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At least 199 records · Page 11Linked to original sources
PubMed1988

The acute surgical abdomen after cardiac surgery involving extracorporeal circulation.

From 1972 through 1984, 7140 cardiac operations were performed at one university teaching hospital; they were reviewed to elucidate common factors in patients developing an acute surgical abdomen after cardiac surgery and extracorporeal circulation. Twenty-one patients (0.29%) developed an acute surgical abdomen in the period following cardiac surgery. The abdominal surgical complications were, in general, due to complications of peptic ulcer disease, decreased intestinal blood flow, and cholecystitis. There was no correlation between preoperative history, physical examination, cardiac function, laboratory data, and the subsequent development of an acute abdomen. Mortality rate, 24% after abdominal surgery, was increased with emergency cardiac operations, combined cardiac procedures, complications of cardiac surgery, unnecessary delay of abdominal surgery, and abdominal wound complications. Major abdominal wound complications were seen in 38%. Patients undergoing cardiac surgery may develop a variety of common abdominal surgical disorders. Patients so inclined cannot be identified prior to cardiac surgery. Ulcer prophylaxis, wound management, prompt resuscitation, and timely surgery are critical.

Abdomen, Acute↗
PubMed1996

False-positive radioiodine uptake in the abdomen and the pelvis: radioiodine retention in the kidneys and review of the literature.

Because the kidneys are usually not visualized on radioiodine whole-body scans, the renal uptake can be mistaken for a thyroid cancer metastasis. The authors report the prevalence and characteristics of radioiodine retention in the kidneys and review the reported causes of false-positive radioiodine uptake in the abdomen and pelvic areas. Radioiodine uptake in the renal bed was noted on 9 of 400 (2.2%) I-123 diagnostic whole-body scans performed over a 7-month period in our center. The uptake was noted more clearly on posterior views, cleared on delayed images after further hydration, and was not consistently present on follow-up scans. It was unilateral and mimicked a renal or adrenal metastasis in 44% of the scans. In three cases, the uptake was associated with a dilated calyx, an extrarenal pelvis, or a voluminous pelvis. False-positive radioiodine uptake in the abdomen and pelvis has been previously reported in association with 14 different conditions. However, renal retention may represent the most common cause of false-positive radioiodine uptake in the abdomen pelvis. Delayed imaging after additional hydration is usually sufficient to clarify its origin.

Abdomen↗
PubMedDate not supplied

Castleman disease of the abdomen: imaging spectrum and clinicopathologic correlations.

PURPOSE: The purpose of this work was to define the imaging spectrum of Castleman disease of the abdomen and to correlate the results with clinicopathologic findings. METHOD: Seventeen patients (male/female 7:10; mean age 35.6 years) with pathologically proved Castleman disease in the abdomen were included in this study. Radiologic findings (CT, n =17; US, n =10; MR, n =1) were retrospectively reviewed by two readers and were correlated with clinical and pathologic findings. RESULTS: Subjects were divided into those with localized (n = 11) and disseminated (n = 6) disease. In localized disease, the pathologic subtypes were hyaline vascular type in eight and plasma cell type in three. Radiologic studies showed a single large mass in six and a single dominant mass with small satellite nodules in five. Central low attenuation was seen in two cases, and calcification was seen in three cases. Regional lymphadenopathy was found in five cases. In disseminated disease, there were three hyaline vascular types and three plasma cell types. Radiologic findings included diffuse lymphadenopathy (n = 6), hepatosplenomegaly (n = 5), ascites (n = 3), and thickening of the retroperitoneal fascia (n = 3). Disseminated disease revealed symptoms and abnormal laboratory findings (anemia, hypoalbuminemia, elevated erythrocyte sedimentation rate/C-reactive protein, etc.) more frequently than localized disease and showed poor prognosis. CONCLUSION: There are two distinctive types of radiologic manifestations in Castleman disease of the abdomen: localized and disseminated. The localized type usually shows single or multiple discrete masses, and the disseminated type frequently shows nonspecific organomegaly and lymphadenopathy.

Abdomen↗
PubMed2005

Prospective study on the role of the CT scan in patients with an acute abdomen.

OBJECTIVES: Recent reports indicate that early CT scan (within 24 h) increases diagnostic accuracy, reduces hospital stay and mortality in patients with an acute abdomen. The aim of this study was to assess the surgeons' use of CT in patients with an acute abdomen and the impact of this on diagnostic accuracy and mortality. PATIENTS AND METHODS: Patients older than 25 years admitted as an emergency with acute abdominal pain were prospectively evaluated. RESULTS: Two hundred and eleven patients fulfilled the inclusion criteria including 129 women and 82 men with a mean age of 62.4 years (range 27-92 years). The correct diagnosis on admission was made in 99 (47%) patients. CT was performed in 81 (38%), including 24 who had the scan performed within 24 h of admission. The sensitivity, specificity and accuracy of CT were 86%, 79% and 84%. CT was considered to have changed clinical management in 40 patients. Fifteen patients died, and one death may have been prevented by an early CT. Five had a delay in diagnosis of a serious condition; all could have been prevented by early CT. CONCLUSION: Selective use of CT increases diagnostic accuracy and improves the management of patients with an acute abdomen. Clinical trials are necessary to assess outcome following selective vs routine use of CT in this group of patients.

Abdomen, Acute↗
PubMed1977

Ultrasound measurement of the fetal head to abdomen circumference ratio in the assessment of growth retardation.

Fetal head and abdomen circumference measurements have been made using pulsed ultrasound techniques. The mean head to abdomen (H/A) circumference ratio with 95% confidence limits was determined in 568 normal pregnancies from 17 to 41 weeks menstrual age. The mean ratio was 1-18 at 17 weeks, but decreased slowly until 29 weeks when the ratio was 1-11; thereafter there was a sharp fall in the mean ratio to 1-01 at 36 weeks and 0-96 at 40 weeks. The H/A circumference ratio was also determined in 31 small-for-dates fetuses within one week of delivery. In all cases the fetal weight as predicted from the fetal abdomen circumference measurement was below the 5th centile weight for gestation. The ratio was above the 95th centile limit in 22 (71%) of these fetuses and evidence is presented to suggest that the H/A circumference ratio can be used to distinguish between symmetrical and asymmetrical growth retardation.

Abdomen↗
PubMed2005

Immobilization effect of air-injected blanket (AIB) for abdomen fixation.

A new device for reducing the amplitude of breathing motion by pressing a patient's abdomen using an air-injected blanket (AIB) for external beam radiation treatments has been designed and tested. The blanket has two layers sealed in all four sides similar to an empty pillow made of urethane. The blanket is spread over the patient's abdomen with both ends of the blanket fixed to the sides of the treatment couch or a baseboard. The inner side, or patient side, of the blanket is thinner and expands more than the outer side. When inflated, the blanket balloons and effectively puts an even pressure on the patient's abdomen. Fluoroscopic observation was performed to verify the usefulness of AIB for patients with lung, breast cancer, or abdominal cancers. Internal organ movement due to breathing was monitored and measured with and without AIB. With the help of AIB, the average range of diaphragm motion was reduced from 2.6 to 0.7 cm in the anterior-to-posterior direction and from 2.7 to 1.3 cm in the superior-to-inferior direction. The motion range in the right-to-left direction was negligible, for it was less than 0.5 cm. These initial testing demonstrated that AIB is useful for reducing patients' breathing motion in the thoracic and abdominal regions comfortably and consistently.

Abdomen↗
PubMed1994

Non-Hodgkin lymphoma: whole-abdomen irradiation as an adjuvant to chemotherapy.

PURPOSE: To evaluate the efficacy and toxicity of whole-abdomen irradiation in the treatment of abdominal non-Hodgkin lymphoma (NHL). MATERIALS AND METHODS: Between 1978 and 1990, 39 patients with abdominal NHL were treated with modified three-way whole-abdomen irradiation as either an adjunct to chemotherapy (in 34 patients) or sole therapy (in five patients). RESULTS: The 5-year relapse-free survival rate in 36 patients who received at least 30 Gy was 38% and was 64% in 17 patients treated for consolidation of complete or partial response to chemotherapy. Treatment was terminated in four of 19 patients in whom treatment was interrupted because of acute toxicity. The major acute toxicities were decreased blood counts and enteritis. There were four grade 3 or 4 late toxicities. CONCLUSION: Whole-abdomen irradiation is a safe adjunct to chemotherapy in patients with NHL who are at high risk for intraabdominal failure.

Abdomen↗
PubMed1994

Gravitational and shear-associated pressure gradients in the abdomen.

The abdomen has been variously characterized as a hydrostatic system, in which pressures exhibit a gravitational gradient and pressure fluctuations are spatially uniform, and as a compartment, in which pressure gradients are not simply gravitational and pressure fluctuations differ markedly from place to place. To characterize the pressures acting on the ventral abdominal wall, we used saline-filled catheters and air-filled balloons in anesthetized dogs in various body positions during spontaneous breathing and mechanical ventilation. Pressures were measured in the stomach and at multiple sites next to the abdominal wall. Under most circumstances, measurements next to the abdominal wall exhibited a hydrostatic gravitational gradient of approximately 0.89 cmH2O/cm height and pressure fluctuations were spatially homogeneous. Deviations from this hydrostatic behavior were seen when abdominal pressures were compared with gastric pressures, when measurements were made with a balloon catheter, and when the lower abdomen was constricted with a binder. Analysis of these and previously published data suggests that the abdomen does, at times, behave like a hydraulic system but can deviate from simple hydrostatic behavior to the extent that shape-stable abdominal viscera are deformed.

Abdomen↗
PubMed1996

Transmission of pressure within the abdomen.

The extent to which transmission of pressure within the abdomen is accomplished in accordance with the laws of fluid mechanics, i.e., homogeneous transmission to all portions of the abdomen, is controversial. To examine the cranial-to-caudal as well as side-to-side transmission of pressure within the abdomen in humans, we measured intra-abdominal pressure at four sites in five subjects undergoing colonoscopy. Liquid-filled catheters were inserted into the colon, and intracolonic pressure was measured in the rectum and in transverse, descending, and sigmoid colon. Differences in intracolonic pressure were recorded during breaths to total lung capacity and brief expulsive maneuvers. Measurements were taken in the supine, right lateral, and seated position. Comparison of pressure swings at all sites showed that the pressure changes were nearly equal during both inspiratory and expulsive maneuvers. The changes in pressure were uniform in the cephalocaudal axis as from side to side. We conclude that transmission of abdominal pressure in humans is nearly homogeneous. Our findings provide support for the hydraulic model of abdominal mechanics.

Abdomen↗
PubMed1993

Dynamics of reflex cocontraction in hermit crab abdomen: experiments and a systems model.

1. Both stretch and release of the ventral superficial muscles (VSM) in the abdomen of the hermit crab, Pagurus pollicarus, activate the VSM motoneurons in the intact animal and in the isolated abdomen. 2. This reflex was studied by recording intracellularly from muscle fibers innervated by single motoneurons during stretch and release of the VSM. The three motoneurons of the right fourth segment respond to both stretch and release with a phasic burst lasting approximately 250 ms. The burst in the two tonic motoneurons has two components, a short burst lasting 10-20 ms, with a latency from the beginning of stretch of 60-90 ms, and a longer burst of variable length, with a latency of 120 ms. Ramp stretches of different amplitudes and velocities were used to show that the first component is proportional to the absolute value of the second derivative of force and the second component to the absolute value of the first derivative of force. 3. Stretch and release of the VSM also simultaneously evoke phasic bursts in the motoneurons of the dorsal superficial muscles and the VSM circular muscles (functional antagonists of the longitudinal VSM), as well as in contralateral homologues of the same segment and in ipsilateral homologues of the next anterior segment. The effect of this coactivation is to stiffen the abdomen in response to perturbations in any direction. 4. Stretch or release of phasic mechanoreceptors in the VSM evokes this reflex. Isometric electrical stimulation of the isolated muscle also activates them, showing that they are transducing changes in force and suggesting that they operate to increase muscle stiffness by positive feedback. 5. A mathematical systems model of this reflex, composed of two parallel pathways activating the motoneurons, was constructed. The first pathway produces a signal proportional to the absolute value of the second derivative of force, the second pathway a signal proportional to the first derivative of force. The sum of the signals from the two pathways is filtered by an adaptation process, which is followed by a low-pass filter representing muscle activation kinetics. The muscle activation signal is then fed back to multiple muscle force. 6. Simulations using this model generate the phasic bursts to stretch and release as well as reproducing the frequency dependence of this reflex. The predominant action of this reflex is to enhance muscle stiffness.

Abdomen↗
PubMed2006

Compartimentalization for chylothorax originating from the abdomen after extended esophagectomy. Report of two cases and review of the literature.

BACKGROUND: Chyle leakage from the chest after extended esophagectomy originating from the abdomen is a rare complication with various clinical presentations and treatments. METHODS: Two cases of chylothorax originating from the abdomen are discussed and the literature concerning diagnosis, management and outcome is reviewed. RESULTS AND CONCLUSION: Initially conservative measures should be installed; however, prolonged conservative treatment should be avoided. Reoperation gives an opportunity to identify the leak. If the leakage originates from the abdomen, compartimentalization is the essential step to solve the problem.

Abdomen↗
PubMed2005

Early definitive closure of the open abdomen: a quiet revolution.

Contrary to the management strategy recommended only 2-3 years ago, temporarily covering the open abdomen with an absorbable mesh or a plastic sheath without preserving the peritoneal space is no longer considered in the patient's best interest. The use of the vacuum pack, in conjunction with vacuum-assisted wound management and new biological prostheses now offer patients with an open abdomen a better and simpler alternative to the giant "planned ventral hernia". With very few exceptions in the most critically ill patients, the survivors of damage control surgery or infected pancreatic necrosis should not be sent home with a huge defect only to undergo a complex reconstruction a year later. Simpler and better alternatives exist. The new concepts and technologies presented in this review, when widely adopted, will rapidly translate into safer and better management of the patient with an open abdomen.

Abdomen↗
PubMedDate not supplied

Acute painful neuropathy restricted to the abdomen following rapid glycaemic control in type 2 diabetes.

A 46-year-old Japanese man with type 2 diabetes mellitus, whose only diabetic complication was simple retinopathy, developed acute painful neuropathy. This presented as paresthesia and hyperesthesia restricted to the abdomen. The patient's haemoglobin A(1c) had dropped from 12% to 7.5% within 5 months, following a rapid improvement in glycaemic control. On investigation, there were no indications of disease in the intraabdominal area. Nerve conduction studies were consistent with mild sensorimotor peripheral and autonomic neuropathy. The patient required medication (mexiletine, sulpiride and imipramine hydrochloride) to control the pain. Four months after presentation, the symptoms showed a dramatic improvement and the treatment for pain relief was discontinued without any recurrence of paresthesia or hyperesthesia in the patient's abdomen. This was a very unusual case of diabetic post-treatment painful neuropathy in which the prominent features were severe pain, paresthesia and hyperesthesia restricted to the abdomen.

Abdomen↗
PubMed1994

Competitive reverse transcription-polymerase chain reaction analysis indicates that levels of aromatase cytochrome P450 transcripts in adipose tissue of buttocks, thighs, and abdomen of women increase with advancing age.

Circulating androstenedione is converted to estrone in adipose tissue, which is the principal site of estrogen biosynthesis in postmenopausal women. This reaction is catalyzed by a specific form of cytochrome P450 (P450arom; the product of the CYP19 gene). The fractional conversion of plasma androstenedione to estrone as well as the specific activity of aromatase in adipose stromal cells were previously shown to increase with advancing age. To determine whether this positive effect of aging on estrogen biosynthesis is due to an alteration in tissue levels of P450arom transcripts, we quantified P450arom mRNA levels in sc fat biopsy samples (n = 33) from buttocks, thighs, and abdomen of 11 women who ranged in age from 23-61 yr. Competitive polymerase chain reaction linked to reverse transcription was used to quantify P450arom transcripts in total RNA that was isolated from sc fat obtained by needle aspiration. In each sample, primer extension and coamplification of a rat P450arom cRNA as an internal standard were used to control possible differences in amplification efficiencies between samples. The results demonstrate that with advancing age in women, there is a progressive and statistically significant increase in adipose tissue P450arom transcript levels (normalized to total RNA content) in buttocks, thighs, and abdomen (correlation coefficients: r = 0.704, 0.854, and 0.933, respectively). The levels of transcripts observed in the older subjects reach 2- to 4-fold greater than those observed in the young women. Adipose tissue P450arom transcript levels were highest in the buttocks, followed by the thighs, and lowest in the abdomen. This increase in P450arom transcript levels is likely to be a major factor contributing to the increased extragonadal estrogen biosynthesis in elderly women.

Abdomen↗
PubMed1986

The potential distribution generated by the fetal heart at the maternal abdomen.

The pathways along which the electrical currents generated by the fetal heart are conducted to the surface of the maternal abdomen are not known. As a consequence, in recording the fetal electrocardiogram (FECG) it is hard to predict where electrodes should be placed in order to obtain an optimal signal. The amplitude of the FECG varies with gestation, and there is a large interindividual variability in the amplitude of the FECG and in the optimal recording site among subjects within the same gestational age. Attempts have been made to explain these phenomena in terms of volume conduction. In this research the complete potential distribution on the maternal abdomen is studied in connection with the geometrical configuration of the electrical source (fetal heart) and the volume conductor (surrounding tissues). For a small group of pregnant women the abdominal FECG is recorded simultaneously in 32 leads during a period of about one minute, once every two weeks from 20 weeks of gestation onwards. A spatial filtering technique which combines information of all 32 leads is used to provide a trigger of the fetal QRS complexes. Using this trigger, an average fetal complex is constructed for each lead by time coherent averaging, after subtraction of the maternal contribution. These average fetal complexes are combined to plot the complete potential distribution generated by the fetal heart at the maternal abdomen (fetal body surface map, FBSM) at any given time instant during the fetal cardiac cycle. At these recording sessions the geometry is carefully quantified by making transverse scans every 2 cm with a compound echo scanner. The contours of fetal head and body, the placenta and the uterus are manually drawn on hardcopies of the video display images. Real time echoscopy is used to support the identification of the geometry. The contours are fed into a computer using a graphics tablet. The three dimensional surfaces of fetus, placenta and uterus are separately represented by a triangulation of the respective contour lines. Figures 5 and 6 show an example of the triangulated representation of the recorded geometry. Figure 7 shows the average fetal complexes of an individual at 26 weeks of gestation, plotted at the site where they have been recorded.(ABSTRACT TRUNCATED AT 400 WORDS)

Abdomen↗
PubMed1997

Perfusion-weighted MR imaging in the upper abdomen: preliminary clinical experience in 61 patients.

OBJECTIVE: We quantitatively analyzed the potential usefulness of perfusion-weighted (PW) MR imaging of the upper abdomen performed with a single-shot gradient-recalled echo echoplanar (GRE EP) sequence. SUBJECTS AND METHODS: PW imaging of the upper abdomen with a GRE EP sequence was performed in 61 patients who had suspected liver or pancreatic disease. PW imaging was started at the time of administration of 0.1 mmol/kg of gadopentetate dimeglumine, and images were obtained every 2 sec for 88 sec. Time-intensity curves for the liver, pancreas, spleen, and kidney, and for subgroups of patients with various pathologic conditions, were constructed for quantitative analysis. RESULTS: The signal-intensity changes seen throughout the PW imaging process differed for each abdominal organ and pathologic condition. In the spleen, pancreas, and renal cortex, a transient signal-intensity decrease was seen in the perfusion phase (42%, 39%, and 78%, respectively). In the liver and renal medulla, the maximum signal-intensity decrease occurred in the later phase rather than in the perfusion phase. Signal-intensity recovery in the spleen and pancreas occurred soon after the maximum signal-intensity decrease, whereas such recovery was delayed in the liver and renal cortex. In cirrhotic livers, the signal-intensity change seen throughout the examination was minimal. CONCLUSION: Unlike conventional MR imaging, PW imaging with a GRE EP sequence can provide detailed hemodynamic information about upper abdomen organs and about disorders of these organs because of its excellent temporal resolution and susceptibility to contrast enhancement.

Abdomen↗
PubMed2003

Strongyloidiasis associated with amebiasis and giardiaisis in an immunocompetent boy presented with acute abdomen.

Strongyloides stercoralis (SS) is an intestinal nematode that is mainly endemic in tropical and subtropical regions and sporadic in temperate zones. SS infection frequently occurs in people who have hematologic malignancies, HIV infection and in individuals undergoing immunosuppressive therapy. In this study, we report a 12- year-old immunocompetent boy who was admitted to our hospital with acute abdomen. Laboratory evaluation showed strongyloidiasis, amebiasis and giardiasis. Clinical and laboratory findings immediately improved with albendazole therapy. Therefore, when diarrhea with signs of acute abdomen is observed, stool examinations should be done for enteroparasitosis. This approach will prevent misdiagnosis as acute abdomen. Complete clinical improvement is possible by medical therapy without surgical intervention.

Abdomen, Acute↗
PubMed1986

Increased echogenicity in the lower fetal abdomen: a common normal variant in the second trimester.

Ten cases displaying a focal area of increased echogenicity in the lower fetal abdomen on prenatal sonography are reported. This was an isolated finding in each case. Nine cases were noted early in the second trimester. The last case corresponded to a postmature gestation. In all cases, a normal lower abdomen was documented on follow-up prenatal sonography, at birth, or at autopsy. The authors believe that increased echogenicity in the lower fetal abdomen represents a normal variant that is more common than suggested by the literature. A possible explanation of this pattern is offered.

Abdomen↗