. Fever, excessive weight and lean tissue loss, and the involvement of skin, blood vessels, joints and possibly, the liver suggest an immune response as a common factor in the pathogenesis. The clinical improvement with antibiotics such as metronidazole or with restitution of normal bowel continuity indicates that the bacterial flora in the excluded small bowel segment or its byproducts are causally related to the systemic complications. Hyperoxaluria may be primarily the sequela of steatorrhea and not of the inflammatory process.
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PMID:Bypass enteropathy: an inflammatory process in the excluded segment with systemic complications. 83 42

Four cases of sarcoma of the small intestine (2 leiomyosarcoma, 1 fibrosarcoma, and 1 Hodgkin's disease) are described. In each case, diagnosis was the outcome of surgery: emergency operation for acute abdomen in three cases (2 mechanical ileus, 1 perforation); exploratory laparotomy for recurrent haemorrhage following negative X-ray examination per os and clyster of the digestive tract on a number of occasions. The relevant literature is surveyed. Attention is drawn to the different anatomopathological and clinical forms, and to the difficulty of diagnosis.
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PMID:[Sarcomas of the small intestine]. 85

Clindamycin (7-chloro-7-deoxylincomycin) may induce mild or severe colitis. In 28 months, clindamycin-associated diarrhea was encountered in 8 patients who had received oral therapy. Severe, acute colitis was seen in 4 older patients, 3 of whom had acute pseudomembranous colitis and one who had an adynamic ileus mimicking an acute abdomen. Mild colitis with protracted diarrhea occurred in 4 younger patients who had mild, nonspecific inflammation in the rectum which responded to symptomatic treatment. The mechanism and true incidence of diarrhea as a sequel of clindamycin therapy are unknown. In all 8 patients, the use of clindamycin was arbitrary. Because of potentially serious gastrointestinal disturbance, including acute pseudomembranous colitis, clindamycin should be reserved for anaerobic and other serious infections.
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PMID:Colitis associated with clindamycin therapy. 120 37

We report the case of a patient on dialysis for 13 years, including continuous ambulatory peritoneal dialysis (CAPD) for 11 years, who developed sclerosing peritonitis with gross peritoneal calcification. The patient first presented with abdominal pain in January 1990, when peritoneal calcification was detected for the first time. Her symptoms settled spontaneously and 1 year later she presented with acute peritonitis and adynamic ileus. The peritonitis settled with antibiotics and Tenchkoff catheter removal, but the ileus persisted. She was commenced on long-term parenteral nutrition, but never recovered useful bowel function. After 8 weeks of hemodialysis and total parenteral nutrition, a further laparotomy for an acute abdomen showed what appeared to be extensive bowel infarction and peritoneal calcification. She died several days later. Of significance, peritoneal calcification was first noted on x-ray and computed tomography (CT) scan while the patient was still largely asymptomatic and before peritoneal ultrafiltration capacity was significantly impaired. Unlike other reported cases of calcifying peritonitis, sclerosing peritonitis was present and calcification was far more extensive. It was not associated with factors such as frequent infective peritonitis or acetate dialysate. Calciphylaxis was not present nor was there any abnormality of calcium-phosphate metabolism. The outcome of this case suggests that patients with recurrent or persistent bowel symptoms on long-term CAPD should have early abdominal x-ray or CT scanning to exclude sclerosing peritonitis or bowel calcification. If present, consideration should be given to transferring the patient to another therapeutic dialysis modality if possible.
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PMID:Sclerosing peritonitis with gross peritoneal calcification: a case report. 146 95

Clostridium difficile-associated pseudomembranous colitis is an increasingly common nosocomial infection that usually responds to oral antibiotics. Presentation as an acute abdomen occurred in 12 patients, leading to 14 laparotomies. A distinctive clinical picture was observed: advanced age, recent treatment with antibiotics, fever, abdominal pain, tenderness, marked leukocytosis, and ileus. Only six of the 12 patients had diarrhea. Five were immunosuppressed. Abdominal computed tomographic scans revealed ascites and a massively thickened colonic wall. All four patients treated by subtotal colectomy survived. Four of 10 patients treated only with laparotomy or segmental colectomy died, four responded to medical therapy, and the conditions of two deteriorated but were salvaged by subtotal colectomy. Early diagnosis via endoscopy or computed tomography should obviate the need for exploratory operations. However, progressive toxic effects indicate failure of medical therapy and the need for subtotal colectomy.
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PMID:Laparotomy for fulminant pseudomembranous colitis. 152 85

The term "acute abdomen" stands for a group of abdominal symptoms which rapidly get worse and therefore require immediate treatment--especially conditions associated with peritonitis, ileus or massive bleeding. No time should be wasted on lengthy diagnosis or organizational problems. In the majority of cases a simple clinical diagnosis gives sufficient indication for surgery. Various manifestations simulating acute abdomen in children are discussed in order to prevent unnecessary laparotomy.
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PMID:[The concept of the acute abdomen]. 179 95

The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of volvulus of the small intestine, a stress ulcer, gangrenous appendicitis, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute abdomen as a postoperative complication]. 182 40


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