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

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

Hereditary angioedema (HAE) is characterised by episodic swelling of the extremities, face, larynx and recurrent abdominal pain, which can mimic the acute abdomen. Trauma of the larynx may result in acute airway obstruction. The management of emergency anaesthesia for Caesarean section of a patient with documented HAE is described and the special problems presented discussed. The methods of prophylaxis available are considered and the use of fresh frozen plasma advocated.
Anaesthesia 1979 Feb
PMID:Hereditary angioneurotic oedema. 44 16

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

A 26-year-old woman came to hospital with an acute abdomen and a history of abdominal pain for about 6 months. She showed signs of peritonitis and ileus and underwent a laparotomy after initial diagnostic procedures. There was massive terminal ileitis with perforation and localized peritonitis. Resection of the affected bowel was performed over 5 1/2 h without surgical or anesthetic complications. Postoperatively several attempts were made to insert a venous catheter via the internal jugular vein, first on the right and then on the left side. The catheter was finally placed and was used for infusions, although there were some signs that indicated a possible arterial position. Neurological disturbances followed the end of anesthesia; 2 h later the catheter was removed because of arterial malpositioning diagnosed by a blood gas analysis. The patient developed brainstem and cerebellar infarctions and died 2 days later. The main postmortem finding was massive swelling and paleness of the cerebellum and brainstem with macroscopically unaffected supporting arteries. The other main arteries of the head and neck were also unremarkable, except for two healing punctures of the left common carotid artery. Further examination revealed an embolism at the top of the basilar artery. The source was macroscopically obscure; stereomicroscopic examination of the heart showed small dark spots behind one fold of the aortic valve caused by parietal thrombosis of the damaged endothelium. The tip of the misplaced catheter had entered this region and caused the lethal embolism.
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PMID:[Arterial misplacement of a central venous catheter with a fatal cerebral embolism]. 195 38

A case of pericardial effusion with tamponade that presented as an acute abdomen is described.
Anaesthesia 1990 Feb
PMID:An unusual presentation of cardiac tamponade. 232 16

Peritoneoscopy is a simple and effective means of diagnosing or excluding intra-abdominal disease. It is currently underutilized and merits increased recognition particularly by general surgeons. The first 77 peritoneoscopic examinations performed by a general surgeon in a large hospital associated with a cancer agency are reviewed. An exact diagnosis was made in 78% of 58 patients in whom the primary diagnosis was in doubt and in 93% of that group management was influenced. Surgical exploration of the abdomen was avoided in 29 patients. The major indications for using the method were: to search for metastases, to evaluate the acute abdomen and to stage lymphoma. Local anesthesia and nitrous oxide insufflation were used almost exclusively. Biopsy was performed in 36 patients and there was one death directly attributable to liver biopsy. In two patients peritoneoscopy was unsuccessful.
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PMID:Peritoneoscopy in general surgery. 645 2

Although the morbidity of porphyria is rare, the surgical and anesthetic managements of patients with porphyria should be prudent, for various stresses including surgery and anesthesia may cause occurrence or exacerbation of this disease, occasionally resulting in the mortal course. Several drugs such as barbiturate, diazepam, pentazocine, and pancuronium, which can be used during anesthesia or after operation, reportedly exacerbate the disease. Furthermore, the acute exacerbation of porphyria may be misdiagnosed as acute abdomen, ileus, acute appendicitis, cholelithiasis, urolithiasis, or ectopic pregnancy. The managements of patients with acute porphyria during anesthesia and after surgery are discussed along with the introduction of our case report. Since there is no definitive treatment of porphyria, the most important thing is to understand the disease and to prevent the acute exacerbation of the disease. When patients are suspected of porphyria or possible porphyria, careful management is required during anesthesia and after operation with selecting secure drugs against the disease.
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PMID:[Surgical and anesthetic managements of patients with porphyria]. 761 68

A previously healthy 39-yr-old man was scheduled for exploratory laparotomy due to acute abdomen. There was no sign of difficult intubation. After induction of anesthesia with thiopental and succinylcholine, the trachea was easily intubated with a 7.0 mm cuffed endotracheal tube. Surgery for a ruptured appendix with 2 drainage tubes lasted for 75 min was uneventful. At the end of surgery, the endotracheal tube was removed without difficulty. On the 1st postoperative day, the patient developed stridor. The symptom persisted even after conservative treatment and removal of NG tube. On the 12th postoperative day, a telescopic videolarygoscopy revealed immobile right vocal cord with anterior and medial displacement to the right. Arytenoid cartilage was moderately edematous. A diagnosis of right arytenoid subluxation was then made. On the 17th postoperative day, a closed reduction of right arytenoid cartilage using direct laryngoscope was performed successively under general anesthesia. Eight weeks after the reduction, his voice and laryngoscopic findings were normal. There has been only 18 reports with 27 cases of this complication found in the literature. However, it is generally believed that it is not so unusual. The post-intubation syndromes, such as sore throat, dysphonia, odynophagia, difficulty in swallowing or breathing which persists beyond 5 days warrant ENT consultation. Abnormal mobility of vocal cord, edema over arytenoid area found by indirect laryngoscopy should suggest the complication. Further confirmation is then needed. Although the result of our case is good, the reduction should ideally be done within 24-48 h after the incidence to avoid unfavorable long-term sequelae.
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PMID:[Arytenoid subluxation following endotracheal intubation--a case report]. 778 99

From September 1992 to September 1993, 150 patients aged 15-68 years underwent laparoscopic gynecologic surgery. These patients included 63 patients with acute abdominal diseases (46 had ectopic pregnancy, 9 rupture of ovary, and 8 torsion of ovarian cyst), which consisted of 90% of total patients with acute abdomen in corresponding period, 63 patients with mass of adnexa, which made up 72% of total patients with ovarian tumors, and 24 patients with uterine diseases. We successfully performed laparoscopic salpingostomy, fallotomy, removal of ovarian cyst, oophorosalpingectomy, myomectomy and laparoscopy assisted vaginal hysterectomy (LAVH) with 2-4 puncture technic after general anesthesia. The largest ovarian tumor and the enlarged uterus were 14 and 16 cm in diameter respectively. Four patients had laparotomy because of severe pelvic adhesions and the laparotomy rate was about 2.6%. The procedure lasted 20-240 minutes and bleeding was less than 200ml. No major surgical complication was encountered.
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PMID:[150 cases of vedio-laparoscopic gynecologic surgery]. 792 58

Securing the airway following surgery can be a problem in certain patients. Preparation, therefore, should include a plan for safe reintubation, if necessary. We report two patients with a difficult airway (recurrent thyroid carcinoma, inoperable carcinoma of the hypopharynx) who were at a high risk for intubation under general anaesthesia. In addition, one of the patients suffered from an acute abdomen and ileus. We used a guidewire placed into the trachea via a fiberscope to facilitate fiberoptic reintubation.
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PMID:[A guidewire as a reintubation aid. Translaryngeal fiberoptic insertion of a guidewire into the trachea to assist fiberoptic reintubation in patients difficult to intubate]. 797 89


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