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

We report on 3 patients who presented with an acute onset of abdominal pain, a palpable abdominal mass and a rapid decrease in hemoglobin. In 2 patients a spontaneously ruptured hypernephroma was found and the other patient had a squamous cell carcinoma of the ureter with bleeding into the tumor. Although in all 3 cases the tumors were at an advanced stage of development, the patients had been entirely free of urological symptoms until shortly before hospitalization. The importance of considering the possibility of spontaneous rupture of such a tumor in the evaluation of cases of an acute abdomen is stressed.
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PMID:Spontaneous rupture of renal and ureteral tumors presenting as acute abdominal condition. 50 31

We report on 8 patients who presented with acute abdominal pain, palpable mass and a rapid decrease in hemoglobin. Intravenous pyelogram, ultrasound and computed tomography had been performed but the underlying cause of the perirenal hematoma couldn't be detected. Surgical exploration was decided and 6 total and 2 partial nephrectomies were performed. The pathological report revealed 4 adenocarcinomas and 4 angiomyolipomas. The possibility of spontaneous rupture of the kidney in the evaluation of cases of acute abdomen is particularly stressed.
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PMID:Diagnostic and therapeutic dilemmas in nontraumatic spontaneous perirenal hemorrhage. 185 27

We report on 5 patients who presented with acute onset of abdominal pain, a palpable mass, and a rapid decrease in hemoglobin. All 5 patients had been entirely free of urological symptoms until shortly before hospitalization. Spontaneous rupture of a kidney with an underlying pathological condition was found in all cases. In 2 cases the underlying lesion was renal cell carcinoma, while in the other 3 cases the lesion was a renal angiomyolipoma, a polycystic kidney and hydronephrosis secondary to UPJ obstruction, respectively. The importance of considering the possibility of spontaneous rupture of the kidney in the evaluation of cases of an acute abdomen is stressed.
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PMID:Spontaneous rupture of the kidney: a cause of acute abdominal pain. Case report. 259 30

Surgical therapy of the acute abdomen often allows only limited time for differential diagnosis to confirm the indication for surgery. Under consideration of clinical aspects and case history both common and rare causes of an acute abdomen should be investigated without undue loss of time. Differential diagnostic considerations and eventual therapy are presented in the following case of a 25-year-old Afro-american who developed multiorgan failure after an initial course of lower-back pain. In addition to the clinical setting of an acute abdomen the patient presented with acute respiratory failure and laboratory signs of severe hemolysis in combination with newly detected splenomegaly. The indication for splenectomy was made following CT-proven complete splenic infarction due to repeated acute squestration. Histologic examination of the spleen together with hemoglobin electrophoresis confirmed the clinical assumption of unusually late primary manifestation of a sickle cell crisis. In the underlying case, the hemoglobinopathy was in fact the less common form of combined sickle-cell-beta-thalassemia. A ten-day course of intensive care therapy was necessary to treat ongoing multiorgan failure due to persistent sickle cell crisis. Current diagnostic and therapeutic procedures in connection with sickle cell crisis as a rare cause of an acute abdomen with the necessity for surgical intervention are presented.
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PMID:[Differential diagnosis and therapy of acute abdomen in sickle cell crisis. A rare case in visceral surgery]. 1074 38

Pooling of blood in the spleen is a frequent occurrence in children with sickle cell diseases, particularly in the first few years of life, resulting in what is termed "splenic sequestration crisis." The spectrum of severity in this syndrome is wide, ranging from mild splenomegaly to massive enlargement, circulatory collapse, and even death. The diagnosis is usually clinical, based on the enlargement of the spleen with a drop in hemoglobin level by > 2 g/dl, and it is rare that imaging studies are ordered. However, in the patient who presents to the emergency department with non-specific findings of an acute abdomen, it is important to recognize the appearance of sequestration on imaging studies. We studied seven patients utilizing contrast-enhanced CT scans and found two distinct patterns--multiple, peripheral, non-enhancing low-density areas or large, diffuse areas of low density in the majority of the splenic tissue. Although radiological imaging is not always necessary to diagnose splenic sequestration, in those situations where this diagnosis is not immediately obvious, it makes an important clarifying contribution.
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PMID:CT imaging of splenic sequestration in sickle cell disease. 1114 89

Renal Angiomyolipoma (AML) is a rare benign tumor As it is usually asymptomatic and small, AML sometimes may cause acute abdomen by spontaneous rupture and hemorrhage that may be life threatening in some cases for which surgical management is necessary. A 58-year-old female patient was admitted for right side and right upper abdominal pain, nausea and vomiting. Right upper abdominal and right side sensitivity were remarkable on physical examination. Whole blood count revealed the ongoing with steady remarkable decrement in hematocrite and hemoglobin. Radiological examination showed right kidney mass with retroperitoneal hematoma. Patient underwent a right nephrectomy with mass excision. Her postoperative period was uneventful. On this case report we conclude that; angiomyolipoma may cause serious complications by the spontaneous rupture and life threatening hemorrhage. In case of massive hemorrhage and/or whole renal involvement, nephrectomy is the most feasible surgical treatment of all the other treatment methods.
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PMID:[Acute abdomen due to spontaneous renal angiomyolipoma rupture]. 1521 38

The spontaneous rupture of the uterine vessels during pregnancy is a potentially lethal complication that usually is not suspected as cause of acute abdomen in pregnancy. The clinical presentation is often sudden abdominal pain, accompanied by signs of hypovolemic shock and reduction in hemoglobin levels. The case of a 23-year-old woman at 22 weeks of gestation with acute abdomen is reported, without traumatic antecedents, and signs of hypovolemic shock. During exploratory laparotomy as hemoperitoneum cause, a laceration in the right uterine artery was found. Bleeding vessel was repaired to continue with pregnancy until 38 weeks of gestation.
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PMID:[Uterine vessels spontaneous rupture during pregnancy: case report and literature review]. 1879 22

Perivascular epithelioid cell (PEC) tumors (or PEComas) are myomelanocytic lesions defined by coexpression of melanocytic and muscle markers, suggesting dual differentiation. They are rare mesenchymal tumors and include subtypes with distinct clinical features: angiomyolipoma, lymphangioleiomyomatosis, and clear cell "sugar" tumors of the lung, pancreas and uterus. Consequent upon the World Health Organization's recognition of PEC-derived tumors as a distinct entity, an increasing number of reports has documented PEComas arising at various anatomical locations. Clear cell myomelanocytic tumors of the falciform ligament/ligamentum teres (CCMTs) represent a rare variant of the PEComas. These hepatic PEComas, different from angiomyolipoma of the liver, pose a clinical, radiological and morphological diagnostic challenge. Because of their rarity, the clinical features and biological behavior of these tumors have yet to be established. We experienced our first case of CCMT in a 36-year-old woman who presented to our emergency department with a 3-day history of abdominal discomfort and progressive growth of an epigastric bulk. Intralesional hemorrhage was causing abdominal distension, which progressed to acute abdomen soon after. The hemoglobin concentration was 9.9 g/dL. Liver laboratory tests showed slight elevation of AST, ALT and gamma-GT. The alpha-fetoprotein level was not elevated. The radiological images showed a hemorrhagic mass with some bizarre features in left hepatic lobe, immediately adjacent to the ligamentum teres and falciform ligament. The patient underwent a left hepatic lobectomy. The diagnosis of CCMT was based on histological and immunohistochemical staining. The postoperative course was uneventful. The patient received no adjuvant treatment and is currently, 34 months after surgery, alive and disease free. In this report we describe a peculiar and hitherto undescribed clinical presentation of this tumor and its further course. Moreover, we discuss previously undescribed diagnostic imaging. We recommend that all unusual carcinomas and mesenchymal tumors of the liver should be tested for HMB-45: when positive, there is a high likelihood of PEComa.
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PMID:Acute abdomen as an unusual presentation of hepatic PEComa. A case report. 1936 72

The primary malignant tumors of the small bowel are rare, representing 1 to 1.4% of all gastrointestinal tumors. We report a case of a 33 year-old women, admitted to our emergency department of visceral surgery for acute abdomen. The clinical examination revealed diffuse abdominal distension, defenseless, the hernia orifices were free and the rectal examination was normal. The biological test showed no hydro electrolytic disorders with normal hemoglobin and normal renal function. The abdominal CT-Scan showed signs of bowel obstruction due to a volvulus with intussusception without ischemia. The patient was operated urgently; the exploration has revealed a small bowel obstruction in the ileum with volvulus, an intussusceptum associated with a retractile mesenteritis, and the hepatic exploration found no metastases. The patient underwent a bowel resection taking away the intussusceptum with the infiltrated mesentery. The postoperative course was uneventful. The pathological result has proved a well-differentiated neuroendocrine tumor with five free nodes. Through this observation, we aim to highlight that an obstruction of small bowel with volvulus and intussusception could be exceptionally due to a neuroendocrine tumor, this complication has enabled a relatively early diagnosis in the absence of metastases and a 6-month follow-up without recurrence is a demonstration.
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PMID:Small bowel volvulus with intussusception: an unusual revelation of neuroendocrine tumor. 2660 Sep 6

Acute pancreatitis in pregnancy (APIP) is a rare but dangerous complication. APIP has common symptoms with acute abdomen. Assessment of an acute abdomen is more complicated during pregnancy because the gravid uterus could mask most of symptomatic signs. It has been a challenge to diagnose APIP by physical examination or diagnostic imaging. Case studies on APIP are also limited for analysis on the risk factors associated with the disease. This retrospective study evaluated a series of risk factors from a relatively substantial number of APIP cases to determine early predictors or prognosis markers for APIP.Fifty-nine APIP patients together with 179 random normal pregnant women in Shengjing Affiliated Hospital of China Medical University were included for this retrospective study. Medical parameters of blood test in biochemistry and hematology were compared between 2 groups using t test. Multivariate logistic regression analysis was performed to investigate the relationship between various factors and APIP using Statistical Applied Software (SAS student version).Compared with normal pregnant women, APIP patients have elevated values in alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen, creatinine, C-reactive protein, direct bilirubin, fibrin degradation products, gamma-glutamyl transpeptidase (GGT), glucose, lipase, pH and decreased values in albumin, fibrinogen, high-density lipoprotein (HDL), hemoglobin, low-density lipoprotein cholesterol (LDL-D), and total proteins from their blood tests. In addition, APIP patients have decreased numbers in red cells but increased numbers in white blood cells and increased ratio of neutrophil/lymphocyte (N/L). Among these factors, N/LR, GGT, lipase, and HDL are significantly associated with APIP. This study suggests that the combination of those factors serve as a panel of indicators for early-onset prognosis of APIP.GGT, lipase, HDL, and N/LR can serve as a panel of factors to predict APIP. More case studies are important to further evaluate the predicting power of this panel factors in APIP.
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PMID:Neutrophil-lymphocyte ratio, gamma-glutamyl transpeptidase, lipase, high-density lipoprotein as a panel of factors to predict acute pancreatitis in pregnancy. 2995 70


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