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

Adnexal torsion is a rare finding during pregnancy. Here we report a patient with bichorial twin pregnancy in the 21st week of gestation with adnexal torsion. She was admitted with acute abdominal pain. Open laparoscopy was performed and the left adnexa was unwinded successfully. The postoperative follow-up was uneventful. Adnexal torsion as differential diagnosis of acute abdomen in pregnancy should be considered seriously to avoid irreversible lesions of the ovary and (salpingo-) oophorectomy.
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PMID:Adnexal torsion in a patient with bichorial twin pregnancy in the 21st week of gestation treated by open laparoscopy: a case report. 1659 74

When patients attend the physician's office with acute abdominal pain, the doctor must first exclude a potentially dangerous condition (acute abdomen) before initiating symptomatic treatment (e. g. painkilling drugs). The need for this is based in the first instance on the presence of severe complaints in combination with the absence of a plausible explanation for the patient's distress, as well as, secondarily, the anxiety of the patient or the person accompanying him, or even the doctor's own anxiety about possibly overlooking a serious pathology.
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PMID:[Diagnostic work-up of abdominal pain by the family doctor: an avertable potentially threatening situation must be excluded]. 1664 3

In a patient presenting with acute abdominal pain, initiation of symptomatic treatment must be preceded by the reliable exclusion of a potentially serious situation (acute abdomen = red light). Rapidly progressive or severe abdominal pain mandates an urgent diagnostic investigation on the part of the physician. No less important is the positive diagnosis of psychosomatic disorders (yellow light). If the family doctor fails to properly counsel the patient, too much diagnostic effort can lead to an iatrogenic somatic fixation. In the absence of all the above, the light shows green for causal therapy, an open mind on the diagnosis, symptomatic treatment and follow-up.
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PMID:[Red, yellow, green: management of gastrointestinal complaints]. 1664 4

We report on a six-year prospective study to determine the presentation and outcome of acute abdominal TB at Komfo Anokye Teaching Hospital. Between January 1998 and December 2003, material for biopsy including resected bowel was taken from all cases of acute abdomen, which at laparotomy were suspected as one or other form of abdominal TB. TB-positive cases were then retrospectively analysed for clinical presentation and outcome of surgical treatment. There were 96 histologically proven cases of abdominal TB, 60 in women and 36 in men. Seventy patients (72.9%) were admitted as acute intestinal obstruction with acute abdominal pain, vomiting, constipation, distension and fluid levels on abdominal X-ray. Twenty-two (22.9%) patients were admitted as acute diffused peritonitis - with generalized abdominal tenderness, guarding and rebound - and four (4.2%) as acute appendicitis. There were 74 emergency bowel resections (77% resection rate) for 34 ileocaecal masses, 16 strictures, 10 perforations and 14 adhesions, with a mortality of 4.2%. Previous series from our subregion have reported similar emergency resection mortality rates for other abdominal conditions. All the patients received postoperative anti-TB therapy. This paper notes that acute intestinal obstruction is the most common acute presentation of abdominal TB in our environment. The results of emergency resection compare favourably with resection for other acute abdominal conditions.
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PMID:Case series of acute presentation of abdominal TB in Ghana. 1703 7

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

A 65-year old man presented with acute abdominal pain and fever. The initial diagnosis was small bowel gangrene. Pathology revealed small to large abdominal vessels obliterated by cells of intravascular B-cell-lymphoma (IVL). Visceral IVL involvement is common at autopsy but rarely reported in patients with acute abdomen. The subtype of diffuse large B-cell lymphoma is a rare and aggressive malignancy, which in typical cases is characterized by cephalic or cutaneous manifestation. Few cases showed involvement of large vessels which in combination to fibrin thrombi may lead to infarction of the organ involved. Thus IVL should be considered in cases of ischemic diseases with fever of unknown origin.
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PMID:[Intravascular lymphoma causing acute abdomen]. 1714 42

The objective of this study was to validate the Enhanced Peritoneal Stripe Sign (EPSS) in diagnosing pneumoperitoneum in patients presenting with acute abdomen. The EPSS was described as a specific sonographic sign of pneumoperitoneum in an animal model and few patients who had undergone laparoscopy (Muradali et al. in Am J Roentgenol 173(5): 1257-1262, 1999). This is the first large-scale study in patients to detect the efficacy of EPSS. Six hundred consecutive patients with acute abdominal pain presenting to the author over a period of 3 months in the emergency ultrasonography department were prospectively studied for the presence of the EPSS. As part of their clinical work up, patients also underwent plain radiographs and/or a computed tomography (CT) of the abdomen. The author was unaware of the results of other imaging studies at the time of the sonographic examination. In all cases, the final diagnosis was based on the intra-operative findings, results of other imaging techniques and clinical follow-up. Based on the final diagnosis, 21 out of 600 patients had pneumoperitoneum. The EPSS was found to be positive in all 21 of these patients. Another three patients were found to have the sign false positive. There were no false negatives in this study. The EPSS thus had a sensitivity of 100%, a specificity of 99%, a positive predictive value of 87.5% and a negative predictive value of 100%. The EPSS is a reliable and accurate sonographic sign for the diagnosis of pneumoperitoneum. It should be looked for in all patients presenting with acute abdominal pain.
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PMID:Sonographic diagnosis of pneumoperitoneum using the 'enhancement of the peritoneal stripe sign.' A prospective study. 1734 68

Diagnostic and therapeutic laparoscopy for acute abdomen has been widely reported in the literature. Diagnostic laparoscopy has an accuracy of 99.08% and 1% morbidity. The usefulness of relaparoscopy in acute abdomen has also been reported. We describe a patient with acute abdominal pain who underwent diagnostic laparoscopy. Ischemic segment of small bowel was found and it was decided not to resect but to go in for a second look 48h later. Relaparoscopy revealed the ischemic segment to regain vascularity, so nothing further was done. The patient recovered well and was discharged on the 6th postoperative day. Laparotomy was avoided both the times, thus sparing the patient of morbidity and prolonged hospital stay. Other advantages are lower risk of incisional hernias, less postoperative pain and early return to normal activity. Laparoscopy and relaparoscopy certainly has a definite role in the management of acute abdomen, at least diagnostic if not therapeutic.
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PMID:Relaparoscopy in the management of acute abdomen due to localized ischemic bowel: a novel technique--case report. 1756 64

Epiploic appendagitis, which is an uncommon cause of acute abdomen, is a benign self-limiting inflammatory process of epiploic appendices. It has primary and secondary types. Computed tomography findings of the primary type are specific but are demonstrated rarely. Herein, we present pre- and post-treatment computed tomography findings of two cases who admitted to the emergency clinic with acute abdominal pain and were diagnosed to have epiploic appendagitis. Follow-up computed tomography features correlated well with clinical improvement.
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PMID:An uncommon cause of acute abdomen--epiploic appendagitis: CT findings. 1760 59

We report a case of a 38-year-old woman who presents at 31 weeks of gestation with acute abdominal pain. Computed tomography (CT) scan of the abdomen and pelvis showed a cecal volvulus. Emergency cesarean section was performed for fetal distress. Laparotomy confirmed the CT findings and a right hemicolectomy was performed. While not advocating overutilization, this case demonstrates that helical CT can be, in the correct clinical scenario, an acceptable, useful, and relatively noninvasive test in the accurate assessment of the acute abdomen in pregnancy. We review the safety and utility of medical diagnostic imaging in the assessment of the acute abdomen in pregnancy.
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PMID:Cecal volvulus in pregnancy: report of a case and review of the safety and utility of medical diagnostic imaging in the assessment of the acute abdomen during pregnancy. 1761


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