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

Hereditary angioneurotic oedema is a rare complement-related disorder (C1-esterase-inhibitor deficiency) characterised by recurrent episodic swelling of the limbs, face, gastrointestinal tract, or airways. The mortality rate of the unrecognised disorder is 30 per cent, mainly due to airway obstruction. Two female patients (aged 29 and 61 years) with proven disease were studied by ultrasonography while they suffered from acute abdominal pain: Ultrasound imaging showed a diffuse oedematous but compressible gut wall with reduced bowel motility, distended bowel loops with intraluminal fluid accumulation and free fluid in the peritoneal cavity. The ultrasonographic feature was different from that of other gastrointestinal diseases. In combination with the patient's history, the clinical pattern and the normal routine laboratory findings, abdominal ultrasonography is a suitable tool for early diagnosis of a potentially life-threatening disorder.
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PMID:[Abdominal sonography in hereditary angioneurotic edema. A contribution to the early diagnosis of a disease of interdisciplinary significance]. 332 42

Appendectomy with mesenteric lymph node biopsy was performed in an 18-year-old man because of acute abdominal pain that was subsequently attributed to infectious mononucleosis. The appendix demonstrated intense hyperplasia of the lymphoid tissue with marked expansion of the interfollicular lamina propria by a mixed diffuse proliferation of immunoblasts including Reed-Sternberg-like forms, together with large and small lymphoid cells. Germinal centers were reactive but inconspicuous. This pattern was distinguishable from malignant lymphoma and, like the characteristic lymph node changes, may be strongly predictive of infectious mononucleosis. Involvement of gut-associated lymphoid tissue may contribute importantly to abdominal symptomatology in this infection.
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PMID:Infectious mononucleosis. Appendiceal lymphoid tissue involvement parallels characteristic lymph node changes. 383 69

2 cases of midgut infarction in patients taking oral contraceptives are reported. Case 1 was a 38-year-old married woman with 3 children. After 2 isolated bouts of severe abdominal pain and diarrhea, examination revealed only minimal epigastric and left loin tenderness. Blood counts were normal. Other tests were negative. She had been taking cyclical tablets of 2.5 mg norethynodrel and .1 mg mestranol (Con ovid-E) for 48 months and continued after 8 days in the hospital. 18 weeks later severe abdominal pain, vomiting, and diarrhea occurred with abdominal tenderness and rigidity. The white-cell count was 25,000 with 85-90% segmented forms. Other blood tests were normal. At operation the superior mesenteric artery was found to be occluded distal to the origin of the middle colic artery. The thrombus was removed and the circulation to the gut seemed adequate. Intravenous heparin was given. Reoperation at 12 and again at 36 hours revealed viable intestine. 8 days after hospital admission ileus symptoms occurred. Reoperation revealed gangrene of almost all of the small intestine and part of the large intestine. The patient died 3 days later. Autopsy showed thrombosis of the superior mesenteric artery which was apparently not associated with local atheroma. Minimal atheroma in the aorta and an infarct of the spleen were noted. Case 2 was a 45-year-old married woman with 2 children who complained of severe abdominal pain and vomiting of 8 hours duration. A similar attack 1 week earlier had subsided in 6 hours. She had been taking tablets of 5 mg ethinyl-esternol (lynestrenol) and .15 mg mestranol (Noracyclin) for 11 months. There was no fever. The white-cell count was 19,500 with 85% segmented forms. Other laboratory tests and X-ray were normal. A loud bruit was heard over the upper abdomen. Bowel sounds were hyperactive. A diagnosis of acute small-bowel obstruction was made. At operation a definite diagnosis could not be made. Symptoms became worse. Reoperation 10 days later revealed gangrenous small intestine and part of the large intestine. The gangrenous parts were removed. After a complicated convalescence the patient recovered, but has moderate steatorrhea. Histologic examination of the resected intestine showed no evidence of atheroma in the mesenteric vessels. Considering these 2 cases with premonitory warning symptoms and without evidence of an atheromatous cause but associated with oral contraceptive therapy the immediate discontinuance of such therapy in women who develop acute abdominal pain is irecommended.
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PMID:Infarction of the midgut associated with oral contraceptives. Report of two cases. 568 97

A 76-year-old man was admitted to the surgical department with acute abdominal pain and impaired sensation of the lower extremities. An aneurysm of the abdominal aorta (AAA) was diagnosed already in the past. There were no signs of cardiovascular failure. Examination (sonography, CT) did not show intraabdominal bleeding. Nevertheless AAA rupture was suspected. A decision on an urgent operation was taken. Despite permanent resuscitation the patient died on the table before the operation began. In the discussion four type of AAA rupture are mentioned: into the open abdominal cavity, into the retroperitoneum, into surrounding organs such as gut or vena cava and so-called "sealed rupture". In every symptomatic AAA connected with circulatory instability rupture is suspected. An urgent operation is necessary in these cases. Rupture of AAA into the vena cava inferior is rare. A syndrome including a history of aneurysm, abdominal pain, continuous abdominal murmur and heart failure is pathognomic for this type of rupture. Computer tomography, sonography or arteriography could be helpful the diagnose determination. However, correct preoperative diagnosis is difficult. Other causes of circulatory failure, especially heart attack, must be differentiated. Treatment of such cases is surgical, using a stent graft is rare and determined only for indicated cases.
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PMID:[Spontaneous rupture of an abdominal aortic aneurysm into the inferior vena cava--case report]. 1214 74

Diaphragmatic hernias in adults usually pose a diagnostic challenge; the presentations are varied and range from acute abdominal pain with features of gut obstruction, pleuritic chest pain, breathlessness, to a pregnant woman with pain abdomen. The usual cause in adults is posttraumatic. Because of varied presentations, the diagnosis is often delayed. We present a case of a young woman who presented with sudden-onset breathlessness with similar episodes in the past and no history of trauma, who proved to be having a right-sided diaphragmatic hernia. This case is reported not only because of rarity of nontraumatic right-sided Bochdalek hernias in adults, but also because of peculiar presentation and history.
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PMID:Nontraumatic massive right-sided Bochdalek hernia in an adult: an unusual presentation. 2067 93

Parasites are rarely associated with inflammation of the appendix. Generally, parasites cause acute abdominal pain via blocking the gut lumen. In this article, we presented a case of appendicitis where Enterobius vermicularis was detected in the surgical specimen and Taenia was detected in the stool. A 31 year old male patient was admitted to the emergency room with severe abdominal pain, which has begun two days ago. On physical examination, tenderness was positive on palpation of the right lower abdominal quadrant and the patient was operated on with the diagnosis of acute appendicitis. Histopathological examination of the patient's appendectomy material revealed numerous parts of parasites resembling Enterobius vermicularis and slight mucosal erosion. On parasitological examination of the patient's stool, Taenia eggs and adult forms were determined. Antiparasitic therapy was started with niclosamide for taeniasis and albendazole for enterobiasis. Parasitic infections can mimic acute appendicitis clinically. Radiological and laboratory findings do not help to distinguish the diagnosis of acute appendicitis. In the histopathological examination of the appendix, the findings of acute inflammation of the appendix wall may not be defined. For patients with normal histopathological examination, screening for parasites should be done, and anti-parasitic treatment should be started after appendectomy.
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PMID:[Acute appendicitis and coinfection with enterobiasis and taeniasis: a case report]. 2465 5

Small gut volvulus with multiple Jejuno-ileal diverticulosis is an unusual pathology of the small intestine with a scarce number of cases reported so far. It usually goes unnoticed because it is often asymptomatic but complications like diverticulitis, perforation, bleeding or intestinal obstruction can occur in 10-30% of the cases. Mechanical obstruction, if it occurs, can be caused by adhesions or stenosis due to diverticulitis, intussusception at the site of the diverticulum and volvulus of the segment containing the diverticula. Acute volvulus of the small bowel is a serious abdominal emergency that poses a difficulty in diagnosis and delayed operative intervention can lead to dire consequences. We herein report the case of a 42-yearold man presented at the emergency department with acute abdominal pain, absolute constipation and vomiting. Preoperative investigations followed by laparotomy revealed small gut volvulus and multiple giant jejunal and ileal diverticula.
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PMID:Small Gut Volvulus, A Rare Twist, In The Setting Of An Even Rarer Entity; Multiple Giant Jejuno Ileal Diverticula. 2871 96

Small bowel obstruction secondary to phytobezoars is a rare presentation in surgery. These are masses of undigested food and vegetables, which obstruct the narrowest part of gut. We discuss a case of a young patient presenting in emergency department with history of acute abdominal pain, distension and constipation. Diagnosis of acute intestinal obstruction was made on the basis of history, examination, and initial investigations. Exploratory laparotomy revealed a phytobezoar at the origin of Meckel's diverticulum, which was an incidental finding. He underwent wedge resection with primary closure and removal of phytobezoar. The change in dietary habits, decreased fiber intake, and psychiatric evaluation can prevent recurrence.
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PMID:Impaction of Phytobezoar at Meckel's Diveticulum. 3082 58

Undifferentiated abdominal pain is a common presentation often requiring immediate medical or surgical intervention. Providing an accurate diagnosis involves a detailed patient history and thorough physical exam. Point of care ultrasound is gaining acceptance as a rapid diagnostic tool that can be used to accurately detect life-threatening conditions while potentially avoiding unnecessary radiation exposure and facilitating rapid treatment. Detection of pneumoperitoneum with point-of-care ultrasound is a simple procedure that relies heavily on the experience of the investigating practitioner. Standard technique involves placing a high-frequency linear-array transducer in the right upper quadrant, where abdominal free air is most likely to accumulate. Detection of the 'gut point', which is the transition of abdominal wall sliding to lack thereof in a single image, is the pathognomonic finding of pneumoperitoneum. If visualization is difficult, moving the patient to the left lateral decubitus position or using the scissors technique can provide additional image views. This representative case report and review highlights the use of abdominal POCUS for the diagnosis of pneumoperitoneum. Ultrasound should continue to be explored by clinicians to narrow the differential diagnosis of acute abdominal pain.
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PMID:Diagnosis at gut point: rapid identification of pneumoperitoneum via point-of-care ultrasound. 3328 63