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Query: UMLS:C0740577 (acute abdominal pain)
1,982 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of dramatic radiation enterocolitis inducing portal venous air diagnosed by Doppler sonography only. The sonographic pattern consisted of multiple irregular hyperechoic areas into the liver, with internal repetitive noisy bidirectional peaks superimposed on the usual continuous Doppler display of the portal flow. Although portal hyperechoic moving foci alone may reflect only slow portal velocity, they do not create any Doppler distortion as do moving bubbles. Portal air may have multiple causes such as abdominopelvic abscesses, sepsis, intestinal distension, fulminant hepatitis, cholangitis, cholecystitis, diabetic acidosis..., but mesenteric infarct, necrotic enterocolitis, and radiation enteritis are life-threatening conditions that have to be diagnosed as soon as possible. Although large quantities of portal air may be demonstrated on plain film of the abdomen or by computed tomography, Doppler sonography may detect smaller quantities, allowing earlier diagnosis of intestinal pathology requiring immediate surgical treatment. Therefore, Doppler sonography of the liver should be performed in any patient with acute abdominal pain or distension, especially if being treated by abdominal radiotherapy.
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PMID:[diagnostic ultrasonography of air in the portal venous system: apropos of a case of colonic radionecrosis and literature review]. 782 61

There are increasing challenges for the practising gastroenterologist in treating AIDS-related gastrointestinal diseases. The differential diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, non-specific aphthous ulceration and non-AIDS oesophageal diseases, especially reflux oesophagitis. Chronic subacute abdominal pain with nausea, vomiting, early satiety and weight loss is suggestive of an obstructive lesion caused by lymphoma or Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis or intestinal perforation due to cytomegalovirus. Right upper quadrant pain (with or without fever, vomiting or abnormal liver function tests with a cholestatic profile) is suggestive of hepatobiliary pathology including cholecystitis, cholangitis, acalculous cholecystitis and AIDS cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare, Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni), and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition and weight loss can shorten the life-span of patients with AIDS. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting.
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PMID:AIDS and the gut. 805 32

A teenaged white male, admitted with a 58% total body surface burn, was treated with extensive debridement and grafting. Cadaver skin was applied in preparation for grafting with cultured epithelial autograft (CEA). The abdomen and upper arms were then grafted with CEA applied over 6:1 meshed autograft with satisfactory take. The patient was discharged with his wounds healed on postburn day 67. Six months after this, he was readmitted with acute abdominal pain. A perforated gallbladder, diagnosed as acalculous cholecystitis, was found at exploratory laparotomy and removed. The laparotomy incision was made through the burned area grafted with CEA. The patient's recovery from his cholecystectomy and the healing of the postoperative cutaneous wound made through CEA were uneventful.
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PMID:Acute cholecystectomy performed through cultured epithelial autografts in a patient with burn injuries: a case report. 888 67

Metastatic melanoma to the gall-bladder producing symptoms which mimic cholecystitis is an uncommon and unusual clinical presentation of metastatic disease. We present a case of a 40-year-old women who initially had a thin primary cutaneous melanoma, and later presented with acute abdominal pain which was diagnosed as acute cholecystitis. Pathological review of the gall-bladder revealed metastatic melanoma.
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PMID:Acute cholecystitis from metastatic melanoma to the gall-bladder in a patient with a low-risk melanoma. 906 51

From the surgical point of view acute abdominal pain is the cardinal symptom of acute abdomen. Additional leading symptoms of acute abdomen are tension of the abdominal wall, peristaltic disorders and, in rare cases, shock symptoms. Acute abdomen is an operational diagnosis for painful, in part life threatening diseases of various etiologies. The most frequent cause is acute appendicitis, followed by cholecystitis and by diverse forms of ileus. These three diseases together are the cause of acute abdomen in more than 80% of cases. Over 90% of cases with acute abdomen are treated surgically. The decision in favour of a surgical intervention must be determined within minutes to hours depending on the etiology. A delay may lead to further, partly most serious sequelae.
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PMID:[Acute abdominal pain. Surgeon's viewpoint]. 908 28

A prospective study of 584 consecutive patients presenting with acute abdominal pain was conducted to evaluate the role of ultrasonography as a first-line diagnostic tool for differentiating between surgical and nonsurgical diseases. The study reveals a high sensitivity and specificity for the diagnosis of diverticulitis, cholecystitis, and bowel obstruction. In acute appendicitis the method is highly specific, but the sensitivity is rather low. Taking into account the high rate of specific results, routine ultrasonography can be recommended as a screening method in patients suffering from acute abdominal pain.
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PMID:[Role of sonography as primary diagnostic method in acute abdomen--a prospective study]. 957 76

An emergency cesarean section was performed in the 38th week of pregnancy in a patient with acute abdominal pain in the left upper quadrant. The ultrasound picture was interpreted as a retroplacentar hematoma. Cardiotocography demonstrated fetal tachycardia which was interpreted as asphyxia. A diagnosis of abruptio placentae was made, but was finally ruled out when the cesarean section was performed. The intraabdominal exploration revealed a large hematoma of the rectus sheath with about 800 ml of blood. After evacuation and drainage the postoperative recovery was uneventful. Sudden rupture of a deep epigastric vessel with formation of an abdominal wall hematoma also mimics intraabdominal conditions such as appendicitis, diverticulitis, cholecystitis, tumours and visceral injuries.
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PMID:[Spontaneous hematoma of the abdominal wall: diagnostic error of abruptio placentae]. 1044 6

A total of 3,727 in-patients with acute abdominal symptoms were identified during the first quarter of 1995 at the surgical clinics of the nine hospitals with emergency departments in the county of Stockholm. The diagnoses were: non-specific abdominal pain 24%; cholecystitis 9%; appendicitis 8%; bowel obstruction 7%; intra-abdominal malignancy, diseases of the urinary tract and peptic ulcer 6% each; gastrointestinal hemorrhage, diverticulitis of the colon and pancreatitis 5% each; other diseases as a cause of abdominal symptoms, 19%. 1,601 operations were performed of which 47% were endoscopic procedures. The mean duration of hospital stay was 4.8 days. The length of stay increased significantly with age. The age-related relative frequency of hospitalization due to acute abdominal pain was also dramatically higher in the elderly cohorts. These facts and the prognosis of an 18% increase of inhabitants 50 years of age or older until 2010 in Greater Stockholm signal an increased need of hospital resources for this large group of patients in the coming years.
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PMID:[Acute abdomen calls for considerable care resources. Analysis of 3727 in-patients in the county of Stockholm during the first quarter of 1995]. 1103 59

Omental infarction, an uncommon cause of acute abdominal pain, is the result of compromised perfusion to the greater omentum. Although its etiology remains uncertain, predisposing factors include obesity [Surg. Today 30 (2000) 451], strenuous activity [N. Z. Med. J. 111 (1998) 211], trauma, and idiopathic omental torsion. Often confused with acute appendicitis or cholecystitis on clinical grounds [Surg. Today 30 (2000) 451], its diagnosis has traditionally been one of exclusion, based on intraoperative and pathologic findings. This diagnosis can be made radiologically based on the characteristic findings of an inflammatory mass containing fat and fluid. We describe a case of right lower quadrant omental infarction temporally related to bowel surgery.
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PMID:Omental infarction as a delayed complication of abdominal surgery. 1168 93

Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films--bowel obstruction, pneumoperitoneum, and the search of ureteral calculi--are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain.
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PMID:Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies. 1219 63


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