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

Acute abdomen is not a disease entity on its own but describes a critical state of the patient which can be caused by numerous diseases. The surgeon and internist have to apply an interdisciplinary approach to enable a rapid decision on whether immediate laparotomy is mandatory. Few appropriate diagnostic procedures support decision making. In many cases there is an indication for immediate surgery, such as perforated gastric or duodenal ulcer, acute appendicitis, diverticulitis, ruptured aortic aneurysm, mechanic ileus, infarction of the mesenteric artery. This review is mainly focused on diseases which may present as acute abdomen but for which surgery is usually not indicated, such as acute pancreatitis. Furthermore, one also has to consider rare diseases in which laparotomy would clearly be a mistake, such as acute intermittent porphyria or intestinal pseudo-obstruction.
Internist (Berl) 2005 Sep
PMID:[Acute abdomen]. 1596 64

The acute abdomen in the pediatric age group is not infrequently fraught with diagnostic pitfalls. The younger the patient, the more problematic the presentation can be. Among the more unusual manifestations of an acute abdomen is an apparent encephalopathic picture. We present 2 cases which serve to illustrate the diagnostic difficulties encountered.
Pediatr Emerg Care 2005 Sep
PMID:Neurological manifestations of an acute abdomen in children. 1616 Jun 64

Mesenteric inflammatory veno-occlusive disease (MIVOD) is a relatively recently known and not very often diagnosed form of ischemic bowel disease of low incidence und unknown etiology. We present the case of a patient who after presentation of inconclusive signs of epigastric pain and rectal bleeding suddenly developed right abdominal pain with local peritonism. Suspecting intestinal ischemia or perforated appendicitis we first performed laparoscopy, which showed an inflammable tumor of cecum, ascending colon and appendix with massive adhesions to the abdominal wall. We performed an open right hemicolectomy with primary anastomosis. The patient developed a deep vein thrombosis of the vena tibialis post. and vena saphena parva. After 12 months our patient is free of complaints and recurrence. Investigations carried out showed no evidence of hypercoagulopathy. The presentation of MIVOD can range from chronic inflammatory bowel disease with recurrent abdominal pain in combination with nausea, emesis and bloody diarrhea to acute abdomen. Therefore diagnostic misinterpretation and mistherapy as well as underdiagnosis is common. Histologic investigation shows a variable inflammatory infiltration of multiple veins of the intestinal wall and the mesentery as well as thrombotic vessel occlusion in different stages without involvement of the arteries. All forms of hypercoagulopathy, parasitic disease, sepsis and malignancy have to be excluded. Therapeutic success can only be achieved with surgical resection of the affected bowel, whereon in general no recurrence will occur.
Wien Klin Wochenschr 2005 Sep
PMID:[Mesenteric inflammatory veno-occlusive disease (MIVOD)--a rare cause of intestinal ischemia]. 1639 91

Superior mesenteric artery syndrome or cast syndrome is a recognised and reported complication of Kyphoscoliosis correction in orthopaedic surgery but much less published in the general surgical literature. The purpose of this case report is to review and highlight the occurrence, presentation and management of this unusual cause of the acute abdomen presenting as a general surgical emergency.
Ann R Coll Surg Engl 2005 Sep
PMID:The acute surgical abdomen following Kyphoscoliosis corrective surgery. 1640 59

Familial Mediterranean fever is an autosomal recessive disease characterized by recurring inflammatory attacks of synovial membranes. More than 95% of patients show peritoneal involvement which mimics acute abdomen and can sometimes cause unnecessary surgical intervention. The authors present two patients with the diagnosis of familial Mediterranean fever who underwent surgery because of rare abdominal complication of the disease. Two patients with the diagnosis of familial Mediterranean fever underwent laparotomy, and segmental small bowel resection was done because of the necrosis. Adhesive intestinal obstruction with associated bowel strangulation and volvulus is a rare complication of familial Mediterranean fever, and this life-threatening emergency must be kept in mind.
Turk J Gastroenterol 2006 Sep
PMID:An unusual complication of familial Mediterranean fever: intestinal volvulus and necrosis. 1694 Dec 62

A case of perforated gastrointestinal stromal tumor (GIST) of small intestine causing acute abdomen is described, with a brief review of the literature. A male patient presented with symptoms of acute abdomen. After evaluation, a laparotomy was performed, where perforation of a tumor in the ileum was found. The perforated part along with the tumor was resected and the cytopathological examination showed that the tumor was GIST. Postoperatively, the patient received treatment, using imatinib. Gastrointestinal stromal tumors are relatively rare and often present with vague symptoms. Their first clinical manifestation as acute abdomen due to their perforation is extremely rare. In emergency laparotomy, a R0 resection is required and adjuvant therapy with imatinib must be considered.
J Gastrointestin Liver Dis 2006 Sep
PMID:Perforated GIST of the small intestine as a rare cause of acute abdomen: Surgical treatment and adjuvant therapy. Case report. 1720 57

Primary omental torsion (POT), is a rare cause of acute abdomen commonly affecting obese male adults, whereas it is extremely rare in children. In this retrospective study, we present our experience regarding the management of five children with POT and discuss the diagnostic and therapeutic implications of this entity. We retrospectively reviewed the medical records of children diagnosed for POT, from January 1996 to July 2006 at our department. Among 2,734 children operated for acute appendicitis, five patients were diagnosed with POT (ratio 1:587 or 0.18%). Clinical presentation, laboratory findings, diagnostic imaging results as well as surgical and histological findings were reviewed. There were four boys and one girl, M/F ratio 4:1, with a mean age of 9.5 years (range 7.2-10.3). All subjects were obese and their weight percentages were over 85% for their age group. On admission the clinical symptoms and laboratory findings were similar to those of acute appendicitis. They were submitted to laparotomy and the surgical findings were; free serosanguineous fluid in the peritoneal cavity, normal appendix and an ischemic twisted mass of the omentum at the right side of the abdomen. The mass and the appendix were excised and the postoperative course was uneventful. The histological examination of the specimens revealed hemorrhagic ischemic necrosis of the omentum and normal appendix. POT is very rare in children. In the pediatric age group the clinical presentation and the laboratory findings are similar to those of acute appendicitis and it is extremely difficult to be diagnosed preoperatively. Obesity seems to be an important predisposing high-risk factor. Excision of the twisted omentum is the treatment of choice.
Pediatr Surg Int 2007 Sep
PMID:Primary omental torsion in children: ten-year experience. 1760 20

Primary appendiceal Burkitt lymphomas are rare occurring in 0.015% of all gastrointestinal lymphomas. Presentation of such lymphomas with peritonitis and obstructive jaundice owing to its subhepatic location is even more unusual. Burkitt lymphoma is very rare in children below 5 years old. We will present a 3-year-old boy with primary appendiceal lymphoma whose first symptom was obstructive jaundice caused by a ruptured retrocecal subhepatic appendix which in essence is a combination of all 3 mentioned occurrences complicated with acute abdomen.
J Pediatr Hematol Oncol 2007 Sep
PMID:Nonendemic Burkitt lymphoma presenting with an atypical clinical picture. 1780 48

Abdominal pain is an important and the most frequent symptom of acute gastrointestinal diseases; crucial hints on the diagnosis can be gleaned from its location and from associated symptoms and signs. As symptomatic therapy the treatment of pain plays a major role in acute gastrointestinal diseases, e.g. the acute abdomen, acute pancreatitis, biliary colic, peptic ulcer disease and diverticulitis. Acute pain arising from peptic ulcer disease is effectively treated with the H(+)-, K(+)-ATPase inhibitor omeprazole or one of the H(2)-receptor antagonists. While moderate to severe pain caused by these conditions can be effectively treated by intravenous administration of nonopioid analgesic drugs, supplemented by butylscopolamine in a biliary colic, more severe pain or inadequate responsiveness to nonopioid analgesic drugs requires the intravenous administration of a highly potent opioid. Acute severe pain arising from biliary colic and acute pancreatitis should be treated with an opioid that does not influence the sphincter of Oddi or the pressure in the common bile duct, e.g. buprenorphine, nalbuphine or tramadol. An effective but not widely known therapy for colic pain is parenteral administration of a nonsteroidal anti-inflammatory drug, e.g. indomethacin or diclofenac.
Schmerz 1993 Sep
PMID:[Treatment of acute gastrointestinal pain.]. 1841

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.
J Emerg Med 2010 Sep
PMID:Rectus sheath hematoma caused by non-contact strenuous exercise mimicking acute appendicitis. 1872 39


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