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)

Twenty-five patients were operated on at the Brigham and Women's Hospital for colonic diverticulitis complicating treated renal failure during the period 1951 to 1983. Twelve patients had functioning renal allografts (eight cadaver, four living-related); 13 were on dialysis therapy. Six patients had polycystic kidney disease. The majority of patients had acute abdominal pain. Four had histories of chronic abdominal pain; nondiagnostic exploratory laparotomies were performed on two of these patients, who developed localized tenderness. The overall mortality in this series was 28 percent, with sepsis being the most common cause of death. Six of seven patients who died had free colonic perforations at surgery. Mortality correlated with age, with six of 14 patients (43 percent) over age 50 dying, as compared with one of 11 patients (9 percent) under age 50. There was no correlation between survival rate and type of surgery performed, dose of prednisone or azathioprine used, or type of treatment received for renal failure.
 ...
PMID:Surgery for diverticulitis in renal failure. 390 14

Acute colonic diverticulitis typically occurs in patients older than 60 years of age but is uncommon in patients under the age of 40, which may lead to a delay in diagnosis. Because abdominal pain is a very common presenting symptom in emergency department patients, we retrospectively analyzed the cases of 21 patients 40 years of age and younger diagnosed with acute diverticulitis and characterized the presenting signs and symptoms, laboratory and radiographic findings, treatment, and outcome. There were 17 men and 4 women with a mean age of 34.1 +/-5.9 years. All patients had abdominal pain, with 14 (67%) patients noting pain in the left lower quadrant (LLQ) and 5 (24%) patients noting right lower quadrant (RLQ) pain. Nausea was present in 18 (86%) patients and fever in 15 (71%) patients. The mean pulse rate was 103 +/- 16 and the mean temperature was 100.7 +/- 1.4 F. Leukocytosis was present in 19 (90%) patients. Plain abdominal radiographs were obtained in 19 (91%) patients and were normal in 15 (79%) of these cases. Computed tomographic (CT) scans were obtained in 15 (71%) patients which revealed findings consistent with acute diverticulitis in 14 (93%) patients. The admitting diagnosis was diverticulitis in 10 of the 12 patients with LLQ tenderness and appendicitis in 4 of the 6 patients with RLQ tenderness. Overall, six patients were taken to surgery: three patients had cecal diverticulitis and three patients had perforated colonic diverticulitis. General treatment measures included bowel rest in 18 (86%) patients, and intravenous fluids and antibiotics in all patients. All patients survived. In conclusion, acute diverticulitis is uncommon in patients under 40 years of age; however, this condition may be confused with other conditions, usually acute appendicitis. As a result, clinicians should consider acute diverticulitis in young patients with acute abdominal pain, especially if they are male with nausea, fever, tachycardia, and leukocytosis, and consider obtaining a CT scan to aid in the diagnosis.
 ...
PMID:Acute diverticulitis in patients 40 years of age and younger. 1075 Sep 16

The clinical diagnosis of acute colonic diverticulitis (ACD) is at times difficult and an early detection by a non-invasive method as ultrasonography (US) is required. The aim of this study is to evaluate the diagnostic sensibility of US performed on admission in patients with ACD, its value in monitoring assessment of severity and its influence on surgical decision. The Authors have carried out a retrospective study on 22 patients (8 men and 14 women, median age 58 years) admitted from January 1997 to June 1999 for ACD. In 21 cases the diagnosis was made on admission by US. The diagnostic sensibility was 95.5% (false-negative: 1 case). The true diagnosis in 2 false-positive patients was: ischemic colitis (1 case), aspecific thickening of colonic wall in patient with left renal carcinoma (1 case). The sensibility of clinical evaluation on admission was 68% (false-negative: 7 cases). The clinical diagnosis was unequivocal in only 36.4% of cases. In 14 patients, successfully treated conservatively, the US gave monitoring the reduction of hypoechogenic thickening of the colonic wall. Seven patients who underwent urgent surgery: in 3 cases for generalized peritonitis, but in 4 patients (18.2%) the immediate management was influenced by US detection of a clinical misdiagnosed abscess. The Authors conclude that, in the hands of an expert investigator, the extensive use of US in acute abdominal pain facilitate an accurate diagnosis of ACD and its appropriate management.
 ...
PMID:[Ultrasonography of acute colonic diverticulitis. Effect on surgical treatment]. 1091 53

Patients with acute abdominal pain are a great challenge to the radiologist. The clinical diagnosis is classically unreliable, resulting in both negative laparotomies as well as ill-advised surgical delay in a large number of patients. Ultrasound offers a non-invasive way to decrease both false-negative and false-positive diagnoses in this category of patients. This article focuses on the role of sonography in the diagnosis of acute conditions of the gastrointestinal tract tract such as appendicitis, sigmoid diverticulitis, Crohn's disease, colitis, infectious ileocecitis caused by Yersinia, Campylobacter or Salmonella, right-sided colonic diverticulitis, bowel malignancy presenting acutely, small bowel obstruction, intussusception, omental infarction, and epiploic appendagitis. The sonographic spectrum of these conditions as well as possible pitfalls are discussed using illustrative case histories.
 ...
PMID:Ultrasound of acute GI tract conditions. 1170 19

Although multislice, helical CT is increasingly replacing ultrasonography for the evaluation of patients with acute abdominal pain, ultrasound does have certain specific advantages over CT. This article discusses the advantages of ultrasound in imaging of the acute abdomen, exploring such areas as appendicitis, ileocecal Crohn's disease, infectious ileocolitis and infectious ileocecitis, mesenteric lymphadenitis, cecal carcinoma, sigmoid diverticulitis, right-sided colonic diverticulitis, and perforated peptic ulcer.
 ...
PMID:Ultrasonography of the acute abdomen: gastrointestinal conditions. 1466 68

Meckel diverticulum is the most common congenital defect of the gastrointestinal tract. It can be asymptomatic or mimic appendicitis and may be complicated by bleeding, diverticulitis, obstruction, and, rarely, neoplasia. We report the first case of extranodal marginal zone lymphoma occupying a Meckel diverticulum. A 44-year-old man with history of colonic diverticulitis presented to the emergency department for evaluation of acute abdominal pain. Radiography showed enteric obstruction, prompting diagnostic laparoscopy. Above the level of mid-ileum an intact Meckel diverticulum was identified. Microscopy showed extensive infiltration of sheets of small lymphocytes with abundant cytoplasm (monocytoid B-cells) prominently in submucosa and focally transmural involving serosal adipose tissue with multiple reactive germinal centers. The immunostains showed positivity for CD20, BCL-2, and CD43 (weak) and negativity for CD3, CD5, BCL-1, CD10, and BCL-6 in monocytoid B-cells. Fluorescence in situ hybridization studies revealed API2-MALT1 fusion signals consistent with t(11;18)(q21;q21), which confirmed the diagnosis of extranodal marginal zone lymphoma, also known as mucosa associated lymphoid tissue lymphoma.
...
PMID:Extranodal Marginal Zone Lymphoma Presenting within the Meckel Diverticulum as Diverticulitis: A Case Report. 2486 77