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Query: UMLS:C0740577 (acute abdominal pain)
 1,982 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fine catheter aspiration cytology of the peritoneal cavity was performed successfully in 61 patients admitted with acute abdominal pain. Aspirates were examined microscopically and the percentage of neutrophils in the specimen counted. In patients in whom the clinical need for operation was certain (n = 25) all patients required surgery and the peritoneal neutrophil count was greater than 50 per cent. In patients in whom the clinical need for operation was uncertain (n = 36) 19 patients required operation: the peritoneal neutrophil count was greater than 50 per cent in 18 and in one patient with ectopic pregnancy fresh blood was aspirated. Of the 17 patients not requiring operation the peritoneal neutrophil count was less than 10 per cent in 15 and greater than 50 per cent in two patients (both had acute pelvic inflammatory disease). This study confirms peritoneal cytology as a useful adjunct to decision making in those patients with acute abdominal pain in whom the decision to operate is in doubt.
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PMID:Evaluation of fine catheter aspiration cytology of the peritoneum as an adjunct to decision making in the acute abdomen. 230 22

Pelvic inflammatory disease (PID) from the perspective of African practitioners is reviewed: diagnosis, staging and treatment. PID is the most common disorder treated in the gynecological department, and is a major public health problem because of the large number of patients, prolonged hospital stays, high mortality rate, and serious late sequelae of chronic pain, infertility and ectopic pregnancy. Diagnosis is difficult without confirmation by laparoscopy. PID is probable in complaints of acute abdominal pain, arising just after menses, with cervical excitation tenderness upon vaginal examination. The most reliable laboratory finding is accelerated sedimentation rate. State I is acute PID without peritoneal irritation; Stage II involves peritonitis and bilateral lower quadrant rebound tenderness; State III is a mass or abscess; Stage IV is rupture of the tubo-ovarian abscess. Culdocentesis producing gross pus suggests polymicrobial infection. The goals of treatment are to cure the patient and reach all of her partners, and to prevent late sequelae. Stage I patients can be treated with oral antibiotics as outpatients. Stage II can be effectively treated with penicillin and chloramphenicol in 80% in Zimbabwe. Stage III can sometimes be treated with antibiotics, but usually requires early surgery, by colpotomy if possible. Aggressive use of 3 antibiotics e.g., penicillin, clindamycin and gentamicin, will cover enteric organisms. Stage IV is life-threatening, with a mortality rate of 30-50% from septic shock. Total abdominal hysterectomy and bilateral adnexectomy are advised. A table depicting management of PID is included.
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PMID:Pelvic inflammatory disease in Zimbabwe. Guidelines for diagnosis and treatment. 336 58

This study analyzes the clinicopathologic findings in patients with ectopic pregnancy (EP), and deals with the differential diagnosis of the EP, intrauterine pregnancy (IUP), and pelvic inflammatory disease (PID). We evaluated 346 patients with suspected EP. Among those, 119 patients had EP, 82 had IUP, and 55 had PID without pregnancy. The incidence of EP was 1/32.9 live births. Comparing with the other groups, the patients with EP were slightly older, gave a history of previous pregnancies, had acute abdominal pain, nausea, vomiting, dizziness, and fainting, and had direct and rebound abdominal tenderness, pain on motion of the cervix, absence of a pelvic mass, and bilateral adnexal or cul de sac fullness. Culdocentesis was accurate in 95.1% of EP cases. Salpingectomy was performed in 89.9% of the patients with EP. The patients with EP had gross evidence of PID at the surgery in 31% and microscopic evidence of tubal inflammation in 19.4% of cases.
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PMID:Ectopic pregnancy. A prospective study on differential diagnosis. 726 61

The authors review the color Doppler ultrasonographic (US) features of appendicitis and other diseases that can manifest with acute lower abdominal pain. Causes of acute abdominal pain, other than appendicitis, include gynecologic abnormalities (ovarian cyst, ovarian torsion, pelvic inflammatory disease), gastrointestinal abnormalities (infectious enteritis, Crohn disease, mesenteric lymphadenitis, intussusception), and urinary tract diseases. On color Doppler images, inflammatory and infectious processes usually show locally increased blood flow, whereas cysts and twisted masses have absent blood flow. Enlarged lymph nodes also are avascular. Color Doppler US is a useful adjunct to gray-scale US in evaluating acute lower abdominal pain in children and can aid in defining and clarifying gray-scale abnormalities.
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PMID:Color Doppler US of children with acute lower abdominal pain. 829 Jul 24

A 24-year-old woman presented to the emergency department with acute abdominal pain and a physical examination consistent with acute pelvic inflammatory disease. She was treated and released only to return several hours later with worsening of her condition and unstable vital signs. Laparotomy revealed acute mesenteric venous thrombosis with patent mesenteric arteries. This is an unusual case of mesenteric thrombosis in a young, healthy woman.
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PMID:Primary mesenteric venous thrombosis: an unusual cause of abdominal pain in a young, healthy woman. 830 18

This study retrospectively evaluates the laparoscopic treatment of acute abdominal pain in 120 young girls aged 13 to 25 years from 1990 to 1995. Seventy-two (60%) of all operations were emergency procedures. Of these, 55 had functional ovarian cysts, eight patients were operated on for adnexal torsion and nine patients had other adnexal conditions. Ovarian cyst resection was performed in 46 patients and ovarian cyst coagulation in 17 patients. In the rest of the 48 patients (40%), 31 (26.67%) cases had pelvic inflammatory disease, three (2.5%) benign ovarian tumors, two (1.6%) ectopic pregnancies, one (0.8%) a paraovarian cyst and 11 (5%) endometriosis. Laparoscopy appeared to be a safe and effective surgical procedure.
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PMID:Contribution of laparoscopy in young women with abdominal pain. 1793 93

The incidence of heterotopic/ectopic pregnancy has risen in recent years, largely due to more frequent use of ovulatory medicine and increased incidence of pelvic inflammatory disease. In a natural cycle, it is a very rare event. Most heterotopic/ectopic pregnancies are localized in the uterine tube and, usually, it is diagnosed when symptoms develop. We report the case of a 37 year-old, gravida 2, para 0, abortion 1 woman with no known risk factors for heterotopic pregnancy. The patient attended the emergency department because of acute abdominal pain. She was evaluated in our department and a heterotopic twin pregnancy in the tube was diagnosed by transvaginal sonography. Intrauterine pregnancy with positive fetal cardiac activity at 9 weeks of gestation according to crown-rump length measurement was detected. Laparotomy was carried out because of acute abdominal syndrome. Right ruptured tubal ectopic/heterotopic pregnancy and hemoperitoneum were diagnosed. Right salpingectomy was carried out. Pathology revealed monochorionic twin tubal pregnancy. In a review of the literature, this is first case of twin tubal pregnancy in one uterine tube. In conclusion, heterotopic pregnancy in twin form in the uterine tube is possible in natural cycles. Intrauterine pregnancy does not exclude extrauterine pregnancy in natural cycles.
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PMID:Heterotopic triplet pregnancy (twin tubal) in a natural cycle with tubal rupture: case report and review of the literature. 1884 Jan 98

We report herein a 41-year-old female with a tubo-ovarian abscess (TOA), which microbial cultures showed to contain extended-spectrum beta-lactamase (ESBL)-producing E. coli, a causative agent of community-acquired infection. The patient initially presented with acute abdominal pain and back pain. Pelvic computed tomography and transvaginal ultrasonography revealed multiple cystic lesions in the bilateral ovaries that suggested TOA. An emergency laparotomy was therefore performed due to the potential for life-threatening septic shock from the TOA-associated pelvic inflammatory disease. Microbial cultures of postoperative fluid discharge from the placed intra-abdominal catheter, vaginal secretions, urine, blood, and feces detected ESBL-producing E.coli. In summary, we successfully performed emergency surgery for life-threatening septic TOA caused by ESBL-producing E. coli infection.
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PMID:Emergency surgery for tubo-ovarian abscess identified extended-spectrum beta-lactamase-producing Escherichia coli: the first case presentation revealing causative bacteria. 2636 63

Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis.
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PMID:Acute Abdominal Pain in Children. 2717 18

Introduction: Small bowel obstruction (SBO) is a common presentation to emergency abdominal surgery. The most frequent causes of SBO are congenital, postoperative adhesions, abdominal wall hernia, internal hernia and malignancy. Patients: A 27-year-old woman was hospitalized because of acute abdominal pain, blockage of gases and stools associated with vomiting. Abdominal computed tomography showed an acute small bowel obstruction without any obvious etiology. In view of important abdominal pain and the lack of clear diagnosis, an explorative laparoscopy was performed. Diagnostic of pelvic inflammatory disease was established and was comforted by positive PCR for Chlamydia Trachomatis. Results: Acute small bowel obstruction resulting from acute pelvic inflammatory disease, emerging early after infection, without any clinical or X-ray obvious signs was not described in the literature yet. This infrequent acute SBO etiology but must be searched especially when there is no other evident cause of obstruction in female patients. Early laparoscopy is mostly advised when there are some worrying clinical or CT scan signs.
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PMID:Acute pelvic inflammatory disease as a rare cause of acute small bowel obstruction. 2956 Jul 94


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