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

This is a case presentation and discussion of a dialysis patient who presented to the surgical service with abdominal pain, hypotension, and tachycardia and in extremis who was found to have a contained retroperitoneal hematoma after rupture of his left kidney. Six months after an uneventful nephrectomy and postoperative recovery he again presented with hypotension and anemia and was found to have a contralateral retroperitoneal hematoma consistent with renal hemorrhage. After unsuccessful angioembolization, the patient underwent a right nephrectomy and recovered without sequelae. Bilateral spontaneous renal rupture is a rare event documented by only a few anecdotal reports in the literature and usually associated with acquired cystic kidney disease. Rupture of renal cysts is relatively common in renal cystic disease but usually presents as asymptomatic hematuria or flank pain. Trauma is the most common cause of renal rupture, but other causes of spontaneous renal rupture are rare and include polyarteritis nodosa and urothelial carcinoma. The diagnosis of acute abdominal pain in the dialysis patient is a challenging differential. While a rare complication the diagnosis of spontaneous renal rupture should not be excluded in a patient presenting with abdominal pain, hypotension, and anemia.
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PMID:Bilateral renal rupture in a patient on hemodialysis. 1285 8

We report a case of a 36-year-old man who was admitted to the Emergency Department with right flank pain. The clinical presentation was suggestive of renal colic. However, a computed tomography scan showed the presence of a foreign body in the inferior duodenal flexure. Upper gastrointestinal endoscopy demonstrated a 6.5-cm wooden toothpick deeply embedded in the duodenal wall; this was removed via endoscopy. The peri-duodenal inflammatory reaction had encased the right ureter, resulting in hydronephrosis. The patient did well and was discharged on post-operative day 7. He did not recall toothpick ingestion. When evaluating patients with acute abdominal pain, foreign body ingestion should be considered. In patients with a history of toothpick ingestion, immediate diagnosis with endoscopic management should be performed.
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PMID:Duodenal perforation and right hydronephrosis due to toothpick ingestion. 1797 46

Acute Epiploic Appendagitis is a rare self limiting disease that represents ischaemic infarction of an epiploic appendix. It is usually discovered incidentally on imaging of abdomen done for other causes of acute abdominal pain. It is difficult to diagnose clinically due to the lack of pathognomonic clinical features, since it is characterized by a sudden onset of sharp localized pain either in the left or right iliac fossa with minimal gastrointestinal symptoms, which can simulate a surgical clinical picture. Awareness of imaging findings of this entity is important to arrive at a correct diagnosis and to avoid unnecessary hospitalization and surgery. We report cases of three male patients presenting with acute flank pain who were diagnosed as case of Primary epiploic appendagitis. All 3 patients were treated conservatively.
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PMID:Primary epiploic appendagitis: 3 case reports. 2236 11

Annually, approximately 70 million computed tomography (CT) scans are performed in emergency department (ED) settings in the United States of America. From 1995 to 2007, there has been a 5.9-fold increase in the use of CT scans nationally. The radiation risks and high costs associated with CT scans underscore the fact that the imaging modality, although necessary, carries a myriad of long-term risks to both patients and providers. For the workup of abdominal pain, most algorithms include the use of CT scan as an early step. To understand better the use of CT scans in our ED, we performed a retrospective review of patients presenting to the ED with abdominal pain. Two main questions were addressed: 1) what were the reasons for scans and how often did the scans reveal pathology related to the presenting symptoms, 2) how often were incidental findings identified. Our results showed that among patients presenting with abdominal pain to the ED, 50 per cent of the scans were normal, about 20 per cent of the patients had findings correlating with acute abdominal pain, whereas the rest (30%) had incidental findings that may have led to further outpatient studies or long standing abdominal pain. Most patients who presented to the ED had nonspecific abdominal pain i.e. 64.4 per cent. There was a low agreement between the presenting quadrant of pain and final pathological diagnosis (9.5-33.3% concordance), with left flank pain presentation having the highest level of agreement with the final pathologic diagnosis.
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PMID:Use of Computerized Tomography in Abdominal Pain. 2998 54