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At least 253 records · Page 14Linked to original sources
PubMed2000

Selective surgical indication in the management of neutropenic children presenting with acute abdomen.

As the treatment of pediatric malignancies improves and survival increases, the diagnosis of acute abdomen in these patients also becomes more common. Nevertheless, the management of this condition is still controversial. The authors report their experience in treating 12 neutropenic children with acute abdomen. The charts of 12 neutropenic patients with a diagnosis of acute abdomen treated at Boldrini Children's Cancer Center in Campinas, Brazil, between 1991 and 1996, were reviewed. Therapeutic strategy included an initial period of bowel rest, general supportive measures, and broad-spectrum antibiotics while waiting for the neutrophil count to rise. Three patients recovered completely without surgery, 8 underwent late surgery without complications, and 1 died due to uncontrolled sepsis before surgery. The treatment of acute abdomen in neutropenic children remains controversial. As shown in the present series, an initial nonoperative approach with selective surgical indication appears to be safe and to yield good results. Supportive treatment, until the neutrophil count rises, followed by surgery, if necessary, appears to be a sound therapeutic approach for neutropenic children with acute abdomen.

Abdomen, Acute↗
PubMed2003

Pain as a presenting feature of acute abdomen in spinal injuries.

The diagnosis of acute abdomen can be difficult in patients with spinal injuries. We reviewed all the 1039 case records of patients admitted with spinal injuries to the Queen Elizabeth National Spinal Injuries Unit, Glasgow over a 7-year-period and found 5 (0.48%) cases of acute abdomen that required surgical intervention and were not caused by original injury. Their presenting signs and symptoms were analysed. Pain was found to be an unreliable symptom in these patients.

Abdomen, Acute↗
PubMedDate not supplied

[Acute abdomen in diabetic patients --diagnostical questions].

The acute abdominal diseases in diabetic patients have some typical clinical features, which may be responsible for delated or even erroneous diagnosis. Severe anatomo-pathological forms of these diseases may advance, despite a rather discreet clinical evidence. The authors analyze a series of 132 diabetic patients with acute abdomen, operated between 1996 and 2001 in Surgical Clinic "I. Juvara", from Clinical Hospital "Dr. I. Cantacuzino"-Bucharest. The difficulties and also the inadvertences of diagnosis are detailed. Finally, a set of indices is presented, in order to help the differential diagnosis between acute abdomen and abdominal signs of the diabetic ketoacidosis.

Abdomen, Acute↗
PubMed1991

[Acute abdomen as a postoperative complication].

The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of volvulus of the small intestine, a stress ulcer, gangrenous appendicitis, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed2006

[A case report of two incidents of acute abdomen in a woman during pregnancy and in the early puerperium].

The authors present a case of a 32 year old pregnant woman who is admitted to the Obstetric clinic in the 16th gestational week with a pain in the ileoceacal region of the abdomen and vomitting. The woman has clinical signs of acute abdomen. A clinical diagnosis of acute appendicitis was suggested. During the operation under general anesthesia was found a phlegmonous inflammation of a Mekel diverticulus with perforation as well as local peritonitis and a catharal inflammation of the appendix. The appendix and the Mekel diverticle were removed during the operation. No comlications were observed during the post operative period. No fetal distress was observed during and after the operation Three months later the same patient was admitted to the obstetric clinic in the 32nd gestational week with a diagnosis Threatened premature delivery in ml VIII status post resection of a Mekel diverticle and appendectomy. The patient had pain to the right of the umbilicus and vomiting. The labor was induced and a viable premature infant was born. Two days after delivery there was again a clinical symptoms and signs of an acute abdomen due to ileus. A strangulation of the terminal ileum was found due to adhesions A Debridman and a lavage were performed No complications were observed during the postoperative period. The authors discuss the difficulties which might ensue when the diagnosis acute abdomen is made in a pregnant woman

Abdomen, Acute↗
PubMed1988

[Acute abdomen in unrecognized hyperparathyroidism].

The incidence of acute abdomen in patients with unrecognised hyperparathyroidism (HPT) was investigated in 61 patients with primary and 15 patients with secondary HPT, operated on at the Surgical University Department in Düsseldorf between 4/86 and 10/87. In seven patients (9%) an acute abdomen occurred preoperatively (bleeding ulcer n = 3, ulcer perforation n = 1, acute pancreatitis n = 3). Recurrent gastrointestinal disease was observed in 20 of the 76 Patients (28%). The fast and surprising clinical recovery of patients with pancreatitis and HPT after operation of the HPT support the assumption of a causal relation between hyperparathyroidism and pancreatitis. The importance of hypercalcaemia and HPT as causative factors in gastrointestinal ulcers, remains uncertain, however. Possible acute abdominal emergencies in the clinical course of primary hyperparathyroidism support the indication for early operation.

Abdomen, Acute↗
PubMed1983

[Acute abdomen caused by phlegmonous appendicitis and leukemic infiltration of the cecum in a patient with acute lymphatic leukosis in relapse: clinico-therapeutic aspects].

We report a case of eleven years old child with an acute lymphoblastic leukemia who developed an acute abdomen while in haematological relapse. He had an acute appendicitis with leukemic infiltration of the coecum. The early surgical intervention and the coecum irradiation were successful: the following chemiotherapy achieved remission. A more aggressive surgical approach to the acute abdomen, combined with careful supportive measures, might improve the usually grim prognosis in patient whose leukemia offers a chance for remission.

Abdomen, Acute↗
PubMedDate not supplied

Acute intermittent [corrected] porphyria. An often forgotten diagnosis in acute abdomen.

Three cases of Acute Intermittent Porphyria (AIP) are described. All presented with acute intermittent abdominal pains. One had grand-mal epilepsy as well. Two were diagnosed by chance. In the third case the diagnosis was thought of. It is suggested that AIP should always be considered as one of the differential diagnosis in Acute Abdomen in West Africa.

Abdominal Pain↗
PubMedDate not supplied

Diagnostic aspiration of abdominal fluid in patients with acute abdomen.

Twenty-two patients with acute abdominal symptoms were studied by abdominal sonography and by sonographically guided aspiration of intraperitoneal fluid. The colour of the fluid was found to be diagnostically valuable: a green colour indicated gallbladder perforation, a yellow colour was found in a variety of infectious diseases, a red colour in haemorrhagic pancreatitis or haemorrhage. Aspirating fluid from the peritoneal cavity under ultrasound guidance in connection with any routine ultrasound examination is a valuable and easy method for studying patients with symptoms of acute abdomen.

Abdomen, Acute↗
PubMed2004

Infective complications according to duration of antibiotic treatment in acute abdomen.

INTRODUCTION: Adjuvant antibiotic therapy for acute abdominal conditions is widely used. Its timing, duration, dose and spectrum, however, are not homogeneous amongst surgeons and prolonged courses are often used despite the unproven benefits of this practice. OBJECTIVE: To evaluate use and compare duration of antibiotic treatments in acute abdominal surgery. METHODS: Retrospective cohort study. The medical records of 290 patients who underwent operations for acute abdomen from July 1998 to July 1999 in a teaching hospital were reviewed. The pattern of antibiotic use and rates of postoperative complications were evaluated, along with surgical diagnosis, degree of contamination/infection, and incidence of postoperative complications. The patients were stratified according to the degree of contamination/infection noted during the operation. The study population was divided in two groups according to the duration of antibiotic use (cut-off point at the median antibiotic use in days, for each group of contamination/infection degree), and outcomes were compared. RESULTS: The degree of contamination/infection was significantly associated with an increased risk of wound infection, intra-abdominal abscess, postoperative infective complications and overall postoperative complications (p < 0.001). A long course of antibiotics was not associated with lower infective complication rates. CONCLUSIONS: Shorter courses of antibiotic therapy based on the degree of contamination/infection seem to be safe. A prospective study should confirm this hypothesis.

Abdomen, Acute↗
PubMed2003

Selective role of nuclear medicine in evaluating the acute abdomen.

The imaging evaluation of the acute abdomen has clearly evolved with the introduction of high-resolution imaging techniques, such as CT, US, and MR imaging, leaving scintigraphic examinations an important, though selective, role based on their noninvasive, physiologic, and functional nature. Proper use of these examinations among all the diagnostic methods requires a good understanding of their strengths and limitations.

Abdomen, Acute↗
PubMed1995

Atypical presentation in the elderly--case report of an acute abdomen.

An elderly woman with an acute abdomen due to a perforated peptic ulcer is discussed to illustrate the problem of atypical presentation of illness in the elderly. The importance of not dismissing non-specific symptoms and signs such as confusion, restlessness, abdominal distention and non-localising abdominal tenderness in the elderly, is highlighted. In addition, the useful radiological features of pneumoperitoneum are described. The need for functional assessment and rehabilitation are emphasised as important components in the practice of geriatric medicine.

Abdomen, Acute↗
PubMed1997

[Anisakidosis of the colon as a cause of acute abdomen].

We report a case of acute abdomen caused by the invasion of the ascending colon by larvae of Anisakis simplex in a 57 year-old-woman whose initial symptoms were colic abdominal pain, diarrhea and fever. The diagnosis was done by the histological study of the surgical specimen in which two parasites were morphologically identified in the submucosa. Although a causal relationship of the disease with the ingestion of crude fish could not be established initially, there were antecedents of ingestion of anchovy in vinegar (Engraulis encrasicholus) and dyspeptic symptoms for several months.

Abdomen, Acute↗
PubMedDate not supplied

[Iatrogenic acute abdomen].

The autors present 41 cases of acute abdomen occuring after medico-surgical procedures, diagnostic explorations, or conservative treatments. The clinicat pictures of these patients were suggestive of acute abdomen of the peritonitis or hemorrhagic type. The severity of the cases was more frequently determined by the basic disease, for which the exploration was performed, by the retarded intervention and the septic fluid that flooded the peritoneal cavity. Without attempting to minimize the value of explorative or therapeutic procedures, that may sometimes determine acute abdominal syndromes, the authors stress the necessity to make a careful selection of the cases that will undergo these procedures, as well as the capability and the experience of those that will carry them out.

Abdomen, Acute↗
PubMed1997

[Value of diagnostic laparoscopy and minimal invasive procedures in acute abdomen].

During the last three years 172 diagnostic laparoscopies (DL) were performed at our department in patients with an acute abdomen of unclear causes. This corresponds to 17% of all patients who underwent operation due to an acute abdomen in the same period. Always the indication for a diagnostic laparoscopy arose then, when the cause or the localization of the acute abdomen could not be found by conventional diagnostic methods. The advantages of DL were either the confirmation (93%) or the exclusion (7%) of the diagnosis "acute abdomen", the exact localization and simultaneously a definitive operative treatment of the cause by minimal invasive interventions (n = 109/65%). In these patients with acute abdomen the main causes were acute inflammations of gallbladder (n = 48) and appendix (n = 29), ulcus perforations (n = 9) and ileus (n = 9). The conversion rate amounted to 2.7%, the postoperative complication rate to 11% and the lethality rate to 1.8% in these patients. A new indication is the so-called "bedside laparoscopy" as means to control the postoperative course of mesenteric embolism (n = 9) and diffuse peritonitis (n = 3) in order to avoid the stress of a second-look operation for these seriously ill patients or to secure the indication for relaparotomy.

Abdomen, Acute↗
PubMed1997

Clostridium difficile colitis presenting as an acute abdomen: case report and review of the literature.

Pseudomembranous colitis associated with Clostridium difficile rarely manifests as an acute abdomen and even more rarely as an acute abdomen without abnormal radiologic studies. The following is a case report of a 52-year-old white man who had an acute abdomen without abnormal radiologic studies, and was given a final diagnosis of C difficile colitis. Surgery was averted only by the ability to do an expeditious flexible sigmoidoscopy with the visualization of pseudomembranes. Diagnosis was later confirmed by a positive toxin assay and culture of C difficile. Treatment for C difficile colitis is usually medical, with oral vancomycin the preferred agent. Surgery may be needed when there is an acute abdomen with other systemic signs (fever or leukocytosis) or abnormal radiologic studies.

Abdomen, Acute↗
PubMed2002

[Acute abdomen in the child].

The acute abdomen in childhood demands early diagnosis for the sake of appropriate and early therapy. A high number of differential diagnosis in the assessment of acute abdominal pain and problems, as well as different causes of diseases in different age of the children, make a partition with respect to the age of the children considerable. A partition in diseases, which are leading to acute abdominal pain in neonates, in toddlers and small infants and in schoolchildren makes sense. In older schoolchildren and adolescents also diseases of the grown up generation are possible as a cause of acute abdominal pain. The lack of compliance (cooperation and communication) in small children obstructs clinical and radiological assessment and elucidates the necessity of knowledge of causes of acute abdominal pain as much as possible. A lot of patience and experience are mandatory in the evaluation of small children and therefore make a dedicated, trained and experienced stuff necessary. A dedicated paediatric radiologist will find a safe and proper technique, and in cooperation with the referring clinician the necessary decision for therapy will be made.

Abdomen, Acute↗
PubMed2000

[Differential diagnosis and therapy of acute abdomen in sickle cell crisis. A rare case in visceral surgery].

Surgical therapy of the acute abdomen often allows only limited time for differential diagnosis to confirm the indication for surgery. Under consideration of clinical aspects and case history both common and rare causes of an acute abdomen should be investigated without undue loss of time. Differential diagnostic considerations and eventual therapy are presented in the following case of a 25-year-old Afro-american who developed multiorgan failure after an initial course of lower-back pain. In addition to the clinical setting of an acute abdomen the patient presented with acute respiratory failure and laboratory signs of severe hemolysis in combination with newly detected splenomegaly. The indication for splenectomy was made following CT-proven complete splenic infarction due to repeated acute squestration. Histologic examination of the spleen together with hemoglobin electrophoresis confirmed the clinical assumption of unusually late primary manifestation of a sickle cell crisis. In the underlying case, the hemoglobinopathy was in fact the less common form of combined sickle-cell-beta-thalassemia. A ten-day course of intensive care therapy was necessary to treat ongoing multiorgan failure due to persistent sickle cell crisis. Current diagnostic and therapeutic procedures in connection with sickle cell crisis as a rare cause of an acute abdomen with the necessity for surgical intervention are presented.

Abdomen, Acute↗