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

Patients with intra-abdominal processes that require prompt surgical intervention, including appendicitis, perforated viscus, ischemic bowel, volvulus, and bowel obstruction, often present with signs and symptoms of an acute abdomen. Several medical problems can mimic an acute abdomen. Overwhelming postsplenectomy infection is a life-threatening condition that can present with acute abdominal symptoms. The incidence of overwhelming postsplenectomy infection ranges from 1% to 25%, and is caused by Streptococcus pneumoniae in 50% of cases. Capnocytophaga canimorsus, a bacteria commonly found in dog saliva, accounts for less than 1% of cases. Overwhelming postsplenectomy infection has a rapidly deteriorating course that progresses to respiratory and renal failure, cardiovascular collapse, and death. The mortality associated with overwhelming postsplenectomy infection is 60% to 80%. Early diagnosis and institution of appropriate antibiotic therapy and supportive care is essential to improve patient outcome. A previously healthy woman who had undergone splenectomy secondary to trauma 11 years earlier presented with symptoms of an acute abdomen. A diagnosis of overwhelming postsplenectomy infection due to C canimorsus was made based on her peripheral blood smear and blood culture findings. Early aggressive care and antibiotic treatment resulted in a successful outcome for this patient with no long-term morbidity. This patient's clinical course demonstrates the importance of early diagnosis and treatment of overwhelming postsplenectomy infection.
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PMID:Postsplenectomy Capnocytophaga canimorsus sepsis presenting as an acute abdomen. 986 57

Bowel obstruction is an acute alarming situation with limited diagnostic conditions. Therapeutic decisions must be taken in time. Diagnostic differentiation between incomplete or complete bowel obstruction, intestinal obstruction and paralytic ileus is often uncertain and the underlying cause difficult to detect. Besides plain films in acute abdomen the ultrasound examination presents important additional informations: 1st Dilated intestinal loops and gas caps correlate with the characteristic x-ray finding, i.e. erected dilated intestinal loops with fluid levels. The location of the obstruction is defined in small bowel obstruction by differentiation between jejunum (with Kerckring folds) and ileum (without Kerckring folds). In large bowel obstruction the caecum is dilated and a collapse of the distal colon is detectable. 2nd Additional sonographical findings are: oedema of the intestinal walls, hyperpendulum peristalsis or absence of peristalsis, sedimentation of intestinal contents, pearlstring-like lined up gas bubbles under the ventral intestinal walls, and concomitant ascites. Duplex sonographical studies of the intestinal peristalsis may help to differentiate between mechanical obstruction and paralytic ileus. 3rd In bowel obstruction stenoses can be detected as a result of tumour, Crohn's disease diverticulitis, invagination, strangulated hernias or gall stone ileus. Intestinal adhesions cannot be found by ultrasound. Small and large bowel is dilated in paralytic ileus. Numerous causes like acute pancreatitis, ureteral colic, free gastrointestnal perforation and so on can be diagnosed. 4th In ileus of vascular disorder early diagnosis is high important, but inspite of colour flow imaging diagnostic possibilities are limited. 5th Sonographical diagnosis is of special interest when the x-ray plain films is "empty". The lack of massive fluid collection and meteorism allows an optimal ultrasound examination. In this early phase disorders of peristalsis and intestinal walls are reliably found, and it is easier to find the cause of bowel obstruction. In this way the definitive diagnosis can be arrived at earlier, because it still takes up to 6 hours to obtain the classical x-ray finding. There is a rule that the earlier ultrasound is done, the more findings one will get.
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PMID:[Ultrasound ileus diagnosis]. 1002 58

Pooling of blood in the spleen is a frequent occurrence in children with sickle cell diseases, particularly in the first few years of life, resulting in what is termed "splenic sequestration crisis." The spectrum of severity in this syndrome is wide, ranging from mild splenomegaly to massive enlargement, circulatory collapse, and even death. The diagnosis is usually clinical, based on the enlargement of the spleen with a drop in hemoglobin level by > 2 g/dl, and it is rare that imaging studies are ordered. However, in the patient who presents to the emergency department with non-specific findings of an acute abdomen, it is important to recognize the appearance of sequestration on imaging studies. We studied seven patients utilizing contrast-enhanced CT scans and found two distinct patterns--multiple, peripheral, non-enhancing low-density areas or large, diffuse areas of low density in the majority of the splenic tissue. Although radiological imaging is not always necessary to diagnose splenic sequestration, in those situations where this diagnosis is not immediately obvious, it makes an important clarifying contribution.
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PMID:CT imaging of splenic sequestration in sickle cell disease. 1114 89

The acute abdomen (AA) is a typical but very rare complication of idiopatic haemochromatosis (IH). The possible mechanisms are not sufficiently clarified. We report a case with IH who died with clinical features of (AA) 20 hours after gastroscopy was performed. The histological examination established nonspecific damage of visceral peritoneum and ascites. Fulminant form of spontaneous bacterial peritonitis (SBP) as a reason of death is discussed, nevertheless endoscopic esophageal varices sclerotherapy was not performed. The role of pulmonary infection and intestinal bacterial overgrowth with possible bacterial translocation in mesenterial lymph nodes, ascitic fluid, and blood is also discussed. The source of infection is usually unknown. The iron is important factor for bacterial growth. The pluriglandular deposition of iron including the suprarenal glands is precondition to development of collapse. The possible pathogenesis of SBP in IH is discussed. It is important to mention that unlike SBP the clinical course of IH AA might appear which does not necessary require surgical management.
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PMID:[Acute surgical abdomen in idiopathic haemochromatosis]. 1251 36

Latex allergy is a cause of anaphylactic reactions during general anesthesia. It is currently the second most common cause of anaphylaxis during anesthesia and should be considered in all cases in which signs develop during surgery. Clinical manifestations are highly variable and depend on the type and amount of exposure to the allergen as well as on individual sensitivity. Cardiovascular collapse is the most common presentation in anesthetized patients, and the second most common manifestations are skin rash and bronchospasm. Latex gloves are implicated in most allergic reactions triggered by latex. Individuals allergic to latex are also sensitive to certain fruits (latex-fruit syndrome) because the presence of specific proteins common in both causes a phenomenon known as cross reactivity. A 34-year-old man with acute abdomen underwent emergency exploratory laparoscopy, which was converted to laparotomy based on findings in the surgical field. Coinciding with surgical manipulation, the patient developed severe hypotension, tachycardia, bronchospasm, and arterial desaturation, which responded favorably to intravenous fluids and medication. After all other possible causes of the events were ruled out, intraoperative anaphylactic reaction was suspected and later confirmed by tests, including allergy tests. When the patient was stable and the surgical environment was latex-free, the procedure was carried out with no complications and the postoperative course was uneventful.
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PMID:[Intraoperative anaphylaxis in a patient with undiagnosed latex sensitivity]. 1576 86

A 5-month-old, male Saint Bernard was presented for acute collapse and abdominal discomfort. Significant findings were a cranial abdominal mass, hemorrhagic abdominal effusion, anemia, and disseminated intravascular coagulation. An exploratory surgery revealed torsion of both the left lateral and middle liver lobes, a condition that has not been previously described in the veterinary literature. Torsion of one or more hepatic lobes is a rare condition but should be considered as a differential diagnosis for acute abdomen syndrome in both young and mature dogs. Early diagnosis and prompt surgical intervention may be curative.
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PMID:Left lateral and left middle liver lobe torsion in a Saint Bernard puppy. 1696 42

The availability of technological advances like ultrasonography (USG) and magnetic resonance imaging (MRI) has made the diagnosis of rudimentary horn pregnancy possible at an early gestation. However, in advanced pregnancy, such cases can sometimes pose a diagnostic dilemma and are recognized only when patient presents with abdominal pain and collapse and is taken for laparotomy. We report one such rare case of a nulliparous female who was carrying on well with her pregnancy till she developed symptoms of acute abdomen at 28 weeks of gestation. She underwent USG and MRI but it was only after laparotomy that a final diagnosis of a pregnancy in a rudimentary horn with placenta percreta perforating through the fundus could be made. There was a significant amount of hemoperitoneum; however, the horn was intact and the fetus could be salvaged. We excised the rudimentary horn with ipsilateral tube and ovary. Post operatively, both the mother and the baby were discharged in healthy condition.
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PMID:A rare case of intact rudimentary horn pregnancy presenting as hemoperitoneum. 2120 59

The authors report a case of atherosclerotic stroke in a 46-year-old recreational bodybuilder with a 20 year history of anabolic-adrenergic steroid (AAS) abuse. Cerebrovascular accident (CVA) occurred during his third week of hospital admission for an acute abdomen and on day 8, postemergency laparotomy. CVA presented with collapse, generalised seizures, reduced Glasgow Coma Score and severe hypertension. He was subsequently admitted to the intensive care unit (ICU), where initial investigations did not illustrate an underlying diagnosis. By day 4 in ICU, there had been no significant clinical improvement and radiological investigations were repeated, identifying a left frontal lobe infarct in the middle cerebral artery territory. The authors propose CVA was secondary to AAS. After a prolonged and complicated period of rehabilitation, he has been discharged home; he requires carers due to dyspraxia and is mobilising independently.
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PMID:Delayed diagnosis of a cerebrovascular accident associated with anabolic steroid use. 2820 81

Background. Adrenocortical carcinomas represent rare malignancies. In cases of hormone-secreting tumors, the hormone in excess determines the nearly diagnostic clinical presentation. Biologically inert tumors are diagnosed either due to the mass effect or incidentally. The purpose of the present study was to present an extremely rare presentation pattern of adrenocortical carcinoma. Case Presentation. We present the case of a 35-year-old female patient that underwent emergency laparotomy due to signs of acute abdomen and concomitant cardiovascular collapse caused by a spontaneously ruptured large adrenocortical carcinoma. Conclusion. Spontaneous rupture of an adrenocortical carcinoma presenting with signs of acute abdomen is an extremely rare clinical scenario. Increased level of suspicion is essential in order to diagnose and treat timely this life-threatening complication.
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PMID:Adrenocortical carcinoma presenting with signs of acute abdomen. 2342 7

Our aim is to feature the management of ectopic pregnancy in a non-communicating rudimentary horn. It has a remarkable life-threatening potential, being rare and difficult to be considered during differential diagnosis of acute abdomen or sudden maternal collapse in early pregnancy. Therefore, this is a report of mid-trimester triplet's ectopic pregnancy which presented with sudden repeated syncopal attacks and hemodynamic instability that necessitated emergency laparotomy to treat ruptured non-communicating rudimentary horn. The rarity of this clinical condition can lead to multiple challenges. When a diagnosis is confirmed, the intervention plans should be independently tailored based on the patient's age, obstetric history, fertility wishes, as well as, surgeon's experience. Moreover, most cases passed unnoticed till complications took place. Thus, early diagnosis of Mullerian anomalies preconceptionally or even during the initial antenatal visits is crucial step regarding the avoidance of such catastrophic maternal outcomes.
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PMID:A triplet's ectopic pregnancy in a non-communicating rudimentary horn and spontaneous rupture. 3303 Jul 38


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