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At least 361 records · Page 20Linked to original sources
PubMed2000

[Pulse triggering for improved diffusion-weighted MR imaging of the abdomen].

PURPOSE: The aim of this work was to reduce the influence of motion on diffusion-weighted MR images of the abdomen by pulse triggering of single-shot sequences. METHODS: Five healthy volunteers were examined both without and with finger pulse-triggering of a diffusion-weighted single-shot echo planar MR imaging sequence at 1.5 T. Series of diffusion-weighted images were acquired at different phases of the cardiac cycle by varying the time delay between finger pulse and sequence acquisition. The measurements were repeated three times. The diffusion weighted images were analysed by measuring the signal intensities and by determining the ADC values within the spleen, kidney and liver. RESULTS: The magnitude of motion artifacts on diffusion weighted images shows a strong dependence on the trigger delay. The optimum trigger delay is found to be between 500 and 600 ms. For these values the abdominal organs appear homogeneous on all diffusion weighted images and the strongest signal intensities are detected. At optimum triggering the accuracy of the apparent diffusion coefficients is up to 10 times better than without triggering. Moreover, the standard deviation of the repeated measurements is smaller than 12% for all volunteers and for all organs. Without triggering the standard deviation is larger by a factor of 4 on average. CONCLUSION: Pulse triggering of single-shot sequences leads to significant reduction of motion related artifacts on diffusion weighted images of the abdomen and provides more accurate and reproducible ADC values.

Abdomen↗
PubMed2002

[Ultrasound examination of non-traumatic acute abdomen].

Amongst all imaging procedures available for the exploration of an acute non traumatic abdomen, ultrasound comprises the first line technology. Non ionising, easily accessible, cheap and usable at the bedside, this imaging technique also has the advantage of close contact with the patient, which may help to focus the exploration on painful regions. Moreover, ultrasound has not only diagnostic capabilities, but also therapeutic ones. Nevertheless, sonography has limitations, which have to be known in order to avoid misdiagnosis or inadequate reassurance. The aim of this review is to present and discuss the most recent opinions about ultrasound diagnosis of acute non-traumatic abdomen related to digestive system diseases.

Abdomen, Acute↗
PubMed2004

Detection of therapeutically relevant diagnoses made by sonography of the upper abdomen: portable versus high-end sonographic units -- a prospective study.

AIM: To compare the efficiency of a portable sonographic unit with a high-end unit used for sonographic examinations of the upper abdomen to detect therapeutically relevant diagnoses and to answer clinical questions. METHODS: Over a period of five years, 575 patients were examined by four examiners as part of the daily routine work. Patients without known diagnoses were examined first with the portable SonoSite 180 system, with documentation of the findings and diagnoses, and immediately thereafter with the high-end Philips HDI 5000 system. Subsequently, any discrepant findings and diagnoses were recorded. The assessment was confined to therapy-demanding diagnoses and to the resolution of the clinical question (major findings) as well as to other therapeutically relevant findings (minor findings). RESULTS: Of the 575 data sets (duplicated examinations), 574 could be evaluated. The major findings coincided in 447 (78 %) of 574 cases and were discrepant in 121 (22 %) cases in which the major findings were solely detected with the high-end Philips HDI 5000 system and missed with the portable SonoSite 180 system. Findings of the upper abdomen coincided in 252 (85 %) of 297 cases and were undetectable with the portable unit in 44 (15 %) cases. For 166 intestinal examinations, the proportion of coinciding major findings was 58 % (96 of 166 cases), with 42 % (71 of 166 cases) overlooked with the portable unit. For examinations of the pleura, the findings coincided in 99 (89 %) of 111 cases. The findings of emergency examinations coincided in 138 (75 %) of 185 cases, with 47 (25 %) findings exclusively detected with the HDI 5000 system. In emergencies without intestinal involvement, the findings coincided in 105 (89 %) of 118 cases. CONCLUSION: As expected, the high-end unit is markedly superior to the portable sonographic unit, especially for clinical questions requiring a high physical resolution, as needed for gastrointestinal structures, biliary system and pancreas. The portable unit provided its best results for examinations of the pleura and for emergency examinations as long as the gastrointestinal tract is excluded. For the routine use of portable sonographic units, it is important to know the limitation of the particular unit.

Abdomen↗
PubMed2006

[Abdominal dressing -- a new standard in therapy of the open abdomen following secondary peritonitis?].

INTRODUCTION: The management of patients with a laparostoma due to peritonitis is a challenge for every surgeon and intensivist. The goal of this study was to compare the different treatment strategies for the open abdomen: Abdominal Dressing (AD), the classic V.A.C. therapy (CV) and conventional open therapy (CT). METHODS: Between 2001 and 2005 we identified 62 patients in 4 surgical departments in Austria who had to be treated with a laparostoma due to peritonitis. 27 patients were conventionally treated, 16 with the Classic V.A.C. therapy and 19 patients with V.A.C. abdominal dressing. RESULTS: The mortality was 3/16 (14 %) in the AD group vs. 4/12 (21 %) patients in the CV group and 18/9 (59 %) in conventional therapy. There was no significant difference for survivors in the length of ICU stay: 26.6 +/- 23.0 days in the CT group, 34.6 +/- 30.2 days in the CV group and 38.9 +/- 27.2 days in the AD group. Apache II Score and Mannheimer Peritonitis Score showed no difference between the groups. CONCLUSION: We found a reduction of mortality in the V.A.C. Abdominal Dressing group by approximately 40 % (AD: 14 %, CT: 59 %). Although we could identify a difference in age in our retrospective study we believe that V.A.C. Abdominal Dressing is the important factor for the different clinical outcome. These first results indicate the need for further prospective evaluation of the V.A.C. Abdominal Dressing therapy, to prove if a new standard in the therapy of the open abdomen is created.

APACHE↗
PubMed1996

[Ultrasound "screening examination" of the abdomen: of value or senseless?].

Screening examinations are diagnostic procedures without an individual indication with the purpose to detect a possible disease in an early, asymptomatic stage. Primary sonographic screening of the abdomen in individuals without any signs or symptoms of abdominal disease cannot be recommended. Secondary screening (sonographic examinations of the total abdomen in patients with unspecific symptoms) and to examine the remaining abdominal, pelvic and retroperitoneal organs which are not needed to answer the specific diagnostic question are procedures of doubtful benefit. However, ultrasound is recommended for specific screening programs, i.e. tumour detection or diagnosis of aneurysms, in those subpopulations with a high prevalence for the specific disease.

Abdomen↗
PubMed1999

[Initial manifestation of primary intestinal lymphangiectasis as acute abdomen].

HISTORY: A 32-year-old man had ten years previously undergone several laparotomies for recurrent ileus of the small intestine. They revealed severe intestinal oedema and histology showed hyperplasia of the lymphatic system but the aetiology was unclear. After a 10-year interval free of symptoms he presented with marked hypoproteinaemic oedema and exudative enteropathy the cause of which was to be clarified by exploratory laparotomy with excision of lymph nodes and a small section of small intestine. INVESTIGATIONS: Histology revealed intestinal lymphangiectasis with partly hyperplastic lymphoid tissue. Lymphangiography demonstrated several lymph nodes in the region of the aortic bifurcation and renal vessels with a central filling defect. It is thought likely that obstruction to lymphatic flow in this region resulted in oedema of the intestinal wall which caused the recurrent episodes of ileus. DIAGNOSIS: Retrospectively it is assumed that primary intestinal lymphangiectasis was responsible for the initial manifestation of an acute abdomen. For treatment of hypoproteiaemia with human albuminea prot system was implanted. The course was complicated by recurrent inflammation and thrombosis of the port catheter. Because of immune deficiency risk of carcinoma is high in primary intestinal lymphangiectasis. CONCLUSION: Primary intestinal lymphangiectasis, even though a rare condition, should be considered in the differential diagnosis of otherwise unclear acute abdomen.

Abdomen, Acute↗
PubMed1995

Intraperitoneal foreign body as a cause of acute abdomen in pregnancy.

Although surgical textbooks commonly include foreign bodies in the differential diagnosis of acute abdomen, this cause of abdominal pain has not been reported in the obstetric literature. A 35-year-old woman presented at 24 weeks' gestation with right lower quadrant pain and peritoneal signs. The only abnormal finding at exploratory laparotomy was a free-floating intraperitoneal foreign body, presumably left inadvertently during prior surgery. The differential diagnosis of acute abdomen in pregnancy should include intraperitoneal foreign body in any woman with a history of previous abdominal surgery.

Abdomen, Acute↗
PubMed1984

[Initial results with the use of "contrast media", the so-called sonographica, for ultrasound examination of the upper abdomen].

First experiences with contrast media, so-called "sonographica", for the purpose to improve the ultrasonographic diagnostic of the upper abdomen are reported; special emulsions and suspensions with particle diameters between 50-2000 mu were used. The sonographica cause an echo texture similar to the liver and a more homogeneous ultrasonic absorption in the upper abdomen--within the range of frequencies and intensities used in sonographic diagnostic. This improves the possibility of obtaining cross-sections by using several transducers--arranged on a circuit--simultaneously. By increasing the echogenicity of the sonographicum the thickness of the stomach and duodenal wall can be indicated regularly for the first time.

Abdomen↗
PubMed1995

[The torsion of an accessory liver lobe as the rare cause of acute abdomen].

HISTORY AND CLINICAL FINDINGS: A 35-year-old woman was admitted because of cramp-like abdominal pain with nausea and vomiting since the previous evening. There was no history of previous abdominal symptoms of jaundice. Physical examination suggested atypical appendicitis with pain on palpation of the right mid-abdomen, localized paraumbilical guarding tension and diffuse pressure pain, more on the right, on rectal examination. Body temperature was 37.8 degrees C. EXAMINATIONS: There were leucocytosis (12000/microliters) and abnormally high liver function tests (GOT 95 U/l, GPT 110 U/l, LDH 368 U/l, alkaline phosphatase 335 U/l). Ultrasonography of the abdomen demonstrated free fluid in the Douglas pouch. TREATMENT AND COURSE: Laparotomy, performed because atypical appendicitis was suspected, revealed a torsioned pedicle of a severely bleeding accessory liver lobe positioned near the gall bladder bed. The accessory lobe was removed and the patient became symptom-free. This is the 15th reported case of clinical manifestations of an accessory liver lobe.

Abdomen, Acute↗
PubMed1982

[Sonography of the upper abdomen in cystic fibrosis (author's transl)].

Ultrasound scans of the upper abdomen were carried out in fifty patients with cystic fibrosis (age 2 to 26 years). 38% showed an abnormal hepatic sonogram. On eight occasions it was possible to confirm these changes by a liver biopsy. In 14% there was homogenous increase in liver echoes. 22% showed an non-homogeneous liver structure due to fibrotic and cirrhotic changes and cholangitis. Four of these patients had splenomegaly due to portal hypertension. 85% of the pancreatic scans which could be evaluated showed small pancreases with high echoes. Cholelithiasis was not present in any. Sonography of the upper abdomen is the method of choice for evaluating the liver, biliary system, pancreas and spleen.

Abdomen↗
PubMed2003

Acute surgical abdomen as presenting manifestation of Kawasaki disease.

Ten children (4.6%) among a cohort of 219 with Kawasaki disease (KD) had their onset with severe abdominal complaints. Incomplete KD presentation at the time of acute abdomen was present in nine of 10 patients. Acute abdominal pain and distension, vomiting, hepatomegaly, and jaundice were the most common symptoms at onset. Hematemesis was present in one; toxic shock syndrome requiring care in the intensive care unit occurred in four. Five patients had laparotomy, three had percutaneous transhepatic biliary drainage, and one had a gastrointestinal endoscopy. Postoperative diagnosis was gallbladder hydrops with cholestasis in five, paralytic ileus in three, appendicular vasculitis in one, and hemorrhagic duodenitis in one. All patients completely recovered, but 50% developed coronary aneurysms despite early intravenous gammaglobulin treatment. Acute surgical abdomen can be the presenting manifestation of KD. In older children with fever, rash, and acute abdominal pain or hematemesis, KD should be considered in the differential diagnosis.

Abdomen, Acute↗
PubMed1999

Acute abdomen in mentally retarded patients: role of aerophagia. Report of nine cases.

Between 1993 and 1996 nine mentally retarded patients presented because of an acute abdomen. All had the habit of aerophagia, diagnosed previously by a general practitioner. Massive distension of the bowel led to ileus, volvulus, and necrosis. After placement of a percutaneous endoscopic gastrostomy catheter or performing a gastrostomy during laparotomy with the intention to use as a desufflator, no recurrence of the signs and symptoms of an acute abdomen were observed.

Abdomen, Acute↗
PubMed2000

Implications of respiratory motion for the quantification of 2D MR spectroscopic imaging data in the abdomen.

Magnetic resonance spectroscopic imaging (MRSI) studies in the abdomen or breast are acquired in the presence of respiratory motion. This modifies the point spread function (PSF) and hence the reconstructed spectra. We evaluated the quantitative effects of both periodic and aperiodic motion on spectra localized by MRSI. Artefactual signal changes, both the modification of native to a voxel and spurious signals arising elsewhere, depend primarily upon the motion amplitude relative to the voxel dimension. A similar dependence on motion amplitude was observed for simple harmonic motion (SHM), quasi-periodic motion and random displacements. No systematic dependence upon the period or initial phase of SHM or on the array size was found. There was also no significant variation with motion direction relative to the internal and external phase-encoding directions. In measured excursion ranges of 20 breast and abdominal tumours, 70% moved < or = 5 mm, while 30% moved 6-23 mm. The diaphragm and fatty tissues in the gut typically moved approximately 15-20 mm. While tumour/organ excursions less than half the voxel dimension do not substantially affect native signals, the bleeding in of strong lipid signals will be problematic in 1H studies. MRSI studies in the abdomen, even of relatively well-anchored tumours, are thus likely to benefit from the addition of respiratory triggering or other motion compensation strategies.

Abdomen↗
PubMed1985

The molecular through ecological genetics of abnormal abdomen in Drosophila mercatorum. I. Basic genetics.

The abnormal abdomen syndrome (aa) in Drosophila mercatorum is characterized by the persistence of juvenilized cuticle on the adult abdomen. The aa phenotype is shown to depend on at least two X-linked genetic elements that are about one map unit apart near the centromeric end of the X chromosome. These two genetic elements are necessary for aa expression; one behaves as a dominant element and the other as a recessive. Overlaying these genetic studies upon molecular work reported elsewhere, it is argued that the dominant element is the presence of a 5 kb insertion in a majority of the X-linked repeats coding for the 28S ribosomal RNA. The recessive element appears to be a locus controlling differential replication of noninserted over inserted 28S genes during polytenization. The aa syndrome requires both the presence of the inserted repeats and the failure to preferentially amplify noninserted repeats. Given the necessary X-linked elements for aa, a variety of modifiers are revealed. First, aa expression in males is Y-linked, apparently corresponding to a deletion of the 18S/28S rDNA gene cluster normally found on the Y. Moreover, all major autosomes can modify the penetrance of aa.

Abdomen↗
PubMed1992

The molecular through ecological genetics of abnormal abdomen. IV. Components of genetic variation in a natural population of Drosophila mercatorum.

Natural populations of Drosophila mercatorum are polymorphic for a phenotypic syndrome known as abnormal abdomen (aa). This syndrome is characterized by a slow-down in egg-to-adult developmental time, retention of juvenile abdominal cuticle in the adult, increased early female fecundity, and decreased adult longevity. Previous studies revealed that the expression of this syndrome in females is controlled by two closely linked X chromosomal elements: the occurrence of an R1 insert in a third or more of the X-linked 28S ribosomal genes (rDNA), and the failure of replicative selection favoring uninserted 28S genes in larval polytene tissues. The expression of this syndrome in males in a laboratory stock was associated with the deletion of the rDNA normally found on the Y chromosome. In this paper we quantify the levels of genetic variation for these three components in a natural population of Drosophila mercatorum found near Kamuela, Hawaii. Extensive variation is found in the natural population for both of the X-linked components. Moreover, there is a significant association between variation in the proportion of R1 inserted 28S genes with allelic variation at the underreplication (ur) locus such that both of the necessary components for aa expression in females tend to cosegregate in the natural population. Accordingly, these two closely linked X chromosomal elements are behaving as a supergene in the natural population. Because of this association, we do not believe the R1 insert to be actively transposing to an appreciable extent. The Y chromosomes extracted from nature are also polymorphic, with 16% of the Ys lacking the Y-specific rDNA marker. The absence of this marker is significantly associated with the expression of aa in males. Hence, all three of the major genetic determinants of the abnormal abdomen syndrome are polymorphic in this natural population.

Abdomen↗
PubMed1996

Acute abdomen following dermoid cyst rupture during transvaginal ultrasonographically guided retrieval of oocytes.

We report a case of acute abdomen due to puncture of a dermoid cyst during oocyte aspiration, which required laparotomy. A woman who had undergone an in-vitro fertilization and embryo transfer required hospitalization due to onset of an acute abdomen. An ultrasonographic scan showed a pelvic mass with the features of dermoid cyst. The patient required diagnostic laparotomy which confirmed the presence of a ruptured dermoid cyst with subsequent peritonitis.

Abdomen, Acute↗
PubMed1996

Ga-67 scintigraphy in pediatric patients. Comparison of extended SPECT of the chest and abdomen with planar imaging.

Ga-67 SPECT has been shown to be more sensitive than planar imaging in several pediatric and adult studies. With multidetector SPECT cameras, SPECT imaging of multiple sites and volumes rendered images are possible. This study was performed to determine if SPECT of the chest, abdomen, and pelvis can be substituted for planar imaging of the same body regions. Fifty-one Ga-67 studies in 36 patients with lymphoma (29 patients) and inflammation (7 patients) were reviewed. Ga-67 SPECT of the chest, abdomen, and pelvis was compared with planar images of the same body regions. There were 52 abnormal sites on SPECT and 42 on planar imaging. Ten sites were positive only on SPECT; five of these sites were seen on SPECT because of improved three-dimensional separation of sites of gallium uptake. In the limited number of cases in this study, duplicate planar and SPECT imaging of the same volume was unnecessary.

Abdomen↗