Gene/Protein Disease Symptom Drug Enzyme Compound
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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 37-year-old woman underwent an emergency operation at our hospital because of severe abdominal pain and ileus. Most of her small intestine and ascending colon were observed to have become necrotic due to occlusion of her superior mesenteric artery (SMA). Pathological findings of the resected intestine revealed that her SMA was completely thrombosed 2 cm distal from its origin with smooth muscle proliferation. Post-surgical blood analysis of her pre-operative serum was positive for lupus anticoagulant and antinuclear antibodies. She noticed vaginal bleeding due to missed abortion on the 31st day after the operation. We diagnosed her acute abdominal pain to be that of antiphospholipid syndrome associated with her pregnancy.
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PMID:Antiphospholipid syndrome complicated by thrombosis of the superior mesenteric artery, co-existence of smooth muscle hyperplasia. 924 May 7

We report three cases of severe haemorrhagic rupture of luteal ovarian cyst requiring surgical haemostasis in young women treated with long-term oral anticoagulation for antiphospholipid syndrome (APS) who used no contraception. At the time of bleeding, the international normalized ratios were 3.78, 4.24, and 7.11. Anticoagulation was resumed post-operatively, in association with antigonadotropic progestins to induce ovulatory suppression. A systematic use of these progestins should probably be discussed in young women receiving long-term warfarin for APS. Ovarian haemorrhage must be considered when such patients develop acute abdominal pain.
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PMID:Massive ovarian haemorrhage complicating oral anticoagulation in the antiphospholipid syndrome: a report of three cases. 1048 20

Medium-sized artery aneurysms are rare in patients with systemic lupus erythematosus (SLE). We report on a 21-year-old Chinese man with SLE and secondary antiphospholipid syndrome (APS) who presented with acute abdominal pain due to a ruptured right hepatic artery aneurysm. He was also found to have aneurysms of the left hepatic artery and splenic artery on autopsy. There have been only eight cases of hepatic artery aneurysm and one case of splenic artery aneurysm associated with SLE in the English literature. Abdominal aneurysm must be suspected in SLE patients presenting with acute abdominal pain, haemoperitoneum or occult bleeding.
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PMID:Abdominal crisis in a young man with systemic lupus erythematosus. 1628 47

The catastrophic variant is an accelerated form of the antiphospholipid syndrome resulting in multiorgan failure because of multiple small vessel occlusions. We report a case of catastrophic antiphospholipid syndrome in a patient with subacute cutaneous lupus erythematosus and ischemic bowel, who presented with acute abdominal pain due to diffuse right colon and small bowel necrosis requiring large resection, associated with acute respiratory distress syndrome, thrombocytopenia and disseminated intravascular coagulation. Histopathological examination of resected tissues showed diffuse arteriolar and venous thrombosis but no vasculitis, and mesenteric artery lumen severely narrowed by intimal fibrosis. The patient died 15 days after admission despite treatment with anticoagulation, steroids, continuous hemofiltration and plasma exchange. Ischemic bowel and diffuse intestinal necrosis may be secondary to the antiphospholipid syndrome, and a high level of suspicion and an early diagnosis are required.
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PMID:Diffuse large and small bowel necrosis in catastrophic antiphospholipid syndrome. 1689 16

Women taking anticoagulants or those with a clotting factor deficiency are at increased risk of corpus luteum rupture due to coagulation abnormalities and three such cases are described here. Case 1 was a 35-year-old woman with prosthetic mitral valve replacement who was on anticoagulant therapy, in whom hemoperitoneum secondary to ruptured corpus luteum was seen. Emergency laparotomy revealed 1.2 L of massive hemoperitoneum. Left salpingo-oophorectomy was performed. Case 2 was two episodes of hemoperitoneum from luteal cyst rupture in a young patient with the rare congenital factor X deficiency. This patient was managed conservatively with fresh frozen plasma and blood transfusion. This is the first case of congenital factor X deficiency manifested as luteal rupture to be managed conservatively. Case 3 was two episodes of hemoperitoneum from luteal cyst rupture in a patient with antiphospholipid antibody syndrome who was on oral anticoagulants. Laparotomy was done twice with left salpingo-oophorectomy in the first instance and partial excision of the right ovary in the second instance. Hemoperitoneum secondary to rupture of the corpus luteum should be considered in the differential diagnosis of acute abdominal pain in women with congenital and acquired coagulation deficiencies.
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PMID:Corpus luteum hemorrhage: rare complication of congenital and acquired coagulation abnormalities. 1757 71

There are various causes of splenic infarction. Antiphospholipid antibody is associated with numerous thromboembolic phenomena. We report a case of young male who presented with acute abdominal pain and was diagnosed as a case of splenic infarction and acute pancreatitis with antiphospholipid syndrome. He was positive for anticardiolipin antibody, showed splenic infarction on abdominal CT scan. The patient's clinical, laboratory and imaging finding were consistent with splenic infarction and acute pancreatitis associated with antiphospholipid syndrome.
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PMID:[A case of acute pancreatitis and splenic infarction associated with antiphospholipid syndrome]. 1915 73

Antiphospholipid syndrome (APS) is a systemic autoimmune disease, which may be primary or secondary to other autoimmune diseases. It produces thrombosis of arteries and veins of any caliber, and no organ is immune to its insult. This report describes two cases of massive gastric gangrene due to primary APS, which presented in a span of 2 years. In the first case a multiparous, 40-year-old woman presented with acute abdominal pain, hematemesis, and progressive abdominal distension, and was in azotemia and shock. A laparotomy revealed gangrene of the stomach without any other organ involvement. She was managed with a total gastrectomy and esophagojejunal anastomosis. Postoperative serology revealed a persistent elevation of anticardiolipin antibody with no other apparent predisposing cause. The histopathological examination of the specimen revealed characteristic extensive intramural vascular thrombosis without inflammatory changes in the vessel wall, confirming antiphospholipid syndrome. The second patient was a primiparous, 26-year-old woman who had severe abdominal pain in the first trimester followed by shock. An exploratory laparotomy revealed massive gangrene of the stomach with complete loss of the posterior wall and hemoperitoneum. She also underwent a total gastrectomy with esophagogastric anastomosis and was later managed in the intensive care unit, where she succumbed within 8 days. Her serology showed a highly elevated anticardiolipin antibody titer, and histopathological examination of the stomach revealed characteristic intramural vascular thrombosis without inflammatory cellular infiltrate in the vessel wall. Patients undergoing a total gastrectomy following acute gastric necrosis have very high mortality (50%-80%). Its association with APS is rare and it has not been previously reported. The combination is a formidable challenge to the physician and a dangerous disease for the patient. The rarity of the condition and its grave prognosis is highlighted.
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PMID:Massive gangrene of the stomach due to primary antiphospholipid syndrome: report of two cases. 2010 59

Catastrophic antiphospholipid syndrome (APS) in pediatric medicine is rare. We report 3 adolescents who presented with acute onset of severe abdominal pain as the first manifestation of probable catastrophic APS. The 3 patients, 2 male patients and 1 female patient were 14 to 18 years old. One had been diagnosed with systemic lupus erythematosus in the past, but the other 2 had no previous relevant medical history. All presented with excruciating abdominal pain without additional symptoms. Physical examination was noncontributory. Laboratory results were remarkable for high inflammatory markers. Abdominal ultrasonography was normal, and abdominal computed tomography scan showed nonspecific findings of liver infiltration. Only computed tomography angiography revealed evidence of extensive multiorgan thrombosis. All patients had elevated titers of antiphospholipid antibodies. The patients were treated with full heparinization, high-dose steroids, and intravenous immunoglobulin with a resolution of symptoms. One patient was resistant to the treatment and was treated with rituximab. In conclusion, severe acute abdominal pain can be the first manifestation of a thromboembolic event owing to catastrophic APS even in previously healthy adolescents. Diagnosis requires a high index of suspicion with prompt evaluation and treatment to prevent severe morbidity and mortality.
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PMID:Severe abdominal pain as a presenting symptom of probable catastrophic antiphospholipid syndrome. 2271 21

A 33-year-old male with systemic lupus erythematosus (SLE) presented with acute abdominal pain and was found to have lupus mesenteric vasculitis on imaging and during exploratory laparotomy. Post laparotomy he continued to have persistent nausea and dyspepsia and an electrocardiogram showed evidence of an inferior ST elevation myocardial infarction (STEMI). Emergency cardiac catheterization showed evidence of thrombotic right coronary artery occlusion. His coronaries were otherwise normal with no evidence of underlying coronary artery disease. Extensive workup with trans-esophageal echo, serologies for antiphospholipid antibody syndrome (APS) and bubble study was negative. This effectively ruled out Libman-Sacks endocarditis, APS-induced arterial thrombus and paradoxical emboli as potential causes of his STEMI. By exclusion of other causes, the etiology of his STEMI was felt to be secondary to in-situ coronary artery thrombosis in the setting of active SLE. To the best of our knowledge, this is the first report of a patient with SLE presenting with both lupus mesenteric vasculitis and in-situ coronary arterial thrombosis in the absence of APS.
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PMID:Spontaneous coronary artery thrombosis in the setting of active lupus mesenteric vasculitis. 2567 73