Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical presentation of an abdominal aortic aneurysm can be misleading. The typical triad of abdominal pain, pulsate mass, and hypotension may be absent. Delay in diagnosis is associated with a high mortality. Described in the article is a case of a ruptured abdominal aneurysm presenting as a large bowel obstruction. When found at surgery, the aneurysm had ruptured and was sealed by overlying colonic mesentery, along with retroperitoneal fascia. Elderly male patients who are smokers are believed to be at higher risk for atypical presentations from ruptured abdominal aortic aneurysms. This is thought to result from a generalized defect in collagen combined with diffuse atherosclerotic vascular disease. The diagnosis requires maintenance of a high clinical suspicion, in particular for those patients with higher risk factors.
 ...
PMID:Ruptured abdominal aortic aneurysm presenting as an obstruction of the left colon. 235 97

In an audit of 1190 emergency admissions with abdominal pain (1166 patients) in a general surgical unit, the diagnosis was non-specific abdominal pain (NSAP) in 415 (35 per cent), acute appendicitis in 200 (17 per cent) and intestinal obstruction in 176 (15 per cent). The largest number of admissions occurred in the age groups 10-29 years (31 per cent) and 60-79 years (29 per cent). Surgical operations were performed in 551 patients (47 per cent) and there was a 16 per cent incidence of unnecessary appendicectomy (22 per cent in the age group 20-29 years). Fifty-one deaths resulted in a 30-day hospital mortality rate of 4.4 per cent and a perioperative mortality rate of 8 per cent. The mortality rate increased significantly in patients aged greater than or equal to 60 years, and patients aged 80-89 years had a perioperative mortality rate of 20 per cent. The causes of perioperative death included laparotomy for inoperable disease (28 per cent), ruptured abdominal aortic aneurysm (23 per cent), perforated peptic ulcer (16 per cent) and colonic resections (14 per cent). The perioperative mortality rates for ruptured aneurysm and perforated ulcer were 71 and 23 per cent respectively. The duration of inpatient stay increased significantly with the age of the patients, including those with NSAP. The results of the study indicate a need to review the methods of management of ruptured aortic aneurysm and perforated peptic ulcer, the methods of diagnosis of appendicitis, particularly in young females, and the factors that determine the duration of stay of patients suffering from NSAP.
 ...
PMID:Abdominal pain: a surgical audit of 1190 emergency admissions. 259 64

The clinical courses of three cases with various alimentary tract malignant lesions coincidental with abdominal aortic aneurysm were reported. Of those three patients, a simultaneous resection of the malignant lesion and aneurysm was carried out in two patients, while an secondary abdominal aneurysmectomy following the resection of the malignant lesion was done in one patient. A 70-year-old man with cancer of the cecum and an infra-renal abdominal aneurysm, was diagnosed preoperatively, and a simultaneous right hemicolectomy and aneurysmectomy were carried out. In the other patient, a 77-year-old man, presence of the gastric cancer was incidentally found at laparotomy and a 75 percent gastrectomy and an aneurysmectomy were carried out. In the third patient, both gastric cancer and an abdominal aneurysm were detected preoperatively. Distal partial gastrectomy was performed first because of severe epigastralgia and an asymptomatic aneurysm. The abdominal aneurysmectomy was carried out six months later. All patients were treated by daily administration of Cefazolin sodium or cefalotin sodium (4-10 g) and Dibekacin sulfate (200 mg) for seven to ten days postoperatively. In the case of second look operation, however, Fosfomycin 2-4 g/day was added to the above mentioned drug following the aneurysmectomy. All tolerated surgery well without any signs of infections. The first patient died on the 57th postoperative day from panperitonitis carcinomatosa following an episode of intestinal obstruction. Selection of the operative approaches for patients having both an alimentary tract malignant tumor and an abdominal aortic aneurysm was difficult, although the initial surgical intervention for the more life threatening lesion would be better justified.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Surgical approach to abdominal aortic aneurysm with malignant alimentary tract tumor: report of three cases]. 374 94

To understand the surgical approach to acute abdominal pain, the internist must be familiar with common presentations of most abdominal emergencies; these emergencies include acute appendicitis, acute gall bladder disease (biliary colic, acute cholecystitis, and acute pancreatitis), ischemic bowel disease and ischemic colitis, abdominal aortic aneurysm, and intestinal obstruction. Nothing compares to experience; this article reviews the salient points that deserve consideration.
 ...
PMID:An internist's approach to acute abdominal pain. 837 23

The abdomen, as the largest cavity in the body, holds both fixed as well as relatively mobile organs, which when either diseased, traumatized, malfunctioning, or infected may present a wide and diverse range of signs and symptoms. Clues to the origin of abdominal pain can be well-localized or referred and quite obtuse. This article reviews the surface anatomy of the abdomen, the types of abdominal pain, approach to the patient with abdominal pain, and history-taking and physical examination. Adjunctive studies, which might help to reduce the differential diagnosis, are mentioned. The goal of this article is to help the reader formulate an accurate diagnosis in a timely manner via a complete but also well-focused physical examination; attention is paid to a comprehensive differential diagnosis to include common and not so common causes of acute abdominal pain. Intra-abdominal sources of abdominal pain include: peritonitis, bowel obstruction, and vascular disorders. Extra-abdominal sources of abdominal pain include the thorax, pelvis, and the abdominal wall. Some metabolic and neurogenic sources of abdominal pain are examined. Life-threatening causes of abdominal pain include ectopic pregnancy, acute myocardial infarction, abdominal aortic aneurysm, splenic rupture, and obstructed bowel. Discussion of these entities concentrates on the initial presentation of the patient, typical progression of symptoms, and appropriate initial treatment as well as referral. The process of ruling out emergent abdominal pain is also examined.
 ...
PMID:Primary care diagnosis of acute abdominal pain. 923 49

The advantages of aneurysm repair with straight tube graft were studied. Between January 1984 and March 1994, 277 patients with abdominal aortic aneurysm underwent operation using straight or bifurcated prosthetic grafts. Of those 277 patients, 37 patients (14%) received straight grafts and the remaining 240 patients received bifurcated ones. These two patient groups were compared in terms of influences of intraoperative aortic clamping, operative time, postoperative recovering condition, incidence of perioperative complications, and long-term results. Hemodynamic influences of aortic clamping were determined by the changes in systemic blood pressure. The duration of aortic clamping was significantly longer in the bifurcated graft group than in the straight graft group (p < 0.01). In addition, the elevation of blood pressure was significantly higher after aortic clamping in the bifurcated graft group than in the straight graft group (p < 0.05) although the blood pressure changes after release of the clamp did not differ significantly. The bifurcated grafts required significantly longer operating time than the straight grafts. There was a tendency for the patients of bifurcated grafts to suffer from complications associated with long duration of the laparotomy, such as pneumonia and bowel obstruction. During an average follow-up period of 5 years, only one patient had to undergo subsequent operation for an aneurysm of the remaining iliac artery. This patient had had a dilatation of the hypogastric artery 1.5 times as large as is normal in the first operation. The long-term results of the remaining 36 patients with straight graft was satisfactory and the remaining iliac arteries were found to be intact. It is concluded that the surgical repair with straight tube graft is a durable procedure for patients with abdominal aortic aneurysms as long as the dilatation of the iliac artery is limited to 1.5 times the normal dilatation.
 ...
PMID:Advantages of straight graft for abdominal aortic aneurysm repair. 978 17

The differential diagnosis of left lower quadrant abdominal pain in an adult man includes, among others, sigmoid diverticulitis; leaking abdominal aortic aneurysm; renal colic; epididymitis; incarcerated hernia; bowel obstruction; regional enteritis; psoas abscess; and in this rare instance, situs inversus with acute appendicitis. We report a case of situs inversus totalis with left-sided appendicitis and a brief review of the literature. There were several subtle indicators of total situs inversus present that were missed by the physicians and surgeons who initially evaluated the patient prior to surgery. Computed tomography scan with contrast, however, revealed the diagnosis immediately, and treatment was successfully initiated.
 ...
PMID:Left lower quadrant pain of unusual cause. 1126 11

Newer, minimally invasive catheter-based endovascular technology utilizing stent grafts are currently being evaluated for abdominal aortic aneurysm (AAA) repair. A retrospective review of all (3 years) consecutive, non-ruptured elective AAA repairs was undertaken to document the results of AAA surgical repair in a modern cohort of patients to allow a contemporary comparison with the evolving endoluminal data. One hundred twenty-one AAAs were identified in a male veteran population. Mean age was 68.5 +/-7.7 years. Medical history review showed hypertension in 55%, heart disease in 73.5%, peripheral vascular disease in 21%, stroke and transient ischemic attacks in 22%, diabetes mellitus in 7%, renal insufficiency in 10%, and smoking history in 80%. The AAA size was documented with ultrasound (5.2 +/-1.3 cm, n=40) and computed tomography (5.6 +/-1.3 cm, n=100). Fifty-nine percent had angiography. Intraoperative end points included an operative time of 165 +/-6.3 minutes from incision to dressing placement. A Dacron tube graft was used in 78%, the remaining were Dacron bifurcated grafts. A suprarenal clamp was used in 8% for proximal aortic control with juxtarenal aneurysms. A pulmonary-artery catheter was placed in 69%. A transverse incision was used in 69% of patients and a midline incision was used in the rest. Estimated blood loss was 1505 +/-103 mL; cell saver blood returned 754 +/-53 mL; crystalloid/Hespan 4771 +/-176 mL; banked packed red blood cells 0.75 +/-0.11 U. Time to extubation was, in the operating room (78.5%), on the day of the operation (5.0%), postoperative day (POD) 1 (12.4%), POD2 (1.7%), POD3 (0.8%), and one case was performed with epidural anesthesia only. Postoperative end points included a 30-day mortality rate of 1.6% (two patients). Postoperative morbidity included wound dehiscence 0.8%; sepsis, urinary tract infection, wound infection, leg ischemia, ischemic colitis, and stroke each had an incidence of 1.6%; myocardial infarction, congestive heart failure, pneumonia, re-operation for suspected bleeding, and ileus or bowel obstruction occurred with an incidence of 3.3%. No significant increase in serum creatinine levels was noted. Time to enteral fluids/nutrition was 3.5 +/-0.08 days. Patients were out of bed to a chair or walking by 1.3 +/-0.06 days postoperatively. The length of stay in the intensive care unit (ICU) was 2.0 +/-0.12 days and postoperative hospital stay was 6.6 +/- 0.33 days. Transfusion requirement for the hospital stay was 1.6 +/-0.2 U per patient. This review highlights a cohort of male veteran patients with significant cardiac co-morbidity who have undergone repair with a conventional open technique and low mortality and morbidity rates. This group had rapid extubation, time to oral intake, and ambulation. In addition, ICU and hospital stays were relatively short.
 ...
PMID:Abdominal aortic aneurysm repair. 1156 37

While ileus is common after repair of abdominal aortic aneurysm, small bowel obstruction is uncommon and duodenal obstruction is rare. We report a case of high-grade, mechanical obstruction of the third and fourth portions of the duodenum that required operative intervention. A review of the literature is included, with emphasis on the causes, diagnosis, and management options for duodenal obstruction associated with aortic reconstructive surgery.
 ...
PMID:Causes, diagnosis, and management of duodenal obstruction after aortic surgery. 1284 11

The purpose of this study was to evaluate the prevalence of radiographically detected abdominal wall defects (AWD) after open abdominal aortic aneurysm (AAA) repair and to correlate it with prospectively gathered clinical information. Fine collimation, high-resolution, serial follow-up computed tomography (CT) scans for 99 patients in the control group of the Guidant Ancure device trial were reviewed. CT scans were obtained at 12, 24, 36, 48, and 60 months. AWDs, defined as discontinuity of the fascial layer with protrusion of abdominal contents, were identified. Clinical information regarding AWDs was retrieved from the study registry. The prevalence of AWD exceeds 20% and plateaus at 24 months. Eight patients (8%) had clinical evidence of ventral incisional hernias. One patient underwent repair, but no other patient developed hernia incarceration or intestinal obstruction or required additional procedures related to the AWD. AWDs are radiographic findings occurring frequently after open AAA repair. Radiographic evaluation is more sensitive than clinical observation for detection of ventral hernias. Clinical events and reinterventions related to these radiographic abnormalities are rare.
 ...
PMID:Abdominal wall hernias after open abdominal aortic aneurysm repair: prospective radiographic detection and clinical implications. 1518 5


1 2 3 Next >>