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)

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

Between 1974 and 1978 we saw nine patients with acute gastro-duodenal ulcers. Morphologically these were characterised by their unusual extent without deep penetration, by sharp bizarre contours, and with symmetrical findings in the gastric antrum. Spasm and submucous inflammatory reactions may obscure the niche of an antral ulcer and lead to stenosis and rigidity; in the differential diagnosis an infiltrating carcinoma must be excluded. This is possible by double contrast demonstration of the ulcer en face. The clinical picture is one of sudden, severe upper abdominal pain with features of an acute abdomen, often with a previous history of stress or of gastric distension with vomiting.
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PMID:[Acute gastro-duodenal ulceration--lesions without a niche (author's transl)]. 645 96

A 47-year-old man presented with backache and signs of acute abdomen. An exploratory laparotomy was performed. Post-operatively he developed hypoxaemia in the operating theatre and was brought to the Surgical Intensive Care Unit for ventilatory support and further investigations. History was then retaken and revealed a minor foot injury one month ago with subsequent development of muscle spasm and dysphagia. The diagnosis of tetanus was made. The patient was then treated with human antitetanus immune globulin and crystalline penicillin. Ventilatory support was continued, aided by infusion of morphine, diazepam and alcuronium. The recovery course was complicated by chest infection, urinary tract infection and sympathetic overactivity. He improved later and ventilatory support was discontinued three weeks after admission. He then made uneventful recovery and was discharged from the hospital forty days after admission.
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PMID:A case of tetanus mimicking acute abdomen. 776 95

A 52-year-old man without history of angina pectoris underwent emergent abdominal surgery for acute abdomen. General anesthesia was maintained with isoflurane, nitrous oxide and fentanyl. The depth of anesthesia during surgery was considered adequate for the stimuli, but the patient developed ECG abnormality repeatedly finally followed by short run. After anesthesia, we re-examined the recorded ECG and coronary spasm was strongly suspected. Fatal arrhythmia might be avoidable if the prior abnormality in ECG is properly assessed.
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PMID:[Repeated coronary artery spasm under general anesthesia]. 1192 95

Schwannomas are benign neurogenic tumors that arise from Schwann cells that line the sheaths of peripheral nerves. Schwannomas are commonly located in the soft tissues of the head and neck, extremities, mediastinum, retroperitoneum, and pelvis, but they are very rare in the mesentery. A 56-y-old man was admitted to the emergency service with nausea, vomiting, acute abdominal pain, and constipation. He reported weight loss and an intra-abdominal mass. On physical examination, the abdomen was distended, and a mass that was approximately 15 cm in diameter was palpated at the middle abdomen. Generalized abdominal tenderness and muscle spasm were noted. Air-fluid levels were seen on plain radiographs. Ultrasonography identified an intra-abdominal mass with intra-abdominal hemorrhage or perforation. Clinical signs and laboratory findings suggested an intra-abdominal mass, mechanical bowel obstruction, and an acute abdomen. The patient underwent surgery. The mass was completely excised and included a 4-cm-long intestinal segment that was densely adherent to the mass. Histopathologic and immunohistochemical examination revealed a mesenteric schwannoma. The patient was well 11 mo after surgery. Although schwannomas are very rare and generally asymptomatic, these tumors can become quite large and may cause acute abdominal problems such as mechanical bowel obstruction.
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PMID:Case report: mesenteric schwannoma. 1714 3

We report the case of an elderly patient with diastolic heart failure and renal insufficiency admitted to hospital as he complained of having a history of hypogastric pain and dysuria without fever due to renal lithiasis and urinary infection. Because the pain was persistence, and considering the presence of renal dysfunction, it was administered a single low dose of paracetamol/codein (500/30 mg). After about 1 hour of the administration, he suddenly complained of the onset of a lancinating epigastric pain radiating to the whole abdomen and retrosternum accompanied by nausea. The electrocardiogram (EKG) was negative for myocardial infarction and computed tomography excluded aortic dissection and other causes of acute abdomen. Laboratory tests showed instead liver and pancreatic damage. The symptomatology was relieved 3 hours later of the onset after antispastic treatment with anticholinergics (floroglucine). The likely underlying pathophysiological mechanism is the codein-induced spasm of the sphincter of Oddi combined with dysfunction of the same sphincter and reduced bile storage capacity related to a previous cholecystectomy. When a similar event does not regress, it may lead to more severe conditions such as acute pancreatitis. Since codein is a widely used drug, this report may suggest cholecystectomy as a contraindication during administration for the risk of occurrence of these complications.
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PMID:Sudden severe abdominal pain after a single low dose of paracetamol/codein in a cholecystectomized patient: learning from a case report. 1982 93