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Pivot Concepts:
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Target Concepts:
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Query: UMLS:C0027497 (
nausea
)
23,468
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Among a variety of acute abdomens, acute torsion of omentum, first reported by Marchett in 1851, is least suspected under the impression of, most commonly, acute appendicitis and then acute cholecystitis,
mesenteric thrombosis
, ovarian cyst, perforated peptic ulcer, etc. A 52-years-old woman was admitted on May 2, 1987 with anorexia,
nausea
and RLQ pain for 2 days. Physical examination revealed tenderness, guarding and rigidity over RLQ. White cell count was 12.100/mm3. A reducible hernia was found in the right inguinal region. The operation through McBurney's incision showed blood-stained fluid. Appendix was slightly congested. A solid, gangrenous mass was palpated at right iliac fossa that disclosed a completely tight torsion of omentum twisting 6 times counterclockwise with distal infarction. Segmental omentectomy, appendectomy and hernioplasty were done. The patient's recovery was uneventful. This case emphasizes the necessity of routine examination of the omentum during the course of abdominal exploration especially when serosanguinous fluid was encountered in the peritoneal cavity.
...
PMID:[Acute torsion of greater omentum. Report of a case mimicking acute appendicitis]. 263 74
Mesenteric vein thrombosis
is generally difficult to diagnose and can be fatal. A case of extensive thrombosis of the mesenteric and portal veins was diagnosed early and successfully treated in a 26-year-old man with Down syndrome who was admitted to hospital because of abdominal pain, severe
nausea
and high fever. Ultrasonography revealed moderate ascites, and there was minimal flow in the portal vein (PV) on the Doppler examination. Computed tomography (CT) showed remarkable thickening of the walls of the small intestine and extensive thrombosis of the mesenteric, portal and splenic veins. Because neither intestinal infarction nor peritonitis was seen, combined thrombolysis and anticoagulation therapy without surgical treatment was chosen. Urokinase was administered intravenously and later through a catheter in the superior mesenteric artery. Heparin and antibiotics were given concomitantly. The patient's symptoms and clinical data improved gradually. After 10 days, CT revealed that collateral veins had developed and the thrombi in the distal portions of the mesenteric veins had dissolved, although the main trunk of the PV had not recanalized. The only risk factor of thrombosis that was detected was decreased protein S activity.
...
PMID:Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation. 1185 47
A 50-year-old man with abdominal pain,
nausea
, and vomiting presented at our emergency department. Physical examination revealed diffuse abdominal tenderness and absent bowel sounds. Computed tomography showed partial portal vein thrombosis extending to the right portal vein and the superior mesenteric vein, perfusion defects in the liver, and nonopacified intestinal segment after contrast injection. An emergency laparotomy was performed. The wall of the distal jejunum was edematous, congested, and a 10-cm jejunal segment was necrotic. A partial intestinal resection and a primary anastomosis were performed. Screening for thrombophilia revealed a heterozygote 20210 G/A mutation of the prothrombin gene. Anticoagulation was initiated. Computed tomography 45 days after surgery showed a complete dissolution of the thrombi and cavernous transformation in the main portal vein. His subsequent clinical course was uneventful.
Mesenteric venous thrombosis
which causes an intestinal infarction is rare, and also difficult to diagnose. However, a prothrombin 20210 defect should be considered in the differential diagnosis of patients with unexplained thrombosis.
...
PMID:Prothrombin 20210 G/A defect as a cause of mesenteric venous infarction: report of a case. 1734 69