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

The diagnosis of enteric intussusception is rare in adults but not in children. The clinical picture often takes an insidious course. Acute abdomen may also be caused by enteric intussusception. We report on three patients with enteric intussusception and acute abdomen. In two cases, a CT led to the diagnosis of invagination of the small intestine. In one patient, invagination of the terminal ileum was detected during coloscopy. All patients were submitted to limited segment resection and end-to-end anastomosis. In all three cases, the invagination was caused by benign pathological changes. Enteric intussusception in adults always requires surgery. In more than 95% of the cases, pathological findings are obtained intraoperatively, which are benign in the small intestine in 85-95% of the cases.
Chirurg 2003 Sep
PMID:[Diagnostics and surgical therapy of enteric intussusception in adults illustrated by three cases]. 1450 99

We report a patient in whom lupus peritonitis and cystitis developed after ovulation induction therapy with human menopausal and chorionic gonadotropins followed by in vitro fertilization and embryo transfer. The lupus peritonitis and cystitis presented clinically as an acute abdomen. This disease should not be misdiagnosed as a nonspecific or infectious pelvic peritonitis, especially after oocyte retrieval.
Am J Obstet Gynecol 2003 Sep
PMID:A case of lupus peritonitis and cystitis after ovulation induction therapy. 1452 38

We report a case of primipara with triplet pregnancy who underwent combined spinal and epidural anesthesia 10 weeks after epidural blood patch. At 15 weeks of gestation, a woman with triplet gestation underwent Shirodkar operation under spinal anesthesia and subsequent epidural blood patch as a treatment of post-dural puncture headache. At 26 weeks she presented with acute abdomen and laparotomy was scheduled. Spinal anesthesia was selected with an epidural catheter inserted in case of prolonged operation and for postoperative pain control. The placement of an epidural catheter was without problem. Laparotomy revealed right paraovarian cyst torsion and the right salpingo-paraoophocystectomy was performed. Patient-controlled analgesia with epidural bupivacaine and fentanyl was effectively continued for two days. Postoperative course was uneventful and the triplets were delivered by cesarean section at 35 weeks.
Masui 2003 Sep
PMID:[Anesthesia for a woman with triplet pregnancy presenting with acute abdomen after the recent epidural blood patch]. 1453 Dec 58

Intussusception, although a common cause of pediatric surgical emergencies, is a rarely fatal condition. A 7-month-old infant who was discovered in her cot was unresponsive and pronounced dead after 2 h of uneventful cardiopulmonary resuscitation in an emergency hospital. Forensic autopsy which was performed in order to clarify the circumstances surrounding the death revealed intussusceptions at two sites of the ileum. Although morbidity and mortality rates from the condition have progressively declined in recent decades but avoidable deaths still occur as was experienced in the present case. The forensic pathology significance in this case was the occurrence of 'painless intussusception' whereby the affected child clinically exhibited no discomfort or characteristic features of acute abdomen until death. In summary, the present case has exhibited an uncommon fatal occurrence and demonstrated the importance of forensic autopsy in such unexpected sudden infant deaths.
Leg Med (Tokyo) 2003 Sep
PMID:Fatal intussusception in infancy: an experience in forensic autopsy. 1456 80

A growing body of clinical cases suggests that a kind of nematode larva, type X larva of the suborder Spirurina that inhabits firefly squids (Watasenia scintillans, or 'Hotaru-ika' in Japanese), can cause acute ileus in humans. However, the larva itself has rarely been found in the wall of the obstructed intestine. We describe here a case of acute ileus, in which a type X spirurina larva was found histologically. A 60-year-old Japanese man suffered from acute abdomen, and an emergency laparotomy revealed a marked stenosis of the ileum. Histological study of the surgically resected ileum showed severe eosinophilic enteritis and a nematode larva. The morphological features of this larva were identical to those of the type X spirurina larva. Interestingly, the larva that was found existed within a small blood vessel, suggesting that the larva migrans of type X spirurina can take place via vasculature. The patient in the present case did not recall ingesting raw squids prior to the onset of his disease. Hence, this indicates that even if the ingestion of raw firefly squids is uncertain, spirurina infection should be included in the differential diagnosis of acute ileus or eosinophilic enteritis.
Pathol Int 2004 Sep
PMID:Case of acute ileus caused by a spirurina larva. 1536 43

Over a three-year period 49 cases were admitted to our hospital with an acute abdomen in pregnancy due to cholecystitis. In this article we compare surgical treatment with medical treatment and consider the aetiology of the high prevalence. Out of the 49 cases admitted, 15 cases (31%) had emergency cholecystectomy within the first week and 34 cases (69%) were treated conservatively of whom 24 relapsed many times and had to be readmitted to the hospital (mean number of admissions was 4 +/- 1.4 and the mean hospital stay was 8 +/- 2.3 days) and of the remaining 10 on conservative management, three had emergency cholecystectomy and seven reached term safely. The maternal morbidity is significantly less in the surgically treated group (P < 0.0001) but the perinatal outcome failed to show any significant difference. The frequency of acute cholecystitis in pregnancy (0.33%) is high in comparison with other studies. Although tocolytics were used in 13 cases they did not improve the fetal outcome significantly and had maternal and fetal side effects. In conclusion early surgical intervention is recommended and the use of tocolytics did not improve the perinatal outcome.
J Obstet Gynaecol 1997 Sep
PMID:Is surgical intervention in acute cholecystitis in pregnancy justified? 1551 15

Cytomegalovirus (CMV) is an important cause of morbidity after solid organ transplantation. We report a case of CMV infection involving the transplanted duodenum that developed after simultaneous pancreas-kidney transplantation. The patient, a 30-year-old woman with insulin-dependent diabetes undergoing hemodialysis due to chronic renal failure, received a simultaneous cadaveric pancreas-kidney transplantation. The exocrine secretion was diverted using bladder drainage. Immunosuppression was maintained by a combination of tacrolimus, mycophenolate mofetil, and steroids together with OKT3 induction. Both the donor and the recipient were serologically positive for CMV IgG CMV prophylaxis consisted of a short course of parenteral gancyclovir. The patient was discharged on postoperative day 39 with normal pancreas and kidney function. She presented 2 months after transplantation with hematuria. Cystoscopic pancreas allograft biopsy specimens showed evidence of tissue invasive CMV infection in the graft duodenum and bladder. The CMV antigenemia test was positive. At 4 months after transplantation, the patient underwent surgery with the diagnosis of acute abdomen. The surgical findings consisted of a diffuse acute purulent peritonitis due to perforation of the duodenal graft. We sutured the perforation with nonreabsorbable material. The CMV antigenemia test was negative. Eight days later, the patient developed massive hematuria. At surgery, the graft was removed. The patient was discharged from the hospital with normal renal function. Pathological study of the removed graft showed the duodenal segment to have multiple wide ulcers with CMV inclusions in epithelial cells.
Transplant Proc 2004 Sep
PMID:Cytomegalovirus infection of the graft duodenum and urinary bladder after simultaneous pancreas-kidney transplantation. 1551 99

Although Meckel's diverticulum is the commonest congenital gastrointestinal anomaly, there is still debate concerning the proper management of asymptomatic diverticula. Records of all patients whose Meckel's diverticulum was resected at our hospitals between 1990 and 2002 were reviewed. Clinical characteristics, mode of presentations, and management for all patients were analyzed. Meckel's diverticula were resected in 68 patients. Patients were divided into two groups: the incidental group included 40 patients (24 males) in whom the diagnosis of diverticula was incidental. The symptomatic group included 28 patients (20 males) who presented with diverticulum-related complications. Preoperative diagnosis was possible in only four cases. In four patients from the symptomatic group, Meckel's diverticula were found and left untouched during a previous laparotomy. There was no significant difference between the two groups with respect to gender (p = 0.48). Patients in the symptomatic group were significantly younger than patients in the incidental group (p = 0.002). The diverticula in the symptomatic group tended to be longer (p = 0.001) with a narrower base (p = 0.001) than the diverticula in the incidental group. A diameter of < or = 2 cm was significantly associated with more complications (p = 0.01). Heterotopic tissue was present more significantly in the symptomatic group than the incidental group (p = 0.01). There was no significant difference in the morbidity rate between the two groups (p = 0.71), and there was no mortality in either group. Preoperative diagnosis of Meckel's diverticulum is difficult and should be kept in mind in cases of acute abdomen. Resection of incidentally found diverticula is not associated with increased operative morbidity or mortality.
World J Surg 2004 Sep
PMID:Meckel's diverticulum: comparison of incidental and symptomatic cases. 1559 67

Angiomyolipoma of the liver or kidney is one of the clinical manifestations of tuberous sclerosis complex. However, concurrence of angiomyolipoma in both liver and kidney associated with tuberous sclerosis complex is a rare entity. Renal angiomyolipomas with large aneurysms confer a higher probability of rupture as compared to small aneurysms. Herein, we document a case of tuberous sclerosis coexisting with hepatic and renal angiomyolipoma in a 37 year-old woman who presented with an acute abdomen due to ruptured tumor. Computed tomography of the abdomen revealed multiple tumors over the bilateral kidneys and liver. A right nephrectomy was performed. During surgery, a liver biopsy was performed from which a preliminary diagnosis of necrosis was established. However, immunoreactivity staining using monoclonal antibody HMB-45 (Human Melanoma, Black) led to the final diagnosis of angiomyolipoma. We emphasized that pathologists and clinicians should be aware that cases of tuberous sclerosis complex may be associated with renal and hepatic angiomyolipoma. To avoid an inappropriate diagnosis, before diagnosing liver necrosis, immunohistochemical staining for HMB-45 is recommended.
Chang Gung Med J 2004 Sep
PMID:Concurrent hepatic and ruptured renal angiomyolipoma in tuberous sclerosis complex. 1560 11

In the past, primary closes for perforated duodenal ulcer were not effective because of the high incidence of recurrence (42%), therefore most surgeons preferred definitive procedures to control acid production. Since the association of Helicobacter pylori with peptic ulcers and the effectiveness of the medication for acid control, definitive surgery is less frequently used. Today, primary closes of the perforation are the immediate alternative. Furthermore laparoscopic repair allows to perform the same technique than open surgery but with the benefits of the minimum invasion. The video shows the management of a 51-year-old woman who came to the emergency room with acute abdomen, leukocytosis, and fever. Laparoscopy showed peritonitis with apparent gastric perforation. Duodenal perforation was confirmed by endoscopy. Primary closes of the perforation, cavity cleaning, and placement of drainages were performed by laparoscopy. Evolution was excellent; the patient left the hospital 3 days after surgery. The contribution of laparoscopic and endoscopic surgery were shown to be highly beneficial for the patient, since an endoscopic view of the stomach and the duodenum was the pertinent approach to assure the correct perforation closes as well as to obtain diagnostic biopsy.
Surg Endosc 2004 Sep
PMID:Multimedia article: management of duodenal ulcer perforation with combined laparoscopic and endoscopic methods. 1580 42


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