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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1977 and 1988, 155 patients with abdominal aortic aneurysm in the Dumfries and Galloway health region were traced. One hundred and six patients underwent surgery; 57 elective operations for non-leaking aneurysms were performed locally without mortality, and of the 49 patients operated on with ruptured aneurysm, 11 were transferred to a major vascular centre with four deaths (36% mortality rate). The remaining 38 patients were treated locally. Twenty-three of these were operated on by a surgeon with vascular interest with nine deaths (39% mortality rate) and of the remaining 15 patients operated on by a surgeon without a vascular interest, ten died (66% mortality rate). These findings emphasize that patients presenting at a district hospital with leaking abdominal aortic aneurysm should be transferred to a major vascular unit if there is no local vascular expertise available, and our figures suggest that transfer of such patients does not prejudice survival. Further, of those patients who died of leaking aneurysm in hospital without undergoing surgery (25 patients), 15 were in hospital for longer than 3 h without the correct diagnosis. A significant improvement in mortality could follow prompt and accurate diagnosis at hospital level, with the most common error in diagnosis being renal colic.
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PMID:Abdominal aortic aneurysm in south-west Scotland. 157 18

Rupture of an abdominal aortic aneurysm often presents with an abdominal pain, hypotension and a pulsatile abdominal mass. In the last years same clinical reports describe patients with less apparent clinical signs who were found later in their evaluation to have a contained rupture of an abdominal aortic aneurysm. The diagnosis may be delayed by consideration of other disease causing similar symptoms (herniated disc, renal colic). In these patients with confusing abdominal symptoms CT scan provides a rapid and noninvasive diagnosis. We report three cases of contained rupture of an abdominal aortic aneurysm evaluated by computed tomography with different clinical presentation: back pain for erosion into the lumbar vertebral bodies, lower extremity neuropathy and obstructive jaundice. All patients were operated on within 24 hours on admission; there was no operative mortality and survival was 100% at one year.
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PMID:[Chronic rupture of abdominal aortic aneurysms. (Report of 3 cases)]. 1092 Apr 98

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.
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PMID:Left lower quadrant pain of unusual cause. 1126 11

Placement of an aortic wallstent for treatment of an abdominal aortic aneurysm (AAA) is a frequent therapeutic measure. Whereas AAA is known to mimic renal colic, aortic wallstent dislocation is a novel diagnostic problem. Herein, we report the first case of a patient with a dislocated aortic wallstent and subsequent aneurysm rupture and discuss appropriate diagnostic measures.
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PMID:Rupture of an abdominal aortic aneurysm due to aortic wallstent dislocation masquerading as renal colic. 1148 84

The differential diagnosis of acute flank pain includes kidney stones, urinary tract infection, dissecting abdominal aortic aneurysm (AAA), arterial or venous compromise of the kidney, renal abscess, renal carcinoma, and papillary necrosis. This is a report of an unusual cause of renal colic: pyelocalyceal diverticulum. Stasis of urine within a diverticulum promotes both calculus formation and urinary tract infection, either of which can lead to colic. Several radiographic findings may suggest a calyceal diverticulum, including, on plain X-ray, a very peripheral or mobile renal calculus, or on intravenous pyelogram, an early filling-defect and delayed or retained filing of a circular or ovoid mass.
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PMID:Pyelocalyceal diverticulum: an unusual cause of acute renal colic. 1221 67

The classic presentation of acute renal colic is the sudden onset of very severe pain in the flank primarily caused by the acute ureteral obstruction. The diagnosis is often made on clinical symptoms only, although confirmatory exams are generally performed because many others significant disorders may present with symptom of flank pain that mimics renal colic. Life threatening emergency such as abdominal aortic aneurysm must be ruled out. While non contrast CT has become the standard imaging modality, in some situations, a plain abdominal radiograph associated with a renal ultrasound or a contrast study such as intravenous pyelogram may be preferred. Hematuria is frequently present on urine analysis. The usual therapy represented by analgesic and nonsteroidal anti-inflammatory drugs should be started as soon as possible. Size and location of the stone are the most important predictors of spontaneous passage. Uncontrolled pain by medical therapy, fever, oligo-anuria suggest complicated stone disease. Such conditions require emergency treatment by drainage or stone extraction. Although recurrent stone rate is important, extensive metabolic explorations are not recommended after an uncomplicated first episode. Nevertheless fluid intake is encouraged and a stone chemical analysis should be performed whenever possible.
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PMID:[Excruciating flank pain: "acute renal colic"]. 1518 32

Extracorporeal shock wave lithotripsy (ESWL) is considered a very safe and noninvasive procedure for the treatment of urolithiasis. Achievements in the technical development of recent decades resulted in a continuous reduction of side effects. One of our patients, a woman with cystinuria, developed a temporary ureteral stricture after several sessions of ESWL. Encouraged by this observation we set out to explore--based on a MEDLINE literature search--published reports of more severe side effects observed in modern ESWL therapy. Besides hydronephrosis and renal colic the most common side effects were renal and perirenal hematomas in up to 4% in the larger series. Uncommon extrarenal complications are described mostly in case reports, which are also outlined in this report. The injury of visceral organs (liver, spleen, gut, pancreas) was published most frequently. A rupture or dissection of an abdominal aortic aneurysm as an outstanding serious complication was also reported several times. Taking obvious and well-known contraindications into consideration and carefully preparing the patients for the therapy (i.e., checking hemostasis, drug history), ESWL is a very safe procedure with a low risk of serious complications. Yet, postoperative clinical and ultrasound monitoring seems to be essential especially with respect to the increasing numbers of outpatient procedures.
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PMID:[Ureteral stricture after extracorporeal shock wave lithotripsy. Case report and overview of the spectrum of rare side effects of modern ESWL treatment]. 1745 33

Spontaneous aorto-caval fistula is a rare complication of abdominal aortic aneurysm. A definitive diagnosis is sometimes difficult, as the classic diagnostic signs (pulsatile abdominal mass with bruit, high-output hearth failure, and acute dyspnea) are present in about half of the patients. Diagnosis may be suspected from clinical symptoms, but sometimes atypical clinical features may obscure the actual situation. Computed tomography findings include early detection of contrast medium in the dilated inferior vena cava, which is isodense with the adjacent aorta, an associated aortic aneurysm, loss of normal anatomic space between aorta and vena cava, and rarely one can even visualize the abnormal communication between aorta and vena cava. Prompt radiological diagnosis is of key importance in the management of these patients. We describe findings of multislice computed tomography of the patient with dissecting aortic aneurysm and aortocaval fistula, clinically presenting as left renal colic. Multislice computed tomography is the imaging modality of choice for diagnosis of abdominal vascular pathology as it is noninvasive, fast and demonstrates a high diagnostic accuracy.
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PMID:Aorto-caval fistula clinically presenting as left renal colic. Findings of multislice computed tomography. 1879 39

The acute treatment of kidney stones (urolithiasis) addresses pain management and focuses on the effects of the morbidity associated with an obstructed renal system. Minimal fluid intake, resulting in decreased urine production and a high concentration of stone-forming salts, is a leading factor in renal calculi development. Radio-opaque calcareous stones account for 70% to 75% of renal calculi. Microscopic hematuria in the presence of acute flank pain is suggestive of renal colic, but the absence of red blood cells does not exclude urolithiasis. Furthermore, many inflammatory and infectious conditions cause hematuria, demonstrating the low specificity of urinalysis testing. The diagnostic modality of choice is a noncontrast computed tomography (CT); ultrasonography s preferred in pregnant patients and children. Combining opioids with non-steroidal anti-inflammatory drugs (NSAIDs) is the optimal evidence-based regimen to treat severe symptoms. Rapid intravenous (IV) hydration has not shown a benefit. Potentially life-threatening diagnoses including abdominal aortic aneurysm, ovarian torsion, and appendicitis may mimic renal colic and must be ruled out.
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PMID:Renal calculi: emergency department diagnosis and treatment. 2216 98

Described below is a case of a 72-year-old man with an abdominal aortic aneurysm (AAA) presenting with symptoms of renal colic. This case illustrates the hazards of making a diagnosis of renal colic in an elderly patient without considering the diagnosis of a leaking AAA. The diagnosis of an AAA can be challenging and renal colic is the single most common misdiagnosis. The patient's initial presentation can be misleading as symptoms fit the features of renal colic or a leaking AAA. Despite normal haemoglobin, microscopic haematuria and a dilated ureter on intravenous urogram (IVU); a leaking AAA should still have been considered. An ultrasound or CT (rather than an IVU) scan would have confirmed the appropriate diagnosis. A high degree of suspicion, early identification and surgical intervention can help reduce the high incidence of mortality in such cases.
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PMID:Elderly patient with ureteric colic: suspect leaking aneurysm. 2342 Jul 32


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