Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0740577 (acute abdominal pain)
 1,982 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To assess the diagnostic accuracy of a computer-aided-diagnosis system when implemented in different parts of the world, an automated system, which had established its reliability in Leeds, England, was transferred to Sherbrooke, Quebec. In this preliminary study two retrospective series, comprising 104 patients with acute abdominal pain and 101 patients with dyspepsia, were drawn from the files of the Centre Hospitalier Universitaire in Sherbrooke. The history and physical-examination sheet was analyzed, coded and tested against the Leeds data base on a WANG 2200 computer, and the results were compared with the final Sherbrooke pathologic diagnosis. Overall the computer made a correct diagnosis in 78.8% of cases of acute abdominal pain and 70% of cases of dyspepsia. Computer diagnoses of appendicitis were correct in 97% of cases and the system recognized 91% of the actual appendicitis cases. Similar figures for cholecystitis were 91% and for peptic ulcer, 87%. However, the "pick-up" rate by the computer of pancreatitis was only 25%. It is concluded that geographical differences in disease presentation will probably not impair the validity of the computer method used in this study. A comparison of various diagnostic methods and levels of competence will await a prospective trial of this method.
 ...
PMID:Computer-aided diagnosis of gastroenterologic diseases in Sherbrooke: preliminary report. 76 27

The infarction of the greater omentum is an unusual cause of acute abdominal pain. The Authors report their experience in the management of three cases. It is stressed that clinical manifestations are those of an appendicitis or cholecystitis; therefore, the diagnosis is usually intraoperative.
 ...
PMID:[Primary infarction of the greater omentum: our experience in 3 cases]. 179 77

In a prospective study 152 consecutive patients presenting with acute abdominal pain were assessed clinically and an ultrasonographic examination was performed immediately. Of these, 16 (11 per cent) patients would normally have had an immediate ultrasonographic scan requested; routine (within 24 h of admission) ultrasonographic examination would have been requested in a further 66 (43 per cent) patients. In 70 (46 per cent) patients an ultrasonographic examination would not have been requested. Ultrasonography altered the diagnosis in one patient from probable appendicitis to cholecystitis. Ultrasonography missed one abdominal aortic aneurysm and one empyema of the gallbladder. Ultrasonography had a sensitivity of 96 per cent, a specificity of 94 per cent, a positive predictive value of 96 per cent, a negative predictive value of 94 per cent and an accuracy of 95 per cent in diagnosing appendicitis. Exactly the same values were found for the clinical diagnosis of appendicitis. The study shows that routine immediate ultrasonographic examination of the acute abdomen is rarely helpful, with the possible exception of appendicitis. Where an urgent ultrasonographic scan is necessary on clinical grounds the expertise of a radiologist is probably required, whereas in specific areas, for example in the diagnosis of right iliac fossa pain, there may be a place for training the surgical trainee.
 ...
PMID:Ultrasonography in the acute abdomen. 195 78

50% of the patients admitted for acute abdominal pain have an infectious intra-abdominal disease, most of them an appendicitis, a cholecystitis or a diverticulitis. These infectious diseases are due to a noninfectious lesion of the wall of an intestinal organ. The defense mechanism and the bacterial synergism limit the number, nature and local extension of the multiple micro-organism, producing a strong selection. For the treatment, antibiotics play an important adjuvant role. The main question in all cases is to determine if the cure of the wall lesion is necessary. Furthermore, it is important to choose the ideal time to do it, according to the extension of the lesion, the immunocompetence and the physiological state of the patient. The advantages and inconveniences of an early or late operation have to be weighted. Some special aspects of appendicitis, cholecystitis and diverticulitis are discussed.
 ...
PMID:[Intra-abdominal infections]. 220 75

A 65-year-old man on maintenance dapsone therapy for dermatitis herpetiformis for 30 years was admitted to hospital with acute abdominal pain and vomiting. Investigations revealed a Heinz body haemolytic anaemia. Worsening symptoms prompted an emergency laparotomy that revealed a perforated gall bladder with pigmented biliary calculi. In previous reviews of the haematological abnormalities associated with dapsone therapy, life-threatening cholecystitis has not been described.
 ...
PMID:Gall-bladder perforation after long-term dapsone therapy. 226 52

Two patients presented with fever and acute abdominal pain. Acute cholecystitis was diagnosed when ultrasound examination showed a double-contour gallbladder wall. Radiography showed gas in the gallbladder wall in both cases, indicating emphysematous cholecystitis. This demonstrated that gas in the gallbladder wall may go undetected by ultrasound at the time when it could still be detected by conventional radiography of the abdomen. Awareness of the value of conventional radiography in these cases has an important diagnostic significance which may affect patient management.
 ...
PMID:False negative sonographic finding in emphysematous cholecystitis. 296 36

This study aimed to discover whether the disease spectrum in elderly patients (50 years and over) differed from that in other ages, and to compare patient presentation, progress and outcome between different age groups. In all, a total of 2406 patients from the OMGE series who were aged 50 and over were studied. Cholecystitis was the commonest disease category, commoner even than NSAP and appendicitis. Obstruction was more than three times as common in the elderly patients. One in four obstruction cases eventually proved to be due to an undiagnosed hernia. Cancer rates rose to 24% in patients over 70; whilst vascular causes accounted for 2.3% of patients over 50. As regards outcome, the risk to life rose steeply after the age of 50, possibly reflecting low rates of diagnostic accuracy. The clinical presentation of appendicitis was quite different in those over 50. Patients over 50 years with acute abdominal pain should be viewed differently from other younger patients, with special care being taken to look for hernia, cancer, and vascular disease. Educational material should also be reviewed to reflect the different features of the elderly patient. It is clear that further data on elderly patients are urgently required.
 ...
PMID:Acute abdominal pain in patients over 50 years of age. 316 55

The Research Committee of the World Organization of Gastroenterology has gather information regarding the etiology of acute abdominal pain. Seven diseases cover 96% of the causes of this syndrome in many countries of the world, but some geographical variations have been observed. One example of these variations is amoebic liver abscess, present in 5 to 10% of Mexico City patients. Right upper quadrant pain is often present in amoebic liver abscess and acute cholecystitis. Thus, differential diagnosis of these two entities is difficult. Using discriminant analysis and "stepwise" procedures in 100 cases with cholecystitis and a similar number of patients with amoebic liver abscess, we found six variables (symptoms and signs with a significant chi square to distinguish between these two diseases. The symptoms and signs chosen were hepatomegaly, Murphy's sign, duration of pain greater than or equal to 48 hours, previous history of abdominal pain, dysentery, and facial pallor. These variables proved to be better than laboratory test results. With five of these variables it was possible to obtain an accuracy of 92%. Using six variables, if cases of tie (three variables present and three absent) were excluded, accuracy rose to 96%.
 ...
PMID:Differential diagnosis between amoebic liver abscess and acute cholecystitis. 635 41

326 patients presenting with acute abdominal pain to a hospital in Tampere were compared with others in England and Norway, and with a large series of 6097 cases collected under the auspices of the World Organization of Gastro-Enterology. The distribution of disease in these 326 Finnish patients bore remarkable similarities to the distribution in other countries. When subjected to a computer-aided diagnostic analysis, comparing Finnish patients with UK and world-wide data, as regards appendicitis, cholecystitis and nonspecific pain, the computer performed roughly as well as the clinicians diagnosing the same cases. It is concluded that these diseases therefore have a common presentation in Finland with that elsewhere. As regards small bowel obstruction however, the computer diagnosed only 22% of cases correctly, (compared with the accuracy of clinical diagnosis 73%). This leads us to conclude that this disease presents unusually in Scandinavia, and possible reasons are discussed.
 ...
PMID:Presentation and diagnosis of acute abdominal pain in Finland: a computer aided study. 636 50

A 40-year-old woman presented with acute epigastric pain with vomiting. Within 24 hours, the pain spread to the right periumbilical region. Tc-99m disofenin hepatobiliary scan failed to demonstrate the gallbladder on a 60-minute view. The presumative diagnosis of acute cholecystitis was thought to be confirmed on this basis by the patient's physicians. However, a 75-minute view demonstrated filling of the gallbladder. In hepatobiliary scanning for acute abdominal pain, delayed views (2 to 24 hours) are recommended when the gallbladder is not visualized on the 60-minute view. If the gallbladder is visualized, cystic duct obstruction can be excluded and diagnoses such as pancreatitis, acalculous cholecystitis, and acute appendicitis should be investigated.
 ...
PMID:Hepatobiliary scan with delayed gallbladder visualization in a case of acute appendicitis. 720 Aug 46


1 2 3 4 5 6 Next >>