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

Three children presented as acute surgical emergencies due to undiagnosed diabetes mellitus. Where diabetic ketoacidosis mimicks the acute abdomen three clinical features are important in reaching the right diagnosis-namely, a history of polydipsia, polyuria, and anorexia preceding the abdominal pain, the deep sighing and rapid respirations, and severe dehydration.
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PMID:Acute diabetic abdomen in childhood. 5 84

Occlusion of the celiac, superior mesenteric, and inferior mesenteric artery has been studied in 46 patients treated by operation. The condition was acute and was caused by embolic obstruction of the superior mesenteric artery in four cardiac patients and detachment of the inferior mesenteric artery in two patients during removal of infrarenal abdominal aortic aneurysms. The condition was chronic and involved two or all three of the vessels in 40 patient. Embolic obstruction caused severe abdominal pain but few physical signs early in the process,, but the picture of an acute abdomen indicating bowel gangrene developed in a few hours. Ischemia from inferior mesenteric detachment was observed at operation. Patients with chronic obstruction had abdominal pain, weight loss, and diarrhea. Patients with embolic obstruction were treated successfully by embolectomy, and patients developing intraoperative sigmoid ischemia were treated by reattachment of inferior mesenteric arteries to aortic graft. Various procedures were employed in patients with chronic multiple obstruction. However, graft bypass using Dacron tubing was preferable because of its simplicity and because the frequently (48%) associated occlusive disease and aneurysm of the distal aorta were treated at the same time. Confining operation to the abdomen significantly reduced the magnitude of operation and eliminated risks in this age group. Of the 46 patients, 91% survived and were relieved of their symptoms despite associated disease. The 5-year survival rate in this group of patients was 62%.
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PMID:Celiac axis, superior mesenteric artery, and inferior mesenteric artery occlusion: surgical considerations. 14 29

Four cases of spontaneous acute hemoperitoneum due to rupture of a liver tumor are presented. The resulting acute abdomen was the first manifestation of the neoplasia. The four tumors corresponded histopathologically to a cavernous hemangioma, a bening adenoma related to anabolizing androgens, and two hepatocarcinomas in cirrhotic livers. All of the patients presented abdominal pain and shock, the characteristics of which are described in this report. One of the patients died due to cardiac arrest before surgical treatment. Emergency surgery was performed on the other three, consisting of left hepatic lobectomy and ligature of the hepatic artery for the hemengioma, and segmented hepatectomy for the adenoma and the hepatocarcinoma. Only the patient with benign tumor survived. Lastly, the authors review the literature, commenting on the clinical, physiopathologic, therapeutic, and prognostic aspects.
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PMID:[Acute abdomen due to hemoperitoneum as the first manifestation of a liver tumor. Report of four cases (author's transl)]. 21 4

Hereditary angioedema (HAE) is characterised by episodic swelling of the extremities, face, larynx and recurrent abdominal pain, which can mimic the acute abdomen. Trauma of the larynx may result in acute airway obstruction. The management of emergency anaesthesia for Caesarean section of a patient with documented HAE is described and the special problems presented discussed. The methods of prophylaxis available are considered and the use of fresh frozen plasma advocated.
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PMID:Hereditary angioneurotic oedema. 44 16

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

86 plain films of the abdomen from 63 patients with acute mesenteric infarction were compared with plain films of 90 patients with acute abdomen of different origin. The airless abdomen, the increased thickness of the gut wall and the hairpin sign proved tbe nonspecific, but more pronounced and more frequent in mesenteric infarction. Gas in the gut wall and in the portal vein system was found only in mesenteric infarction. All 6 patients with gas in the portal veins died. The airless abdomen in a patient with severe abdominal pain is a surprising finding and points to the possibility of mesenteric infarction.
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PMID:[Abdominal plain films in mesenterial infarct]. 83 Dec 50

A study was performed to determine the value of peritoneal lavage in the acute abdomen not related to trauma. Lavage was performed in 33 patients in the evaluation of abdominal pain of sufficient degree to warrant consideration for surgical intervention. Peritoneal lavage was truly positive or truly negative in 64% of the cases. It showed false negative results in 28% and false positive results in 8%. The lavage was most accurate in the evaluation of appendicitis, colonic disease, and intra abdominal bleeding. It was highly inaccurate in the evaluation of cholecystitis and peptic ulcer disease. It was concluded that the peritoneal lavage can be a useful adjunct in the evaluation of patients with abdominal pain and should be considered in difficult diagnostic problems but not routinely employed.
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PMID:Diagnostic peritoneal lavage in evaluating acute abdominal pain. 113 36

18 patients were admitted from 1969 to 1973 to the Surgical and Urological University Clinic in Mainz with ruptured infrarenal aortic aneurysms. Three patients died immediately following the operation and three during surgery from internal hemorrhage. Eight patients died later following prolonged shock. Four patients survived surgery. The classical symptoms of shock, abdominal pain and pulsating tumor was only present in three patients. The diagnosis was only made in seven patients at admission, from the clinical findings. Urological symptoms were also prominent such as unilateral flank pain, colic, dysuria, anuria and tenderness over the kidney. There is no typical clinical picture of ruptured aortic aneurysm. Acute urological symptomatology in cases of acute abdomen with unclear etiology and in connection with shock could indicate a ruptured aortic aneurysm. There is absolute indication for immediate operative intervention. The aneurysm is removed and replaced by a vascular prosthesis. Early diagnosis is important since prolonged shock and anuria will result in a poor postoperative prognosis. Abdominal exploration is therefore also indicated when a ruptured aortic aneurysm is only suspected.
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PMID:[Urinary tract manifestations of ruptured infrarenal aortic aneurysms (author's transl)]. 120 8

Intussusception is one of the leading causes of bowel obstruction in early infancy and childhood. From 1984-1989, 67 patients under 2 years of age with intussusception were diagnosed and treated in our institution. There were 48 boys and 19 girls ranging in age from 2 months to 2 years with a mean of 7.4 months. Presenting symptoms and signs included abdominal pain (96%), vomiting (93%), rectal bleeding (60%) and a palpable mass (67%). Symptoms and signs were present for less than 24 hours in about 80% of cases. Most of the intussusceptions were of the ileocolic type (75%). The overall success rate of hydrostatic barium enema reduction was 49%. The highest rate of reduction by enema was among patients between 9 and 16 months of age (83%). The success rate of barium enema reduction was negligible after 24 hours of cardinal symptoms. Five children underwent surgical exploration without contrast studies because of delayed presentation and signs of an acute abdomen. A pathological lead point was found in only four cases, the commonest being Meckel's diverticulum. The average length of hospitalization was 2.57 days after barium enema reduction and 7.55 days after surgical reduction. There were no deaths. There was no case of perforation during enema reduction. Three children had recurrence within 3 months of initial presentation. The best outcome is associated with early diagnosis and barium enema reduction, or selected surgical intervention when indicated.
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PMID:Intussusception in children under 2 years of age in the State of Qatar : analysis of 67 cases. 137 79

A case of obstructive colitis associated with rectal carcinoma in a 56 year old Japanese man is reported herein. He presented to Shinkokura Hospital with severe abdominal pain following a one month history of anal bleeding and mild abdominal pain. On palpation, muscle guarding was observed in the left lower quadrant and the white blood cell count was 14,200/mm3. An exploratory laparotomy was performed under the provisional diagnosis of acute abdomen, which revealed localized peritonitis 8 cm oral to an area of rectal carcinoma. An anterior resection of the lesion was therefore performed together with a descendo-proctostomy. The histopathologic diagnosis revealed adenocarcinoma and obstructive colitis involving the entire thickness of the sigmoid colon and resultant fibrino-purulent peritonitis. His post-operative course was uneventful and he was continuing to do well on the 30th postoperative day, at the time of writing. The clinical significance of this combination of obstructive colitis with rectal carcinoma is briefly discussed following the presentation of this case.
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PMID:A case of localized peritonitis caused by obstructive colitis proximal to rectal carcinoma: a rare manifestation of obstructive colitis. 139 36


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