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

Contemporary work in medical decision support is characterized by a multitude of methods. To investigate their relative strengths and weaknesses, we built four diagnostic expert systems based on different methods (Bayes, case-based classification, heuristic classification) for analysis of the same set of 1254 cases of acute abdominal pain previously documented in a prospective multicenter study. The results of the comparative evaluation indicate that differences in overall performance are relatively small (statistically not significant). The performance depends more on the quality of the knowledge base and the case data than on the inference methods of the expert systems. Methods relying exclusively on empirical knowledge (Bayes, case-based classification) tend to have slightly higher overall performance scores due to a diagnostic bias toward ordinary and common diseases. By contrast, methods operating with expert knowledge (e.g., heuristic classification) perform slightly worse overall, but are more sensitive toward uncommon (serious) diseases.
Methods Inf Med 1995 Sep
PMID:Evaluating four diagnostic methods with acute abdominal pain cases. 747 68

5-aminosalicylic acid has been reported to cause acute pancreatitis. We report the first Scandinavian case. A 27 year-old woman with a three month history of ulcerative colitis treated with Mesalazine developed acute abdominal pain. Serum and urine amylase were raised, and ultrasonographic and computed tomography scan showed oedema of the pancreas. Immediately following withdrawal of the drug, serum and urine amylase returned to normal. We discuss the possibility of acute pancreatitis as an extraintestinal manifestation of ulcerative colitis.
Ugeskr Laeger 1995 Sep 25
PMID:[Acute pancreatitis--induced by 5-aminosalicylic acid or an extraintestinal manifestation of ulcerative colitis?]. 748 55

Spontaneous perforation is a rare complication of pyometra and is usually associated with uterine cervical occlusion. We report a very rare case of spontaneously perforated pyometra without cervical occlusion. A 56-year-old woman with severe abdominal pain was admitted to our hospital. Exploratory laparotomy was performed because of suspicion of gastro-intestinal perforation with generalized peritonitis. There was no perforation of the stomach, gallbladder, or bowels, but examination of the uterus revealed a perforation of the uterine fundus. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, the condition must be born in mind with regard to elderly women with acute abdominal pain.
Asia Oceania J Obstet Gynaecol 1994 Sep
PMID:Spontaneous perforation of pyometra: a case report. 781 Nov 91

Approximately 10% to 15% of adults have gallstones, resulting in more than 600,000 cholecystectomies being performed annually in the United States. It is not surprising, therefore, that biliary disease is a major consideration in the patient with acute abdominal pain. Although there is no substitute for skillful physical diagnosis, the radiologist is often the central player in the evaluation of biliary disease. This article focuses on three specific areas of importance to the radiologist: (1) the diagnostic approach to acute biliary disease, (2) imaging of specific clinical entities, and (3) the relationship between imaging findings and the use of new therapeutic modalities.
Radiol Clin North Am 1994 Sep
PMID:Acute diseases of the gallbladder and biliary ducts. 808 5

A case of acute gastric volvulus associated with eventration of the diaphragm in a previously well 6 year old child is reported. The child presented with acute abdominal pain, abdominal distension and vomiting. At operation, mesentero-axial type gastric volvulus was found, associated with laxity of the gastro-splenic, gastrohepatic and gastrocolic ligaments and eventration of the left hemidiaphragm. Rapid recovery followed surgery that included release of distension and fixation of the stomach to the anterior abdominal wall. There has been no evidence of recurrence on a 2 year follow-up.
Med J Malaysia 1993 Sep
PMID:Acute mesentero-axial volvulus of the stomach in a child. 818 52

Laparoscopic cholecystectomy has become the standard of care for the elective management of cholelithiasis. Little information exists, however, regarding the appropriateness of this procedure in the setting of acute symptomatology. We retrospectively reviewed our experience with 516 laparoscopic cholecystectomies performed at a single institution from May 1990 to May 1991. Seventy-five (14.5%) of these patients were admitted from the emergency department with acute abdominal pain (100%), fever (4 of 75, 5%), and/or an elevated white blood cell count (22 of 75, 29%). There were 54 females and 21 males, with a mean age of 50.0 +/- 2.4 years (range: 17 to 89 years). Laparoscopic cholecystectomy was attempted in all patients, and was successful in 68 of 75 patients (91%). Seven procedures were converted to open cholecystectomy because of the difficulty in dissection precluding safe laparoscopic cholecystectomy. The time from admission to surgery (mean: 3.4 +/- 0.3 days), as well as the total hospital stay (mean: 5.5 +/- 0.6 days), was much longer than in the elective circumstance. Mean laboratory values for the group as a whole were as follows: white blood cell count (mean: 9.6 IU/L +/- 0.4 IU/L, range: 4.1 IU/L to 19.5 IU/L), alkaline phosphatase (mean: 97.0 IU/L +/- 13.7 IU/L, range: 27 IU/L to 375 IU/L), and alanine aminotransferase (mean: 78.3 IU/L +/- 13.7 IU/L, range: 15 IU/L to 701 IU/L). Patients requiring open cholecystectomy were older (mean: 61.4 +/- 4.4 versus 48.8 +/- 2.6), were more likely to be febrile (3 of 7, 42%, versus 1 of 68, 1%), and were more likely to have a significant leukocytosis (mean: white blood cell count 12.9 +/- 1.8 x 10(3) cells/mm3 versus 9.2 +/- 0.4 x 10(3) cells/mm3) than were those undergoing successful laparoscopic cholecystectomy. Laparoscopic cholecystectomy can be performed safely in the majority of patients presenting with acute biliary symptoms. Patients with a triad of acute abdominal pain, fever, and elevated white blood cell count, particularly elderly patients, are more likely to require conversion to open cholecystectomy, however.
Am J Surg 1993 Sep
PMID:Laparoscopic cholecystectomy in patients admitted with acute biliary symptoms. 818 49

The patient with acute abdominal pain presents the attending physician with a wide and varied gamut of diagnostic possibilities. Prompt and accurate diagnosis is essential for the proper care and management of these acutely ill patients. Diagnostic radiology is often an integral part of the emergent evaluation of these patients. This article focuses on some of the key plain-film findings in the patients suffering from acute abdominal pain of intestinal causes and reviews the radiologic evaluation of several major abdominal conditions such as acute appendicitis, diverticulitis, inflammatory bowel disease, bowel ischemia, and infarction.
Med Clin North Am 1993 Sep
PMID:The radiologic evaluation of acute abdominal pain of intestinal origin. A clinical approach. 837 22

To understand the surgical approach to acute abdominal pain, the internist must be familiar with common presentations of most abdominal emergencies; these emergencies include acute appendicitis, acute gall bladder disease (biliary colic, acute cholecystitis, and acute pancreatitis), ischemic bowel disease and ischemic colitis, abdominal aortic aneurysm, and intestinal obstruction. Nothing compares to experience; this article reviews the salient points that deserve consideration.
Med Clin North Am 1993 Sep
PMID:An internist's approach to acute abdominal pain. 837 23

We report a case of a 28-year-old female, Grava 2, Para I, Ab. 0, who presented acute abdominal pain on the 21st week of her gestation. A diagnosis of acute appendicitis was entertained and an appendectomy performed. The pathologic specimen revealed an inflamed appendix with endometriosis and a marked decidual reaction. A decidual polyp, which occluded most of the appendiceal lumen, is proposed as a rare cause of acute appendicitis during pregnancy.
P R Health Sci J 1995 Sep
PMID:Endometriosis of the appendix with decidual polyp formation: a rare cause of acute appendicitis during pregnancy. 858 24

A quality audit was performed of the case records of 1313 children admitted with acute abdominal pain over a three year period under the care of paediatric surgeons at the Princess Margaret Hospital for Children, Perth. Fifty-four per cent (n = 714) of the patients were discharged without surgical intervention; in this group the most frequent (70%, n = 503) diagnosis was non-specific abdominal pain (NSAP). Of those children having surgery, 74% (n = 443) had appendicitis proven on histopathology; the remaining appendices (n = 134) were reported as normal and no other surgical cause for the patients symptoms were identified. Only 3.7% (n = 22) of children having surgery had another surgical cause for their pain. Of this group, 11 had adnexal pathology, eight had complications of a Meckel's diverticulum and three had torsion of the omentum. There were no deaths in this series, and 39 patients (3%) had wound infections. Based on these results, only 35% of children referred to a surgeon with abdominal pain will actually require surgical intervention, although as a consequence of concern over clinical status an additional 10% will have a laparotomy with normal findings.
J Qual Clin Pract 1996 Sep
PMID:Acute abdominal pain in children: an analysis of admissions over a three year period. 888 58


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