Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000727 (acute abdomen)
 3,084 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65-year-old man with long-standing diarrhoea, recurrent Clostridium difficile infection (CDI) in the previous 5 months presented to the gastroenterology clinic with recurrent diarrhoea and abdominal cramping. Physical examination was negative for signs of acute abdomen. Stool C difficile PCR was positive. Abdominal imaging demonstrated an extensive pneumatosis intestinalis involving the small bowel and a dilated small bowel loop. He was treated conservatively with oral vancomycin for recurrent CDI with resolution of diarrhoea and abdominal cramping on 1-month follow-up visit.
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PMID:Pneumatosis intestinalis in a patient with recurrent Clostridium difficile infection. 2311 56

A 1-year-old boy presented at our hospital with common gastroenteritis symptoms such as fever, vomiting and diarrhoea. Clinical and laboratory findings were normal. An emergency ultrasound examination was performed and excluded abdominal complications. After 2 days of complete regression of symptoms, the patient began to vomit again, diarrhoea stopped with a sudden worsening of clinical conditions. Laboratory and radiological findings showed signs of an acute abdomen with differential diagnosis between an infectious and an obstructive cause. Owing to the rapid and progressive toxic condition, an emergency laparoscopy was performed. An axial torsion of a swollen and gangrenous Meckel's diverticulum was detected.
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PMID:A common case of gastroenteritis in a child followed by an axial torsion of Meckel diverticulum: a rare and unusual complication. 2343

Ipilimumab (anti-CTLA-4 antibody) is a new tool for the treatment of metastatic melanoma patients that has led to an improvement in survival rates worldwide. New types of toxicities have been described with ipilimumab called 'immune-related adverse events' or irAEs. Here, we report an acute and steroid resistant case of ipilimumab-induced colitis treated with infliximab in a melanoma stage IV AJCC patient. The patient presented with acute grade 3 diarrhea after the second perfusion of ipilimumab. After the administration of intravenous steroids, the patient continued to have grade 2 diarrhea with erythematous mucous with several ulceration sites on rectosigmoidoscopy. Infliximab perfusion (5 mg/kg) was performed and resulted in resolution of symptoms within 2 days with complete healing was observed by rectal sigmoidoscopy on day 7. After failure of two further lines of chemotherapy, the patient died 10 months after the diagnosis of stage IVM1C melanoma. Treatment algorithms exist for the management of these digestive adverse events; however, some points remain unclear. No predictive marker for the occurrence of this digestive toxicity has been validated to date. Modes of administration of steroids and dosage are not clearly defined, except in cases of acute abdomen; surgery is difficult to propose for patients with a poor prognosis. Infliximab is another option for the treatment of steroid-resistant ipilimumab-induced colitis but its use in metastatic melanoma raises questions of its possible impact on the evolution of cancer. We reviewed at least 19 cases published of infliximab administration for ipilimumab-mediated colitis. Unfortunately, tolerance and cancer evolution have scarcely been reported. Thus, because more patients are being treated with CTLA-4 blockade, management of ipilimumab-induced colitis requires further studies.
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PMID:Ipilimumab-induced acute severe colitis treated by infliximab. 2345 60

A 52-year-old man with cervical spondylosis sustained a hyperextension injury to the neck and subsequently developed central cord syndrome after 2 weeks. The diagnosis was confirmed clinically and on MRI. During the admission he was febrile from Streptococcus anginosus bacteraemia from a gum infection and was started on penicillin. This resulted in pseudomembranous colitis with abdominal distension and bloody diarrhoea but a lack of expected abdominal complaints. Unfortunately his neurology deteriorated and a repeat MRI showed a discitis at C5-C7 which required a 2-level discectomy, debridement and instrumented fusion. Owing to his spinal cord injury, an abdominal perforation was initially missed owing to the lack of clinical features of an acute abdomen. He underwent a right hemi-colectomy for ascending colon perforation and eventually made a good recovery and was discharged to a spinal rehabilitation unit. By one year follow-up he had returned to full neurological function.
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PMID:A silent acute abdomen in a patient with spinal cord injury. 2353 47

Ipilimumab, an anticancer drug, is an anti-CTLA4 monoclonal antibody. It is used in treatment of disseminated melanoma. Therapy is associated with high risk of complications. One of the most serious, although one of the rarest is perforation of gastrointestinal tract. In this case report we describe a 52-year old male, with disseminated melanoma with unknown starting point, treated with anti- CTLA4 monoclonal antibody. After 3rd dose of drug administration, bloody diarrhea and acute abdominal pain occurred as a symptom of gastrointestinal perforation. A single perforation was sutured during laparotomy. Symptoms of acute abdomen returned after 10 days. Pus-faecalperitonitis, symptoms of necro-hemorrhagic colitis and multilocal perforation of the colon were found during relaparotomy. Pancolectomy with end ileostomy was performed. Few hours since relaparotomy pacient died due to multiple organ failure. The purpose of this case report is to draw attention to a risk of multilocal colon perforation in patient treated with ipilumumab.
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PMID:Multiple colon perforation as a fatal complication during treatment of metastatic melanoma with ipilimumab - case report. 2467 Mar 41

An 81-year-old man was admitted to a primary care hospital due to bloody diarrhea. The findings of abdominal computed tomography indicated ischemic colitis, so conservative therapy was started. On the 4th hospital day, the patient was transferred to our hospital because of renal dysfunction. Physical examination showed clouding of consciousness and abdominal distention. Abdominal computed tomography revealed massive ascites and thickening of the whole colonic wall. With a diagnosis of acute abdomen, an emergent laparotomy was performed. Extended right hemicolectomy was performed because of severe ischemic change and necrosis of the right side of the colon. In the stool culture before the operation, Escherichia coli O157 and verotoxin were found, so this case was diagnosed as hemorrhagic colitis with hemolytic uremic syndrome and acute encephalopathy due to Escherichia coli O157 infection. Postoperatively, the hemolytic uremic syndrome and acute encephalopathy were prolonged. However, with intensive care, the patient recovered and was discharged on the 33rd postoperative day.
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PMID:Successful Colectomy for Hemorrhagic Colitis with Hemolytic Uremic Syndrome and Acute Encephalopathy due to Escherichia coli O157 Infection. 2480 91

A 78-year-old woman with long-standing obstipation presented herself to the hospital with diarrhoea and progressive abdominal cramping since 2 days. Acute abdomen developed and an emergency exploratory laparotomy was indicated, which showed no signs of bowel ischaemia. After admission to the internal ward, stool Clostridium difficile PCR was tested positive. Hence the diagnosis of pseudomembranous colitis became apparent. Abdominal imaging demonstrated multiple gas foci in the wall of the bladder and extensive pseudomembranous colitis. The patient was initially treated with oral vancomycin and secondarily with metronidazole for recurrent C. difficile infection. Resolution of diarrhoea and abdominal cramping was noted on 6-week follow-up visit.
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PMID:Emphysematous cystitis due to recurrent Clostridium difficile infection. 2551 62

Sodium valproate is one of the most common first-line antiepileptics prescribed for primary and secondary generalised seizures. However, serious complications associated with sodium valproate, such as acute pancreatitis, need to be considered when choosing this medication for treating epilepsy in certain populations such as children and persons with intellectual disability. We report a case of a 21-year-old man with intellectual disability who presented to the emergency department with an acute abdomen, vomiting and diarrhoea. He had to undergo an emergency exploratory laparotomy during which acute necrotising pancreatitis was diagnosed intra-operatively. We believe that the recent increase in sodium valproate dosage for his epilepsy was the cause of the pancreatitis. Carers of such persons should be adequately informed regarding possible life-threatening complications of medications prescribed to avoid delay in diagnosis and unwanted incidents.
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PMID:Sodium valproate induced necrotising pancreatitis: A case report. 2589 54

Eosinophilic enteritis is a rare disorder presenting mostly with diarrhea, malabsorption, abdominal pain, weight loss, and hypersensitivity. Surgical manifestation of eosinophilic gastrointestinal disorders depends on the site and extent of involvement. In our case series of four patients two of them had ileocaecal masses with recurrent subacute intestinal obstruction with past history of intake of antitubercular drugs for 9 months. On histopathological examination both of them proved to have eosinophilic enterocolitis. Thus it is a clinical dilemma to differentiate between these two conditions. The other two patients presented as acute abdomen with perforation and intussusception. All four patients were treated surgically. Postoperatively they recovered well with no symptoms on one year follow-up. In Indian setup tuberculosis being rampant there may be under reporting or wrongly diagnosed cases of eosinophilic enteritis. Thus a strong clinical suspicion and awareness of this clinical entity are essential among surgical community.
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PMID:Spectrum of surgical presentation of eosinophilic enteritis. 2596 Sep 10

Congenital anomalies of the digestive system represent a complicated topic concerning many medical specializations. The goal of this article is to describe two cases of children with mesenterium commune. First was an infant (5.5 months old female) who died shortly after being admitted to hospital with acute bronchitis, vomiting and diarrhoea. The autopsy revealed the cause of death--volvulus of the entire small intestine and the first portion of the large intestine with haemorrhagic infarsation of the intestinal wall in an infant with congenital anomaly of intestinal fixation--mesenterium commune. Second case was a 2.5 years old female after two heart surgeries, with pulmonary hypertension, who died suddenly at home. The cause of death was volvulus of a portion of the small intestine with haemorrhagic infarsation of the intestinal wall and also mesenterium commune. Congenital malpositions of the intestine originate due to malrotation and malfixation of the intestine during prenatal and early postnatal period. This wide range of the individuals developmental disorders always result in a condition where the topographical findings in the abdominal cavity are not as commonly found. Abnormally positioned intestines cannot develop a normal mesentery and are prone to volvulus, which represents the most serious complication with acute abdominal symptoms and when diagnosed late, it can lead to sudden death. Whilst performing autopsies such cases are rarely seen. However in forensic medicine and also in clinical practice it is important to consider intestinal malposition as a cause of acute abdomen.
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PMID:[Two sudden deaths of children with mesenterium commune -- a case report]. 2597 Dec 28


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