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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous extraperitoneal haemorrhage is a rare but well-described complication of anticoagulation therapy. We report a case of spontaneous rectus sheath haematoma in a 69-year-old Chinese woman who had received low-molecular-weight heparin for pulmonary embolism. She presented with sudden onset of lower abdominal pain, hypotension and a tender lower abdominal mass after 1 week of anticoagulation therapy. Computed tomography revealed a huge right rectus sheath haematoma extending into the pelvis, and angiography demonstrated active contrast extravasation from the right inferior epigastric artery. Arterial embolization with Gelfoam was performed and succeeded in stopping the bleeding. Transcatheter arterial embolization can be an effective and safe modality to localize and treat the bleeder in spontaneous extraperitoneal haematoma for high-risk patients.
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PMID:Transcatheter arterial embolization of spontaneous rectus sheath haematoma in a Chinese woman. 1833 69

A case of intra- and retroperitoneal haemorrhage after a splenic vein aneurysm rupture is described. A 27-year-old woman complained of chest pain on her first postpartum day. Symptoms were initially suggestive of pulmonary embolism, but within 3 h she developed severe acute abdominal pain, abdominal distension and haemodynamic instability. Ultrasound demonstrated a non-echogenic mass in the abdomen suggestive of a fluid collection and a computed tomography scan confirmed the presence of a lesion at the pancreatic tail. Urgent laparotomy revealed splenic vein rupture near the pancreatic tail. Partial pancreatectomy and splenectomy were performed. The patient subsequently made an uneventful recovery. Histological examination revealed a splenic vein aneurysm and chronic inflammatory changes in the pancreatic tissue. Rupture of a splenic vein aneurysm is a rare event and the diagnosis may present difficulty because its presentation is similar to several other more common conditions. However, rupture of a splenic vein aneurysm should be suspected in any pregnant woman with unexplained abdominal pain or with clear signs of haemorrhage, as delay in diagnosis can have devastating consequences.
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PMID:Spontaneous splenic vein aneurysm rupture in the puerperium. 1868 14

Ovari an vein thrombosis (OVT) is an uncommon, life-threatening complication of pregnancy. OVT clinical presentation is similar to that of acute appendicitis, and the latter is therefore the suspected diagnosis in most cases. We describe a case of a 36-year-old woman experiencing deep vein thrombosis and pulmonary embolism during the course of pregnancy and presenting to the emergency department with sudden pain in the right lower quadrant and severe abdominal pain. This case illustrates the difficulty in diagnosing OVT, which should be considered in any pregnant woman with unexplained lower abdominal pain suggestive of acute appendicitis.
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PMID:Acute right lower quadrant abdominal pain as the presenting symptom of ovarian vein thrombosis in pregnancy. 1884 Jan 80

Up to 3% of patients receiving unfractioned heparin develop heparin-induced thrombocytopenia (HIT). We report on a polytrauma patient who developed severe HIT with bilateral pulmonary embolism. Lepirudin treatment resulted initially in rapid improvement. Ten days after discharge the patient complained of abdominal pain. A large subcapsular hepatic hematoma was diagnosed, requiring repeat surgery and ending in secondary sclerosing cholangitis. This process can potentially be avoided by regular tests of lepirudin concentration and coagulation.
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PMID:[Heparin-induced thrombocytopenia and liver hemorrhage following polytrauma]. 1921 29

Massive pulmonary embolism complicated by cardiogenic shock and severe abdominal pain represents both a diagnostic and therapeutic challenge. We present the case of a critically ill patient in whom acute abdominal ischemia, which was caused by splanchnic hypoperfusion secondary to critical ostial celiac trunk stenosis, manifested during the course of massive pulmonary embolism complicated by a cardiogenic shock.
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PMID:Critical ostial celiac trunk stenosis presenting as abdominal angina during massive pulmonary embolism with cardiogenic shock. 1925 47

Li Fraumeni Syndrome (LFS) is a rare autosomal disorder characterized by a familial clustering of tumors. Analysis of several series of LFS families have shown that 70% of such families are attributable to germ-line mutations in TP53. We report the case of a patient who had a first degree family antecedent of cancer in young ages. At the age of 31 years, the patient was operated of bladder papillary superficial carcinoma; five years later, he was treated for a high grade pleomorphe sarcoma of the left thigh and treated by surgery, adjuvant chemotherapy and radiotherapy. At the age of 38 years, after abdominal pain, radiologic examination reveled pancreatic tumor with bone and lymphatic metastases. The patient died one month later from pulmonary embolism. Sequencing revealed a germiline mutation of this patient that was confirmed in a member of his family in codon 1009C>T, protein Arg337Cys, exon 10 of TP53 gene this mutation was revealed in his nephew (died at the age of 20 from bone sarcoma).
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PMID:[Li Fraumeni syndrome: a case with multiple primary cancers and presenting a germline p53 mutation]. 2047 80

Spontaneous rupture of a splenic artery aneurysm is an uncommon and usually catastrophic event during pregnancy and puerperium. The mortality rate among pregnant women is very high at 75% with a fetus mortality rate of 95%. This report describes the clinical course of a 25-year-old woman with hemorrhagic shock four hours after elective Cesarean Section. Symptoms like hypotension, tachycardia, dyspnoe were initially suggestive of pulmonary embolism. Ultrasound demonstrated a nonechogenic mass in the abdomen suggestive of a fluid collection. Ruptured splenic artery aneurysm was recognized during the second emergency laparotomy for hemoperitoneum. Splenectomy was performed. The outcome for the patient was good. We underline that the only way to avoid a fatal event is to know and to think about this rare but very important complication in any woman with unexplained abdominal pain or with clear signs of haemorrhage during pregnancy or shortly after delivery.
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PMID:[Rupture of splenic artery aneurysm--life-threatening condition for women during pregnancy and after birth (with report of one case)]. 2073 69

Venous and arterial thromboembolism are both serious extraintestinal manifestations of inflammatory bowel disease (IBD). Acquired risk factors seem to play a more prominent role than congenital in promoting thrombotic events. Prevention of thromboembolism is thus mainly aimed at minimizing the acquired/reversible risk factors (e.g., inflammation, immobility, hospitalization, steroid therapy, central intravenous catheters, smoking, oral contraceptives, and deficiency of B vitamins and folate). The diagnosis of venous and arterial thromboembolism is extremely challenging and requires a high degree of vigilance. Deep vein thrombosis and pulmonary embolism may be clinically silent or manifest with only few specific symptoms. Thrombosis of the portal vein system may occur with nonspecific symptoms such as abdominal pain, nausea/vomiting, abdominal tenderness, ascites, and fever. The diagnosis of arterial thromboembolism may also be challenging, particularly when the splanchnic region is involved. Indeed, arterial thrombosis of the splanchnic region tends to be overlooked and misinterpreted as a clinical exacerbation of IBD. Early diagnosis plays a central role in optimizing the therapeutic intervention and reducing the risk of short-term and long-term thrombosis-associated complications. The decision regarding the duration of systemic anticoagulation must take into account the individual risk of intestinal bleeding.
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PMID:Thromboembolism in inflammatory bowel disease: an insidious association requiring a high degree of vigilance. 2145 56

Primary iliac vein aneurisms are extremely rare being described as anomaly, without any history of trauma, cardiovascular pathology or arteriovenous fistula. This clinical condition has a high rate of potentially fatal complications: pulmonary embolism; ruptured aneurism; deep vein thrombosis. There are only 7 cases of iliac vein aneurism described in the literature. We describe an additional case of a 59-year old patient presented with abdominal pain, right lower limb edema and palpable mass in the right iliac area. Ultrasound (US) revealed a liquid formation, confirmed by computed tomography (CT). Surgical removal of the aneurism with lateral venorrhaphy was performed. Postoperative evolution was uneventful. The patient is asymptomatic during 36 month follow-up.
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PMID:[Iliac venous aneurysm: a case report and review of literature]. 2169 69

In current practice, inferior vena cava (IVC) filters are commonly used in the prevention of pulmonary embolism. Despite their widespread use, periprocedural as well as late complications do occur. Filter penetration of the IVC wall into surrounding structures, including bowel, is a known although rare complication. This complication may manifest with abdominal pain, gastrointestinal bleeding, duodenocaval fistula, or small bowel obstruction. The authors present a case of abdominal pain from duodenal penetration by a Greenfield IVC filter 13 years after insertion. A detailed operative description and pertinent review of the literature is provided.
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PMID:Late gastrointestinal complications of inferior vena cava filter placement: case report and literature review. 2246 55


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