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)

A 25-year-old Japanese woman who had been suffering from systemic lupus erythematosus (SLE) for 12 years was admitted to our hospital with a suspected diagnosis of peritonitis after suddenly developing severe abdominal pain and distention which could not be relieved by treatment with anodyne. Noninvasive examinations did not provide enough evidence to rule out acute appendicitis, bowel perforation, or ischemia due to vasculitis. Therefore, in consideration of the severity of her uncontrollable abdominal pain, an exploratory laparotomy was performed. The operative findings revealed nonbacterial peritonitis with a large amount of ascites and an edematous small bowel. No perforation of the intestine was found. On post-operative day (POD) 3, the severe abdominal pain redeveloped, but responded well to steroid pulse therapy. Based on the operative findings and her clinical course, the most likely diagnosis was thought to be acute lupus peritonitis. It is often difficult to ascertain whether abdominal pain in an SLE patients is due to lupus peritonitis or to an underlying cause requiring surgery. Thus, it is essential that continuous and careful assessment of the surgical abdomen is performed when a patient with SLE develops acute abdominal pain, and if a surgical condition cannot be ruled out, a laparotomy should be performed without delay.
 ...
PMID:Lupus peritonitis mimicking acute surgical abdomen in a patient with systemic lupus erythematosus: report of a case. 888 45

Gastrointestinal complications of cocaine abuse occur less frequently than those of the cardiovascular and nervous systems. The clinical history and pathologic findings of three patients with cocaine-induced mesenteric ischemia are described, and the mechanism of acute and chronic cocaine-induced mesenteric ischemia is discussed. The role of preoperative angiography in detecting occlusive arterial lesions so that arterial revascularization can be carried out is emphasized. Briefly, recent intravenous cocaine use in a 45-year-old man resulted in sharply demarcated small intestinal ischemia with perforation characterized by pseudomembranous enteritis. Histologic sections of the small-bowel resection showed intraluminal fibrin and intimal hyperplasia in rare submucosal arterioles. Two women, 29 and 35 years of age, both with a 2-year history of intravenous cocaine use, presented with acute abdominal pain and had angiographic documentation of occlusion of the celiac axis and the superior mesenteric arteries. Vascular bypasses were performed in both cases. Microscopic examination of both arteries and their branches revealed total obstruction by luminal thrombus with recanalization.
 ...
PMID:Histologic spectrum of arterial and arteriolar lesions in acute and chronic cocaine-induced mesenteric ischemia: report of three cases and literature review. 980 33

Dissection is a recognized finding after blunt trauma to the abdominal aorta. Immediate and long-term prognosis is poor without surgical treatment especially since most patients present severe associated injuries. On the basis of encouraging results using endovascular techniques to treat experimental dissection of the descending thoracic aorta, we treated three patients with traumatic infrarenal abdominal aortic dissection by percutaneous stent placement. There were two men 34 and 41 years of age and one 89-year-old woman. In all patients, dissection began in the infrarenal portion of the aorta and extended into the iliac arteries. All patients had multiple associated injuries. The main symptoms were acute abdominal pain (two patients) and ischemia of the lower extremities (two patients). Diagnosis was missed in one patient despite exploratory laparotomy for an associated injury. Two patients were treated in the acute phase by placement of a self-expanding endovascular prosthesis at the aortoiliac level. The third patient was treated in the chronic phase by placement of a balloon-expandable endovascular stent. All procedures were performed uneventfully by femoral route. Success of treatment was confirmed by arteriography and computed tomography (CT) scan demonstrating obliteration of the dissection. Upon late follow-up examination, all patients were in satisfactory condition, with normal Doppler ultrasound findings. These findings confirm experimental studies using endovascular treatment for dissection of the descending thoracic aorta and are promising for future clinical management.
 ...
PMID:Endovascular management of traumatic infrarenal abdominal aortic dissection. 984 80

Volvulus of the sigmoid colon is rare in children. An early, accurate diagnosis can avoid unnecessary surgery and reduce the risk of complications. This condition is mainly due to a redundant sigmoid colon with a narrow mesosigmoid attachment. We describe two cases of sigmoid volvulus, which showed different clinical severities and were treated with different methods. Patient 1, a 9-year-old boy, presented with acute abdominal pain and vomiting. Patient 2, an 11-year-old boy, presented with abdominal pain, abdominal distention, and bloody mucoid stool. Plain abdominal radiographs revealed a distended colonic loop extending upward from the pelvis in patient 1 and a typical "coffee bean" sign in patient 2. Barium enema examination was used to confirm the diagnosis in both cases. The volvulus was reduced by insertion of a rectal tube in patient 1 and surgically in patient 2. Sigmoid colon volvulus should be included in the differential diagnosis of childhood abdominal pain or distention. This report suggests that nonsurgical reduction should be attempted first for uncompromised sigmoid volvulus in children, unless bowel ischemia or perforation develops.
 ...
PMID:Sigmoid volvulus in children: report of two cases. 1139 2

Acute appendicitis remains one of the most difficult diagnoses to make in the Emergency Department. We present a puzzling and unusual case. A 47-year-old man had several hours of acute abdominal pain in the right upper quadrant, point tenderness in the right midquadrant on examination, and normal chemistries. Early appendicitis was suspected and a computed tomography (CT) scan of the abdomen was obtained. Appendicitis was not seen. What was evident was a retroperitoneal lipoma estimated to weigh 10 pounds. The general surgeon was consulted who believed that operation was necessary in light of the patient's continuing abdominal pain and the presence of the mass. Masses this large could cause pain from local compression of structures, or ischemia of the mass from outgrowing its blood supply. In surgery, a lipoma was observed that filled most of the retroperitoneum and displaced all the contents of the abdomen, including the cecum and its appendix. Also present was an acute appendicitis. On retrospective analysis of the CT scan, the appendicitis was evident but atypically located in the epigastrium. This case illustrates once again that the CT scan is a useful diagnostic adjunct for the diagnosis of new onset abdominal pain and specifically for appendicitis.
 ...
PMID:Appendicitis masquerading as tumor: a case of two diagnoses. 1172 67

Laparoscopic antireflux procedures currently are considered to be as safe, cost efficient, and effective as the techniques used previously in antireflux surgery, although life-threatening complications after antireflux surgery have been reported with both open and laparoscopic fundoplication. We report the case of a 38-year-old man who presented with acute abdominal pain and vomiting 8 months after a laparoscopic Nissen-Rosetti fundoplication. The diagnosis of gastric volvulus was suspected. The endoscopic examination showed a proper location of the fundoplication and features consistent with early gastric ischemia. Rotational maneuvers failed to untwist the volvulus. Emergency surgery was performed, involving a conventional laparotomy. At surgery, the volvulus was found related to a thick adhesion between the opening of the xiphoidal cannula and the hilus hepatis. The section of the adhesion allowed immediate untwisting of the volvulus. Despite a general assumption that laparoscopic procedures will reduce the incidence of postoperative adhesion formation, it should be kept in mind that laparoscopic techniques do not preclude the deposit of unusual foreign microbodies, which is an admitted mechanism of adhesion formation.
 ...
PMID:Acute gastric volvulus related to adhesions after laparoscopic fundoplication. 1192 46

Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective.
 ...
PMID:Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. 1197 65

A 32 years old female was admitted to hospital due to acute abdominal pain, nausea, vomiting and liquid stools. Physical examination was normal except for pain on her left inferior abdominal quadrant without peritoneal irritation signs. An abdominal CAT-scan suggested thrombosis at celiac trunk, although the echo Doppler showed no alterations except for signs of ischemia in the distal branch of the superior mesenteric artery. An exploratory laparotomy was performed disclosing a necrosis of the distal ileum and cecum, diffuse peritonitis and thrombosis of the ileocecoapendiculocolic artery. No vasculitis lesions were found in the arteries of medium size examined. A history of intermittent claudication for the past 3 years as well as acrocyanosis, asymmetry of pulses and blood pressure in the superior extremities was ascertained after the surgery. A MRI angiogram showed multiple stenoses and irregularities at the celiac trunk, hepatic, superior mesenteric and fibular arteries. No abnormalities at the aortic arch and its main branches were documented. A sepsis due to Candida sp complicated her postoperative period. After recovery, prednisone 1 mg/kg/day was started and the anticoagulation continued. The abdominal pain, intermittent claudication and superior limb acrocyanosis disappeared. This is an unusual case of type IV Takayasu's arteritis with acute abdominal signs as the first manifestation.
 ...
PMID:[Intestinal necrosis as clinical presentation of Takayasu arteritis]. 1249 34

Partial mesenteric ischemia is defined as an incomplete occlusion of the superior mesenteric artery resulting in acute abdominal pain, distended abdomen,and bowel hypomotility on auscultation. This disease can be acute or chronic and is caused by vascular occlusion or non-occlusive mechanisms. CT scan and ultrasound show a thickening of the ischemic bowel wall. On endoscopy, initially mucosal edema is observed which may proceed to necrosis. Therapy modalities depend upon the clinical findings: prevailing acute abdominal pain and peritonitis result in emergency laparotomy; prevailing cramping abdominal pain without clinical signs of peritonitis allows time for further diagnostic steps such as mesenteric angiography and interventional procedures. Laparoscopy should be performed in exceptional situations only.
 ...
PMID:[Partial ischemia. Occlusive and nonocclusive mesenteric ischemia, ischemic colitis, systemic lupus erythematosus]. 1274 89

A 42-year-old Japanese man who had undergone amputation of the left leg below the knee because of Buerger disease required emergency thrombectomy 7 months later. He complained of acute abdominal pain after thrombectomy. At aortography the distal superior mesenteric artery and its branches were not well visualized. Emergency laparotomy was performed because of suspected intestinal ischemia, and the terminal ileum and cecum and part of the ascending colon were resected. In total, the patient underwent laparotomy four times. Histopathologic findings revealed that the arteries and veins of the resected small intestine were occluded with organized thrombi. Inflammatory cell infiltration was recognized mainly in the intima. These findings are compatible with Buerger disease.
 ...
PMID:Ischemic intestinal involvement in a patient with Buerger disease: case report and literature review. 1476 Aug 32


<< Previous 1 2 3 4 5 6 7 8 Next >>