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

Seventy-four cases of acalculous cholecystitis in infants and children (seven personal cases and 67 from the literature) were analyzed. In 45 cases the cholecystitis appeared as a complication of another illness. The primary illnesses in our patients were leptospirosis (four cases), diarrhea (two cases), and third-degree burns (one case). All seven children were critically ill. Abdominal pain and an abdominal mass were present in all. Fever was present in six of the seven patients, jaundice in four. Tube cholecystostomies were done in all cases. After recovery from their illness, the five surviving patients had normal bilary tracts when studied by cholangiography via the tube. Acute acalculous cholecystitis in infancey and childhood as a complication of injury or illness should be treated as an undrained abcess.
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PMID:Acute acalculous cholecystitis. Complication of other illnesses in childhood. 113 Sep 99

Thirty-two patients with acute acalculous cholecystitis are presented. The age of the patients ranged from 1 to 80 years, with an average of 46.3 years. Acute acalculous cholecystitis occurred during the postoperative period in only four patients. Three patients were receiving total parenteral nutrition and 16 patients had one or more associated medical diseases. One patient had acute acalculous cholecystitis due to mechanical obstruction of the cystic duct caused by a diaphragmatic hernia. The most frequent signs and symptoms were right upper quadrant abdominal pain, nausea, vomiting, fever, abdominal mass, and jaundice. All patients were subjected to cholecystectomy. Nine (28.1%) gallbladder specimens had gangrene. Pericholecystic perforation was observed in four patients (12.5%) free perforation in one patient (3.1%), and empyema of the gallbladder in one patient (3.1%). Bacteria were cultured from 18 of 24 bile specimens. E. coli was the most common organism isolated. The overall postoperative mortality and complication rates were 15.6% and 40.6% respectively. The average hospital stay was 16.4 days.
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PMID:Acute acalculous cholecystitis. 193 1

A 74-year-old man developed bilateral arterial thrombosis of the lower limbs related to heparin-associated thrombocytopenia syndrome (HATS). On day 4 after thrombectomy of both limbs, abdominal pain, fever, hypotension, abdominal tenderness appeared. Acute acalculous cholecystitis was suspected and cholecystectomy was carried out although the gallbladder was not imflamed. Later on, hyponatremia in addition to the aforesaid signs suggested the diagnosis of adrenal insufficiency. Diagnosis was confirmed by low cortisol and aldosterone plasma concentration and by CT scan, which showen two enlarged adrenal glands. HATS might explain two unexpected facts: occurrence of adrenal hemorrhage during heparin therapy with coagulation tests within the therapeutic range and paradoxical thrombosis in the central vein of adrenal gland. HATS must be regarded as one cause of adrenal hemorrhage necrosis.
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PMID:Heparin-associated thrombocytopenia syndrome: an underestimated etiology of adrenal hemorrhage. 829 32

Acute acalculous cholecystitis is a relatively rare complication occurring after surgery on organs other than the bile duct system. It is often misinterpreted to be a post-operative symptom, and can progress into a very serious condition with high risk of mortality if gangrene and perforation develop. Its occurrence after open heart surgery is relatively rare. We experienced a case of acute hemorrhagic, gangrenous acalculous cholecystitis that developed after coronary-artery bypass grafting. The patient, a 78-year-old man, complained post-operatively of a right upper abdominal pain. The diagnosis of acute gangrenous acalculous cholecystitis was established on the basis of abdominal sonography and CT, and emergency operation performed was successful. Etiological factors in this case may have included post-operative stasis of bile, swelling of the gallbladder, hypotension during cardiopulmonary bypass, and post-operative anti-coagulant therapy administered after open heart surgery. These factors induced intracystic hemorrhage followed by sudden exacerbation, which resulted in gangrenous cholecystitis followed by perforative biliary peritonitis.
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PMID:[A case of acute hemorrhagic gangrenous acalculous cholecystitis with bile peritonitis during anti-coagulant therapy after coronary-artery bypass grafting]. 845 51

Acute acalculous cholecystitis (AAC) is a very serious complication which can be found in patients with multiple serious traumatic lesions ('polytrauma'). Very few patients have been reported in the literature with an acute spinal injury and associated AAC. We report seven patients with polytrauma and acute spinal cord injury who developed AAC. All had no complaint of the principal warning symptom: right upper quadrant abdominal pain. All presented with a palpable mass in this site and the laboratory results were compatible with cholestasis. The diagnosis of AAC was confirmed both by ultra sound and CT scanning. We discuss the possible precipitating factors and the treatment. One hundred and ninety one patients were admitted to the Intensive Care Unit in our Hospital with SCI over a period of 2 years, all of these in the acute stage. AAC was diagnosed in seven patients among them. Our purpose is to call attention to this clinical condition which can complicate the outcome of patients with multiple trauma and acute spinal cord injury. To date AAC in this group of patients has been infrequently described in the available literature.
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PMID:Acute acalculous cholecystitis in patients with acute traumatic spinal cord injury. 904 22

Acute acalculous cholecystitis (AAC) is a potentially life-threatening complication, which is sometimes found in patients with multiple injuries, burns, or after an operation. It is unclear, however, whether AAC occurs after cerebrovascular disease (CVD). We studied the incidence of AAC complicating CVD and the clinical characteristics of AAC that occurs after CVD. One thousand three patients with CVD were studied who had been admitted at the acute stage to Kenwakai Hospital from January 1989 through September 1995 and to Seguchi Hospital of Neurosurgery from January 1993 through September 1995. There were 557 patients with cerebral infarction, 273 with cerebral hemorrhage, 94 with subarachnoid hemorrhage, and 79 with TIA/RIND. Twelve patients developed acute cholecystitis, ten of whom had AAC. Of the ten patients with AAC, six had cerebral infarction, two cerebral hemorrhage, and two TIA/RIND. Eight of ten were male. The incidence of AAC was 1.0% in the CVD patients studied. The majority of the AAC patients showed severe hemiparesis. The time interval from CVD to the onset of AAC ranged from 1 to 89 days, with a mean of 25.1 days. AAC occurred 0 to 16 days (mean 5.8 days) after the start of oral or tube food intake in five patients. The most common initial symptom was fever (70%), whereas abdominal pain was infrequent (20%). All the patients showed elevated CRPs and abnormal ultrasonographic findings for the gallbladder and some also had leukocytosis (60%) and elevated aminotransferase of more than 100 IU/l (30%). Cholecystectomy was performed on four AAC patients, but five were successfully treated with antibiotics. The cause of AAC complicating CVD seems to be multifactorial and probably is related to fasting, increased bile concentration, and arteriosclerosis. Our results strongly suggest that AAC is an unrecognized but important complication during acute stage CVD patients.
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PMID:[Acute acalculous cholecystitis as a complication of cerebrovascular disease]. 921 20

Acute acalculous cholecystitis (ACC) is unusual. We present a case of cholecystitis associated with visceral leishmaniasis (VL) in a man in Venezuela who presented high fever, anorexia and abdominal pain. Histopathological study of the gallbladder showed Leishmania spp. ACC in VL must be kept in mind in tropical countries.
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PMID:Acalculous cholecystitis in a patient with visceral leishmaniasis. 1181 34

Acute acalculous cholecystitis is inflammation of the gallbladder in the absence of gallstones. It usually occurs in critically ill patients and is rare in the pediatric age group. We describe a 12-year-old boy who presented with fever, jaundice, and abdominal pain and was found to have acute acalculous cholecystitis, sacroiliitis, and pelvic osteomyelitis associated with bacteremia as a result of Staphylococcus aureus. Antibiotic therapy without surgical intervention was effective. A high index of suspicion is required to make an early diagnosis and institute appropriate treatment for children with this condition. Although cholecystectomy has been considered the standard therapy, medical treatment alone can be successful.
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PMID:Staphylococcal acalculous cholecystitis in a child. 1263 Jun 51

Acute acalculous cholecystitis is uncommon, but not rare. Classically, this disease is observed in the intensive care unit associated with major trauma, burns, or surgery. Moreover, comorbidity such as infection, hypertension, and diabetes mellitus is often found. Although the exact pathogenesis is still not fully understood, it may be multifactorial and ischemia seems to play a central role. We herein report an unusual case of acute alithiasic cholecystitis predisposing to a de Bakey type III aortic dissection. A 57-year-old man was referred to our hospital for investigation of persistent right upper abdominal pain with tenderness and fever, associated with a newly diagnosed aortic dissection treated conservatively. The diagnosis of acalculous cholecystitis, which is often difficult to establish, was particularly delayed. An open cholecystectomy was performed, revealing a preperforating gangrenous gallbladder without any stones. The patient was discharged from hospital 9 days postoperatively without any early or late complications. No operative treatment for the aortic dissection was needed.
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PMID:Acute acalculous cholecystitis associated with aortic dissection: report of a case. 1288 5

Acute acalculous cholecystitis is a very rare complication of typhoid fever, and may be due to multi-drug resistant and virulent forms of Salmonella infection. It is particularly rare in adults. A 21-year-old woman, presenting with fever, vomiting, diarrhoea and abdominal pain, was found to have acute acalculous cholecystitis due to typhoid fever on basis of ultrasonographical findings and a positive Widal's test for Salmonella typhi. She was treated with antibiotics and made a full recovery.
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PMID:Acute acalculous cholecystitis: a rare complication of typhoid fever. 1657 47


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