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 nationwide surveillance of mortality associated with sterilization led to the identification of the death of a woman who was using oral contraceptives (OCs) prior to operation and died as a result of mesenteric venous thrombosis after tubal sterilization. This case is reported as a reminder of the increased risk of postoperative thromboembolism associated with OC use and to suggest how this risk can be decreased. The patient was a healthy, 24-year-old, white woman with 2 living children. She did not smoke and had no history of thromboembolic disorders. She had been using OCs for several years and continued their use until the time of hospitalization for operation. The specific OC preparation she was using is unknown. The first 48 hours following the operation the patient did well except for some mild to moderate lower abdominal pain. On the 4th day, she developed severe, acute abdominal pain and suffered a cardiovascular collapse for which she required resuscitation. She was considered to be septic and dehydrated; thus, treatment with intravenous fluids and antibiotics was initiated. An echogram obtained on the 5th day after sterilization suggested the possibility of an abdominal mass on the right sight, and an exploratory laparotomy was performed. There was 2000 ml of clear fluid in the peritoneal cavity. The cecum and ascending colon were necrotic with thrombosis of the colic and ileocolic veins. The pelvis and the appendectomy stump appeared normal. A right hemicolectomy and resection of the distal ileum were performed followed by a primary side-to-side ilecolostomy. The patient's condition deteriorated after laparotomy despite vigorous management, and she died the next morning, 7 days after the sterilization operation. Significant findings at postmortem examinations were thrombosis of both the ileocolic vein and the superior mesenteric vein and inflammation in the area of colon adjacent to the anastomosis. The cause of death was determined to be endotoxic shock secondary to large bowel necrosis which resulted from thrombosis of the mesenteric veins. This patient was at increased risk for postoperative venous thrombosis because she continued to use OCs during the month before the operation. 2 carefully conducted case-control studies have shown that OCs increase by more than 3-fold the risk of postoperative thromboembolism. It is unclear how much the knowledge of this risk has altered preoperative management of women having elective operation in the U.S. At least 1 prospective study has found no difference in incidence of idiopathic deep venous thrombosis with increasing estrogen doses, but the risk of postoperative thromboembolism associated with OCs containing a lower estrogen content has not been studied.
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PMID:Oral contraceptives and postoperative venous thrombosis. 708 37

Low-molecular-weight heparin (LMWH) has become a popular agent for prophylaxis against deep vein thrombosis and thromboembolic disease after total joint arthroplasty. LMWH allows for consistent dosing in postoperative patients without the need for laboratory monitoring. Hemorrhage is an uncommon but documented adverse reaction when using LMWH; however, intrahepatic hemorrhage has not been previously reported in conjunction with LMWH therapy. We report the case of a woman who suffered intrahepatic hemorrhage presenting with acute abdominal pain and vomiting after the use of enoxaparin for total hip arthroplasty.
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PMID:Intrahepatic hemorrhage after use of low-molecular-weight heparin for total hip arthroplasty. 1022 Jan 93

A healthy, middle-aged Japanese man with no family history of thrombotic disorders presented with acute abdominal pain due to ischemic colitis. Two months later, he developed left leg pain and swelling. A venogram of the lower limbs, computed tomography, and a scintigram of pulmonary blood flow revealed deep vein thrombosis of the left lower limb extending to the inferior vena cava and emboli of both pulmonary arteries with bilateral pleural effusions. The responsible coagulation disorder was not detected in this case. Since these thrombi were refractory to the thrombolytic therapy with urokinase and anticoagulant therapy with warfarin, prednisolone was chosen for the suppression of accompanying thrombophlebitis. Two months following the initiation of prednisolone (20 mg/day), the venous thrombosis, abnormal pulmonary shadows, and pleural effusions had completely resolved. This case demonstrates the successful treatment of idiopathic venous and pulmonary thrombosis with glucocorticoids.
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PMID:A case of idiopathic deep vein thrombosis improved with glucocorticoid therapy. 1043 71

The rate of reporting of childhood Churg-Strauss syndrome (CSS) has increased lately because of either increased awareness to the disease or a real increase in incidence. It is defined as one of the antineutrophil cytoplasmic antibody-associated vasculitides, but the antineutrophil cytoplasmic antibody positivity is less reported in pediatric cases. The cause of CSS remains unknown. Several lines of evidence suggest genetic predisposition, which may entail inherited tendency to dysregulation of the cellular immune system. With the addition of leukotriene receptor antagonists to the treatment regimen of asthma, an association to CSS was presumed. However, the nature of this relationship remains to be elucidated. In addition, some environmental factors seem to provoke transient effects that resemble the disease. Patients' symptoms are defined by various degrees of eosinophilic inflammation and necrotizing vasculitis, which may affect any organ. Three clinical stages have been described in the clinical evolution of CSS: prodromal phase involving allergic rhinitis and asthma (usually without family history of atopy), a second phase that involves peripheral eosinophilia and eosinophilic tissue infiltration, and the hallmark of the final phase is systemic vasculitis. Pulmonary disease is a central feature of pediatric CSS, but other manifestations include skin lesions, testicular pain, hypertension, seizures, and nephropathy. More subtle presentations in children include cervical lymphadenopathy, acute abdominal pain, deep venous thrombosis, oral ulceration, multiple colonic ulcers, chorea, bilateral optic neuropathy, and retinal artery occlusions. Churg-Strauss syndrome patients usually respond well to corticosteroid therapy. Several trials reported additional benefit from cyclophosphamide, azathioprine, and methotrexate, whereas the therapeutic effects of etanercept, plasma exchange, and intravenous immunoglobulin therapy are controversial. The relapse rate is approximately 25% to 30%, but corticosteroids have significantly increased survival, which now approaches greater than 75% at 5 years. However, there is limited information about survival or long-term outcome in childhood.
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PMID:Churg-strauss syndrome in the pediatric age group. 2328 8