Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 8-year-old boy presented at UCLA Hospital with a one month history of hypertension prior to suffering a sudden onset of acute abdominal pain, rectal bleeding, peritonitis, and shock. Sigmoidoscopy showed diffuse mucosal friability. At laparotomy, inflammation and edema of the entire colon and terminal ileum were detected with two necrotic areas on the cecum. A 5 cm right adrenal pheochromocytoma with a hemorrhagic center was removed and a diverting loop ileostomy with inversion of the necrotic cecal areas was performed. Postoperatively, the blood pressure gradually returned to normal, and the colitis improved. Serum calcium and T3 T4 levels were normal. Review of the literature demonstrates that in patients with pheochromocytoma, progression from colitis to necrosis can be precipitated by a hypotensive episode. This patient suggests an example of catecholamine induced enterocolitis.
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PMID:Enterocolitis with peritonitis in a child with pheochromocytoma. 84 39

A case of a woman with pneumococcal peritonitis 3 months after insertion of a Nova-T copper IUD is described and the 5 other cases in the literature are reviewed. The 38-year old woman was multiparous, and had no related history other than recurrent right nephrolithotomy. She had acute peritonitis of 8 hours duration when admitted, with acute abdominal pain, fever, tachycardia and hypertension. She was treated with penicillin, gentamycin and chloramphenicol, and the IUD was removed. Her blood pressure fell to 70/40 and she developed acidosis and septic shock. Laparotomy, drainage, continued antibiotics, artificial ventilation and intensive hemodynamic treatment for 3 days were necessary to reverse coma and respiratory distress. Primary pneumococcal peritonitis only occurs in girls; in women it is though to arise from IUDs, pelvic infection or perhaps from the bowel. The other cases showed no preference for any type of IUD (3 Lippes loops, 1 Dalkon shield and 1 Gravigard) or length of use (1.5-5.5 years). 1 of the women died, and another had recurrent pneumococcal peritonitis. Therapy should include surgical drainage, instillation of antibiotics, and removal of the IUD.
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PMID:Severe pneumococcal peritonitis complicating IUD: case report and review of the literature. 354 5

Coarctation of the abdominal aorta was diagnosed in a pregnant hypertensive patient who presented with acute abdominal pain and fever. Extensive workup failed to establish another cause for the acute illness. Successful vascular reconstruction to correct renovascular hypertension and to bypass the coarctation was accomplished. The relationship of prgnancy to the symptomatology is discussed and evidence is presented which suggests that this case represents a variant of Takayasu's arteritis.
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PMID:Abdominal aortic coarctation and pregnancy. 610 72

Renal artery aneurysm is extremely rare among patients with systemic lupus erythematosus.(SLE). Herein, we report on a 22-year-old male lupus patient who presented with acute abdominal pain, anemia and subsequent hypertension. Abdominal computed tomography revealed a peri-renal hematoma over the right kidney. A renal angiography revealed bilateral renal microaneurysms. The patient subsequently developed a right-side retroperitoneal abscess 4 weeks after hematoma formation and received an emergent laparotomy with drainage. Subsequent culture ofthe abscess-derived fluid revealed the presence of Proteus mirabilis and Escherichia coli. Following appropriate antipyretic and immunosuppressive drugs therapy, the patient recovered successfully. To the best of our knowledge, this is the first report of SLE associated with a retro-peritoneal abscess probably secondary to a ruptured renal microaneurysm.
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PMID:Ruptured renal microaneurysms complicated with a retroperitoneal abscess for a patient with systemic lupus erythematosus. 1272 57

Gallstone ileus is a rare complication of gallstone disease, accounting for 1-4% of all bowel obstructions. The phisiopathology is related to the presence of a bilio-enteric fistula. Cholecistoenteric fistulae occur in fewer than 1% of patients with gallstone. We present the case of an 83-years-old woman, complaining of acute abdominal pain, vomiting and mechanical obstruction at admission. She reported a past history of hypertension, recent miocardial ischaemia, diverticular disease and cholelithiasis. A CT scan revealed aerobilia, gastric and duodenal dilatation and a gallstone impacted just beyond the duodeno-jejunal junction. An exploratory supraumbilical laparotomy was performed: revealing a 4-cm gallstone impacted just caudal to the Treitz ligament. We then performed an enterolithotomy. According to the literature, enterolithotomy is the most commonly used surgical technique, whereas enterolithotomy combined with cholecistectomy and fistulectomy is indicated only in selected cases. The clinical presentation depends on impaction site and generally includes abdominal pain, nausea and vomiting. Some cases may present haematemesis due to mucosal erosion. The gold-standard investigation technique is CT scan.
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PMID:Gallstone ileus: a case report and review of the literature. 1906 3

We report the case of a 56 years old male patient, smoker, obese, with untreated arterial hypertension, hospitalized on 16.02.07 with the diagnosis of inferior acute myocardial infarction, for which he received thrombolysis with streptokinase, followed by anticoagulation with non fractioned heparin. Two days later he started to complain of acute abdominal pain, and laboratory findings showed a low hemoglobin level. Imaging findings (ultrasonography and CT scan) showed evidence of subcapsular liver haematoma, caused by bleeding at hepatic and splenic level. He received red blood packed cells, fresh frozen plasma, cryoprecipitate, activated factor VII and was transferred by helicopter to Fundeni Clinical Institute--Intensive care unit (ICU). On admission, the patient was conscious, anxious, dyspneic, with mild hypoxia, with no signs of low cardiac output and with a painful abdomen. ECG, echocardiography and elevated myocardial necrosis enzymes confirmed myocardial infarction. Shortly after admission there was a worsening of his clinical condition, with a decrease in hemoglobin level despite red blood packed cells administration (Hb=7.8 g/dl) and thrombocytopenia (82000/mmc), with normal coagulation tests, thus suggesting active intraabdominal bleeding. Echography and CT scan confirmed bleeding. Emergency surgery was performed, showing massive haemoperitoneum (approx 4.5 L of blood), due to spontaneous rupture of a subcapsular hematoma in the liver. The surgical hemostasis was performed on the liver parenchyma laceration. Duration of surgery was 4 hours. There were no significant cardiac events during surgery (no signs of ischemia on ECG, no ST elevation), despite the need for inotropic agent. After surgery, the patient was referred to the ICU, intubated and ventilated, with inotropic support - dobutamine. Sequential ECG's, enzymatic trend and echocardiographies were performed to monitor myocardial ischemia. The outcome was favourable, no further bleeding and no postoperative myocardial infarction occurred. Secondary prevention was started early (thromboprophylaxis, selective beta-blocker, angiotensin inhibitors and statins). The patient had a favorable outcome and was discharged from the ICU the fourth day after surgery. He had a total length of stay in hospital of seven days, with a follow-up in the cardiology department.
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PMID:[Liver rupture of a subcapsular haematoma after pharmacologic revascularization (Streptokinase) for acute myocardial infarction--case report]. 1926 Jun 36

Because pregnancy is rare in women with end-stage renal disease, dialysis patients have not been reported to present with acute abdominal symptoms related to pregnancy including ectopic pregnancy. A 41-year-old woman treated with hemodialysis for over 18 years was brought to the emergency room at our institution because of acute abdominal pain. Ultrasonography detected an abdominal fluid collection, and her anemia had worsened (hematocrit 18%). Emergency laparoscopic exploration disclosed a hemorrhagic corpus luteum of pregnancy, causing ovarian bleeding on the left. Coagulation of bleeding points was carried out. At this time, pregnancy at 7 weeks of gestation was discovered. After the procedures, hemodialysis frequency was increased to 5 times weekly, and an erythropoietin derivative was administered to maintain a hematocrit above 30%. The patient developed no hypertension. At 33 weeks of gestation, cesarean section was performed because of a decrease in amniotic fluid and frequent late deceleration of the fetal heart rate. A live baby girl weighing 1,422 g was born. The successful pregnancy reflects remarkable progress in dialysis technology. Pregnancy, then, can underlie an acute abdomen in childbearing-age women (14 - 44 years old) undergoing long-term dialysis.
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PMID:A patient with pregnancy-related acute abdomen after hemodialysis for over 18 years. 1928 51

The aim of this study was to evaluate the anaesthetic assumption of responsibility of the surgery of the aneurism of under renal abdominal aorta. It was a retrospective study over two years (April 2005 - April 2007). Seven patients were operated, the mean age was 69,4 years. An operational pre evaluation was carried out among all patients including/understanding an interrogation, a clinical examination and a clinical assessment. All the patients profited from a general anaesthesia with controlled ventilation. Arterial hypertension (5 cases) was the independent factor of risk followed by the nicotinism (2 cases) with a patient at the stage of obstructive chronic broncho-pneumonopathy (BPCO). A patient was allowed in a table of rupture with acute abdominal pain and a cardiovascular collapse. Electrocardioscopic anomalies were noted among three patients with type of: HVD+ HBAG; HVG; HAG. A patient presented a hypertrophy cardiopathy with deterioration of the function of the VG and an important pulmonary arterial hypertension. A tensionnelle fall was found among three patients after induction with the midazolam. The aortic time of clampage varied between 20 and 120 mn with an average of 57, 6 mn. The incidents at the time of the clampage were: a bradycardia, a hypertensive push and a hypotension. No incident was observed at the time of the declampage. The blood losses per operational were estimated on average at 1000 ml and the numbers of transfusion by patient was on average of 4 pockets. The post operative issue was simple among 5 patients. A surgical recovery was necessary in front of a case of thrombosis of prosthesis. An oligoanurie, an acute respiratory insufficiency was found at the patient admitted in a table of rupture. The intermediate duration of stay threw 11 days. The maintenance of a homodynamic stability per and post operational remainder a good strategy to prevent the operational complications post.
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PMID:[Anesthesia and recovery of infrarenal abdominal aortic aneurysm surgery]. 1966 89

We report on 2 cases of visceral arterial embolism presenting with acute abdominal pain. In neither patient a cause could be established on initial clinical, laboratory, echographic or radiological investigation. Both patients were subsequently found to have a mural thrombus in the thoracic aorta, with visceral arterial embolism. Each underwent a successful operative thrombectomy. Both patients had a normal underlying aortic intima at inspection. The first patient was a young male with no known diseases. He regularly used cannabis and tested positive on admission, an association not yet reported with aortic mural thrombus. He was found to have a slightly reduced protein C. The second patient was a middle aged man with non-insulin dependent diabetes, hyperlipidaemia, arterial hypertension and hyperthyroidism. He was found to have an underlying adenocarcinoma of the lung and received chemotherapy. He died due to his cancer, 4 months after first presentation.
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PMID:An uncommon cause of visceral arterial embolism in patients presenting with acute abdominal pain: a report of 2 cases. 2045 52

Spontaneous splenic infarction has been seen rarely in cirrhosis and portal hypertension. The clinical presentation can mimic other causes of acute abdominal pain. The diagnosis of the condition is based on clinical findings and splenic imaging. In recent years, ultrasonography and computed tomographic scan have gained in popularity for the diagnosis of splenic infarction. Most reported cases are of focal infarction, and treatment is mostly conservative. Herein, we describe a rare case of spontaneous splenic infarction in an elderly cirrhotic patient with portal hypertension who also had comorbidities. A 72-year-old female previously diagnosed with cirrhosis was admitted for left upper quadrant abdominal pain for two days. Her medical history included cryptogenic cirrhosis, congestive heart failure, chronic obstructive pulmonary disease, and hypertension. Physical examination on admission revealed a palpable splenomegaly. Abdominal ultrasonography revealed splenomegaly and a hypoechoic area with lobulated contours measuring 62 x 35 mm extending from the subcapsular area to the hilus in the middle section of the spleen. Abdominal computed tomographic showed a subcapsular hypodense lesion of the spleen measuring 64 x 58 mm. Doppler ultrasound revealed a wedge-shaped heterogeneous hypoechoic avascular area extending from the central zone to the lateral zone of the spleen. In our case, diagnosis of splenic infarction was made by computed tomographic and Doppler ultrasonography. Our patient received conservative treatment for the underlying diseases. Spontaneous splenic infarction must be kept in mind in cirrhotic patients with underlying comorbidities presenting with left upper quadrant pain.
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PMID:Spontaneous splenic infarction in an elderly cirrhotic patient with multiple comorbidities. 2316 8


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