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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 procedure was devised to quickly and reliably determine the patency of the cystic duct in patients suspected of having acute cholecystitis. First the gallbladder was stimulated to empty by a cholecystokinin injection. Thirty minutes later a radiolabeled biliary marker, either 150 muCi 131-I rose bengal or 2 mCi 99-mTc dihydrothioctic acid, was injected, and the accumulation of radioactivity in the liver and gallbladder regions was monitored by external gamma emission imaging and recording devices. The images of diagnostic importance were obtained between 60 and 90 minutes after injection of the tracer. Thirty-nine patients with acute abdominal pain were studied. Ten patients who had acute cholecystitis failed to show gallbladder accumulation of radioactivity, reflecting the cystic duct obstruction that initiates this disease. Twenty-nine patients having a variety of other diseases all showed gallbladder accumulation of activity, indicating in each patient that the cystic duct was patent. No significant adverse effects were noted. We conclude that the procedure is a useful adjunct to the clinical and roentgenographic evaluation of patients with acute abdominal pain.
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PMID:A test for patency of the cystic duct in acute cholecystitis. 111 65

Two patients presented with fever and acute abdominal pain. Acute cholecystitis was diagnosed when ultrasound examination showed a double-contour gallbladder wall. Radiography showed gas in the gallbladder wall in both cases, indicating emphysematous cholecystitis. This demonstrated that gas in the gallbladder wall may go undetected by ultrasound at the time when it could still be detected by conventional radiography of the abdomen. Awareness of the value of conventional radiography in these cases has an important diagnostic significance which may affect patient management.
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PMID:False negative sonographic finding in emphysematous cholecystitis. 296 36

Reported injuries from vibrating tools include vibration syndrome, arthropathies, pneumomediastinum, and rupture of the sigmoid colon. The use of jackhammers in particular is associated with these injuries. The authors have identified a construction worker who suffered torsion of the omentum as a result of using a 42.75-kg (95 lb) jackhammer. His clinical presentation of right upper-quadrant pain and fever was confused with acute cholecystitis, and it was not until laparotomy that the correct diagnosis was made. This diagnosis should be suspected in workers who experience acute abdominal pain and are exposed to vibration or repetitive blunt abdominal trauma.
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PMID:Primary torsion of the omentum in a jackhammer operator: another vibration-related injury. 273 21

The Research Committee of the World Organization of Gastroenterology has gather information regarding the etiology of acute abdominal pain. Seven diseases cover 96% of the causes of this syndrome in many countries of the world, but some geographical variations have been observed. One example of these variations is amoebic liver abscess, present in 5 to 10% of Mexico City patients. Right upper quadrant pain is often present in amoebic liver abscess and acute cholecystitis. Thus, differential diagnosis of these two entities is difficult. Using discriminant analysis and "stepwise" procedures in 100 cases with cholecystitis and a similar number of patients with amoebic liver abscess, we found six variables (symptoms and signs with a significant chi square to distinguish between these two diseases. The symptoms and signs chosen were hepatomegaly, Murphy's sign, duration of pain greater than or equal to 48 hours, previous history of abdominal pain, dysentery, and facial pallor. These variables proved to be better than laboratory test results. With five of these variables it was possible to obtain an accuracy of 92%. Using six variables, if cases of tie (three variables present and three absent) were excluded, accuracy rose to 96%.
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PMID:Differential diagnosis between amoebic liver abscess and acute cholecystitis. 635 41

By 1982, the central analysis team of this on-going multinational survey had received a total of 8,723 cases for analysis and had accepted 8,480. In all some 23 centres in 15 countries, involving over 200 doctors had participated in this survey. A common protocol was used for data collection; around 98% of all possible data was recorded (using pre-circulated definitions) and analysed via a computer-aided system in Leeds, England. As before, the most common surgical diagnosis was acute appendicitis (2336 of 8,480 cases, 27.5%) followed by acute cholecystitis (800 cases, 9.4%). The construction of a worldwide database of information about 6.097 patients is described--as is its use both in diagnosis and in teaching. Particular attention is given to the construction of a computer program which allows medical students to compare their impression of acute abdominal pain with 'reality' as evidenced in these 6,097 patients. As regards additional cases, particular stress has been laid on acquisition of material from countries outside Europe and North America. Series from Mexico (893 patients) and Thailand (311 patients) are discussed in detail, and the implications for future work are reviewed.
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PMID:The O.M.G.E. Acute Abdominal Pain Survey--progress report, 1982. 637 50

The efficacy of 99mTc cholescintigraphy in the diagnosis of gallbladder disease was studied in 116 patients. Sixty-one demonstrated gallbladder visualization (normal) and 55 had nonvisualization. In patients with acute abdominal pain, test sensitivity is 100%, specificity is 77%, and accuracy is 83% for the diagnosis of acute cholecystitis; no patient with gallbladder visualization had acute cholecystitis. Test sensitivity for any form of gallbladder disease is 66%, specificity is 82%, and accuracy is 71%; excluding patients with laboratory evidence of hepatobiliary disease, the predictability of acute or chronic cholecystitis increases to 100%. Cholescintigraphy demonstrated common bile duct patency in all eight post-cholecystectomy patients referred for evaluation of possible choledocholithiasis. Thus, gallbladder visualization with 99mTc-PIPIDA virtually excludes the diagnosis of acute cholecystitis, an abnormal test is a good predictor of gallbladder disease because of high specificity, and cholescintigraphy is extremely safe and simple to perform and may be used to demonstrate common bile duct patency.
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PMID:99mTc-PIPIDA cholescintigraphy in the diagnosis of gallbladder disease. 714 87

A 40-year-old woman presented with acute epigastric pain with vomiting. Within 24 hours, the pain spread to the right periumbilical region. Tc-99m disofenin hepatobiliary scan failed to demonstrate the gallbladder on a 60-minute view. The presumative diagnosis of acute cholecystitis was thought to be confirmed on this basis by the patient's physicians. However, a 75-minute view demonstrated filling of the gallbladder. In hepatobiliary scanning for acute abdominal pain, delayed views (2 to 24 hours) are recommended when the gallbladder is not visualized on the 60-minute view. If the gallbladder is visualized, cystic duct obstruction can be excluded and diagnoses such as pancreatitis, acalculous cholecystitis, and acute appendicitis should be investigated.
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PMID:Hepatobiliary scan with delayed gallbladder visualization in a case of acute appendicitis. 720 Aug 46

Acute abdominal pain frequently accompanies sickle cell crisis. The character of this pain may be difficult to discriminate from acute surgical processes such as acute cholecystitis or appendicitis. Seven patients with sickle cell disease presenting with abdominal pain underwent surgery. Review of the medical records demonstrated a characteristic pattern of presentation consistent from crisis to crisis. When patients with known sickle cell disease present with symptoms of abdominal pain, (1) the character of the symptoms, (2) precipitating events, (3) white blood cell count, (4) bilirubin, and (5) fever should be compared with those characteristics in previous crises. Deviation from previous patterns suggests an illness caused by problems other than sickel cell crisis.
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PMID:Acute surgical illness in patients with sickle cell anemia. 725 5

Sixty patients were evaluated for acute abdominal pain using technetium-99m PIPIDA hepatobiliary imaging. The sensitivity of the test was 90.6 percent in all patients and the accuracy was 93.3 percent. In the evaluation of acutely ill patients with right upper quadrant pain, fever, nausea and vomiting, hepatobiliary imaging with PIPIDA is the preferred test for diagnosing acute cholecystitis. If the test is positive, disease of the gallbladder and probably acute cholecystitis are present. Early operation can proceed if desirable. If the test is negative and the bilirubin level is less than 5.0 mg/dl, acute cholecystitis is not present. In such cases conservative treatment is appropriate, and follow-up tests should be performed to evaluate the possibility of chronic cholecystitis. When the bilirubin level exceeds 5.0 mg/dl, the test is often indeterminate.
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PMID:Diagnosis of acute cholecystitis using hepatobiliary scan with technetium-99m PIPIDA. 728 23

In addition to plain X-ray of the abdomen, ultrasonography has proven to be an accurate complementary imaging method in acute abdominal disorders. It may furnish not only additional information but also the final diagnosis in many cases (i.e. acute cholecystitis, pancreatitis, diverticulitis, appendicitis and gynecological diseases). Ultrasound is the method of first choice especially in children, adolescents, young women and when inflammation appears to be the reason for acute abdominal pain. In this paper, the main indications for ultrasound in acute abdominal diseases are pointed out. The most common diseases are shown with their typical ultrasound appearances in short overviews. Particular reference is made to a critical approach, emphasizing relevant further investigations.
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PMID:[Ultrasound diagnosis of the acute abdomen]. 811 94


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