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

Retroperitoneal, mesenteric, and omental cysts are rare abdominal tumors occurring in approximately one of 105,000 hospitalized patients. These cysts have a similar pathogenesis that primarily may be ectopic lymphatic tissue. Retroperitoneal and mesenteric cysts can occur anywhere in the area between the duodenum and rectum but are most common in the small-bowel mesentery, especially the ileum. They can appear as chronic abdominal pain, a painless abdominal mass, or acute abdomen. The most common physical finding of a retroperitoneal or mesenteric cyst is a compressible abdominal mass, movable transversely but not longitudinally; omental cysts are freely movable. Diagnostic aids include abdominal computed tomography and ultrasound. The upper gastro-intestinal (GI) tract series, barium enema examination, and intravenous pyelogram exclude GI and genitourinary cysts and tumors. Treatment of choice is enucleation; resection of the adjacent bowel may occasionally be necessary. Morbidity and mortality should be very low because of modern surgical techniques and follow-up procedures.
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PMID:Retroperitoneal, mesenteric, and omental cysts. 673 94

During 1970-1976, 459 cases of primary carcinoma of the liver were admitted to the Department of Medicine, Siriraj Hospital, Thailand. Three hundred and two cases (66%) had associated cirrhosis. Fifty-five cases or 12 per cent presented with hemoperitoneum from ruptured carcinomatous nodules. In most of these, the presenting symptom were not dramatic and might be indistinguishable from other uncomplicated carcinoma of the liver. Only 2 cases presented as acute abdomen and 5 cases had severe abdominal pain for short duration prior to admission. Peritonoscopy were performed routinely in all cases with hemoperitoneum except the two cases which presented as acute abdomen. Fifty cases or 91 per cent had associated cirrhosis and the site of the rupture were visualized in 6 cases or 11.32 per cent. Fourteen patients were treated conservatively with the mortality rate of 100 per cent. Eight patients who presumably bled from coagulation defect were also treated conservatively with only 50 per cent mortality. Hepatic artery ligation was employed in 23 cases with 52 per cent mortality and bleeding stopped in 95 per cent, as compare with other conventional surgical measure such as packing, suture and cauterization to control the hemorrhage with 90 per cent mortality. Judging from our experience, hepatic artery ligation is of definite value for palliative treatment particularly in patient with hemoperitoneum from ruptured carcinoma of the liver.
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PMID:Intraperitoneal hemorrhage due to spontaneous rupture of primary liver cancer with particular reference to hepatic artery ligation. 742 31

Enteric intussusception is one f the most frequent causes of acute abdomen in early childhood, with an incidence of 1.3-2/1000 children born and higher frequency from the third to the twelfth month. Primary intussusception is related to predisponsing factors such as peristalsis disorders or Peyer's patch hypertrophy induced by viral infection. Secondary intussusception is due to organic injury in the intestinal wall. The most involved sites are the terminal ileum and the ileocecum, the most frequent type is ileocolic intussusception. Many clinical forms exist, including acute enteric intussusception with its pathognomonic triad intermittent abdominal pain, emesis and rectal bleeding and the atypical form with a neurological presentation, where sopor, myosis and muscular atonicity are dominating, Intussusception can also present in a subacute or chronic form with a slow and apsecific onset. In a retrospective investigation we examined 30 cases of intussusception in children hospitalized at the Pediatric Clinic of Pisa from the 1960s up to today. Our patients (16 males and 14 females) were aged between one month and two years. Clinical presentations resulted in; typical forms (60%), atypical forms (16%), subacute forms 13%) and recurrent forms (10%). Clinical suspicion was confirmed either by the presence of blood observed during rectal exploration, which is a pathognomonic sign, or by the opaque enema which led to recovery by means of hydrostatic reduction in 40% of the cases. The remaining patients (60%) underwent surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intestinal intussusception in children]. 747 46

We present herein the case of a 66-year-old woman with disseminated malignant melanoma in whom a metastasis in the ileal mesentery ruptured into the peritoneal cavity causing an acute abdomen. The patient suddenly developed lower abdominal pain and a computed tomography (CT) scan of the pelvis confirmed the presence of an intrapelvic abscess. At emergency laparotomy, a 10 x 10 cm ruptured metastatic melanoma was found in the ileal mesentery, which demonstrated no communication with the ileum itself. To our knowledge, no other case of an acute abdomen being caused by the rupture of mesenteric metastatic melanoma lacking any communication with the bowel lumen has ever been reported.
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PMID:Malignant melanoma with mesenteric metastasis causing an intrapelvic abscess: report of a case. 764 Apr 77

We investigated peripheral lymphocyte subsets in 34 consecutive acute pancreatitis patients (21 males, 13 females; mean age, 57 years; range, 16-85 years) studied within 48 h of pain onset and for 5 consecutive days to understand better the immunological response during the course of the disease. The diagnosis was based on characteristic abdominal pain associated with a twofold increase in serum lipase and confirmed by imaging techniques in all patients. Acute pancreatitis was of biliary origin in 25 patients, due to alcohol abuse in 5, due to pancreas divisum in 1, and of unknown origin in 3. Fifteen patients had severe illness and 19 had mild disease. In all patients, total lymphocyte and lymphocyte subset counts were carried out on admission, as well as on the third and fifth day of hospitalization, using a flow cytometric analysis. Twenty-three patients (13 with severe illness and 10 with mild disease) also had a repeat count 1 month after recovery. Twenty-five healthy subjects and 27 patients with nonpancreatic acute abdomen comparable for sex and age were studied as controls. On the first day of the study, the leukocyte number was significantly higher in patients with acute pancreatitis and in those with nonpancreatic acute abdomen with respect to healthy subjects, whereas the number of total and CD4+, CD8+, CD3+ DR-, and CD3- DR+ lymphocytes was significantly lower in acute pancreatitis patients than in healthy subjects or in patients with nonpancreatic acute abdomen. These subject counts persisted on the third and fifth days of the study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Circulating lymphocyte subsets in human acute pancreatitis. 766 48

Bleeding complications associated with anticoagulant drugs can development abdominal pain simulating acute surgical conditions of abdomen. We report six cases of intraabdominal spontaneous haemorrhage presenting as an acute abdomen in patients on anticoagulant therapy: two rectus sheath hematomas, a abdominal wall hematoma, a spontaneous hemoperitoneum, a retroperitoneal hematoma and an intramural hematoma of the small bowel. The article conclude that computed tomography examination provided useful information in this complications because can demonstrate the size and location of the mass and its relation to normal intra-abdominal structures. Finally, authors expose the surgical indications of the different bleeding syndromes in this patients.
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PMID:[Acute abdomen in anticoagulated patients. Its assessment and the surgical indications]. 766 21

Plain x-rays of the abdomen remain an integral feature of the diagnostic work-up in cases of acute abdomen. Chest x-rays, often recommended in the USA, are standard routine at only one third of Swedish radiology units. The article outlines the advantages of including chest x-ray in the abdominal examination: it facilitates the detection of pneumoperitoneum, it yields (pre-operative) cardiopulmonary information, and it may show abdominal pain to be of extra-abdominal aetiology. Regarding the latter point, a study of 555 cases showed the chest x-ray to yield valuable information in 14 cases.
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PMID:[Thoracic radiography is indicated in the examination of acute abdomen! The cause of abdominal symptoms may be found in the thorax]. 767 13

Over a period of 7 months a 51-year-old diabetic took mefenamine acid (up to 500mg 20 times daily), diclofenac and, more rarely, paracetamol for lumbosacral pain. In addition, dexamethasone (4 mg three times daily) was prescribed later. For 4 weeks he had colicky abdominal pain which then started acutely to radiate into the flanks. Pressure and rebound pain in the left epi- and mesogastrium, as well as the results of biochemical tests, suggested an acute abdomen. Abdominal X-rays, selective contrast examination of the small intestine and computed tomography demonstrated changes within some segments of the jejunum (thickened wall, irregular wall surface). Laparoscopy showed brown discoloration of the loops of the small intestine. In consequence of these findings a 10 cm long segment of the jejunum was resected. Histological examination showed extensive ulcers at the tip of the rugae with granulating inflammation and bifringent foreign bodies with giant-cells. The villi were extensively atrophied, the blood vessel were congested and the submucosa fibrosed. The patient was discharged after 9 days and, no longer taking NSAIDs, has been free of abdominal symptoms.
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PMID:[Segmental small intestine lesions after taking non-steroidal antirheumatic drugs]. 771 33

A 41-year-old woman with chronic myelogenic leukemia was scheduled to undergo transplantation of bone marrow. The patient complained of nausea and vomiting following the initiation of chemotherapy. One day prior to the planned termination of chemotherapy, the patient developed left-sided abdominal pain. Physical examination and imaging examination indicated the possibility of acute abdomen associated with bleeding or herniation. For therapeutic and diagnostic purposes, an emergency operation was performed. A 6 x 5 cm hematoma was detected within the left rectus abdominis muscle. It is suggested that the gastrointestinal symptoms should be carefully controlled in patients undergoing bone marrow transplantation.
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PMID:Rectus hematoma secondary to vomiting: a complication of conditioning regimen for bone marrow transplantation. 771 78

The role of laparoscopy has been reviewed for these conditions: abdominal trauma, acute abdomen, abdominal pain of uncertain etiology, appendicitis and the acute abdomen in the intensive care unit patient. Laparoscopy should only be performed in trauma patients who are hemodynamically stable and who have some evidence for abdominal injury, such as a positive peritoneal lavage or a positive CT scan. Laparoscopy is an excellent procedure for determining whether a knife or missile has penetrated the peritoneum. For penetrating wounds in the chest and upper abdomen, laparoscopy also allows excellent evaluation of the diaphragm. In blunt trauma, laparoscopy identifies the majority of injuries, but there has been a 5-15% incidence of missed injuries to the small bowel and colon. The acute abdomen is generally caused by perforation, acute inflammation or intestinal obstruction. Of the various types of perforation, diagnostic and therapeutic laparoscopy is most applicable for duodenal perforation. Acute perforation of the stomach and colon should probably be treated by standard open techniques. For acute inflammatory disorders, laparoscopy is an excellent diagnostic tool and can also provide definitive treatment in the form of drainage of an abscess or appendectomy. The role of laparoscopy for ileus and bowel obstruction is controversial; some surgeons advocate diagnostic laparoscopy and treatment, while many others still consider bowel obstruction and abdominal distention to be contra-indications. Finally, there are the intensive care unit patients in whom an acute intraabdominal process is suspected. Laparoscopy in such patients alters the clinical management in about 50% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Laparoscopy for abdominal emergencies. 777 7


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