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

Acute appendicitis was once thought to be rare among rural blacks. It is now known that appendicitis is relatively common among Africans and in Africa. At the University College Hospital, Ibadan, Nigeria, appendicitis is the most common cause of acute abdomen on the surgical service.One hundred and eighty-one cases of appendicitis were operated on in a two-year period from June 1975 to June 1977. A retrospective analysis of 47 fully documented cases showed that wrong diagnosis occurred more often in females than in males. There was a high incidence of perforation (31.9 percent) in this series. Deaths occurred in perforated cases and cases complicated by typhoid perforation of the terminal ileum. Parasites and their ova were often present in the lumen of some appendices.The age group most affected was 16 to 20 years. This disease affected low, middle and upper income groups in our society. Chronic, recurrent appendicitis was frequently diagnosed (31.9 percent) and history of recurrent right lower quadrant pain as far back as three months was often elicited from these patients.
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PMID:Appendicitis in a tropical African population. 53 24

A retrospective review of cecal and appendiceal complications occurring in young patients with acute leukemia since 1969 was performed. The objective of this study was to determine the relative incidence of appendicitis and typhlitis among patients with acute leukemia who had operation or autopsy in this institution as well as to determine the risks of operative intervention. Fifteen patients with these complications were identified among the 400 patients with acute leukemia seen during this time period. Signs and symptoms of an acute abdomen were present despite immunosuppression. The incidence of sepsis at the time of presentation was 53%. Preoperative risk factors identified most frequently were coagulopathy and organ failure resulting from sepsis. Postoperative morbidity (25%) and mortality rates (8%) were related to the development of infectious complications. Appendicitis occurred in eight of the 15 patients studied, whereas typhlitis or its complications was found in seven patients. No preoperative factors could be found to differentiate typhlitis from appendicitis on clinical examination. It is suggested that operation can be safely performed in neutropenic patients who have acute right lower quadrant pain and signs of peritoneal irritation and may be the only effective way of differentiating appendicitis from typhlitis.
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PMID:Right lower quadrant pain in young patients with leukemia. A surgical perspective. 331 27

Although surgical textbooks commonly include foreign bodies in the differential diagnosis of acute abdomen, this cause of abdominal pain has not been reported in the obstetric literature. A 35-year-old woman presented at 24 weeks' gestation with right lower quadrant pain and peritoneal signs. The only abnormal finding at exploratory laparotomy was a free-floating intraperitoneal foreign body, presumably left inadvertently during prior surgery. The differential diagnosis of acute abdomen in pregnancy should include intraperitoneal foreign body in any woman with a history of previous abdominal surgery.
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PMID:Intraperitoneal foreign body as a cause of acute abdomen in pregnancy. 777 87

The primary torsion of the omentum is a rare cause of acute abdomen. The clinic features may mimic closely acute appendicitis, with acute onset of right lower quadrant pain. The Authors, after reporting two cases recently observed, discuss the aetiopathogenetic aspects, point out the problems of diagnosis and finally suggest the most correct surgical approach.
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PMID:[Primary omental torsion in children: report of 2 cases and review of the literature]. 906 74

A perforation of Meckel's diverticulum by foreign bodies is an extremely rare cause of acute abdomen in adults. We herein present a case of a 30-year-old man who was admitted due to symptoms of right lower quadrant pain, anorexia, and vomiting. An exploratory laparotomy was done, and a perforated Meckel's diverticulum due to a chicken bone was found at exploration. A resection of a segment of ileum including the perforated diverticulum was performed, and the patient had an uncomplicated postoperative course.
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PMID:Perforation of Meckel's diverticulum by a chicken bone, a rare complication: report of a case. 1522 56

Torsion of the appendices epiploicae is a rare condition that may present with acute abdominal pain and mimics appendicitis. We report a 20-year-old previously appendectomized man presenting with right lower abdominal quadrant pain. Abdominal ultrasonography showed a localized omental thickening in the right paracolic region. Contrast-enhanced computed tomography revealed well-circumscribed fatty tissue adjacent to the cecum with heterogeneous hyperdense infiltration of the mesentery near the sigmoid colon. Diagnostic laparoscopy revealed 2-cm diameter torsioned and edematous fatty tissue floating on the omentum in the right lower quadrant. The torsioned mass was elevated, and a thick stalk was seen to be connecting the fatty tissue to the sigmoid colon. At this point, the torsioned fatty tissue was considered as a sigmoidal appendix epiploica that was elongated and neighboring on the previously operated-on region. The lesion was removed by laparoscopic means using 3 ports. Grossly, fat necrosis and internal bleeding were seen. Histopathologic analysis of the resected tissue demonstrated adipose tissue surrounded by fibrotic inflammatory changes with marked infiltration of numerous lymphocytes and histiocytes. In conclusion, torsion of appendices epiploicae should be included in the differential diagnosis of acute abdomen when evaluating patients with right lower quadrant pain and a history of appendectomy. Laparoscopic surgery provides definite diagnosis and prevents unnecessary open procedures for such lesions leading to peritoneal irritation.
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PMID:Laparoscopic resection of a torsioned appendix epiploica in a previously appendectomized patient. 1634 May 73

Right-sided diverticulitis is difficult to distinguish from other sources of right-sided abdominal pain and, in particular, is frequently indistinguishable from acute appendicitis preoperatively. Because of the problems concerning preoperative diagnosis and controversies in the management, the choice of the best therapy on the surgeon's part is still open. A total of 1150 patients with a clinical diagnosis of right acute abdomen observed in our surgical department from 1995 to 2003 was analysed. Three patients had a pathologically confirmed diagnosis of caecal diverticulitis. The mean age of the patients was 37 years. Right lower quadrant pain and local tenderness were the only clinical findings in 95.3% of the cases, with a preoperative diagnosis of acute appendicitis in 2 of 3 patients. The operative findings were an inflammatory mass in the caecum and the presence of a minimal amount of free peritoneal fluid. Two patients underwent laparoscopic ileocecectomy and one had a diverticulectomy. The postoperative course was uneventful. Because of the difficulties in diagnosis and surgical treatment, caecal diverticulitis has been the subject of much discussion in the literature and many questions remain unanswered. Right-sided diverticulitis is easily confused with acute appendicitis because it occurs at a somewhat younger age than sigmoid diverticulitis. Caecal diverticulitis needs a high index of suspicion for achieving a preoperative diagnosis. Diverticulectomy should be performed in patients with small diverticula with a limited inflammatory reaction. Right colectomy should be performed in patients with perforation of the diverticulum, caecal phlegmon or abscess formation. A correct intraoperative diagnosis is therefore crucial for selection of the surgical procedure. Laparoscopic treatment of a solitary, acutely infected colon diverticulum is feasible in this setting. A minimally invasive procedure could be performed, therefore, in patients with right acute abdomen, allowing not only the right diagnosis but also the treatment of the commonest pathologies responsible for this clinical picture.
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PMID:Laparoscopic treatment of caecal diverticulitis. 1672 10

Supernumerary kidney is an extremely rare congenital anomaly of the urinary tract. A 39 year-old woman was admitted to the emergency unit with right lower quadrant pain. Physical examination revealed abdominal tenderness and defense on palpation of the right pelvic region. Blood and urine analysis revealed leukocytosis and urinary tract infection. Ultrasound examination demonstrated a suspicious mass which was thought to be a pseudokidney in the pelvis. Native kidneys were found in the normal anatomic position. Further investigation with computed tomography demonstrated a functioning third kidney which has located at the right iliac fossa in addition to normal excreting right and left kidneys. Acute abdomen like symptoms were secondary to the urinary infection of the third kidney and the urinary infection was successfully treated by antimicrobial and anti-inflammatory medication. We conclude that the infection of pelvic supernumerary kidney may create clinical symptoms of acute abdomen. Although extremely rare, congenital anomalies like supernumerary pelvic kidney should be included in the differential diagnosis.
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PMID:[A rare anomaly presented with symptoms of acute abdomen: a third kidney located at right iliac fossa]. 1731 Apr 15

Acute abdomen is a common presentation to the emergency department (ED), accounting for 5% to 10% of ED visits. Of these, 10% require surgery, and 25% go undiagnosed. Usually, most of the cases of undiagnosed abdominal pain are in young women with pelvic etiologies, although occasionally, unusual causes of abdominal pain lead to diagnostic dilemmas and can have adverse clinical outcomes. We present an unusual etiology of abdominal pain in a young man, who presented with acute onset of right lower quadrant pain accompanied by nausea and vomiting. He was an amateur boxer who had recently intensified his training regimen and admitted to binge drinking for several days before presentation. The initial diagnosis was acute appendicitis, but a computed tomographic scan done revealed a normal appendix. Creatine kinase level was then checked and found to be significantly elevated, and a diagnosis of isolated abdominal wall rhabdomyolysis was made.
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PMID:Rhabdomyolysis: a lesson on the perils of exercising and drinking. 1841 Aug 42

A healthy 26-year-old man visited the Emergency Department due to right lower quadrant pain of 2 days' duration that developed after wakeboarding. There was no history of direct trauma to the abdomen. Physical examination revealed tenderness and rebound tenderness on the right lower quadrant area. There was no palpable abdominal mass. Computed tomography (CT) of the abdomen was undertaken to discern the causes of acute abdomen, including acute appendicitis. CT revealed a small-size rectus sheath hematoma beneath the lower end of the right rectus muscle. The patient was admitted for supportive care including pain control and was discharged with improvement after 5 days. Rectus sheath hematoma can be caused by not only a direct blow but also non-contact strenuous exercise, for example, wakeboarding in this case. Although the majority of rectus sheath hematomas are self-limiting, some can cause peritoneal irritation signs, mimicking acute abdomen, and eventually lead to unnecessary laparotomy without clinical suspicion and ancillary tests including CT scan and ultrasonography.
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PMID:Rectus sheath hematoma caused by non-contact strenuous exercise mimicking acute appendicitis. 1872 39


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