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)

Reliable physical examination of patients presenting with acute abdominal pain and tenderness is necessary for identifying serious causes on the one hand, and for preventing further unnecessary imaging on the other. If acute appendicitis or peritonitis is suspected, positive palpatory findings like rigidity and guarding are helpful diagnostic indicators, whereas negative palpatory findings have little value in excluding these conditions. Physical examination is of limited predictive value in diagnosing cholecystitis. Visible peristalsis strongly argues for small bowel obstruction, but this sign is rarely present. Digital rectal examination appears to have no added diagnostic value for appendicitis, peritonitis, or small bowel obstruction.
 ...
PMID:[Physical examination of patients with acute abdominal pain]. 2141

When discussing which laboratory tests or imaging to order in the setting of acute abdominal pain, it is practical to organize information by disease process (eg, acute appendicitis, cholecystitis). Because studies on the accuracy of diagnostic tests are of necessity related to the presence or absence of specific diagnoses, and because clinicians frequently look to tests to help them rule in or rule out specific conditions, this article is organized by region of pain and common abdominal diagnoses. It focuses on the contributions that laboratory testing and imaging make in the emergency management of abdominal complaints.
 ...
PMID:Imaging and laboratory testing in acute abdominal pain. 2151 75

Abdominal complications following cardiac surgery remain unusual, but are associated with high mortality. The most common abdominal surgical complications are mesenteric ischaemia, diverticulitis, pancreatitis, gastrointestinal bleeding and cholecystitis. We describe a case of a 73-year old woman with acute abdominal pain mimicking cholecystitis on day 10 after aortic valve replacement. An abdominal examination showed tenderness of the right upper quadrant with Murphy's sign. Complete blood count, blood chemistries and urinalysis were normal as were the abdominal and chest X-rays and abdominal ultrasonography. The abdominal computed-tomography (CT) scan enabled us to rule out cholecystitis, as it demonstrated the typical appearance of epiploic appendagitis on the right colon, 1 cm below the gallbladder. Epiploic appendagitis results from twisting, kinking or venous thrombosis of an epiploic appendage. Depending on its localization, it mimics many diagnoses requiring surgery: colitis, diverticulitis, appendicitis and cholecystitis. An abdominal CT scan is the diagnostic imaging tool of choice. All physicians involved in post-cardiac surgery care should be aware of this self-limiting disease that usually resolves with non-steroidal anti-inflammatory drugs and watchful waiting, and to avoid unnecessary surgery because the spontaneous evolution of epiploic appendagitis is usually benign.
 ...
PMID:An unusual cause of acute abdominal pain after cardiac surgery: acute epiploic appendagitis. 2254 60

Atypical manifestations of acute hepatitis A virus (HAV) infection include ascites, pleural effusion, acute renal failure, aplastic anemia, and neurological manifestations. Although association of HAV and acute cholecystitis is known, presentation of hepatitis A infection with acute cholecystitis has not been reported in pediatric emergency medicine literature. Primary acute acalculous cholecystitis in children is rare and commonly attributed to systemic infections. We report a case of a child developing acute viral cholecystitis as a presenting feature of sporadic HAV infection and review HAV-associated cholecystitis in children. The article provides a brief illustration of evaluating acute abdominal pain in older children in the emergency department in a developing country.
 ...
PMID:Unusual cause of abdominal pain in pediatric emergency medicine. 2266 60

A 23-year-old second para was admitted for severe anaemia with abdominal distension in the immediate puerperal period following a preterm delivery. She suffered from acute abdominal pain 3 days back (at 32 weeks of gestation) and was evaluated in the emergency medical department for appendicitis/cholecystitis. Abdominal ultrasound was found to be normal and she received antacids for her pain abdomen. Clinical examination the day after delivery revealed abdominal distension, guarding and rigidity. Ultrasonography revealed a normal puerperal uterus with free fluid in the abdomen which on diagnostic aspiration was pus. Emergency laparotomy showed acute suppurative appendicitis with perforation. Appendecectomy with peritoneal lavage was done. Her postoperative period was stormy with high febrile spikes and evaluation confirmed septicaemia. The organism grown on postoperative blood culture and cervical swab culture was Enterococcus fecalis sensitive to vancomycin and she received the same for 10 days and recovered.
 ...
PMID:The consequences of missing appendicitis during pregnancy. 2268 79

Acute acalculous cholecystitis is uncommon in pediatrics and more likely to be encountered in adult patients. Signs and symptoms of acute cholecystitis are similar to other causes of acute abdominal pain such as pancreatitis, gastritis, and acute appendicitis, further making diagnosis difficult. We present a case of acute acalculous cholecystitis in a child with cystic fibrosis and discuss the role of emergency physician bedside sonography in the evaluation of right-upper-quadrant pain.
 ...
PMID:Acute acalculous cholecystitis in a 10-year-old girl with cystic fibrosis. 2328 81

The incidence of acute abdominal pain ranges between 5-10% of all visits at emergency department. Abdominal emergencies of hospital visits may include surgical and non-surgical emergencies. The most common causes of acute abdomen are appendicitis, biliary colic, cholecystitis, diverticulitis, bowel obstruction, visceral perforation, pancreatitis, peritonitis, salpingitis, mesenteric adenitis and renal colic. Good skills in early diagnosis require a sound knowledge of basic anatomy and physiology of gastrointestinal tract, which are reflected during history taking and particularly, physical examination of the abdomen. Advanced diagnostic approaches such as radiography and endoscopy enhance the treatment for acute abdomen including pharmacological and surgical treatment. Therapeutic endoscopy, interventional radiology treatment and therapy using adult laparoscopy are the common modalities for treating patients with acute abdomen.
 ...
PMID:Diagnostic approach and management of acute abdominal pain. 2331 78

Peritonitis is a set of symptoms of varying etiology usually with an accompanying infection, systemic and local changes within the peritoneal cavity Colonic diseases, especially colon perforation, are one of the most common causes of peritonitis. The course of the disease may be turbulent due to sudden perforation. In case of limited peritonitis the disease is not as acute as the perforation hole is small and it can be sealed by the omentum and internal organs. Abdominal pain is usually located around the source of infection and is less severe. A 38-year-old patient at 34 weeks gestation was hospitalized in the obstetric-gynecological ward of the Health Care Center with a diagnosis of preterm delivery urinary infection and renal colic. Due to increasing peritoneal symptoms and deteriorating general condition of the patient, a decision to perform immediately exploratory laparotomy combined with the Cesarean section was made. The surgeon indicated a place in the left mesogastrium that could correspond with a drained interintestinal abscess and also found a large amount of fibrin in the lower floor of the peritoneal cavity The initial point of the abscess remained unknown and the patient received total parenteral nutrition for 10 days. On 5 postoperative day the drain was removed from the peritoneal cavity and since day 10 patient health was steadily improving. Bacteriological cultures revealed abundant growth of E. coli that showed sensitivity to the used antibiotics. On 22 postoperative day the patient and her child were discharged home in good condition. Five months later the patient was admitted to the surgical ward with acute abdominal pain with the diagnosis of an abscess in her left mesogastric and subgastric area, perforation of sigmoid diverticulum and fecal fistula. Our case illustrates great difficulties in diagnosing diseases of the abdominal cavity during pregnancy because causes and symptoms may be typical of this condition, as well as of unrelated diseases, including: kidney problems, appendicitis, cholecystitis and bowel disease. Examination of the pregnant patient presents a challenge and the symptoms are uncharacteristic. Tension of the abdominal wall, as well as the muscles of the digestive and urinary tract are reduced and the topography of the internal organs changes during pregnancy. The interpretation of laboratory tests becomes more difficult. In our case, the initial local peritonitis, caused by microperforation of the diverticulum, ran a latent course and was masked by both pregnancy and renal colic symptoms, consequently leading to diffuse peritonitis. The presented case demonstrates the importance of the problem and forces obstetricians to be more vigilant in determining the diagnosis and decision-making, because of its meaning for the health and even the life of the patient and her child.
 ...
PMID:[Complicated colonic diverticulitis at 34 weeks gestation]. 2348 99

Vasculitis secondary to rheumatoid arthritis (RA) usually occurs in patients with high circulating titres of rheumatoid factor and established, chronic disease. Vasculitis of the gallbladder causing acute cholecystitis is an extremely rare manifestation of rheumatoid vasculitis. To our knowledge, this is the first case in which vasculitis occurred early in the course of disease. We report the case of a localised gallbladder vasculitis in a 74-year-old, newly diagnosed male patient with RA. He presented with acute abdominal pain, a history of constitutional symptoms and a 1-week history of polyarthritis of his wrist and hands. Cholecystitis was diagnosed clinically and radiologically and he underwent a laparoscopic cholecystectomy. Histopathology of the gallbladder confirmed cholecystitis and gallstones but in addition found small vessel vasculitis and rheumatoid nodules. This case illustrates that rheumatoid vasculitis can occur early in the onset of RA. Additionally, although rare, the gallbladder can be a site of localised rheumatoid vasculitis.
 ...
PMID:Vasculitis of the gallbladder in early rheumatoid arthritis. 2397 7

Various biliary pathologic conditions can lead to acute abdominal pain. Specific diagnosis is not always possible clinically because many biliary diseases have overlapping signs and symptoms. Imaging can help narrow the differential diagnosis and lead to a specific diagnosis. Although ultrasonography (US) is the most useful imaging modality for initial evaluation of the biliary system, multidetector computed tomography (CT) is helpful when US findings are equivocal or when biliary disease is suspected. Diagnostic accuracy can be increased by optimizing the CT protocol and using multiplanar reformations to localize biliary obstruction. CT can be used to diagnose and stage acute cholecystitis, including complications such as emphysematous, gangrenous, and hemorrhagic cholecystitis; gallbladder perforation; gallstone pancreatitis; gallstone ileus; and Mirizzi syndrome. CT also can be used to evaluate acute biliary diseases such as biliary stone disease, benign and malignant biliary obstruction, acute cholangitis, pyogenic hepatic abscess, hemobilia, and biliary necrosis and iatrogenic complications such as biliary leaks and malfunctioning biliary drains and stents. Treatment includes radiologic, endoscopic, or surgical intervention. Familiarity with CT imaging appearances of emergent biliary pathologic conditions is important for prompt diagnosis and appropriate clinical referral and treatment.
 ...
PMID:Multidetector CT of emergent biliary pathologic conditions. 2422 84


<< Previous 1 2 3 4 5 6 Next >>