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

A case report of subacute, reversible ischemic colitis associated with use of oral contraceptives (OCs) is reported. A 19-year-old woman was admitted to the hospital with chief complaints of abdominal cramps, nausea, vomiting, diarrhea, and rectal bleeding of 2 days' duration. Past medical history and family history were noncontributory. The patient was receiving no medication other than Norinyl 2 (2 mg of norethindrone and .1 mg of mestranol), which she had been taking for 6 months. 2 days before admission the patient had taken 100 mg of dimenhydrinate and 2 ExLax tablets (90 mg of phenolphthalein) for constipation. Colonic roentgenograms revealed impaired mesenteric circulation and bowel ischemia; OC-induced ischemic bowel disease was diagnosed. Patient symptoms subsided within 96 hours of discontinuing the OC and initiating supportive therapy (including intravenous fluid infusion, nasogastric suction, analgesics, and antiemetics). When a repeat barium enema was performed, it showed resolution of the ischemia. In a short review following the case report, these drugs were indicted in causation of colitis-like syndrome: amoxicillin, ampicillin, cephazolin, chloramphenicol, chlorpropamide, clindamycin, cloxacillin, cotrimoxasole, cyclophosphamide, digitalis, ergotamine tartrate, flucytosine, fluorouracil, gold salts, laxative and cathartic abuse, mercurous chloride, methyldopa, penicillin V, and tetracycline. Ischemic bowel disease secondary to OC use is a rare but important complication because of its significant morbidity and potential mortality, and because of the widespread use of the drugs. The case report emphasizes the need to consider the differential diagnosis of acute vascular insult with bowel ischemia when acute abdominal pain progressing to bloody diarrhea occurs in young women taking OCs.
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PMID:Oral contraceptive-induced ischemic bowel disease. 48 72

Acute mesenteric arterial occlusion is a curable disease, provided it is diagnosed and treated before irreversible changes occur in the ischemic bowel. Forty patients treated for proven mesenteric arterial occlusion were evaluated retrospectively in an effort to broaden the existing criteria for early diagnosis. Twenty-three patients suffered from mesenteric thrombosis and 17 sustained embolic occlusion of the superior mesenteric artery. The overall mortality rate was 77.5% (31 of 40 patients). Three patients survived without bowel resection. The appearance of acute abdominal pain accompanied by profuse cold sweating in a cardiac patient with apparently normal abdomen, hyperactive bowel sounds, and a history of embolic events should always raise the suspicion of acute mesenteric ischemia and should be verified immediately by mesenteric angiography. A high index of suspicion, aggressive measures for early diagnosis, and early operative treatment are presently the only possibilities to provide a better outcome.
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PMID:Acute superior mesenteric arterial occlusion: a plea for early diagnosis. 63 86

We describe a patient with acute intestinal ischemia successfully treated with embolectomy of the superior mesenteric artery. Over the last four years, 11 patients with the same disease were treated with bowel resection at Nordland Regional Hospital. The mortality rate after bowel resection was 45%. Long duration of symptoms, and high frequency of associated cardiovascular disease was characteristic. In elderly patients with acute abdominal pain and cardiovascular disease, a diagnosis of acute mesenterial ischemia should be seriously considered. In patients with acute mesenteric ischemia and no bowel necrosis, embolectomy must be considered in preference to bowel resection.
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PMID:[Surgical treatment of acute intestinal ischemia. Successful treatment with embolectomy of the superior mesenteric artery]. 141 88

Eighteen hemodialysis patients with the diagnosis of mesenteric ischemia (MI), admitted to the Renal Service in the last 5 years, were retrospectively reviewed. All patients, 10 males and 8 females, average age 66.3 +/- 8.6 years, were complaining of acute abdominal pain without other specific clinical or laboratorial findings, had their diagnosis confirmed during laparatomy, with ischemic involvement of the ileocecal/ascendant colon area in 14 cases and the small bowel in 4. Noteworthy was the high incidence of previous dialysis-induced hypotensive episodes (10/18), the presence of leukocytosis (13/18), the high average hemoglobin level of 9.4 gr/dl, and the constant finding of non-occlusive MI. Average time in-hospital was 15.4 days (2 to 30) and the mortality--88% (16 patients). The growing incidence of MI mostly of the non-occlusive type, and its grim prognosis, calls for an early diagnosis of functional ischemic colitis, and the adoption of preventive action to avoid bowel infarction.
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PMID:[Mesenteric ischemia in hemodialysis]. 160 63

A 79-yr-old man with previously documented atherosclerotic vascular disease presented with acute abdominal pain, signs of peritoneal irritation, and guaiac-positive stool. A mesenteric arteriogram showed high-grade stenosis of the superior mesenteric artery with a pressure gradient of 70 mmHg and complete occlusion of the inferior mesenteric artery. Percutaneous transluminal angioplasty of the superior mesenteric artery was performed with immediate reduction of the pressure gradient, increase in vessel caliber, and relief of abdominal pain. The patient went on to complete recovery and remains pain-free 6 mo after discharge from the hospital. To our knowledge, this is the first report of percutaneous transluminal angioplasty used to treat acute mesenteric ischemia.
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PMID:Treatment of acute mesenteric ischemia by percutaneous transluminal angioplasty. 294 29

A case of mesenteric vascular occlusion is detailed. The 30-year-old female had abdominal pain, bloody diarrhea, and small bowel changes seen on x-ray. She had begun taking the oral contraceptive Ovral (.5 mg norgestrel, .05 mg ethinyl estradiol) 3 years prior to hospital admission. Symptoms began to disappear when her oral contraception was discontinued on the ninth hospital day. Over the next 5 days abdominal signs and symptons subsided progressively. A follow-up small bowel series showed complete disappearance of previous abnormalities. In the differential diagnosis of acute abdominal pain progressing to bloody diarrhea, especially in young women or oral therapy, acute vascular insult with small bowel ischemia must be considered.
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PMID:Reversible mesenteric vascular occlusion associated with oral contraceptives. 470 Oct 37

Four cases of pneumatosis intestinalis detected by computed tomography (CT) are described. Plain abdominal films obtained on the same day as CT failed to show pneumatosis in three of the four cases. The CT appearances characteristic of pneumatosis intestinalis are cystic, linear, or curvilinear gas collections in the periphery of distended, partly fluid-filled loops of bowel. Two of the four cases had underlying bowel infarction. Evidence of pneumatosis should be carefully looked for in patients with acute abdominal pain referred for CT examination. Computed tomography may be a useful modality for the early diagnosis of bowel ischemia when plain abdominal films are noncontributory.
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PMID:Computed tomography of pneumatosis intestinalis. 670 77

Two patients with sudden onset of acute abdominal pain caused by embolic disease of the superior mesenteric artery (SMA) were evaluated angiographically. In one patient, the study was performed soon after the clinical onset of symptoms, and successful treatment with low-dose topical streptokinase infusion produced total lysis of the clot over a period of 30 h. In the second patient, the angiogram was obtained 6 days following the initial episode of pain. Radiographic and clinical findings indicated advanced gastrointestinal ischemia with bleeding which contraindicated the use of fibrinolytic therapy. Surgical resection of infarcted intestine was required. Early angiographic detection of acute mesenteric thrombus or embolus is crucial for the selection of patients for fibrinolytic therapy. Our cases suggest that with early diagnosis, streptokinase infusion is an alternative to surgical management of selected patients with acute mesenteric ischemia.
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PMID:Treatment of acute embolus of the superior mesenteric artery by topical infusion of streptokinase. 673 30

The patient with acute abdominal pain presents the attending physician with a wide and varied gamut of diagnostic possibilities. Prompt and accurate diagnosis is essential for the proper care and management of these acutely ill patients. Diagnostic radiology is often an integral part of the emergent evaluation of these patients. This article focuses on some of the key plain-film findings in the patients suffering from acute abdominal pain of intestinal causes and reviews the radiologic evaluation of several major abdominal conditions such as acute appendicitis, diverticulitis, inflammatory bowel disease, bowel ischemia, and infarction.
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PMID:The radiologic evaluation of acute abdominal pain of intestinal origin. A clinical approach. 837 22

The aim of our study was to assess the feasibility of using Doppler sonography for the detection of acute intestinal ischemia due to occlusion of the superior mesenteric artery. Between September 1993 and March 1995, abdominal sonography with Doppler imaging of the mesenteric vessels was performed in 770 patients with emergency admissions for acute abdominal pain. In six cases, the diagnosis, based on surgery or arteriography and computed tomography, was acute intestinal ischemia due to complete or localized occlusion of the superior mesenteric artery. Five cases of occlusion of the superior mesenteric artery were correctly detected by Doppler sonography. These results suggest that Doppler sonography may be a feasible method for detecting acute intestinal ischemia due to proximal superior mesenteric artery occlusion.
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PMID:Acute intestinal ischemia due to occlusion of the superior mesenteric artery: detection with Doppler sonography. 868 69


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