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

An extremely rare case of spontaneous intraperitoneal rupture of the urinary bladder, caused by a combination of a tumor of the vesical wall and an impacted urethral stone, is reported. The patient's symptoms suggested a perforated hollow viscus. Under general anesthesia the urethral stone was removed, while at laparotomy a diffuse peritonitis with blood-stained purulent fluid emerging from the ruptured bladder was found. The vesical wall was repaired and the peritoneal cavity was drained. In spite of the patient's advanced age and debilitated condition and the generalized peritonitis, the postoperative course was uneventful and the patient recovered promptly. Although spontaneous rupture of this kind is rare, one needs to consider unsuspected bladder rupture in any acute abdomen, especially if the patient is in the prostatic age group or has voiding problems.
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PMID:A rare case of spontaneous rupture of the urinary bladder. 125 Dec 53

It is well known that a pleuropneumopathy brought on by local action of biochemical nature (amylase) can occur in the course of quiescent or unknown pancreatitis. The literature on the subject was therefore examined with respect to abdominothoracic diffusion of the pancreatic excretion. Also examined were indications for surgery in the unusual complications which may arise, often with dramatic emergency (acute abdomen in sufferers from slight persistent pleural effusion; pleuropulmonary perforative syndrome in be course of quite stabilized chronic pancreatitis). Personal experience with four successfully treated cases is reported. The literature contains only sporadic examples and some remarks and deductions are made with regard to the controversial ways of amylasic abdominothoracic transfer.
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PMID:[Pancreatic diseases with pleuropulmonary complications of surgical significance]. 125 72

A series of 137 patients with amoebic liver abscess has been studied. Recognition of clearly defined but diverse clinical syndromes was found to be necessary not only in diagnosis but also in planned surgical management. The majority of patients had the classic syndrome of fever, right abdominal or chest pain, hepatomegaly, hepatic tenderness and radiological abnormalities. Other syndromes of presentation included the silent abscess, acute amoebic colitis, the acute abdomen, the intraabdominal lump, the external sinus, pyrexia of obscure origin, obstructive jaundice and renal, pleuro-pulmonary and cardiac symptoms. The syndromes due to an abscess in different parts of the right lobe and in the left lobe of the liver are to some extent distinct. In spite of the varied modes of presentation of amoebic liver abscess, the key to diagnosis is an understanding of the chronological sequence of the disease and its progression from one syndrome to another. Diagnostic methods of value and the mortality are discussed.
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PMID:Syndromes in amoebic liver abscess. 126 Feb 53

During the period 1938-70 there were 303 patients at the Radcliffe Infirmary, Oxford, diagnosed as suffering from Crohn's disease. Of these, 82 have been excluded, leaving 221 with a firm diagnosis. These patients have been divided into 'new cases', in which the disease was diagnosed at the Radcliffe Infirmary, and 'referred cases' in which the diagnosis was already made at the time of referral. In this series, there were three main sites of involvement: small intestinal, large intestinal, and both small and large intestinal. Ileocolitis was the commonest anatomical distribution. The disease showed progression to new, sites in a considerable number of the patients during the period under study. There was a fivefold increase of new cases between the first and third decades covered by the study and this applied equally to patients presenting as an acute abdomen, which supports the idea that the disease is truly increasing. Survival curves have been plotted and compared with expected survival curves. In terms of mortality, Crohn's disease emerges as a disease which becomes progressively more dangerous as the years go by, which is in sharp contrast with the findings in ulcerative colitis in which the main risk of dying is in the early years.
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PMID:Course and prognosis of Crohn's disease. 126 86

The diagnosis of the acute abdomen in the spinal cord injured patient is difficult. Diagnoses are often so delayed that approximately 10% of these patients die of acute abdominal problems. The presentation also varies with the level and duration of injury. An understanding of the functional neuroanatomy of the abdominal wall and viscera aids in timely diagnosis. I present an illustrative case and describe the pertinent functional neuroanatomy.
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PMID:Diagnosis of the acute abdomen in the neurologically stable spinal cord-injured patient. A case study. 129 39

HELLP syndrome continues to be a clinical entity of difficult diagnosis. Weinstein first defined it in 1982 giving the practicing obstetrician a sequence of useful initials (H = hemolysis; EL = elevated liver enzymes; LP = low platelets). Since then a lot has been written and it has become clear that the syndrome is a form of severe preeclampsia. The American College of Obstetrics and Gynecology does not include HELLP in the description of severe pre-eclampsia as such but does accept each of its components as being part of severe pre-eclampsia. The case presented deals with a 33 year old white female, admitted at 27 weeks gestation with nausea, epigastric pain resembling acute abdomen, nose bleeding and mild hypertension. The analysis revealed an abnormal liver profile with elevated GOT, GPT and LDH, heavy proteinuria (14.4 g/day), decreased platelet count (92000/mm3) and elevated total bilirubin. Pregnancy was terminated by cesarean section 24 hours after admission because the patient's condition was deteriorating. Obviously in pre-eclampsia/eclampsia there is a systematic injury to all tissues. Proof of this is the hypertension as a consequence of vascular spasm and proteinuria due to glomerular injury. In HELLP the sequence of events is probably altered; hepatic injury precedes vascular and renal injury of conventional preeclampsia. The syndrome results from many clinical and pathological symptoms derived from endothelial microvascular injury which determine a rapid platelet activation causing vascular spasm, platelet aggregation and further endothelial injury through a feedback mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Massive proteinuria and HELLP syndrome]. 130 8

A case of a HIV-positive patient hospitalized with acute abdomen secondary to infection by cytomegalovirus (CMV), is presented. Infection by CMV is frequent in HIV-positive patients, with a relevant intestinal affection. However, its presentation as acute abdomen is more rare, although it has to be considered given that the demonstration of the presence of CMV and its potential pathogenic power have important therapeutic connotations. Currently, the use of diagnostic techniques based in specific monoclonal antibodies and DNA hybridization methods increases the diagnostic sensitivity of the traditional methods based on histological demonstration of the cytopathic effect and/or viral cultives.
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PMID:[Acute abdomen secondary to cytomegalovirus infection]. 131 10

A case of torsion of a large appendicular mucocele presenting as acute abdomen in a 38-week pregnant woman is reported. Ultrasound showed a localized cystic lesion with internal echoes on the right side of the abdomen. It was diagnosed preoperatively as twisted ovarian cyst. The patient was treated surgically with cesarean section and curative appendectomy.
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PMID:Torsion of a mucocele of the appendix in a pregnant woman. 131 43

The acute abdomen is due to a medical disorder or surgical problems. Diagnosis is often difficult; acute diseases of the lung, chest, kidney, for example, may closely mimic primary diseases of the abdomen and can masquerade as surgical abdomen. The history assumes overwhelming importance, a careful physical examination is absolutely essential. It is incumbent upon the physician first to decide what is the most likely diagnosis to be correct; and then to undertake treatment indicated for that diagnosis. The laboratory studies, x-ray studies, echography, abdominal paracentesis and other diagnostic approaches may be indicated, when the diagnosis may still be obscure. In the course of the investigation of a patient with acute abdomen, the immediate goals are the correction of dehydration, electrolyte depletion and other problems. It is extremely important that no analgesics or sedatives ever be given until a decision is made as to a proper working diagnosis.
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PMID:[Rules and procedures in the diagnosis and medical (non-surgical) treatment of acute abdomen]. 134 Feb 48

A retrospective analysis of 140 cases with amebic liver abscess (ALA) seen at the AUNL University Hospital was done to see if patients with complications can be identified earlier in order to decrease morbidity and mortality. Sixteen patients (11.4%) presented complications and six patients died (4.2%). Patients with complications presented jaundice, large or multiple abscesses, acute abdomen, liver failure and sepsis more often than patients without complications. Hemoglobin, hematocrit, prothrombin time, total proteins, albumin, LDH, and BUN were more altered in patients who presented complications. The titer of antibodies against E. histolytica was higher in this group of patients. The six patients who died had been operated on. The causes of death were septic shock in two, sepsis in one, peritonitis in one, liver failure in one and colon perforation in one patient. Pleural effusion, jaundice and acute abdomen were seen in three patients, respectively (50%), two cases had multiple abscesses (33.3%), one patient had a ruptured abscess (16.7%). Patients who died exhibited more alterations in six laboratory examinations at admission: partial prothrombin time, total bilirubin, albumin, BUN, LDH, and leukocytes. Clinical data together with the severe alterations in laboratory examinations at admission for patients with ALA should alert the clinician to suspect complications earlier in order to decrease morbidity and mortality.
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PMID:Early detection of complications in amebic liver abscess. 134 Mar 6


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