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

A case of obstructive colitis associated with rectal carcinoma in a 56 year old Japanese man is reported herein. He presented to Shinkokura Hospital with severe abdominal pain following a one month history of anal bleeding and mild abdominal pain. On palpation, muscle guarding was observed in the left lower quadrant and the white blood cell count was 14,200/mm3. An exploratory laparotomy was performed under the provisional diagnosis of acute abdomen, which revealed localized peritonitis 8 cm oral to an area of rectal carcinoma. An anterior resection of the lesion was therefore performed together with a descendo-proctostomy. The histopathologic diagnosis revealed adenocarcinoma and obstructive colitis involving the entire thickness of the sigmoid colon and resultant fibrino-purulent peritonitis. His post-operative course was uneventful and he was continuing to do well on the 30th postoperative day, at the time of writing. The clinical significance of this combination of obstructive colitis with rectal carcinoma is briefly discussed following the presentation of this case.
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PMID:A case of localized peritonitis caused by obstructive colitis proximal to rectal carcinoma: a rare manifestation of obstructive colitis. 139 36

A case of urinary undiversion in a 19 year old man with high ileal loop, who at the age of 1 year was inadvertently cystectomized for probable acute urinary retention masquerading as acute abdomen, is reported. The ileo-ceco-colonic segment was isolated and the colon was partially detubularized. After ileocecal intussusception and stabilization to the cecal wall (Hendren), a segment of ileal patch was applied to form an Indiana type pouch. The ileal loop was free from the abdominal wall and its distal end was anastomosed to the terminal ileum of the pouch. Undiversion was completed by connecting the pouch at its dependent portion with the remnant prostatic urethra. At 4 months postoperatively the pouch functions quite satisfactorily as a low pressure and good volume reservoir that empties well without reflux. His erectile and ejaculatory function have also been maintained.
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PMID:[Undiversion in a patient with ileal conduit using cecoileal urinary reservoir, a case report]. 156 31

We report a case of toxic megacolon manifesting in cytomegalovirus (CMV) colitis in a 55-yr-old man with steroid-dependent chronic obstructive pulmonary disease. He presented to the hospital with increasing dyspnea and low-grade fever. His hospital course was characterized by the poor response of his symptoms to treatment, and by the subsequent development of intermittent hematochezia and, eventually, acute abdomen. The surgical specimen showed dilatation of the cecum and ascending colon with a solitary mucosal ulcer in the latter. The major histologic changes were limited to the area of ulceration. In addition to classical CMV inclusions. vasculitis manifested in two forms, namely, leukocytoclastic type and fibrinoid necrosis. The patient died shortly thereafter, due to multi-organ system failure. To our knowledge, this represents the first reported case of toxic megacolon due to CMV infection without underlying inflammatory bowel disease. The pathogenesis of toxic colonic dilatation remains unknown.
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PMID:Toxic megacolon in cytomegalovirus colitis. 254 94

A 66-year-old man presented after having been involved in a motor vehicle accident. He was not wearing his seatbelt, and his vehicle had a deformed steering wheel after the incident. In the emergency department, his only complaint was mild right lower quadrant abdominal pain without signs of rebound or guarding. His laboratory and radiologic evaluations were unremarkable and he was observed in the intensive care unit. Nine hours after the accident, he developed an acute abdomen; exploratory laparotomy revealed a perforation of the gall bladder. Gall bladder injuries secondary to blunt trauma are infrequent events.
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PMID:Perforation of the gall bladder following blunt abdominal trauma. 382 18

An 87-year-old male patient known to have polycythemia vera presented at the hospital as an acute abdominal emergency. Ultrasonography of the abdomen revealed a homogeneous echogenic mass measuring 22 X 15 X 8 cm in fascial planes anterior to the peritoneum, which was consistent with a hematoma. His platelet count was 937,000/mm3. The patient responded to plateletpheresis and supportive management. Older patients with polycythemia vera may present as acute abdomen secondary to spontaneous abdominal wall hematoma. Computerized tomography or ultrasonography of the abdomen can aid in making the diagnosis and preventing unnecessary surgical intervention.
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PMID:Spontaneous massive abdominal wall hematoma in polycythemia vera. 643 15

Rotational gut abnormalities are generally considered a disease process of the neonatal and pediatric populations. However, they may first become manifest in teenagers and adults, often with disastrous outcomes. A case of a 15-year-old boy who presented in shock with an acute abdomen is presented. His symptoms had been mistaken for 1 week as gastroenteritis. At surgery, he was found to have a midgut volvulus. A differential diagnosis is discussed, as well as an anatomical review and typical symptomatology associated with midgut abnormalities.
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PMID:Midgut volvulus: an unusual case of adolescent abdominal pain. 816 89

A new technique of vertical gastroplasty was applied in 50 morbidly obese patients. Eight of them were male and 42 female with a mean age of 34 years (range 2058). The mean excess body weight was 77 kg (range 52-133) and the mean Body Mass Index 51 kg/m(2) (range 42-81). Under direct vision the hepatogastric and gastrophrenic ligaments were divided and two TA-90 doublerow staplers were passed together through the lesser sac vertically downwards from His angle parallel to the lesser curvature of the stomach. An additional TA-90 stapler was applied between the two double rows. The pseudopylorus was constructed 3-4 cm below the stomach angle by the use of two bands of silk No. 0 which were covered by stomach serosa, thus creating a reinforced outlet having the shape of a pylorus which we called 'artificial pseudopylorus'. The circumference of pseudopylorus was 4.8 cm and the total volume of the vertical pouch of stomach 15-20 ml. The percentage excess weight loss on the 3rd, 6th, 12th, 18th and 24th month postoperatively was 35, 51, 68, 80, and 82 respectively. One patient died 12 days after operation. One other patient was re-operated because of staple-line breakdown and acute abdomen formation. It is concluded that vertical gastroplasty with artificial pseudopylorus is a simple and safe method that avoids complications of other forms of gastroplasty, and is of value in the treatment of morbidly obese patients.
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PMID:Vertical Gastroplasty with Artificial Pseudopylorus: A Modification in the Treatment of Morbid Obesity. Early Results. 1074

A 19-year-old man was admitted with fever, haematuria, general malaise, pain on the left side of the pelvis and a full feeling in the left lower abdominal quadrant of the abdomen. His history mentioned a varices operation. During admission he developed an acute abdomen and deep vein thrombosis in both legs. CT of the abdomen showed a pathologic mass and absence of the vena cava inferior. Laparotomy revealed extensive thrombosis in widened veins. Clinical improvement occurred following adequate thrombolysis. Congenital absence of the vena cava inferior results from aberrant development during organogenesis. Patients are typically asymptomatic, but may present with venous insufficiency at a young age and deep vein thrombosis. Absence of the vena cava inferior can be accompanied by other congenital abnormalities such as dextrocardia and congenital heart diseases. Diagnosis is made using CT or MRI. Treatment consists of lifelong anticoagulant therapy and, if necessary, surgery.
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PMID:[Deep venous thrombosis as a complication of congenital absence of vena cava inferior]. 1192 15

We report a 23-year-old man who presented with acute abdomen. At laparotomy, he was diagnosed to have superior mesenteric artery thrombosis, with consequent extensive intestinal gangrene extending from the proximal jejunum till the mid transverse colon. He subsequently developed dry gangrene of the digits. Further evaluation showed that he had marked hyperhomocysteinemia. The gangrenous bowel was resected, and the homocysteine level normalized with folic acid supplementation. He is well at 1-year follow up. His brother, who was asymptomatic, was also detected to have hyperhomocysteinemia, which responded to folic acid.
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PMID:Hyperhomocysteinemia presenting as superior mesenteric artery thrombosis. 1587 60

A rare case of mesenteric lipoma was presented to us as acute abdomen. His abdominal x-ray showed dilated small gut. Ultrasonography of abdomen revealed dilated small gut loops and minimal amount of free fluid in the peritoneal cavity. On exploration, most of the small gut was gangrenous and tightly twisted twice around its mesentery that contained a lump which was confirmed as lipoma on histopathology.
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PMID:Mesenteric lipoma leading to small gut strangulation and short gut syndrome. 1592 47


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