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At least 433 records · Page 24Linked to original sources
PubMed2001

Burst abdomen. Local synthesis of nucleic acids, glycosaminoglycans, proteins and collagen in wounds.

BACKGROUND AND AIMS: Abdominal wound dehiscence and evisceration is a surgical emergency. The general phenomena leading to this complication are for the most part known. However, the local biochemical events of different layers of the abdominal wall in wound dehiscence have not been studied. The purpose of the present study was to analyze the synthesis and contents of DNA, RNA, proteins and collagen in fascial, subcutaneous and skin layers in burst abdomen. MATERIAL AND METHODS: The material consisted of 10 controls and 12 patients divided into two groups. Group A consisted of 7 patients with acute free or covered perforation of the gastrointestinal tract and group B consisted of 5 critically ill patients at admission. RESULTS: In group A, higher amounts of specific isotopes were accumulated into DNA, proteins and collagen in fascial and subcutaneous wound layers than in those of the controls. However, in critically ill patients the corresponding accumulation was lower than in controls. On the other hand, in both group A and B, the content of hydroxyproline (collagen) was below the control level in fascial and subcutaneous layers of the abdominal wound. CONCLUSIONS: The results indicate that the degradation of collagen exceeds the synthesis of collagen in wounds of patients with burst abdomen. Probably this increased degradation of collagen in wounds partly explains the higher wound disruption rate in these patients.

Abdomen, Acute↗
PubMedDate not supplied

[The general surgeon facing acute abdomen caused of gynecologic cause: diagnostic and therapeutic considerations on 2 cases].

The general surgeon has sometimes to face problems arising from an acute abdomen due to gynecologic causes. Such conditions are mainly found in women in reproductive age; the most frequent pathologies are due to complications of ovarian cysts, perlvic inflammatory disease and extrauterine pregnancy. Some short clinical commentaries are herein presented on two cases of gynecologic acute abdomen: the first case reported is related to an intraperitoneal rupture of a large uterine sarcoma and the second an ovarian neoplasm associated with a diffuse peritonitis from perforation of tubo-ovarian abscess.

Abdomen, Acute↗
PubMed2002

Gall stone: a rare cause of acute abdomen in a seven years old girl.

Jamila Khatun a seven years old girl from Shurjunagar, Rajbari, presented with acute pain in the right side of her abdomen. Blood test was normal except mild elevation of serum bilirubin. Chest X-ray reveals no fluid level & no gas under the dome of diaphragm. Ultrasonogram of the abdomen reveled multiple stone in the gallbladder.

Abdomen, Acute↗
PubMed2002

[Acute abdomen after cardiac surgery].

Acute abdomen after cardiosurgery accounts for a minor group of complications, however, they are associated with a high mortality and morbidity. In 2001 in the authors department 940 cardiac operations were performed. In four patients (0.43%) during the early postoperative period acute abdomen developed which called for urgent surgical intervention. Two patients died. Only early diagnosis and subsequent urgent laparotomy can have a positive impact on the prognosis of this group of patients.

Abdomen, Acute↗
PubMedDate not supplied

Acute abdomen in patients receiving chemotherapy.

OBJECTIVE: To assess the incidence of acute abdomen in patients receiving chemotherapy and to evaluate the factors affecting the clinical decision-making. MATERIAL AND METHODS: Retrospective analysis of surgical oncology references for the patients developing acute abdomen while receiving chemotherapy was carried out. A surgical oncologist reviewed each referral and a full work-up was carried out. Surgical interventions were carried out as and when deemed necessary. Response to treatment, whether surgical or conservative, was used as main outcome variable. RESULTS: Mean age of the patients was 37 years (7-58 years). Half of the patients were receiving chemotherapy for lymphoproliferative disorders, 13 for haematological malignancies and 3 for ovarian cancer. Clinical diagnosis was of acute appendicitis in 13, paralytic ileus in 9, typhilitis in 3 and intestinal perforation in 2, acute intestinal obstruction in 3, and obstructed hernia and intussception in one each. Six patients underwent surgery. Two patients expired postoperatively of progressive septicaemia and multi-system organ failure. CONCLUSION: Evaluation of cancer patients on chemotherapy is difficult. Tenderness, presence of peritoneal signs and absence of exaggerated bowel sounds are most important clinical signs, however they may be blunted by progressive neutropenia or corticosteroid administration. Decision to operate, should be made with extreme caution as mortality and morbidity after surgery is high.

Abdomen, Acute↗
PubMedDate not supplied

Comparison between technetium-99m hexamethylpropyleneamineoxide labeled white blood cell abdomen scan and abdominal sonography to detect appendicitis in female patients with an atypical clinical presentation.

BACKGROUND/AIMS: Acute appendicitis is a clinically challenging surgical disease which is particularly difficult to diagnosis in women. An atypical presentation is a major obstacle to quickly diagnose acute appendicitis. METHODOLOGY: Fifty female patients with acute abdomen pain who were suspected of having appendicitis, but who had atypical findings were included in this study. After an intravenous injection of technetium-99m hexamethylpropyleneamineoxide (Tc-99m HMPAO) labeled white blood cells, serial anterior abdomen-pelvis images at 30 min, 60 min, 120 min and 240 min were obtained using a gamma camera. Meanwhile, at the point of maximal tenderness, abdominal sonography was performed with a graded compression technique for both longitudinal and transverse images. RESULTS: Thirty-two patients received a laparotomy for surgical and pathological diagnoses. The remaining 18 patients did not receive operations and showed no evidence of appendicitis after at least a one-month follow-up period. Two patients had false-positive white blood cell scan findings and 2 patients had false-negative white blood cell scan findings. The overall sensitivity, specificity, and accuracy for white blood cell scans in diagnosing appendicitis was 93.3%, 90.0%, 92.0%, respectively. One patient had false-positive abdominal sonographic finding and 5 patients had false-negative abdominal sonographic findings. The overall sensitivity, specificity, and accuracy for abdominal sonography scans in diagnosing appendicitis were 83.3%, 95.0%, and 88.0%, respectively. CONCLUSIONS: The Tc-99m HMPAO white blood cell scan provides a more sensitive and accurate method for the diagnosis of appendicitis in female patients with equivocal clinical presentation when compared with abdominal sonography.

Abdomen↗
PubMedDate not supplied

[Errors and difficulties in the diagnosis and management of acute and chronic abdomen in children].

The authors are reviewing on a lot of 2844 cases between 1996 and 2000 the difficult problems of differential diagnosis between acute surgical abdomen in children and intestinal tuberculosis, abdominal tumors and inflammatory diseases such as acute osteomielitis. They are presenting 13 particular cases in which the acute abdomen diagnosis was difficult or even omitted.

Abdomen, Acute↗
PubMed2003

Ruptured phaeochromocytoma--a lesson in acute abdomen.

Phaeochromocytoma may present as acute abdomen. This report is of a patient with spontaneous rupture of phaeochromocytoma who presented with abdominal pain and a tender abdominal mass. Ruptured phaeochromocytoma is a rare surgical emergency, with only 30 cases reported in the literature. The classical clinical triad of signs is intense vasoconstriction, tachycardia, and labile blood pressure. Computed tomography scanning of the abdomen is the investigation of choice, and a high index of suspicion is the key to diagnosis. Prompt recognition, appropriate supportive measures, and early surgical intervention can improve the likelihood of survival.

Abdomen, Acute↗
PubMed2003

Use of three-dimensional CT in the abdomen: a useful preoperative planning tool.

Multidetector computer tomography (CT) scanners permit large volumes of the body to be scanned during a single breath-hold. Post-processing of the acquired data permits thin-section anatomic reconstructions to be created. Software improvements also currently permit high-resolution reformations to be depicted in multiple planes, along with volume-rendered anatomic depiction and measurements, and fine detail of small vessels. For preoperative surgical planning in the abdomen, these technical advances permit the surgeon to make crucial decisions during the planning phases, by facilitating anatomic and, in particular, vascular depiction, tumor staging, and volumetric determinations of solid organs. This article describes the current state of CT scanning for performing image processing, and illustrates the spectrum of available imaging tools that can be used to facilitate surgical planning. Using the abdomen as a paradigm, practical uses of image processing are demonstrated for pancreas tumor staging, segmental liver resection planning, assessment and planning of liver transplantation, renal transplant donor, and renal cancer evaluation.

Abdomen↗
PubMed1992

[Acute abdomen secondary to cytomegalovirus infection].

A case of a HIV-positive patient hospitalized with acute abdomen secondary to infection by cytomegalovirus (CMV), is presented. Infection by CMV is frequent in HIV-positive patients, with a relevant intestinal affection. However, its presentation as acute abdomen is more rare, although it has to be considered given that the demonstration of the presence of CMV and its potential pathogenic power have important therapeutic connotations. Currently, the use of diagnostic techniques based in specific monoclonal antibodies and DNA hybridization methods increases the diagnostic sensitivity of the traditional methods based on histological demonstration of the cytopathic effect and/or viral cultives.

Abdomen, Acute↗
PubMed1976

[Are unknown ciliates responsible for uncharacteristic pains in the lower abdomen (author's transl)].

It is reported about unknown cells, looking like ciliates, found in the Douglas exudate in women with uncharacteristic pains in the lower abdomen. These self-moving cells were found in 10 out of 48 patients. The clinical results are discussed. There is a possibility that these cells are responsible as well for the uncharacteristic pains in the abdomen as perhaps for the infertility of the patient.

Abdomen↗
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↗
PubMedDate not supplied

[Classification and management of gynecologic acute abdomen at a secondary level hospital emergency department].

This study retrospectively evaluates the preoperative work-up and the classification and operative treatment of acute abdomen caused by gynaecological disorders in emergency admissions to our department. All female patients admitted in the emergency setting and operated on for gynaecological acute abdomen in our emergency department over the period from 1997 to 2002 were included in the study. A total of 103 patients were identified (54 undergoing emergency operations, 9 operated on within 72 hours, and 40 managed conservatively with medical therapy. The 54 emergency operations performed were 24 ovarian resections, 17 salpingectomies, 5 oophorectomies, 4 exploratory laparotomies, 2 uterine polypectomies and 2 hysterectomies. The non-specific presentation of the disease and an inadequate preoperative work-up in these patients often led to a generic diagnosis at admission. This approach tends to increase the number of operations performed on an emergency basis, whereas a wait-and-see type of management should be adopted. A proper use of surgery is mandatory especially in those patients in whom preservation of reproductive capability has a major impact on outcome.

Abdomen, Acute↗
PubMedDate not supplied

[Imaging of acute abdomen. Contribution of new radiological methods and practices].

The acute abdomen is a sudden clinicoradiologic problem that may be resolved promptly by an excellent collaboration between the referring physician and the radiologist. The advent of CT and US has modified the diagnostical approach of acute abdomen. As diagnosis should be assessed in the shortest time with the greatest care and accuracy, it is necessary to choose the appropriate available examinations, reducing the time needed to establish a diagnosis and decreasing the number of examinations required. Thus, this paper is geared toward the determination and the choice of the more accurate procedure for the clinical presentation of acute abdominal emergencies.

Abdomen, Acute↗
PubMedDate not supplied

Diagnostic peritoneal lavage (DPL)--is it useful decision making process for management of the equivocal acute abdomen?

Patients with a traumatic or non-traumatic acute abdominal conditions often have equivocal findings regarding the need for surgery. Ultrasound and computed tomography, though useful, have limitations and not always available in peripheral hospitals. Diagnostic peritoneal lavage (DPL) was investigated as an aid to decision-making in such patients. After preliminary X-ray and ultrasound, DPL was performed in 50 patients with an equivocal acute abdomen (18 trauma, 32 non-trauma). It was found that overall sensitivity, specificity, accuracy, and positive and negative predictive values were high for patients with trauma. All the above parameters except specificity and negative predictive value (NPV) were also found to be high for the non-trauma group. DPL was found to be a bedside investigation, which helped in taking the decision to operate on patients with both traumatic and non-traumatic acute abdomen.

Abdomen, Acute↗
PubMed1992

Doppler color imaging. Abdomen.

Abdominal applications of Doppler ultrasonography are becoming increasingly important as familiarity with Doppler principles and instruments grows. The availability of sensitive duplex and DCI instruments specifically adapted for use in the abdomen and pelvis has stimulated interest in the use of Doppler techniques as a complement to conventional imaging. Although the simultaneous display of tissue and flow information has enhanced the ease of evaluation of vascular abnormalities and increased diagnostic confidence, the role of Doppler is only just beginning to be defined. Since blood flow is a fundamental factor in health and disease, it is hoped that the new information provided by Doppler evaluation of the abdomen will continue to advance the role of ultrasound as a primary diagnostic method as Doppler and color imaging technology mature.

Abdomen↗
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↗
PubMedDate not supplied

[Abdominal migraine simulating acute abdomen].

Migraine is a variant of headache often associated with neurologic and/or vegetative symptoms mainly represented by abdominal pain. This symptom may occur some hours before migraine manifestation and in these cases the differential diagnosis with other clinical conditions characterized by abdominal pain, which is very common during childhood, may be difficult. Abdominal migraine can be diagnosed only if a close relationship is demonstrated between the abdominal symptoms and migraine. Alteration of consciousness is a well known feature during migraine and in some cases EEG may show SNC involvement during the attack. We report a case of abdominal migraine attack evaluated by EEG. The patient, a 10 years old male, presented with a picture of acute abdomen. An EEG performed at the occurrence of the early headache symptoms and of consciousness alteration demonstrated a pattern characterized by a lowering in the electric activity on the left hemisphere. Some hours later he developed a clear migraine followed by disappearance of the abdominal symptoms. This observation confirms the possible association of migraine with a picture simulating an acute abdomen and suggests that the differential diagnosis with a true surgical condition may be achieved by the observation of the progression of symptoms and by early evaluation of patient with EEG.

Abdomen, Acute↗