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At least 217 records · Page 12Linked to original sources
PubMed2004

Isolated echogenic foci in the left upper quadrant of the fetal abdomen: are they significant?

OBJECTIVES: To evaluate fetuses with echogenic foci in the left upper quadrant of the abdomen by sonographic examination. METHODS: Between November 2000 and October 2001, we prospectively assessed fetuses with echogenic foci in the abdominal left upper quadrant on routine prenatal sonography. The location, number, and size of the foci were analyzed, and in utero and postpartum follow-up scans were performed. A pediatrician evaluated the perinatal outcome. RESULTS: Twenty-six fetuses had 35 echogenic foci in the left upper quadrant of the abdomen at gestational ages of 20 to 37 weeks. The locations of the foci along the stomach, spleen, and the left lobe of the liver were found on sonography and measured 2 to 5 mm. Of the 16 fetuses who had follow-up scans in utero, 7 had disappearance of the foci. Postpartum follow-up scans were performed in 12 cases. Among them, 9 neonates had no lesions, and 3 had echogenic foci of a size and appearance similar to those seen prenatally in the left lobe of the liver. Only 1 of 4 patients who had TORCH (toxoplasmosis, other, rubella, cytomegalovirus, and herpes simplex) titers evaluated had elevated immunoglobulin G levels; no patient had any sign of infection after birth. All fetuses had a normal postnatal outcome. CONCLUSIONS: Many echogenic foci in the left upper quadrant of the fetal abdomen will disappear, and the outcome is promising even when the lesion persists after birth.

Abdomen↗
PubMed2000

[Diagnostic radiology in acute pediatric abdomen].

Acute pediatric abdomen is a very common clinical problem. Clinical and laboratory findings, however, are nonspecific or confusing in many instances. This review article focuses on strategy in diagnosing acute pediatric abdomen. A variety of diseases such as appendicitis, gastroenteritis, mesenteric adenitis, intestinal intussusception, Henoch-Schölein purpura, Crohn's disease, Meckel's diverticulitis, duodenal ulcer, congenital biliary dilatation, ovarian torsion, and anomaly of the internal genitalia are discussed in this article. Selection of an appropriate imaging modality is essential to ensure prompt management. In the majority of cases, ultrasound can provide specific diagnoses, whereas in others valuable supplemental information can be obtained. CT will be reserved for selected patients in whom further information is needed. Indications of MR imaging in the management of acute pediatric abdomen are currently limited. MR imaging, however, is indicated on an emergency or semi-emergency basis in selected conditions including anomaly of the internal genitalia, ovarian torsion, and congenital biliary dilatation.

Abdomen, Acute↗
PubMed2000

Pattern of acute abdomen in Yirgalem Hospital, southern Ethiopia.

A retrospective analysis was undertaken on 229 cases of acute surgical abdomen surgically managed at Yirgalem hospital from January to December 1997. Small intestinal obstruction ranked the first and it was mainly due to small intestinal volvulus. Acute appendicitis was the second in the rank. Large intestinal obstruction was the third and it was mainly due to sigmoid volvulus. Typhoid perforation, primary peritonitis, perforated gastroduodenal ulcer, abdominal tuberculosis and empyema of the gallbladder in that order were the other observed causes of acute surgical abdomen. Analysis based on the specific causes of acute abdomen is of great value for early diagnosis and prompt treatment in clinical practice.

Abdomen, Acute↗
PubMed2000

[Laparoscopy in emergency: treatment of choice in acute abdomen].

From 1992 to November 1999, 225 consecutive cases of acute abdomen were observed: 163 suspicious acute appendicitis, 7 ovarian cysts with suspect torsion, 4 intestinal occlusions, 1 digestive hemorrhage due GIST (Gastro-Intestinal Stromal Tumor), 1 case of hemoperitoneum after laparoscopic appendectomy and 49 cases of acute cholecystitis. In the 225 cases of emergency laparoscopic operations for acute abdomen the diagnostic accuracy has been of 99.5%, with only one case of conversion in to laparotomy for diagnosis. The conversion from laparoscopic to laparatomic surgical technique was registers in 2 cases (1%). The realimentation started in all the cases with a liquid diet as soon as 6 hours after the operation and with solid foods the following morning. The Authors haven't registered wound contaminations. The patients of working age rehabilitated in 8 days (between 7 and 21 days). In the athletic patients the average rehabilitation time was 15 days. On the base of the results obtained with their video-laparoscopy experience in acute abdomen emergency surgery, the Authors confirm that this technique can be advised as Emergency Surgery's first choice treatment.

Abdomen, Acute↗
PubMed2002

[Determination of malondialdehyde level in peritoneal fluid in patients with acute abdomen].

BACKGROUND: Our aim is to determine the relationship between free oxygen radicals and tissue destruction in Acute abdomen patients. METHODS: In this study, direct determination of free oxygen radicals is succeeded by measuring the Malondialdehyde level (MDA), which is the last product of lipid peroxidation in the peritoneal fluid of acute abdomen patients. Forty patients are included in the study of whom thirty patients were the study group and ten were taken as the control group. MDA levels of both groups and the differences between daily MDA levels of each group are compared statistically by using one way ANOVA, student t test and student Newman Keuls test respectively. RESULTS: There was statistical significant difference between study and control group (p < 0.05). Also there was significant difference between MDA levels of infected, non-infected and control groups (p < 0.01). It was understood that high MDA levels in the study group source from infected group and there was no significant difference between non-infected and control group. CONCLUSIONS: In this study we proved the high MDA levels in the peritoneal fluid of Infected Acute Abdomen patients. This result is meaningful for the diagnose and following of these patients.

Abdomen, Acute↗
PubMedDate not supplied

[Acute vascular abdomen: personal experience and review of the literature].

Acute vascular abdomen presents an incidence of 1% of all cases of acute abdomen, but the mortality rate is high, ranging from 50 to 80%. Acute mesenteric ischaemia and rupture of abdominal aorta aneurysms are the most frequent causes. Prevention of causal agents and early diagnosis are the only elements capable of improving patient survival. The authors report their personal experience over the period from 1996 to June 2002, analysing different clinical cases of acute vascular abdomen and their diagnostic and therapeutic management and comparing their experience with the relevant literature data.

Abdomen, Acute↗
PubMedDate not supplied

Acute abdomen due to wandering spleen infarction: a case report.

We report a rare clinical case of acute abdomen due to partial infarction of a wandering spleen in the pelvis in a 60-year-old woman. The patient was suffering from stabbing pain in the external lower quadrant of the abdomen, irradiating back to the lumbosacral area, together with an unremitting feverish state (38 degrees C), sickness and constipation. After carrying out serological examinations, which revealed an increase in CPK and leukocytosis, ultrasonography and CT examinations were performed, revealing a mass in the left iliac cavity, which in all probability was a wandering spleen with an abnormally long pedicle and a dyshomogeneous lower area bearing witness to a splenic infarction. The patient was therefore submitted to surgery consisting in splenectomy after lysis of the adherences, which were plainly inflammatory. A wandering spleen, especially when infarcted, is a very rare clinical condition that may be congenital or acquired. Its presence can be confirmed by serological, ultrasonographical and CT examinations and must be suspected when there is no clearly defined acute abdomen.

Abdomen, Acute↗
PubMed2003

[A case of acute abdomen due to ventriculo-peritoneal shunt infection].

Peritonitis is a rare complication of ventriculoperitoneal shunt. Shunt infection may be the cause in patients with ventriculoperitoneal shunt, who have acute abdomen. Specific clues taken from patient's history, physical examination and some further investigations may clarify the diagnosis. This case is a 25-years-old male with a ventriculoperitoneal shunt who presented symptoms of acute abdomen. The patient was admitted with complaints of abdominal pain. There were no neurologic signs or symptoms. Physical examination on admission revealed a mass in the right lower abdomen and abdominal muscular guarding with rebound tenderness. Laboratory studies showed leukocytosis of the peripheral blood. Abdominal ultrasound demonstrated a mass and the preoperative diagnosis was appendicitis. On abdominal exploration, appendix was found to be normal but a catheter infection related omental necrosis was present. Surgical therapy was carried out by withdrawal of the catheter and segmental resection of the omentum. The patient was discharged on seventh day postoperatively.

Abdomen, Acute↗
PubMedDate not supplied

[Complications of the management of secondary peritonitis with contained-open abdomen. Comparison of the Bogota's bag vs polypropylene mesh].

BACKGROUND: Surgery is the cornerstone regarding the treatment of secondary peritonitis, although the complications of the contained-open abdomen are common, and are usually severe. OBJECTIVES: To identify the complications with the use of the "Bogotá's bag" compared with polypropylene mesh in contained-open abdomen. To identify other possible morbidity and mortality risk factors, independently of the mesh type usage. METHODS: One hundred patients with secondary peritonitis were included in this retrospective cohort study. They were treated from January 2000 to March 2002. Fifty subjects were operated on with the "Bogota's bag " (50%) and 50 with the polypropylene mesh (50%). Mannheim's peritonitis severity index, complications and mortality using central tendency and dispersion means, the logistic regression analysis, prevalence and prevalence-ratios were analyzed. RESULTS: Most frequent etiologies of secondary peritonitis were intestinal anastomosis dehiscence, hollow viscera perforation, and severe pancreatitis. Observed complications were: perforation and intestinal fistula in 13 cases (13%); 10 (20%) out of these belonged to the polypropylene mesh group, and 3 (6%) to the Bogota's bag group (p = 0.036). Evisceration was observed in 8 cases (8%); 2 (4%) in the polypropylene mesh group, and 6 (12%) in the Bogota's bag group (p = 0.140). Hemorrhage was present in 30 cases (30%); 16 (32%) in the polypropylene mesh group, and 14 (28%) in the Bogota's bag group (p = 0.662). Colonization was present in 24 cases (24%); and this was mainly evident in the polypropylene mesh group (p = 0.019). Mortality reached 42% (42 cases), and was associated to postoperative bleeding (p = 0.004), peritonitis' severity (p = 0.0012), and surgical reinterventions. CONCLUSIONS: The contained-open abdomen is the best surgical option to treat infection and the compartmental abdominal syndrome in secondary peritonitis, however, complications may be relevant. These results demonstrated a direct relationship between peritonitis severity, the need for surgical re-interventions and mortality. The use of polypropylene mesh was related to an increased risk of intestinal fistulization and prothesis-associated infection.

Abdomen↗
PubMedDate not supplied

[Ruptured aortic aneurysm presenting as acute abdomen: particular case report].

AIM: Ruptured aortic aneurysm can be a cause of acute abdomen. Nowadays using modern diagnostic techniques diagnosis is very easy. We report a particular case of a misdiagnosed ruptured aortic aneurysm. CASE REPORT: Man 65 y.o. admitted to hospital for abdominal pain and stipsis. After 1 week he developed acute abdomen with muscular rigidity and mild acute anemia. Few days before contrast studies showed a sigmoid diverticular disease. At laparotomy a ruptured aortic aneurysm sealed from retroperitoneal fascia and extended to abdominal walls up to rectus abdominis muscles was found. CONCLUSIONS: In case of acute abdomen with muscular rigidity and acute anemia the diagnosis of rectus abdominis muscles hematoma caused by ruptured aortic aneurysm must be considered.

Abdomen, Acute↗
PubMed2005

The acute AIDS abdomen--a prospective clinical and pathological study.

OBJECTIVES: Patients with AIDS who present with an acute abdomen pose a new challenge to surgeons. The purpose of this study was to determine the nature and outcome of intra-abdominal catastrophes in AIDS patients. METHODS: A prospective clinical study was conducted on HIV-positive patients who presented with an acute abdomen. RESULTS: Thirteen patients were included. Average age was 36 years. Seven patients presented with advanced AIDS. In 10 the ileo-caecal region was affected by a chronic inflammatory process resulting in ulceration and necrosis. Intestinal tuberculosis was found in 7 patients. Despite optimal treatment more than half the study group died in hospital. CONCLUSION: The 'acute AIDS abdomen' proved to be different in nature and prognosis than has been described previously. Intestinal tuberculosis can reasonably be suspected. Operative mortality is unacceptably high. Other treatment options are being investigated.

Abdomen, Acute↗
PubMedDate not supplied

Frequency and risk factors for wound dehiscence/burst abdomen in midline laparotomies.

BACKGROUND: Wound dehiscence/burst abdomen is a very serious postoperative complication associated with high morbidity and mortality. It has significant impact on health care cost, both for the patients and hospitals. The aim of the study was to determine the frequency of wound dehiscence/burst abdomen in patients undergoing emergency and elective laparotomies through midline incisions and to identify the risk factors for wound dehiscence. METHODS: This study was carried out at department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from 1st January 2002 to 31st December 2002. 117 consecutive patients undergoing laparotomy with midline incision were included. They were followed by wound examination from third postoperative day onwards to see their normal or otherwise healing. RESULTS: Seven out of 117 (5.9%) patients developed wound dehiscence. Five of them (4.2%) were operated in emergency and two (1.7%) were operated on elective list. CONCLUSION: It is very clear from our study that frequency of wound dehiscence/burst abdomen is still very high in our hospital. Peritonitis, wound infection and failure to close the abdominal wall properly are most important causes of wound dehiscence. Malnourishment and malignant obstructive jaundice predispose a patient to wound dehiscence by slowing the healing, and increasing rate of wound infection.

Abdomen, Acute↗
PubMedDate not supplied

[Comparative analysis of the diagnostic value of ultrasonography and laparoscopy in acute abdomen].

Patients with traumatic or non-traumatic acute abdomen, often exhibit difficulties in the assessment of the real intra-abdominal visceral compromise. This study intends to compare laparoscopy and ultrasonography in patients with non-traumatic or traumatic acute abdomen, in whom there is a doubt on the actual visceral compromise. Forty-five patients were studied in this protocol. Both procedures were performed in 28 and in 17 patients with non-traumatic or traumatic acute abdomen, respectively. The laparoscopic examination was shown to be superior to the ultrasound even when one subtracts from the ultrasound data all pathologies that involved bowel transit and the bowel wall such as the acute appendicitis and cases of pelvic inflammatory disease. The laparoscopic and ultrasound accuracy were 97.8% and 53%, respectively.

Abdomen, Acute↗
PubMed2006

[Acute abdomen caused by Salmonella typhi acute appendicitis].

Salmonella infections can manifest themselves as acute abdominal problems and lead to emergency surgery. Some examples are: salmonella-related intestinal perforations, gallbladder involments, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with salmonella mimics acute appendicitis and it is often difficult to establish a timely and tempestive diagnosis in children with right lower abdominal pain. Because of the difficult diagnostic process, a significant number of patients with salmonella infections present acute abdomen and undergo needless operations. Instead, in our case of salmonella-related acute abdomen, laparotomy was the right therapeutic choice. The conclusion is drawn that, even if there is not a precise diagnosis, in salmonella-related acute abdomen the surgical approach is the right choice, considering the high morbidity and mortality associated with untreated appendicitis and intestinal perforations.

Abdomen, Acute↗
PubMed2006

[Diagnostic laparoscopy in gunshot wounds of the abdomen in children].

Diagnostic laparoscopy in gunshot wounds of the abdomen was performed in 14 children. The diagnostic value of laparoscopic and other methods of diagnostics was evaluated. An analysis of the results has shown that laparoscopy for gunshot wounds of the abdomen in children is of great diagnostic value. The indications and contraindications for diagnostic laparoscopy in such cases have been formulated. The surgical strategy used reduced 3 times the number of unnecessary laparoscopies for gunshot wounds of the abdomen in children.

Abdomen↗
PubMedDate not supplied

[Acute abdomen secondary to spontaneous uterine rupture associated with pyometra].

A 71-year-old female with rheumatoid arthritis and chronic use of corticosteroids presented to the emergency room with 2 weeks of urinary symptoms, abdominal pain and a mass located in hypo-mesogastrium and both flanks. An X-ray film of the abdomen showed that bowels were displaced by the mass. Laboratory studies showed thrombocytosis (549,000/mm(3)) and leukocytosis (41,800/mm(3)). Several hours after her arrival the patient developed acute abdomen and surgery was indicated. A urinary catheter drained 2100 ml of urine and the abdominal mass was reduced in size but did not disappear. Surgery demonstrated that the urinary bladder covered the fundus and the anterior face of the uterus, where extensive necrosis and a 3-cm perforation were found; 400 ml of foul-smelling pus was drained from the uterine cavity. Due to necrosis, a hysterectomy was performed. The histopathological report indicated necrosis, atrophic cervicitis and endometritis; pus culture developed Escherichia coli and Proteus vulgaris. Despite administration of broad-spectrum antibiotics, the patient developed severe sepsis and died 11 days postoperatively. During a literature review, only one similar case was found. Acute abdomen due to uterine perforation secondary to pyometra and associated with chronic use of corticosteroids is a rare complication.

Abdomen, Acute↗
PubMed2006

[Syndrome of acute abdomen in gynaecology and obstetrics].

The syndrome of acute abdomen in gynecology and obstetrics can develop due to inflammatory, ischemic-obstructive and hemorrhagic intra-abdominal etiology as a complication of primary disease, pathologic processes on some organs or injuries (genital, gastrointestinal, urinary, vascular, neurologic and musculoskeletal systems). Clinical and ultrasound examination, x-ray diagnosis, laparoscopy (in early pregnancy) and laboratory findings are the basic diagnostic methods to evaluate etiology of acute abdomen syndrome in gynecology and obstetrics. Rare cases with atypical clinical pictures and etiology of acute abdomen syndrome in gynecologic and obstetric casuistic are described.

Abdomen, Acute↗
PubMedDate not supplied

Acute abdomen due to eosinophilic colitis with liver abscess.

Eosinophilic colitis is an uncommon condition and rarely presents as acute abdomen. We report a 65-year-old man who presented with acute abdomen-- severe pain in upper abdomen, with pyrexia, tachycardia, guarding and right-sided intercostal tenderness--secondary to eosinophilic colitis and was successfully managed. He had additional problems in form of cirrhosis, chronic hepatitis, cholangitis, pyogenic liver abscesses and gout.

Abdomen, Acute↗