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

The authors report on a case of midgut volvulus in a 27-year-old man who presented with bilious vomiting and acute abdominal pain. US demonstrated a reversal of the normal relationship between the superior mesenteric artery (SMA) and superior mesenteric vein (SMV). A clockwise whirlpool sign, diagnostic for midgut volvulus, was not visualised. In a further assessment, upper gastrointestinal series demonstrated obstruction in the second part of the duodenum highly suspicious of Ladd's bands. Malpositioning of bowel structures, as already suggested by the reversal of the SMA and SMV on ultrasound, and a distinctive whirl pattern due to the bowel wrapping around the SMA was demonstrated on CT. Furthermore angiography revealed focal twisting of the SMA. US is the first imaging modality to perform in suspicion of midgut volvulus. When inconclusive, CT is in our opinion the next stage in the diagnostic work-up.
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PMID:Midgut volvulus in an adult patient. 1283 19

We present a case of massive gastric wall necrosis associated with volvulus of the stomach occurring 17 months after laparoscopic gastric banding. The 19- year-old female was admitted to our hospital with acute abdominal pain with rapid deterioration from massive necrosis of a distended stomach which perforated distal to the gastric band, accompanied by splenic infarction. Total gastrectomy and spenectomy were required. We present this very rare complication which should be recognized and treated early, so that a less drastic operation is possible.
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PMID:Gastric wall necrosis from organo-axial volvulus as a late complication of laparoscopic gastric banding. 1501 62

Acute abdominal pain in children occurs often and requires rapid clarification. Hints as to the condition are often given by the first impression and the case history of the patient. When the clinical examination and laboratory results do not lead to a clear finding, imaging methods such as a sonography can clarify the case. The most common cause for abdominal pain in infants is acute enteritis, mostly brought about by rotaviruses. Additional diagnoses are abdominal hernia, malrotation, hypertrophic pyloric stenosis, invagination or gastroesophageal reflux. In school-age children, the classic finding is "appendicitis". This should be differentiated from constipation, gastritis, pancreatitis, sigmoid volvulus, bowel and intestinal obstruction or, perhaps, gallstone trouble.
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PMID:[Acute abdominal pain in childhood]. 1536 66

Caecal volvulus is an infrequently encountered clinical condition and an uncommon cause of intestinal obstruction. Patients with this condition may present with highly variable clinical presentations ranging from intermittent, self limiting abdominal pain to acute abdominal pain associated with intestinal strangulation and sepsis. Lack of familiarity with this condition is a factor contributing to diagnostic and treatment delays. The objective of this review is to promote clinicians' awareness of this disease through patient case illustration, discussion of disease pathogenesis, clinical features, and management strategies.
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PMID:Diagnosis and treatment of caecal volvulus. 1634 1

Intestinal obstruction is a rare cause of acute abdominal pain during pregnancy. We reviewed and analyzed the medical records of four pregnant women with intestinal obstruction, treated at the Department of Surgery in the Kaohsiung Medical University Hospital during a period of 19 years, between June 1984 and December 2002. Their ages ranged from 22 to 35 years (mean, 28 yrs). Three cases had had prior lower abdominal surgery. Adhesion was the unique finding in all four patients during the operation. Enterolysis was needed to release the intestinal obstruction in three of the patients; the fourth required resection and anastomosis of the ileum as a result of volvulus. Premature labor was prevented with tocolysis in two patients. The results of this study lead us to emphasize the importance of close observation and early surgery to avoid intestinal strangulation if a pregnant woman who develops intestinal obstruction has an old surgical scar on her abdomen. Premature labor may be avoided with tocolysis.
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PMID:Intestinal obstruction during pregnancy. 1657 May 64

Midgut volvulus is rare in adulthood and if not diagnosed accurately, carries a high mortality rate. We present a case of a young adult man who presented with acute abdominal pain and was found to have malrotation with abdominal heterotaxia. Abdominal computed tomography can identify anomalies associated with intestinal malrotation. With the awareness of the potential for malrotation to predispose to midgut volvulus, the patient and his physician will have a higher index of suspicion when abdominal pain occurs. Appropriate treatment of midgut volvulus will reduce morbidity and mortality.
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PMID:Midgut volvulus in an adult patient with malrotation and abdominal heterotaxia: a case report. 1741 Mar 90

We report a case of a 38-year-old woman who presents at 31 weeks of gestation with acute abdominal pain. Computed tomography (CT) scan of the abdomen and pelvis showed a cecal volvulus. Emergency cesarean section was performed for fetal distress. Laparotomy confirmed the CT findings and a right hemicolectomy was performed. While not advocating overutilization, this case demonstrates that helical CT can be, in the correct clinical scenario, an acceptable, useful, and relatively noninvasive test in the accurate assessment of the acute abdomen in pregnancy. We review the safety and utility of medical diagnostic imaging in the assessment of the acute abdomen in pregnancy.
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PMID:Cecal volvulus in pregnancy: report of a case and review of the safety and utility of medical diagnostic imaging in the assessment of the acute abdomen during pregnancy. 1761

Primary small bowel volvulus in adults is a very rare condition, and it is defined as torsion of all or a large segment of the small intestine and its mesentery in the absence of any preexisting etiologic factors. Proper management of the patients suffering from a strangulated obstruction depends on making an early and accurate diagnosis. Timely treatment is crucial to prevent gangrene. A 49-year-old man who had a history of previous abdominal surgery was admitted to our hospital with complaints of acute abdominal pain. Simple abdominal x-ray showed multiple dilated loops of small intestine in the mid-abdomen. Enhanced abdominal computed tomography showed the distended small bowel loops and longitudinal tapering of the collapsed bowel loops. We carried out diagnostic laparoscopy to confirm the cause of suspected mechanical ileus. It revealed strangulation of the small bowel at the terminal ileum due to clockwise torsion of the bowel loop. There were no adhesions or congenital anomalies in the peritoneal cavity. The torsional segment was spontaneously reduced with minimal handling, and the strangulated portion was resected. The patient was discharged from hospital on postoperative day 6. Primary small bowel volvulus in adults is a very rare malady; if the diagnosis is uncertain, then diagnostic laparoscopy is a valuable tool for making the definitive diagnosis and administering prompt treatment.
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PMID:Laparoscopic management of a primary small bowel volvulus: a case report. 1771 63

There is a wide variety of uncommon and unusual gastrointestinal causes of acute abdominal and pelvic pain that may be prospectively diagnosed on computed tomography. We demonstrate 10 such diagnoses and briefly review the current computed tomography and clinical literature on intussusception occurring beyond early childhood, small bowel obstruction from internal hernia, cecal volvulus, intramural small bowel hemorrhage, Boerhaave's syndrome, gastrointestinal luminal foreign bodies, small bowel diverticulitis, hemoperitoneum secondary to abdominal tumor; gallstone ileus, and gallbladder torsion. Radiologists and clinicians need to be aware of these disorders, particularly with the widespread utilization of computed tomography (CT) in the management of patients with acute abdominal pain.
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PMID:Uncommon and unusual gastrointestinal causes of the acute abdomen: computed tomographic diagnosis. 1885 44

Internal hernias are a specific cause of acute abdominal pain and are a well-known complication after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Although internal hernias are a rare cause of intestinal obstruction, they may evolve towards serious complications, such as extensive bowel ischemia and gangrene, with the need for bowel resection and sometimes for a challenging reconstruction of intestinal continuity. The antecolic position of the Roux limb is associated with a decrease in the incidence of small-bowel obstruction and internal hernias. The best prevention of the formation of these hernias is probably by closure of potential mesenteric defects at the initial operation with a non-absorbable running suture. We present a patient in late pregnancy with a small-bowel volvulus following laparoscopic Roux-en-Y gastric bypass for morbid obesity and discuss the available literature. For a favorable obstetric and neonatal outcome, it is crucial not to delay surgical exploration and an emergency operation usually is mandatory.
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PMID:Small-bowel volvulus in late pregnancy due to internal hernia after laparoscopic Roux-en-Y gastric bypass. 1918 55


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