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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 case report of subacute, reversible ischemic colitis associated with use of oral contraceptives (OCs) is reported. A 19-year-old woman was admitted to the hospital with chief complaints of abdominal cramps, nausea, vomiting, diarrhea, and rectal bleeding of 2 days' duration. Past medical history and family history were noncontributory. The patient was receiving no medication other than Norinyl 2 (2 mg of norethindrone and .1 mg of mestranol), which she had been taking for 6 months. 2 days before admission the patient had taken 100 mg of dimenhydrinate and 2 ExLax tablets (90 mg of phenolphthalein) for constipation. Colonic roentgenograms revealed impaired mesenteric circulation and bowel ischemia; OC-induced ischemic bowel disease was diagnosed. Patient symptoms subsided within 96 hours of discontinuing the OC and initiating supportive therapy (including intravenous fluid infusion, nasogastric suction, analgesics, and antiemetics). When a repeat barium enema was performed, it showed resolution of the ischemia. In a short review following the case report, these drugs were indicted in causation of colitis-like syndrome: amoxicillin, ampicillin, cephazolin, chloramphenicol, chlorpropamide, clindamycin, cloxacillin, cotrimoxasole, cyclophosphamide, digitalis, ergotamine tartrate, flucytosine, fluorouracil, gold salts, laxative and cathartic abuse, mercurous chloride, methyldopa, penicillin V, and tetracycline. Ischemic bowel disease secondary to OC use is a rare but important complication because of its significant morbidity and potential mortality, and because of the widespread use of the drugs. The case report emphasizes the need to consider the differential diagnosis of acute vascular insult with bowel ischemia when acute abdominal pain progressing to bloody diarrhea occurs in young women taking OCs.
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PMID:Oral contraceptive-induced ischemic bowel disease. 48 72

The aim of this study was to evaluate the contribution of colour Doppler sonography in the diagnosis of acute intestinal ischaemia. In a two years experience, all patients admitted for acute abdominal pain in our emergency department were evaluated with colour Doppler sonography of the abdomen. The final diagnosis based on clinical evolution, endoscopic or surgical findings and further radiological investigations was compared to the sonographic results. Therapy and final outcome of the patients with acute intestinal ischaemia were also evaluated. In twenty-one patients a final diagnosis of acute intestinal ischaemia (mesenteric ischaemia (n = 13) and ischaemic colitis (n = 8)) was made. Intestinal ischaemia was correctly diagnosed by initial clinical and biological data and further confirmed by sonography in eight cases (mesenteric ischaemia (n = 2) and ischaemic colitis (n = 6)). Eleven other cases were detected by suggestive colour Doppler sonography features (mesenteric ischaemic (n = 10) and ischaemic colitis (n = 1)). Sixteen of the 21 patients had a final favourable outcome (mesenteric ischaemia (10/ 13) and ischaemic colitis (6/8)). We conclude that sonography has a place in the diagnosis of acute intestinal ischaemia and has to be integrated in the diagnostic algorithm of this acute condition. By this way, this diagnosis may be suspected earlier and may allow a prompt and adapted treatment with possible improvement in survival rate.
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PMID:Early diagnosis of acute intestinal ischaemia: contribution of colour Doppler sonography. 938 99

We describe three cases of adult intussusception in which ultrasonography provided the correct preoperative diagnosis. Patients underwent ultrasonography to investigate nonspecific acute abdominal pain; intussusception was not suspected. In all cases, the sonographic pattern was typical of intussusception and ultrasonography was the only diagnostic study. Bowel ischemia was not found at surgery in any patient.
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PMID:Sonographic diagnosis of adult intussusception. 1150 84

Bowel ischemia, an uncommon but devastating complication of systemic lupus erythematosus (SLE), poses a significant clinical challenge. A 52-year-old female with SLE presented with recurrent abdominal pain for two months which culminated in acute, severe pain with vomiting. Abdominal CT scan revealed ischemia of multiple segments of bowel. She responded slowly to methylprednisolone alone and eventually responded to methylprednisolone combined with cyclophosphamide. A high index of suspicion for bowel ischemia is required in patients with SLE presenting with acute abdominal pain.
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PMID:Intestinal ischemia in systemic lupus erythematosus. 1859 76

Multi-detector row computed tomography (MDCT) enables fast and thin acquisition of the abdominal anatomy. This allows multi-pass multi-planar studies that can be obtained during defined circulatory phases. When bolus timing is adequate, arterial phases with high contrast levels provide "free lunch" CT angiographies eliminating the need for diagnostic angiographies in most cases. In addition to established clinical indications for abdominal CT such as preoperative MDCT of the liver or pancreas, MDCT of the abdomen is especially gaining ground in the work up for acute abdominal pain and abdominal trauma and is opening new indications for MDCT of the gastrointestinal tract. Indications for gastrointestinal MDCT include tumors, bleeding and ischemia of the small and large bowel as well as diverticulitis. The question of whether to use positive or negative contrast material for bowel distention for MDCT of the gastrointestinal tract is still a controversial issue. In selected cases, modifying the protocol to perform a "CT enteroclysis" might improve sensitivity and specificity in depicting small bowel tumors or inflammatory changes such as in Crohn's disease. The most common gastrointestinal mesenchymal tumor is the gastrointestinal stromal tumor (GIST). MDCT may show hypervascular submucosal masses. Acute gastrointestinal (GI) bleeding is common with patients presenting with melena, hematemesis or hematochezia. In addition to the established initial work-up MDCT is beginning to establish itself for this indication. It may be especially helpful in the work up of obscure bleeding. Another relatively rare but important cause for acute abdominal pain is mesenteric ischemia. It may be caused by many conditions and may mimic various intestinal diseases. Bowel ischemia severity ranges from transient superficial changes of the intestinal mucosa to life-threatening transmural bowel wall necrosis. CT can demonstrate changes in ischemic bowel segments accurately, is often helpful in determining the primary cause of ischemia, and can demonstrate important coexistent findings or complications.
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PMID:MDCT of the abdomen. 1865 67