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

Emphysematous cholecystitis is a rare form of acute cholecystitis, characterized radiographically by the presence of gas within the gallbladder. We report of a patient, who was admitted to the hospital with the diagnosis of acute abdomen. This patient had an emphysematous cholecystitis caused by Clostridium perfringens. We found the wall of the gallbladder emphysematous and gangrenous, the gallbladder was distended and contained purulent material, but no stones. However, in addition, the films of abdomen showed gas in the ducts. Diagnosis, pathogenesis and the aetiological and therapeutical aspects will be discussed.
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PMID:[Acute emphysematous cholecystitis]. 22 5

The experience of acute mesenteric ischaemia at St Vincent's Hospital, Melbourne, has been reviewed over 17 years. The mortality remains appallingly high. This applies particularly to those patients who had thrombosis of the superior mesenteric artery, amongst whom the mortality in this series was 97%. The mortality was slightly less in the group suffering from embolic occlusion of the superior mesenteric artery (66%), and in those suffering from thrombosis of the superior mesenteric vein (60%). A mortality of 66% was also found in patients suffering from non-occlusive gut ischaemia. Delay in diagnosis accounted for this high mortality. Early diagnosis is all-important, and this depends on the performance of mesenteric angiography in any patient suspected of having mesenteric ischaemia. Appropriate surgery may then be carried out in the occlusive group and supportive treatment, including intraarterial papaverine infusion, given to those with non-occlusive ischaemia. There is a pressing need for simple non-invasive tests to segregate those patients suffering from acute mesenteric ischaemia from those whose acute abdomen is due to some other cause.
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PMID:Acute mesenteric ischaemia. 26 14

Overwhelming Clostridium septicum infection is a rare occurrence in children. It is seen almost exclusively as a complication of acute leukemia. A high index of suspicion in the leukemic child with an acute abdomen is the key to early diagnosis and improved survival. A case in a 13-year-old girl with acute myelogenous leukemia is reported and six pediatric cases in the literature were reviewed.
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PMID:Clostridium septicum infection in childhood leukemia: report of a case and review of the literature. 26 32

Three cases are described in which there was concurrent development of acute cholecystitis and a second acute abdominal illness. Acute cholecystitis occurred in patients with acute appendicitis, small bowell obstruction, and acute colonic diverticulitis. Experience with three such cases over the course of eight years by a single surgeon suggests a possible aetiological link between the two diseases. It is suggested that, under some circumstances, exploration of an acute abdomen may need to be more than cursory.
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PMID:Double pathology in acute cholecystitis. 27 27

The diagnosis of acute superior mesenteric artery occlusion in the dog has been achieved in every case by isotope scanning of the abdomen using technetium-labelled red cells or technetium-labelled human serum albumin. The white cell count is also significantly elevated, but the changes in the levels of the enzymes CPK, LDH, AST and serum amylase are not specific for actue mesenteric ischaemia. In the human the presence of a normal gut circulation can be demonstrated by isotope scanning provided that the patient is not severely shocked. The presence of a normal gut circulation as shown on the scintigram conclusively eliminates the possibility of acute main trunk occlusion of the superior mesenteric artery. This should be of help in differentiating acute occulusive mesenteric ischaemia from other causes of the acute abdomen. Abdominal scintiscanning is complementary to angiography, which still remains the most precise means of diagnosing acute mesenteric ischaemia. Although the abdominal scintigram is more limited in its application and is not as accurate as angiography, it is quicker to perform, non-invasive, and entirely safe. Abdominal scintiscanning is an excellent screening test to be used in patients suspected of suffering from acute occlusive mesenteric ischaemia.
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PMID:The early diagnosis of acute occlusive mesenteric ischaemia: experimental results and clinical applications. 28 87

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

Massive spontaneous "anticoagulant" hemorrhage in the bowel wall may cause an acute abdomen with signs of intestinal obstruction within a few hours. An operative revision is indicated if a barium study is not possible to secure this rare diagnosis and therefore other much commoner causes of an acute abdominal illness are not to be excluded. While out of 42 patients, in whom the hemorrhagic segment was resected, only two died as a probable result of the operation, several cases are known where a survival without laparotomy was unimaginable. The dangers of a laparotomy should not, therefore, be overemphasized.
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PMID:[Clinical aspects and therapy of spontaneous under-anticoagulants-occurring intramural intestinal hemorrhages]. 30 82

Spontaneous rupture of an allografted kidney is not such a rare complication of kidney transplantation. In our series 5.2% of the transplanted kidneys ruptured spontaneously. The condition is an acute emergency characterized by the triad, acute abdomen, swelling in the region of the transplant and haemorrhagic shock. The aetiology of transplant rupture seems to be multifactorial, but the superimposition of an acute rejection episode on ischaemic tubular damage with acute renal failure was found to be the most important combination of events leading to transplant rupture in our patients. Exceptionally precise immunological monitoring in the early phases following transplantation and early aggressive therapy of an acute rejection crisis associated with acute renal failure should prevent allograft rupture.
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PMID:[Spontaneous rupture of renal allografts (author's transl)]. 35 16

Acute abdomen syndrome was the presenting sign of leukaemia in the reported case. The authors discuss indications to surgical treatment in patients with leukaemia.
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PMID:[Pericecal abscess and infiltration as a complication in the early phase of acute non-differentiated cell leukemia]. 39 5

Twelve patients, presenting with an acute abdomen of suspected biliary tract origin, had endoscopic retrograde cholangiography performed. Eight patients had either traumatic, spontaneous, or postoperative biliary tract fistulas with five leading to the peritoneal cavity, one to the colon, one to the bronchial tree, and one to the liver parenchyma from a ruptured gall-bladder. Each was confirmed by endoscopic retrograde cholangiography. Four patients with jaundice, following traumatic rupture of the liver, had a pathological communication between the intrahepatic biliary tracts and the hepatic vascular system. It is concluded that ERC is a reliable method for obtaining precise localization of biliary tract problems in surgical emergencies both pre- and post-operatively.
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PMID:Endoscopic retrograde cholangiography (ERC) in surgical emergencies. 41 1


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