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

Cecal volvulus is a rare, but potentially fatal, cause of intestinal obstruction. As computed tomographic (CT) scanning is often the initial diagnostic test in patients with acute abdominal pain, we reiterate the importance of the "whirl sign" in diagnosing intestinal volvulus. We report the first description of the CT diagnosis of cecal volvulus.
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PMID:Cecal volvulus: the CT whirl sign. 850 96

The paper describes a case of a 40-year old woman who presented with complaints of crampy abdominal pain, weight loss, hypermenorrhea, anaemia, fever and peritoneal effusion which were attributed to a large solid pelvic tumour. During the preoperative investigations she had an attack of acute abdominal pain with bloody diarrhea assumed to be caused by gastrointestinal infection. The attack ceased quickly after intravenous infusions and antispasmodics were started. Several days later a second even stronger attack of abdominal pain with evidence of intestinal obstruction necessitated urgent laparotomy which revealed extensive necrosis of the small intestine with a coexistent large uterine myoma. A resection of the small intestine with a side-to-side anastomosis and hysterectomy with bilateral salpingo-oophorectomy were performed. The patient had an uncomplicated recovery gaining weight but still experienced mild discomfort after meals. The symptoms, the diagnostic difficulties as well as the therapeutic approaches in mesenteric ischaemia are discussed.
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PMID:[A case of mesenteric thrombosis occurring in a woman with a uterine myoma during her hospital stay]. 865 30

The survey on emergencies in Obstetrics is addressed here to practitioners and advanced medical students. The specialized gynecologist will, however, find some case reports interspersed illustrating what he/she has already experienced sometimes. The paper should be a refreshment for them. Acute abdominal pain in pregnancy challenges the diagnostic skills of the physician first contacted. Is it, what causes the pain, appendicitis as is frequently in nonpregnant young women, or gall-bladder disease as in the elderly obese, or even dangerous intestinal obstruction, or is the pain deriving from a twisted pedicle of an occult ovarian cyst or is it simple gastrointestinal discomfort? Putting into account the differing frequency of incidences of disease does not always help. Emergency may arise from the rarest event. With increasing traffic on our streets blunt trauma occurs and it might hurt pregnant women as well as their fetus. Even seat-belts can cause damages, if pelvic belts are used instead of shoulder belts. Traumata from accidents are often associated to immediate shock. Shock in pregnancy poses different questions according to the physiology of the progressing pregnancy. There is a variety of shock etiologies. Bleeding from the vagina is the most common complaint. Those can be harmless or they can be the first and leading sign of imminent danger to the fetus and the mother. Diagnosis does not allow any delay. One of the most striking complications in late pregnancy is described by the acronym "HELLP"-syndrome [hemolysis, elevated liver enzymes, low platelets]. This syndrome is a critical complication of preeclampsia. One third of the cases occur after delivery. It has not yet been clearly decided whether active management including immediate delivery by cesarean section in disregard of the maturity of the child, or the conservative approach with intensive care, drastic antihypertensive medication and additional serial plasmapheresis might prove to be more efficient in terms of live-saving for mother and child. The mortality of mothers suffering from HELLP remains to be high, the perinatal mortality is even higher. Post partum hemorrhage is due to the lack of contractibility of the uterus after overdistension, protracted labour, malpositions, mere inertia etc., from lacerations, or from placental retention. It is always an emergency with hemorrhagic shock impending. The risk situation around even normal birth is well known. Emergencies will appear every time unannounced. There are post partum risks as well; they should not be underestimated when home-delivery is desired.
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PMID:[Emergencies in obstetrics]. 876 53

To determine the place of surgery in the management of abdominal Burkitt's lymphoma, we retrospectively reviewed the records of 17 children treated over a period of 10 years (1983-1992). Patients were 14 males. Seven patients presented with acute abdominal pain, 6 with an abdominal mass and 5 with intestinal obstruction. In 3 cases, the diagnosis was made without laparotomy (2 percutaneous tumoral puncture, 1 pleural puncture). In the 14 other cases, the diagnosis was made by laparotomy with 3 biopsies and 11 resection of the tumor (7 complete and 4 incomplete). These laparotomies were complicated by 1 evisceration and 2 intestinal obstruction. At the end of the initial chemotherapy, 1 children was reoperated for a residual mass with no histological viable tumor. Sixteen children were long term survivors (14 > 2 years); 1 died. Surgery was indicated in cases of intestinal intussusception. In cases of abdominal mass, surgery could have been avoided twice (positive ascitic fluid). A complete tumoral resection had no influence on survival which depend of extra-abdominal extension and more over of response to chemotherapy.
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PMID:[Abdominal lymphomas in children: place of surgery]. 881 59

A patient experienced acute abdominal pain that was diagnosed at laparoscopy as being due to an infarcted epiploic appendage. To our knowledge, this is the second report of laparoscopic diagnosis and treatment of an epipolic disorder. Infarcted epiploic appendages may be associated with bowel obstruction and abscess formation. Therefore, they should be looked for at the time of diagnostic laparoscopy for acute abdominal pain of unclear etiology, and removed if present.
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PMID:Laparoscopic diagnosis and treatment of an infarcted epiploic appendage. 905 Jun 51

The abdomen, as the largest cavity in the body, holds both fixed as well as relatively mobile organs, which when either diseased, traumatized, malfunctioning, or infected may present a wide and diverse range of signs and symptoms. Clues to the origin of abdominal pain can be well-localized or referred and quite obtuse. This article reviews the surface anatomy of the abdomen, the types of abdominal pain, approach to the patient with abdominal pain, and history-taking and physical examination. Adjunctive studies, which might help to reduce the differential diagnosis, are mentioned. The goal of this article is to help the reader formulate an accurate diagnosis in a timely manner via a complete but also well-focused physical examination; attention is paid to a comprehensive differential diagnosis to include common and not so common causes of acute abdominal pain. Intra-abdominal sources of abdominal pain include: peritonitis, bowel obstruction, and vascular disorders. Extra-abdominal sources of abdominal pain include the thorax, pelvis, and the abdominal wall. Some metabolic and neurogenic sources of abdominal pain are examined. Life-threatening causes of abdominal pain include ectopic pregnancy, acute myocardial infarction, abdominal aortic aneurysm, splenic rupture, and obstructed bowel. Discussion of these entities concentrates on the initial presentation of the patient, typical progression of symptoms, and appropriate initial treatment as well as referral. The process of ruling out emergent abdominal pain is also examined.
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PMID:Primary care diagnosis of acute abdominal pain. 923 49

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

The evaluation of a simple decision aid in the diagnosis of acute abdominal pain shows that plain abdominal x-rays to exclude bowel obstruction can be avoided if less than two of the following symptoms are present: distended abdomen, increased bowel sounds, history of constipation, previous abdominal surgery, age over 50 or vomiting.
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PMID:[Avoiding abdominal roentgen images in acute abdominal pain--evaluation of a simple clinical decision support aid]. 993 66

The aim of this prospective study was to determine whether plain abdominal radiographs (PAX) are helpful in the management of adult patients presenting with acute pain of the right lower quadrant (RLQ). A questionnaire was filled in for each patient admitted to our hospital for acute abdominal pain of the RLQ, before and after PAX were obtained. The initial questionnaire indicated the suspected diagnosis and a provisional therapeutic option. A total of 104 consecutive patients were included in this study, 76 of whom underwent surgery. The negative laparotomy rate was 22%. PAX changed the suspected diagnosis and management for six patients (6%), leading in one case to negative laparotomy. Of the remaining five patients, three were operated (two for acute appendicitis and one for small bowel obstruction), and two were treated conservatively for ureteral calculi. This prospective study seems to demonstrate that the indiscriminate use of PAX is not helpful for most patients with acute pain of the RLQ. However, it may be performed in selected patients with clinically suspected small bowel obstruction or urinary symptoms.
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PMID:Plain abdominal radiography as a routine procedure for acute abdominal pain of the right lower quadrant: prospective evaluation. 993 97

The authors describe a case of abdominal angiostrongyliasis in an adult patient presenting acute abdominal pain caused by jejunal perforation. The case was unusual, as this affliction habitually involves the terminal ileum, appendix, cecum or ascending colon. The disease is caused by the nematode Angiostrongylus costaricensis, whose definitive hosts are forest rodents while snails and slugs are its intermediate hosts. Infection in humans is accidental and occurs via the ingestion of snail or slug mucoid secretions found on vegetables, or by direct contact with the mucus. Abdominal angiostrongyliasis is clinically characterized by prolonged fever, anorexia, abdominal pain in the right-lower quadrant, and peripheral blood eosinophilia. Although usually of a benign nature, its course may evolve to more complicated forms such as intestinal obstruction or perforation likely to require a surgical approach. Currently, no efficient medication for the treatment of abdominal angiostrongyliasis is known to be available. In this study, the authors provide a review on the subject, considering its etiopathogeny, clinical picture, diagnosis and treatment.
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PMID:Jejunal perforation caused by abdominal angiostrongyliasis. 1060 48


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