Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnosis of hepatic abscesses in outpatients is accurate in hardly half of the cases. The rest of them are commonly taken for: acute cholecystitis, cholecystopancreatitis, pancreatitis, peritonitis, phlebitis of the splenic veins, intestinal obstruction, chronic enterocolitis, pneumonia, pleurisy. Misdiagnosis is usually attributed to the absence of pathognomonic symptoms and atypical course of a hepatic abscess. With right chest and hypochondrium pains of unknown origin and elevation of body temperature, diagnostic efforts should be directed to recognition of a hepatic abscess.
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PMID:[Diagnosis of liver abscess]. 233 34

A review of the literature is made on the problem of the acute surgical abdomen under conditions of thermic shock. Such basic nosologic entities, as acute ulcers, acute cholecystitis, thrombosis and embolism of mesenterial vessels and hematogenous peritonitis, which may be directly related to thermic burns, are given detailed consideration. Thermic trauma raises complex and diverse problems; one of the pathways to reduce the lethal outcome in patients with burns is to face the acute abdomen problem with adequate approach to the pathogenesis, diagnosis and treatment of each nosologic entity.
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PMID:[Acute abdomen and thermal burns]. 266 33

In a series of 120 patients with periarteritis nodosa (PAN), 50 had gastrointestinal manifestations; 34 had transient abdominal pain which regressed spontaneously or in response to corticosteroid therapy and required no further investigation. Thirty one more serious episodes occurred in the remaining 26 patients. Eight of these were in fact the initial signs of PAN and 13 required laparotomy. There were 20 episodes of abdominal pain (peritonitis: 9, pancreatitis: 4, acute cholecystitis: 2, duodenal ulcer: 3, intestinal infarction: 1, unexplained pain without diagnosis at laparotomy: 1) and 11 of gastrointestinal hemorrhage (melaena or hematemesis: 4; hematochezia: 5). Clinical and biological features of patients with and without gastrointestinal manifestation were not significantly different except for cardiac involvement which was significantly more frequent (p less than 0.05) in the second group. Corrected survival rates were significantly lower (p less than 0.05) in patients with gastrointestinal manifestations. These results show that, in patients with PAN, digestive manifestations, particularly perforations, carried a poor prognosis. Nevertheless exploratory laparotomy and surgery unrelated to PAN (eg appendicectomy) were well tolerated.
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PMID:[Digestive manifestations of periarteritis nodosa in a series of 120 cases]. 286 41

Seven cases of acute cholecystitis (4 women and 3 men, mean age 73 years) were observed in a series of 192 patients treated by endoprosthesis for cancerous obstruction of the bile ducts between october, 1984 and october, 1986. The suspected clinical diagnosis was confirmed by ultrasonography. Cholecystostomy was performed by percutaneous puncture under ultrasonic guidance. A catheter was positioned in the gallbladder by the Seldinger technique in 3 cases and by the trocar technique in 4 cases. Pain in the right hypochondrium was relieved in all patients immediately after emptying of the gallbladder. Five patients were cured. One patient developed purulent peritonitis which was treated by surgery. A female patient died of her pancreatic cancer 3 days after cholecystostomy. Provided a number of precautions are taken to prevent leakage of the infected bile into the peritoneal cavity, percutaneous cholecystostomy is the treatment of choice for acute cholecystitis consecutive to biliary endoprosthesis.
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PMID:[Acute cholecystitis after placement of biliary endoprosthesis. Treatment by percutaneous cholecystostomy]. 296 50

A case of primary malignant melanoma of the gall bladder is reported, in which a 29 year old man presented with acute cholecystitis which led to perforation of the gall bladder and biliary peritonitis. To help in the differentiation between primary and secondary malignant melanoma in the gall bladder and to overcome some of the difficulties posed by the clinical identification of what is often a small or relatively inaccessible primary tumour, it is suggested that certain criteria should be fulfilled before primary melanoma is diagnosed. (i) Tumours must be solitary and arise from the mucosal surface of the gall bladder; (ii) they must either be papillary or polypoid; (iii) they must either display junctional activity or have any other primary sites excluded by history taking, examination, and investigation. If these criteria are applied to the published case reports of primary malignant melanoma, only six cases, including the present one, can be regarded as true primary tumours.
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PMID:Primary malignant melanoma of the gall bladder. 305 78

Pylethrombosis is thrombosis of the portal vein or any of its branches. Five cases have been serendipitously detected, four by computed tomography and one by ultrasonography. Two patients had abdominal sepsis. A third patient had apparent acute cholecystitis with choledocholithiasis. The last two patients had a hypercoagulable state, mesenteric venous thrombosis, and enteric infarction that required resection. The newer diagnostic modalities of computed tomography and ultrasound may document unsuspected pylethrombosis. Surgery may be required because of signs of peritonitis, enteric ischemia, or unresolved sepsis. Anticoagulation is indicated for acute thrombosis of the portal or superior mesenteric veins to prevent further extension and enteric ischemia.
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PMID:Pylethrombosis. Serendipitous radiologic diagnosis. 331 Sep 61

A retrospective study of 645 cholecystectomies performed in a surgical unit over a 10-year period is presented, of which 236 were carried out during an acute admission. Of these 236 cholecystectomies, 195 were performed for acute cholecystitis and 41 for acute gallstone pancreatitis. In the acute cholecystitis group the proportion of patients over 70 years of age was significantly higher (35 per cent) than the corresponding elective group (10.3 per cent). Of those patients presenting with complications (empyema, gangrene, perforation, and biliary peritonitis) 51 per cent were over the age of 70 years. The most valuable investigation in the diagnosis of acute cholecystitis was ultrasound carried out within the first 48 h, with positive results in 83 per cent of those examined. The mortality for elective cholecystectomy was 0.5 per cent rising to 4.7 per cent in the urgent/early cholecystectomy group. The mean age of the 11 patients who died was 76 years, 8 of these patients being over the age of 70 years. The mortality in the subgroup of patients over 70 years was 10 per cent rising to 20 per cent in the over-80 age group. There were no deaths in the acute gallstone pancreatitis group. We conclude that emergency or early cholecystectomy is a safe procedure in patients under 70 years of age. However, patients over 70 years present with more serious complications of acute gallbladder disease which necessitate urgent surgery. We therefore recommend early cholecystectomy in patients over 70 years despite the high attendant mortality.
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PMID:Urgent and early cholecystectomy for acute gallbladder disease. 334 1

In 1969-1986 intraperitoneal accumulation of bile occurred in 21 patients after elective cholecystectomy or choledochotomy (n = 16) or percutaneous fine-needle cholangiography or biopsy (n = 5). The cause was established in all but one of the surgical cases, viz. T-tube removal (8), injury to the common bile duct (3), unrecognized aberrant bile duct (3) and leakage from liver biopsy (1). The intraperitoneal accumulation of bile led to laparotomy in 19 cases, when the median amount of bile found was 500 ml (range 100-3,500 ml). Mortality was nil, and only few and relatively minor complications could be attributed to the accumulation of bile--pleural effusion (2 cases), wound rupture (1), lower-limb venous thrombosis (1) and strictured hepatojejunostomy (1). There were no infectious complications. It is concluded that intraperitoneal accumulation of bile alone after elective surgical or invasive diagnostic procedures does not usually lead to severe complications, and that it seems distinctly less noxious than the bile peritonitis associated with acute cholecystitis.
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PMID:Isolated intraperitoneal accumulation of bile after surgical or diagnostic procedures. 342 Oct 5

Evaluation of 135 post-mortem reports over a period from 1953 to 1985 showed that 107 patients without adequate therapy for peritonitis had died of gallbladder perforation within 32 hours from surgery. Another 28 had died of gallbladder perforation following cholecystectomy. Forty patients had been hospitalised in moribund condition and died within 24 hours from admission. Three patients died of the consequences of undetected postoperative or posttraumatic cholecystitis, while another five died following appendectomy or herniotomy, after destructive cholecystitis in them had escaped detection. Cholecystectomy was performed on 28 patients for perforated destructive cholecystitis, and 25 of these died of peritonitis within 32 hours. Bronchopneumonia was the major cause of death of two patients and purulent cholangitis in a third case. Once early operation for acute cholecystitis had been introduced in 1965, no single patient was recordable from the post-mortem documentation who had died of the sequels of untreated gallbladder perforation below the age of 60.
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PMID:[Gallbladder perforation in an autopsy sample]. 382 26

This paper discusses ten patients who developed acute cholecystitis during the postoperative period following surgery which did not involve the gall bladder. All were examined with ultrasound during the first two weeks after surgery and were diagnosed as acute cholecystitis. Six (60%) had complications such as empyema, gangrene, perforation, pericholecystic abscess or localized peritonitis; four (40%) had no evidence of complications. The authors highlight the importance of ultrasound (US) as the technique of choice for a first screening if this entity is suspected because of its speed and high diagnostic reliability.
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PMID:Postoperative acute cholecystitis: sonographic diagnosis. 389 40


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