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

We describe a challenging case of sigmoid volvulus where a previously unrecognised anatomical condition, rather than the patient's age, was the main predisposing factor. A man in his thirties presented to the emergency department with a 3-day history of constipation and acute abdominal pain. Initial assessment and studies were inconclusive, but a CT scan revealed torsion of the large bowelSigmoid volvulus is a frequent cause of bowel obstruction that can be missed if appropriate imaging is not available. Clinical presentation and blood analysis can be similar to the findings in acute abdomen caused by other more common causes.
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PMID:Absolute constipation caused by sigmoid volvulus in a young man. 2374 52

Jejunal diverticula have a prevalence of approximately 1% in the general population. Perforation of jejunal diverticulum is a rare. Clinically this diagnosis may be easily confused with other causes of an acute abdomen. In the article, we discuss a 74-year-old man with a 2-day history of constipation and left-sided abdominal pain. The day before admission he developed an abrupt exacerbation his symptoms with pain localized to periumbilical and left lower quadrant. An abdominal computed tomography scan revealed soft tissue stranding within the left upper quadrant, bilateral plural effusions , larger on the left, an opacity with the right and left pulmonary lobes and polypoid lesion with in stomach. Physical examination revealed left upper quadrant fullness. An emergency laparotomy was carried out. This revealed multiple jejunal diverticula, one of which had perforated 40 centimeters distal to the ligament of Treitz.
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PMID:Perforated jejunal diverticula- a rare cause of acute abdominal pain: a case report. 2483 64

A case of acute sigmoid volvulus in a 14-year-old adolescent girl presenting with acute low large bowel obstruction with a background of chronic constipation has been presented. Abdominal radiograph and CT scan helped in diagnosis. She underwent emergency colonoscopic detorsion and decompression uneventfully. Lower gastrointestinal contrast study showed very redundant sigmoid colonic loop without any transition zone and she subsequently underwent elective sigmoid colectomy with good outcome. The sigmoid volvulus should be considered in the differential diagnosis of paediatric acute abdomen presenting with marked abdominal distention, absolute constipation and pain but without vomiting. Plain abdominal radiograph and the CT scan are helpful to confirm the diagnosis. Early colonoscopic detorsion and decompression allows direct visualisation of the vascular compromise, assessment of band width of the volvulus and can reduce complications and mortality. Associated Hirschsprung's disease should be suspected if clinical and radiological features are suggestive in which case a rectal biopsy before definitive surgery should be considered.
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PMID:Sigmoid volvulus in an adolescent girl: staged management with emergency colonoscopic reduction and decompression followed by elective sigmoid colectomy. 2514 13

A 49-year-old female presented with one week history of severe abdominal pain, vomiting and constipation. Pertinent past surgical history consisted of caesarean section, laparoscopic right fallopian tube cystectomy and myomectomy. There was also recent left mastectomy and adjuvant chemotherapy for breast carcinoma. Clinical examination established a tensely distended abdomen with scanty bowel sounds but no clinical peritonism. Blood tests showed severe acute kidney injury and raised inflammatory markers. Computed tomography without intravenous contrast demonstrated small bowel obstruction of uncertain aetiology but with likely calibre change in the pelvis. At operation, the left fallopian tube had wrapped itself around ischemic bowel. A left salpingo-oophorectomy was performed to release the bowel. On closer inspection, an internal hernia caused by a defect in the broad ligament was diagnosed. This case report describes a differential of atypical small bowel obstruction to be considered when faced with a female acute abdomen.
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PMID:A closed loop obstruction caused by entrapment of the fallopian tube and herniation through the broad ligament. 2601 2

Botulism is an important public health problem in Argentina. It is a potentially fatal disease, and its diagnosis may be difficult. There are rare presentation forms of the disease, such as acute abdomen. We present a 4-month baby with a 3-day constipation condition, associated with weakness and abnormal eating attitude in the last 12 hours. The baby presented preserved muscle tone, with no changes in sucking or deglutition according to the mother's observations. Altered sensorium and acute abdomen were found; the patient was entered into the operating room with presumptive diagnosis of intussusception, which was confirmed by pneumatic desinvagination. During hospitalization, the patient did not make good progress and presented weak cry, progressive hypotonia and respiratory failure requiring intensive care. Clostridium botulinum was isolated from the stool sample and botulinum toxin type A was isolated from serum. The patient was treated with equine botulinum toxin. Twenty five days after admission, he was totally recovered.
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PMID:[Intussusception in infant with diagnostic botulism: A case report]. 2629 64

Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman's colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients.
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PMID:Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients. 2689 47

Postpartum Ovarian Vein Thrombosis (POVT) is a rare, but serious condition that causes slow quadrant pain in the postpartum period. POVT must be considered in the differential diagnosis of postpartum acute abdomen. We hereby report a case on a 36-year-old Italian woman who developed an acute abdomen a week after spontaneous vaginal delivery. She had persistent fever and constipation. Diagnosis of POVT was made with an abdominal Computed Tomography (CT) and treatment with heparin and broad-spectrum antibiotics were started. After 72 hours, the patient was switched from low molecular weight heparin to oral anticoagulant treatment. After 5 months a complete recanalization was demonstrated by abdomen CT and the treatment was stopped 6 months after diagnosis. POVT is a diagnosis of exclusion in the puerperium. This case illustrated that POVT may also occur in low risk patient.
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PMID:Ovarian Vein Thrombosis Presenting as Acute Abdomen in Puerperium. 2704 37

Mesenteric lymphadenitis is a clinical condition that affects mostly children and teenagers. Its symptoms include fever, severe abdominal pain, nausea, and, in some cases, diarrhea, constipation, and acute abdomen. This paper describes the case of a 16-year-old patient with mesenteric lymphadenitis submitted to an exploratory laparoscopy for suppurative lymph nodes that evolved to a drastic reduction of ovarian reserve. Because of the patients age, she was offered cryopreservation of her ovarian tissue.
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PMID:Is mesenteric lymphadenitis a cause of ovarian reserve reduction? - Case Report. 2720 6

We present two cases of wandering spleen, one in a 47-year-old woman who presented with constipation, and one in a 3-year-old girl who presented with acute abdominal pain. Wandering spleen is a rare clinical condition characterized by ectopic positioning of the spleen due to abnormal peritoneal attachments including the lienorenal and gastrosplenic ligaments. The spleen can "wander" or migrate into various positions within the abdomen or pelvis due to this ligamentous laxity. The clinical presentation of patients with this entity is variable and can range from an incidental finding to an acute abdomen associated with torsion. Various imaging modalities can be utilized for the diagnosis of this condition.
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PMID:Wandering Spleen: A Rare Diagnosis with Variable Presentation. 2730 60

The urachus is an embryonic tube that connects the upper portion of the bladder to the umbilicus, and obliterates normally during embryonic development stages forming the median umbilical ligament. Incomplete obliteration of this tube results in many anomalies such as congenital patent urachus, umbilical urachal sinus, vesicourachal diverticulum and urachal cyst. We report in this case a 5-year-old female presented to the Emergency, complaining of generalized abdominal pain, fever, vomiting, and constipation with no umbilical discharge. The clinical presentation accompanied by radiology investigations suggested a case of acute abdomen. We performed an exploratory laparotomy and found a mass above the bladder connected to the umbilicus; we excised the mass and sent a specimen to pathology that confirmed Urachal cyst. Urachal cyst is usually asymptomatic unless it is complicated; depending on our case, we recommend surgical management by complete excision for complicated urachal cyst.
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PMID:Acute abdomen due to an infected urachal cyst in a 5-year-old female: case report. 3113 38


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