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

A patient, born in 1961, is hospitalised for pubic abdominal pain with irradiation to the right and left sides. She has a Turner's syndrome. At first evaluation, an abdominal tomography demonstrates a right pyelonephritis. The patient is treated with quinolones and she evolves favourably, except that she continues to present some abdominal pain. She leaves the hospital, but because of permanent abdominal pain, a new abdominal tomography is performed: an aortic dissection type B for (Stanford), or III anterograde for (De Bakey), is diagnosed. Cardiovascular anomalies are frequent in Turner's syndrome. Aortic dissection is a rare complication. Histological analysis shows a cystic medial necrosis. Medical and cardiological follow-up is needed.
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PMID:[Clinical case of the month. Turner's syndrome and aortic dissection]. 1702 Feb 28

Aortic dissection and aneurysm are related to increased vulnerability of the aortic wall due to arteriosclerosis. Echographic findings of aortic sclerosis include irregularity and strong punctate echoes in the intima and meandering of the aorta. Unruptured abdominal aneurysms are often found incidentally by routine echography. The "maximum diameter" and "increase in the size" of aortic aneurysm on echography are important information closely related to the risk of its rupture. In the evaluation of acute aortic dissection, the flap length indicates the range of dissection. The presence or absence of blood flow in the false lumen must be examined simultaneously using color Doppler echography. Some aortic dissections and aneurysms require emergency treatment on detection, and the evaluation of their images on echography, which is often performed for screening of patients with back or abdominal pain, are important for the determination of the therapeutic approach. In patients who are treated conservatively or observed, echography is very useful for the follow-up. Such patients must also be diagnosed or followed up by combining echography with other imaging techniques depending on the condition and necessary information in each patient.
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PMID:[Evaluation of aortic aneurysm and dissection by abdominal echography]. 1739 Jul 16

Aortic dissection is often a catastrophic, life-threatening condition that may not always present with symptoms. Without intensive treatment, the mortality within the first 2 weeks of onset is reportedly as high as 80%. Acute aortic dissection classically presents with the symptoms of abrupt chest pain that sometimes radiates to the back, abdominal pain, or back pain alone. The patient may be cool and clammy, which is indicative of a shock syndrome. It can be associated with neurologic sequelae in as many as one third of all patients. Painless dissection occurs in approximately 5% of patients, and the diagnosis may often be delayed. We report a case of aortic dissection where the patient presented with a history of accidental fall and a new onset of flaccidity of the left lower limb.
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PMID:Acute aortic dissection presenting as case of accidental falling with flaccidity of left lower extremity. 1904 51

Aortic dissection is a catastrophic illness that is a significant source of liability for hospitals if diagnosis and treatment are not done promptly. The diagnosis is often difficult to make because not all dissections have the typical presentation of sudden severe chest pain radiating to the back. Symptoms often include abdominal pain, flu-like complaints, vomiting and diarrhea, low back pain, stroke syndromes and syncope. Patients at risk include those with Marfan syndrome and other connective tissue diseases, familial aortic disease, age and hypertension. Aortic dissection is a different clinical entity than abdominal aortic aneurysm. Strategies to reduce risk and improve outcome include staff education on various presentations and risk factors, rapid availability of diagnostic testing modalities such as chest CT scan or transesophageal echocardiogram, and protocols to ensure prompt transfer for cardiothoracic surgery.
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PMID:Case studies in acute aortic dissection: strategies to avoid a catastrophic outcome. 2019 21

Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
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PMID:Acute spontaneous isolated dissection of abdominal aorta. 2177 3

Aortic dissection is a rare and a life threatening event. Classically, aortic dissection presents as sudden, severe chest, back or abdominal pain that is characterized as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. So, a high index of clinical suspicion is mandatory for the accurate and rapid diagnosis of aortic dissection. We report a case of a 56 years old male who presented with signs and symptoms of myocardial infarction and was later found to have aortic dissection. This patient was successfully managed with surgery.
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PMID:Aortic dissection or myocardial infarction? 2220 91

Aortic dissection (AD) is a life-threatening condition that requires immediate diagnosis and surgical correction. Patients with acute AD usually present clinically with an insignificant medical history, leading to a high probability of misdiagnosis. The aim of the present study was to investigate the number of misdiagnoses of patients with AD in order to understand this problem and to avoid future misdiagnosis in the emergency department. Clinical data from 361 patients with AD admitted between January 2003 and June 2008 were reviewed as part of a retrospective chart review. Diagnosis of AD was made using either chest x-ray, computed tomography, magnetic resonance imaging, or angiography. Fifty-one patients had an initial misdiagnosis (14.1%), later found to have experienced AD. The condition may clinically present in a varied number of manifestations, including syncope, chest pain, abdominal pain, back pain, acute congestive heart failure, or alternatively with minimal symptoms. Persons of any age can experience an AD, with key clinical manifestations of pain. Echocardiography can be used for primary examination of patients with suspected AD; however, a definite diagnosis is usually made using computed tomographic or magnetic resonance angiography. Care should be taken, particularly in the emergency department, to maintain a level of suspicion for AD diagnosis in order to avoid the potential for misdiagnosis.
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PMID:Misdiagnosis of aortic dissection: experience of 361 patients. 2245 48

Kidney transplant is a last resort to increase the life expectancy and quality of life in patients with renal failure. Aortic dissection is a disease that requires emergency intervention; it is characterized by sudden life-threatening back or abdominal pain. In the case described, constant chest pain that increased with respiration was present on examination of a 28-year-old man (85 kg, 173 cm) who presented at our emergency department complaining of severe back pain. He had undergone a kidney transplant in 2004 from his mother (live donor). He was diagnosed with acute Type II aortic dissection and was scheduled for emergent surgery. Because there were no surgical or anesthetic complications, the patient with 79 and 89 minutes aortic cross-clamping and cardiopulmonary bypass durations was sent, intubated, to intensive care unit. When nephrotoxic agents are avoided and blood flow is stabilized, cardiovascular surgery with cardio-pulmonary bypass may be performed seamlessly in patients who have undergone a kidney transplant.
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PMID:Anesthesia Management in Aortic Dissection in Patients Undergoing Kidney Transplant. 2537 56

A 47-year-old man with diabetes and hypertension presented with sudden onset of chest pain and subsequently developed expressive aphasia. Brain imaging revealed multiple areas of ischaemic infarcts. Transoesophageal echocardiogram revealed aortic dissection with a free-floating thrombus on the dissection flap, which was the source of emboli. Given the poor prognosis, surgical intervention was not pursued and artificial support was withdrawn. Aortic dissection is a highly fatal condition with varied presentation including heart failure, myocardial infarction, neurological deficits, abdominal pain or acute renal failure. Aortic dissection is a relatively uncommon but catastrophic condition. A high degree of clinical suspicion is required for early and accurate diagnosis since mortality is high and increases by the hour. The mechanism for stroke in our case was due to an artery-to-artery embolism from a thrombus, which developed on the intimal surface of the dissected artery. This is an infrequent complication with a very unique mechanism.
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PMID:Dissecting the unspeakable: a fatal case of aortic dissection. 2607 7

Aortic dissection is the most catastrophic clinical condition that involves the aorta. It has a high mortality as well as high rate of misdiagnosis due to frequent unusual presentation. Typically, it presents with acute chest, back, and tearing abdominal pain. However, it can present atypically with minimal or no pain, making diagnosis difficult. Physicians should always suspect acute aortic dissection in patients with certain clinical conditions like difficult-to-control hypertension, giant cell arteritis, bicuspid aortic valve, intracranial aneurysms, simple renal cysts, family history of aortic disease, and Marfan syndrome, especially when a patient presents with ischemic symptoms involving multiple organ without an obvious cause.
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PMID:Painless Aortic Dissection-Diagnostic Dilemma With Fatal Outcomes: What Do We Learn? 2881 88


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