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

Seven cases of rupture of an abdominal aortic aneurysm into the inferior vena cava are reported. In the management of this rare condition it is important to make the diagnosis preoperatively. Most cases show evidence of a large arteriovenous fistula which can, on occasions, dominate the clinical picture, e.g. cyanosed lower extremities or cardiac failure, but abdominal pain is the major feature. Careful examination of all patients with a ruptured aneurysm, particularly listening for an abdominal bruit, will usually allow the diagnosis of aortocaval rupture to be made.
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PMID:Aortocaval fistula associated with ruptured aortic aneurysm. 687 27

An unusual case of a ruptured abdominal aortic aneurysm is described. The patient presented with sudden abdominal pain and obstructive jaundice and was misdiagnosed as suffering from biliary colic. Two months later there was a pulsating mass in the abdomen palpated and the patient operated on. The only pathology which could explain the jaundice was an organized retroperitoneal hematoma extending from a small sealed rupture of the aneurysm towards the head of the pancreas and duodenum.
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PMID:Rupture of an aortic abdominal aneurysm presenting as painful obstructive jaundice. 722 93

Rupture of an abdominal aortic aneurysm continues to be the most imminently catastrophic situation facing the peripheral vascular surgeon. Without emergency resection the mortality is 100%, and in the past, even with operation, few patients have survived. Numerous recent reports continue to show mortality rates exceeding 50%. Our survival rates have been significantly improved by an aggressive, preplanned approach to all patients with abdominal pain and aneurysms. Mortality rates have improved from 69% for 22 patients operated on between 1962 and 1970 to 23% for 35 patients operated on from 1971 to 1978. Successful management requires coordinated effort by the blood bank, emergency room, and operating room facilities, as well as rapid and definitive operative technic to control and replace the aneurysm. Compression of the aorta at the diaphragm, systemic heparinization, and limiting the resection to the aorta whenever possible have proved useful.
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PMID:Improved survival after ruptured abdominal aortic aneurysm. 740 36

A 50 year old man presented with lower abdominal pain and hypotension of sudden onset. Emergency laparotomy for a suspected ruptured abdominal aortic aneurysm revealed the source of hemorrhage to be a ruptured vessel in the vascular pedicle of a large, oval tumor. This tumor had a unique appearance, lying virtually free within the abdominal cavity except for a 17 cm long umbilical cord-like vascular attachment to the greater omentum and a single fibrous adhesion to the anterior abdominal wall. Histologic examination disclosed the features of fibrosarcoma with a prominent population of myofibroblasts. Review of the literature yielded no previous examples of a similar pedunculated fibrosarcoma.
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PMID:Pedunculated fibrosarcoma. Unusual presentation of an intraabdominal fibrosarcoma arising from the greater omentum. 742 23

Abdominal aortic aneurysm is a condition affecting nearly 4% of the elderly population. It has a potential for producing a wide range of symptoms, including abdominal pain and back pain. The latter is particularly difficult to interpret in patients with chronic rheumatological conditions, and delayed diagnosis may be associated with a poor outcome. We present a patient with rheumatoid arthritis and chronic low back pain, who developed bilateral leg weakness and hesitancy of micturition, due to an abdominal aortic aneurysm invading the spine.
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PMID:Direct erosion of lumbar spine by an abdominal aortic aneurysm, resulting in paraparesis: unusual presentation. Case report. 747 45

The operative treatment of chronic contained rupture of a saccular abdominal aortic aneurysm (AAA) with retroperitoneal haematoma is reported. A 62-year-old man presented with a painless abdominal mass and intermittent claudication. He had an episode of severe abdominal pain about 2 years before admission. A giant retroperitoneal neoplasm was initially suspected, based on computed tomography. However, magnetic resonance imaging, angiography and colour Doppler sonography demonstrated chronic contained rupture of an AAA. A punched-out oval defect (width 3.5 cm x length 4.5 cm) that was thought to connect the thrombosed aneurysm to an organized retroperitoneal haematoma was discovered in the posterior wall of the bifurcation of the aorta at laparotomy. An infrarenal aortobiexternal iliac Y-graft with bypass to the left femoral artery was placed without removing the aneurysm or haematoma. Recovery was uneventful. The retroperitoneal haematoma appeared smaller on computed tomography about 1 year after operation. This case fulfilled the criteria for chronic contained rupture of an AAA proposed by Jones and associates.
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PMID:Chronic contained rupture of an abdominal aortic aneurysm. 760 13

In a retrospective study the value of sonography in the diagnosis of acute traumatic and nontraumatic conditions was evaluated. Records of patients who underwent emergency sonography during 1989 (group A, 159 patients) and 1991 (group B, 415 patients) were reviewed. In nontraumatic cases sonography confirmed the preliminary diagnosis in 43% and 50% of patients in groups A and B, respectively. In cases of acute abdominal pain with fever or leukocytosis, but without initial specific diagnosis, biliary disease was diagnosed in 3 group B patients; in a group A patient an abdominal aortic aneurysm was detected. There were positive sonographic findings in 42% and 17% of cases of blunt abdominal trauma in groups A and B, respectively. Sonographic evaluation of suspected splenic trauma confirmed the diagnosis in only 2 out of 9 patients in group B. Both studies show that sonography is a very effective, complementary, noninvasive method for evaluating patients with suspected acute surgical conditions. Sonography significantly reduced misdiagnosed biliary disease in cases of abdominal pain with fever or leukocytosis. In trauma, sonography obviated invasive diagnostic and surgical interventions in a significant number of cases. We recommend routine sonography in evaluating suspected, acute surgical conditions of traumatic or nontraumatic nature and in cases of undiagnosed abdominal pain with fever or leukocytosis.
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PMID:[Ultrasound evaluation of acute abdominal pain in the emergency department]. 775 Aug 49

A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes.
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PMID:Leaking mycotic abdominal aortic aneurysm. 799 59

Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.
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PMID:[Inflammatory aneurysms of the abdominal aorta]. 837 84

Aortic aneurysm infected with Campylobacter fetus spp fetus is rare, the first case having been reported in 1971. We present a case of abdominal aortic aneurysm, with a history of abdominal pain, fever and chills, with identification of this gram negative bacillus in the culture of the aortic wall and visualization of the microorganism in histological examination. Surgical correction was performed by interposition of a dracon prosthetic graft. The patient had a good postoperative course, receiving prolonged antibiotic therapy (intravenous cephalothin for 7 days and oral erythromycin for 6 months), remaining without symptoms for 12 months, when the follow-up was ended. In the 11 cases reported in the literature, 9 presented fever, suggesting the infectious etiology. Four were operated on with the aneurysm already ruptured and all of them died. The other patients, with non-ruptured aneurysms at the time of the operation, were all symptomatic, and they survived. Anatomic reconstruction was performed in 4 cases, with dacron graft interposition and antibioticotherapy, without reported signs of infection on the follow-up (6 to 45 months). Aortic infection with Campylobacter fetus spp fetus is potentially fatal, needing immediate surgical treatment. It is possible to have good long term results with an anatomically placed prosthetic graft and antibiotic therapy.
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PMID:[Abdominal aortic aneurysm infected with Campylobacter fetus spp fetus. Report of a case and review of the literature]. 857 95


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