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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 causes of acute abdominal pain among children admitted to a surgical department were few and the fraction that needed surgical treatment was low (37%). The surgical intervention rate was age-dependent, rising from 11.4% (zero to three years of age) to 48.9% (12-15 years of age). The increase in surgical intervention rate was due to increasing incidence of acute appendicitis while the incidence of intestinal obstruction was unchanged during childhood. No child below the age of four had appendicitis, and the rate of perforated appendix among children seven years and younger (41.7%) was significantly higher than among children eight years and older (20.4%). For acute appendicitis, the surgeons' diagnostic accuracy was 77.9% and there was no significant difference between complications after appendectomy for appendicitis and complications after negative laparotomy. The diagnostic value of biochemical measurements was limited. However, the combined evaluation of C-reactive protein measurements and leucocyte counts possibly supports further observation rather than immediate operation.
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PMID:[Acute abdomen among children and adolescents. A retrospective study of 470 children and adolescents with acute abdominal pain]. 823 18

Three cases of acute abdominal pain in children are presented. The clinical diagnosis was acute appendicitis and emergency appendectomy was performed. The histopathological study showed the presence of Enterobius vermicularis and chronic inflammatory changes in the appendix.
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PMID:[Appendiceal disease caused by Enterobius vermicularis. Presentation of 3 cases]. 831 85

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

To understand the surgical approach to acute abdominal pain, the internist must be familiar with common presentations of most abdominal emergencies; these emergencies include acute appendicitis, acute gall bladder disease (biliary colic, acute cholecystitis, and acute pancreatitis), ischemic bowel disease and ischemic colitis, abdominal aortic aneurysm, and intestinal obstruction. Nothing compares to experience; this article reviews the salient points that deserve consideration.
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PMID:An internist's approach to acute abdominal pain. 837 23

Acute appendicitis is believed to be one of the commonest causes of the acute abdomen in tropical Africa. Negative appendicectomy rates are usually above 20%, which is now considered unacceptably high because of increased risk to patients and the availability of diagnostic facilities to aid clinical decision-making. Our negative appendicectomy rate over a 4-year retrospective period was 29.7% in males, and 47% in females. These reduced to 11% and 10%, respectively, after the introduction of laparoscopy for doubtful cases of acute abdominal pain.
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PMID:Another look at acute appendicitis in tropical Africa: and the value of laparoscopy in diagnosis. 848 83

We report a case of a 28-year-old female, Grava 2, Para I, Ab. 0, who presented acute abdominal pain on the 21st week of her gestation. A diagnosis of acute appendicitis was entertained and an appendectomy performed. The pathologic specimen revealed an inflamed appendix with endometriosis and a marked decidual reaction. A decidual polyp, which occluded most of the appendiceal lumen, is proposed as a rare cause of acute appendicitis during pregnancy.
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PMID:Endometriosis of the appendix with decidual polyp formation: a rare cause of acute appendicitis during pregnancy. 858 24

A retrospective analysis of 224 patients was carried out to evaluate the outcome of elderly patients after operation for acute abdominal pain. The mean (+/- SD) age of the patients was 74.6 (+/- 6.4) years (range 65-96) and the male/female ratio was 104/120. The most common causes for an emergency operation were acute biliary disease (26%), acute appendicitis (18%), gastrointestinal cancer (11%) and incarcerated hernia (10%). Twenty-nine patients (13%) died during the one-month postoperative period. The most common causes of death were gastrointestinal cancer (24%), ischaemic heart disease (14%) and complicated peptic ulcer disease (14%). Ninety-two (41%) patients had non-lethal postoperative complications, the commonest of which were wound infection or dehiscence (28%), urinary tract infection (17%), and paralytic ileus (8%). Ten patients were reoperated on for postoperative complications. The mean hospitalization time was 12.5 days (range 1-99). The results in the analysis of the long-term outcome (mean follow-up time 21 months) revealed that 17% of the primarily survived patients had died. Living patients were satisfied with the treatment and only a few patients were institutionalised after surgery. We conclude that both the short-term and long-term outcome of elderly patients after an emergency abdominal operation is good in benign diseases, and active surgery is justified.
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PMID:The outcome of elderly patients after operation for acute abdomen. 873 27

99 patients, 67 of whom were female, with a mean age of 25.5 years, were admitted as emergencies between 1991 and 1992 for acute abdominal pain of unknown aetiology. The follow-up, carried out prospectively, was 100% at 1 month, 98% at 6 months, 95% at 1 year, 84% at 2 years. The patients were divided into 3 groups: group I: 42 patients only underwent investigations; group II: 31 underwent laparoscopy, and the appendix was left in place after being considered to be normal by the surgeon; group III: 26 underwent laparoscopic appendicectomy for a histologically normal appendix. For 90% of patients, the painful episode never returned. In the other cases the pain returned within one year, but there was no difference between the three groups (11.2%, 9.6%, 11.5%) (ns). The causes found at the second admission were largely genital, or rare diseases (Crohn, Spiegel hernia). 2 patients were operated for acute appendicitis, not recognized in Group I. In those who had a laparoscopy (Group II and III), the incidence of persistent pain was identical whether the appendix was considered to be normal by the operating surgeon or found to be normal histopathologically. This study suggests that: after admission for acute abdominal pain of unknown cause, the incidence of recurrence of pains is of the order of 10% within one year; the investigations carried out during the patient's admission, allowed the exclusion of serious diseases for three years; the risk of missing a true appendicitis is small (2.5%) and has no prognostic significance; the finding of a normal appendix during laparoscopy should not necessarily lead to its removal; one year follow-up is sufficient to assess the outcome of abdominal pain of unknown cause.
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PMID:[What are abdominal painful syndromes of unexplained origin? Prospective study: 99 patients followed for three years]. 876 28

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.
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PMID:Lupus peritonitis mimicking acute surgical abdomen in a patient with systemic lupus erythematosus: report of a case. 888 45

From the surgical point of view acute abdominal pain is the cardinal symptom of acute abdomen. Additional leading symptoms of acute abdomen are tension of the abdominal wall, peristaltic disorders and, in rare cases, shock symptoms. Acute abdomen is an operational diagnosis for painful, in part life threatening diseases of various etiologies. The most frequent cause is acute appendicitis, followed by cholecystitis and by diverse forms of ileus. These three diseases together are the cause of acute abdomen in more than 80% of cases. Over 90% of cases with acute abdomen are treated surgically. The decision in favour of a surgical intervention must be determined within minutes to hours depending on the etiology. A delay may lead to further, partly most serious sequelae.
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PMID:[Acute abdominal pain. Surgeon's viewpoint]. 908 28


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