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

Twenty-four pregnant women with acute appendicitis received exploratory laparotomy during an 8-year period. Abdominal pain accompanied with nausea and vomiting were the most common symptoms. Abdominal tenderness and rebounding pain were the most reliable physical signs. Leukocytosis with WBC count greater than 15,000/cu mm and granulocytes greater than 87% and prolonged symptomatic duration were indications that appendiceal perforation might have occurred. A McBurney's incision and spinal anesthesia were preferred for appendectomy during pregnancy. In cases of uncomplicated appendicitis, tocolytic agents and antibiotics were not routinely used. Premature labor occurred in 21% of patients during postoperative period.
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PMID:Appendicitis during pregnancy. 263 59

This retrospective study of 132 patients less than 12 years of age with Appendectomy done for Acute Appendicitis showed histological confirmation in 106 patients (80.3%) and a "negative appendix" rate of 19.7%. The appendix was perforated in 31 patients (23.5%). In those patients with confirmed Acute Appendicitis, males predominate (1.7 males: 1 female) and the peak incidence was in those 9 years of age or more. Abdominal pain was present in all patients except a 13 month old infant. Abdominal tenderness was also elicited in all patients except one. Fever was present in 83 patients (78.3%), vomiting in 82 patients (77.4%) and diarrhoea in 19 patients (17.9%). There were 2 deaths in this review, giving a mortality rate of 1.9%. Postoperative complications include wound infection (13.2%), pelvic abscess (0.9%), ileus (0.9%) and adhesion obstruction (0.9%).
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PMID:Acute appendicitis in Singapore children--some clinical aspects. 263 19

In a review of 22 years of clinical experience, we found seven previously healthy children with primary peritonitis. The diagnosis was made at laparotomy in all patients. Their symptoms included diffuse abdominal pain, fever, vomiting, and diarrhea. Abdominal tenderness was maximal in the right lower quadrant in five children, which led to confusion with the diagnosis of acute appendicitis. Streptococcus pneumoniae was identified as the etiologic agent in three patients and group A beta-hemolytic Streptococcus in one patient. The remaining three patients all had prior antibiotic therapy, and peritoneal fluid cultures were sterile. All children had a prompt response to treatment with antibiotics and recovered without complications. Long-term follow-up (4 1/2 to 15 years) was available for three patients; all three remained healthy.
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PMID:Primary peritonitis in previously healthy children. 638 16

A series of 19 patients who had amebic peritonitis secondary to rupture of an amebic liver abscess is presented. This represents 2.4% of the patients treated for ALA during an 18.5-year period. Eighty-four percent were men and ages ranged from 6 to 70 years. Rupture occurred prior to admission in 17 patients. Abdominal pain and fever were the most common symptoms. Abdominal tenderness, liver enlargment, distention, and jaundice were the predominant physical findings. All patients underwent operation. Removal of necrotic and purulent material combined with wide drainage were carried out. In two patients with amebic cecal disease, intestinal bypass was also done. The mortality rate was 42%. It was significantly increased in patients over 50 years of age and in those in whom a correct preoperative diagnosis was not made.
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PMID:Amebic peritonitis secondary to amebic liver abscess. 705 6

From July 1, 1972, to June 30, 1979, 149 patients with ectopic pregnancy were treated at Truman Medical Center. The history and physical findings, diagnostic procedures, etiologic factors and patient management were reviewed. Abdominal pain (98.6%), amenorrhea (74.1%) and irregular vaginal bleeding (56.4%) were the most common presenting symptoms. Abdominal tenderness (97.3%) and adnexal tenderness (98%) were the most common physical findings. Culdocentesis was performed in 118 cases and was positive for nonclotting blood in 94.1%. In 115 cases (78.2%) the ectopic pregnancy was ruptured prior to the time of admission. The incidence of diagnostic error was 35.9%. There were no maternal deaths; however, the incidence of morbidity was 26.5%. Our data reemphasize the need for a high degree of suspicion and early utilization of definitive diagnostic procedures if the morbidity and mortality of ectopic pregnancy are to be reduced.
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PMID:Ectopic pregnancy: a review of 147 cases. 709 61

An acute abdomen is a clinical condition characterized by severe abdominal pain that develops suddenly over several hours or less [1]. Abdominal tenderness and rigidity, either generalized or localized, usually are severe and indicate an urgent need for prompt diagnosis and treatment. The underlying cause of acute abdomen varies, and some cases require immediate surgical treatment, whereas for others, surgery is unnecessary or contraindicated. This need for prompt diagnosis and treatment should not preclude an appropriate investigation to establish the precise diagnosis before undertaking surgery [1, 2].
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PMID:CT of the acute abdomen: findings and impact on diagnosis and treatment. 799 21

Fifty-four cases of acute appendicitis were studied prospectively within a period of 11 months spanning between February-September, 1991 and December, 1991-February, 1992. The mean age was 25.4 years with a range of 8-70 years. Ninety percent of the patient were between 11-40 years of age. Male patients accounted for 54% of the cases. Students and civil servants accounted for 68%, while artisans and traders accounted for remaining cases. Low abdominal pain was present in all cases, loss of appetite in 77.7%, and previous history of abdominal pain in 76%. Abdominal tenderness was present in all the patients, rebound tenderness in 77.7%, guarding in 81.5% and Rovsings sign in 50%. In 12 cases (22%) the diagnosis was incorrect 8 of which were female patients. In 9.3% there was perforation. Wound infection and wound dehiscence occurred in 20.4% and 7.4% of the cases respectively. It is concluded from this study that acute appendicitis is commonly encountered in private Hospital, clinical course and postoperative outcome are not different from what obtained in major medical establishments.
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PMID:Acute appendicitis: a prospective study of 54 cases. 819 59

Acute appendicitis in pregnancy is the most common non-obstetric complication warranting emergency laparotomy. A retrospective study of 52 pregnant patients who underwent laparotomy for suspected acute appendicitis between June 1982 and June 1995 revealed a histopathological diagnosis in 29 (56%) patients. The hospital incidence for acute appendicitis in pregnancy was 0.09% (1 in 1102 deliveries). There were 10 (19%) patients who presented in the first trimester, 31 (60%) second trimester, 8 (15%) third trimester and 3 (6%) patients in the puerperium. Abdominal pain in the right lower quadrant was the most common presenting symptom. Abdominal tenderness and rebound tenderness were the most common physical signs, although the latter was less marked in late pregnancy. Preoperative laboratory investigations were equivocal in reaching a decision for surgical intervention. Laparotomy was performed within 24 hours of onset of symptoms in 67% of patients. Perforation of the appendix was found in 4 (14%) patients, all of whom had symptoms exceeding 24 hours. Wound infection occurred in 4 (9.6%) patients, 3 of whom had a perforated appendix. There were 2 (9%) fetal losses among the patients with negative laparotomies. Five (17%) other fetuses were lost in the group with diseased appendix, three of these were in patients with perforated appendix. There was no maternal death in the study.
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PMID:Acute appendicitis in pregnancy. A review of 52 cases. 902 94

A study was undertaken to determine the criteria for ordering abdominal computed tomography (CT) in the emergency department (ED) for stable patients who sustained blunt trauma and to identify a patient population at high risk for having intra-abdominal injury (IAI) utilizing physical examination, decrease in hematocrit, and hematuria. Patients in a university ED who had abdominal CT from April 1995 to October 1995 were evaluated prospectively. Before the scan, the examining physician completed an entry form that included physical findings, hematocrit, hematuria, Glasgow Coma Scale score, intoxication, distracting injuries, reasons for obtaining the scan, and planned disposition. Patients were followed until discharge. A total of 196 patients were evaluated. Abdominal tenderness was present in 120 patients. Twenty-two patients had IAI. Eight required surgical intervention, and all 8 had abdominal tenderness. A total of 40 potential trauma admissions were averted by obtaining CT within the ED. The combined abnormal abdomen examination and presence of hematuria had a sensitivity of 64%, specificity of 94%, positive predictive value of 56%, and negative predictive value of 95%. Decrease of > or = 5 in hematocrit was not statistically significant for detection of IAI. CT had no false negatives in this cohort. These results show that early CT scanning of stable patients who have sustained blunt trauma is an effective screen for IAI and may result in fewer total admissions, but has potential for overuse. Patients with abdominal pain and hematuria should be scanned. The benefit of a CT scan for patients without tenderness or with an isolated decrease in hematocrit is questionable.
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PMID:Computed tomography for blunt abdominal trauma in the ED: a prospective study. 967 45

A study of 441 ectopic tubal pregnancies treated at Harare Central Hospital between 1981-84 was carried out. During that time, there were 162,964 deliveries in the unit. The incidence of tubal pregnancy in this study was only 0.27%. Patients ranged in age from 13-46 years with the majority (67%) between ages 20-29. 88% of the patients were parous, the mean parity being 2.6 96% of the patients complained of abdominal pain, 78% of amenorrhea, and 64% of abnormal uterine bleeding. Abdominal tenderness (96%) and cervical excitation (91%) were the most significant signs. Paracentesis was positive in 78% of the cases. It was a little value in the diagnosis of chronic or unruptured tubal pregnancy. There was 1 maternal death.
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PMID:Ectopic tubal pregnancy in Zimbabwe. 1228 23


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