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PubMed1982

[Hyperthyroidism as a rare cause of "false acute abdomen"].

4 patients affected by hyperthyroidism presenting a feature of "false acute abdomen" as main clinical sign are presented. The low incidence of that association, according to the literature, and the difficulties of a correct diagnosis, which could lead to a useless laparotomy is pointed out. The conclusion is drawn that tests of thyroid functions should be done whenever the feature of acute abdomen presents without any past history of gastro-enteric lesions.

Abdomen, Acute↗
PubMed1985

Plain film diagnosis of the acute abdomen.

Abdominal plain films are essential for accurate assessment of the acute abdomen. In many cases, they may confirm the presence of a perforated viscus, colonic obstruction, or other abnormality requiring immediate surgical intervention. Alternatively, they may suggest relatively benign disease and help avoid unnecessary operations in these patients. In either case, emergency room physicians should benefit greatly from a systematic approach to the plain film diagnosis of the acute abdomen.

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↗
PubMed1985

Amylase isoenzymes in the acute abdomen: an adjunct in those patients with elevated total amylase.

The role of routine isoamylase determinations in differentiating acute pancreatitis from other causes of an acute abdomen with hyperamylasemia and/or hyperamylasuria was evaluated. Values were analyzed from a control group of 21 patients with acute pancreatitis (group I) and from 100 consecutive patients diagnosed in our emergency department as having an acute abdomen (group II). In group I, 100% of patients had hyperamylasemia, hyperamylasuria, and a P isoamylase fraction greater than 0.75 of the total amylase value. In group II, 50% of patients had hyperamylasemia and/or hyperamylasuria. Of these patients, 44% had a P isoamylase fraction less than 0.75 of the total amylase value, a finding apparently incompatible with a diagnosis of acute pancreatitis as identified by our control group. We conclude that routine isoamylase determinations in patients with an acute abdomen and hyperamylasemia and/or hyperamylasuria allows the differentiation from acute pancreatitis in 44% of cases.

Abdomen, Acute↗
PubMed1995

Unusual presentation of acute abdomen in scrub typhus: a report of two cases.

Two young soldiers presented with acute abdomens, then received surgical procedures under initial impression of acute cholecystitis and acute appendicitis respectively. Operative findings did not confirm the initial diagnosis, and the clinical condition did not improve after operation. Scrub typhus was suggested later by clinical manifestations of fever, chills, headache, lymphadenopathy, skin rash and presence of eschar formation; this diagnosis was finally confirmed by positive serologic results of high Weil-Felix OXK agglutination and/or Rickettsia tsutsugammushi immunoflorescence titers in paired sera. Both patients rapidly became afebrile after administration of tetracycline. This unusual presentation with acute abdomen in scrub typhus is emphasized, with caution that the possibility of scrub typhus should be taken considered, especially in patients coming from hyperendemic areas.

Abdomen, Acute↗
PubMed1998

Postsplenectomy Capnocytophaga canimorsus sepsis presenting as an acute abdomen.

Patients with intra-abdominal processes that require prompt surgical intervention, including appendicitis, perforated viscus, ischemic bowel, volvulus, and bowel obstruction, often present with signs and symptoms of an acute abdomen. Several medical problems can mimic an acute abdomen. Overwhelming postsplenectomy infection is a life-threatening condition that can present with acute abdominal symptoms. The incidence of overwhelming postsplenectomy infection ranges from 1% to 25%, and is caused by Streptococcus pneumoniae in 50% of cases. Capnocytophaga canimorsus, a bacteria commonly found in dog saliva, accounts for less than 1% of cases. Overwhelming postsplenectomy infection has a rapidly deteriorating course that progresses to respiratory and renal failure, cardiovascular collapse, and death. The mortality associated with overwhelming postsplenectomy infection is 60% to 80%. Early diagnosis and institution of appropriate antibiotic therapy and supportive care is essential to improve patient outcome. A previously healthy woman who had undergone splenectomy secondary to trauma 11 years earlier presented with symptoms of an acute abdomen. A diagnosis of overwhelming postsplenectomy infection due to C canimorsus was made based on her peripheral blood smear and blood culture findings. Early aggressive care and antibiotic treatment resulted in a successful outcome for this patient with no long-term morbidity. This patient's clinical course demonstrates the importance of early diagnosis and treatment of overwhelming postsplenectomy infection.

Abdomen, Acute↗
PubMed1997

Acute abdomen due to endometriosis as a diagnostic and therapeutic challenge in the treatment of acute myelocytic leukemia.

Acute abdominal pain is a frequent diagnostic and therapeutic challenge in hematologic patients. We report on the very rare case of organ endometriosis with acute abdominal symptoms in a 43-year-old female patient with AML-M5, starting 4 days after induction chemotherapy with idarubicin, ara-C, and etoposide. The patient presented with an acute abdomen with clinical findings of acute cholecystitis, subileus, and local pain in the right upper abdomen accompanied by severe diarrhea. Probably due to impaired intestinal resorption, menstrual bleeding occurred despite regular administration of lynestrenol. Ultrasound examination of the abdomen disclosed a tumor with poor echoes in the pouch of Douglas, a subcapsular splenic hemorrhage, and a thickened gallbladder wall with surrounding edema. A cystic adnex tumor was confirmed by endovaginal ultrasound. Based on history and the findings on ultrasound, an endometriosis was diagnosed, and the LHRH agonist (nafarelin) was administered nasally in combination with lynestrenol. Following this medication the abdominal pain ceased, supporting the diagnosis of endometriosis. Nasal administration of an LHRH agonist in the following cycles of chemotherapy was effective in preventing further abdominal discomfort and vaginal bleeding. LHRH agonists should be given to patients with known endometriosis before starting myeloablative chemotherapy to prevent painful hemorrhage from endometriosis.

Abdomen, Acute↗
PubMed2004

Long-term outcome, adhesions, and quality of life after laparoscopic and open surgical therapies for acute abdomen: follow-up of a prospective trial.

BACKGROUND: The objective of this study was to determine the long-term outcome of laparoscopic and open therapies for acute abdomen, and to assess the patients postoperative quality of life, with special attention to adhesions. METHODS: A follow-up study was conducted from June through December 2001 of a case-control trial of laparoscopic and open surgical treatment in patients with acute abdomen. Mean (median) duration of follow-up was 35.9 months (32.5) for the laparoscopic group (L) and 40.7 months (38.5) for the open group (O). A total of 284 (92%) of the original 310 study patients (108 L and 202 O) were contacted. Twenty-eight (9%) were confirmed to be dead. From the remaining 256 patients (131 men and 125 women, mean age [+/- SD] 38.9 +/- 19.9 years), we enrolled 153(67 L and 91 O) in the follow-up. The main outcome measures were frequency of relapse requiring treatment, frequency of reoperations, incidence of adhesion ileus and incisional hernia, distant morbidity and mortality, satisfaction with therapy, and Gastrointestinal Quality of Life Index (GQLI) scores. RESULTS: The morbidity and mortality rates, readmission rates, incisional hernia rates, and scores for long-term quality of life were the same in both groups. The reoperation rate was significantly higher among L patients, but there were significantly fewer episodes of adhesion ileus in this group. Patient satisfaction was 85% in the L group and 73% in the O group (p = NS). CONCLUSIONS: The laparoscopic treatment of patients with acute abdomen offers an outcome comparable to that achieved with the open approach. There were fewer episodes of adhesion ileus in laparoscopic patients. Consequently, the operative treatment of acute abdomen patients by laparoscopy can be recommended.

Abdomen, Acute↗
PubMed2006

Perforated GIST of the small intestine as a rare cause of acute abdomen: Surgical treatment and adjuvant therapy. Case report.

A case of perforated gastrointestinal stromal tumor (GIST) of small intestine causing acute abdomen is described, with a brief review of the literature. A male patient presented with symptoms of acute abdomen. After evaluation, a laparotomy was performed, where perforation of a tumor in the ileum was found. The perforated part along with the tumor was resected and the cytopathological examination showed that the tumor was GIST. Postoperatively, the patient received treatment, using imatinib. Gastrointestinal stromal tumors are relatively rare and often present with vague symptoms. Their first clinical manifestation as acute abdomen due to their perforation is extremely rare. In emergency laparotomy, a R0 resection is required and adjuvant therapy with imatinib must be considered.

Abdomen, Acute↗