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PubMedDate not supplied

Recent technical advances in MR imaging of the abdomen.

MRI of the abdomen has been under development for well over a decade. In the past, considerable work was directed toward identification and suppression of the artifacts caused by motion. However, within the last several years, image quality has further improved, particularly as various fast-scan techniques have been adapted for abdominal imaging. The purpose of this work is to review these technical developments. Specific methods include adaptation of the acquisition time to breath-holding, acquisition over multiple respiratory cycles, adjustment of the contrast of various sequences, and development of more sensitive receiver coils and faster gradient systems. Opportunities for future development are also identified, including improved slice sampling, increased in-plane spatial resolution, real-time means for monitoring respiration, and expanded applications. As these technical advances are implemented, it is expected that the overall sensitivity and specificity of abdominal MRI will further improve.

Abdomen↗
PubMed1986

Efficacy of polyglycolic acid mesh sling in keeping the small bowel in the upper abdomen after abdominal surgery: a 12-month study in baboons.

The purpose of this study was to determine if a "sling" made of polyglycolic acid (PGA) would be a reliable method of preventing small bowel descent into the pelvis following abdominal surgery. Baboons were used, as they respond to infection and ambulate similarly to humans. Animals had the small bowel mobilized to the upper abdomen and had the PGA "sling" sewn into place. Documentation of small bowel position was evaluated by upper gastrointestinal series over the 12-month study. Small bowel descent into the pelvis was prevented by utilization of the PGA "sling." Animals were sacrificed and autopsied, and sections of small bowel were taken. There was no evidence of mesh, obstruction, sepsis, fistulae, or herniation in animals at autopsy. Small bowel sections were considered normal histologically. Utilization of PGA sling appears to be a safe and reliable method of preventing small bowel descent into the pelvis after abdominal surgery.

Abdomen↗
PubMed1995

A microfluorometric method for measuring ethoxycoumarin-O-deethylase activity on individual Drosophila melanogaster abdomens: interest for screening resistance in insect populations.

We developed a method for measuring ethoxycoumarin deethylase (ECOD) activity using a single Drosophila abdomen. The activities obtained were well correlated with the classic method from microsomes (r = 0.902). This new method, performed in microtitration plates, was at least six times more sensitive compared to the conventional cuvet fluorometric one. Moreover, it was possible among a large number of insects to differentiate those with low or high ECOD activities. This improved procedure has been checked upon crosses between resistant strain (with high ECOD activity) and susceptible strain (with low ECOD activity). The results demonstrate the possible separation of resistant phenotypes and emphasize the importance of this approach in assessing the spreading of insecticide resistance in natural populations of insects.

7-Alkoxycoumarin O-Dealkylase↗
PubMed1996

Cell fates in the adult abdomen of Drosophila are determined by wingless during pupal development.

wingless activity is required for the patterning of tergites and sternites in the adult abdomen of Drosophila melanogaster. In the absence of wg, tergite and sternite cuticular differentiation is replaced by that of pleura. Temperature shift analysis of a wg temperature-sensitive allele has shown that sensory bristles and tergite/sternite histotype are determined independently and that wg is required between 15 and 20 hr after pupariation for bristle formation. The determination of sensory mother cells at this stage of development was confirmed by expression of the neuralized gene in a subset of the proliferating histoblasts. Ectopic expression of wg leads to the appearance of ectopic bristles and expanded tergite and sternite, indicating that wg expression is sufficient to promote both bristle formation and tergite/sternite differentiation. wg is expressed in the dividing and spreading histoblast population in a restricted pattern which may determine the spatial arrangement of cuticular elements.

Abdomen↗
PubMed1996

Luteinized thecoma with sclerosing peritonitis presenting as an acute abdomen.

The seventh reported case of luteinized thecoma with sclerosing peritonitis is described. Unlike the other reported patients with this condition, the patient presented with a short history of secondary amenorrhea, a subsequent acute abdomen, and an absence of abdominal distention and ascites. The tumor had undergone extensive hemorrhagic necrosis secondary to infarction, and the patient's amenorrhea may have been secondary to the release of steroid hormones from the necrotic cells. The presence of extensive necrosis and a brisk mitotic rate raised the suspicion of a malignant thecoma, but the finding of subserosal fibrosis in the biopsied omental tissue led to the diagnosis of a benign luteinized thecoma with sclerosing peritonitis.

Abdomen, Acute↗
PubMed1993

[Entero-enteral invagination of the small intestine in adults. A rare cause of "uncertain abdomen"].

The present paper reports on a 43-year-old female patient who complained over a number of weeks of paroxysms of crampy pain in the mesogastrium. The diagnosis of ileoileal invagination was only made after she had been admitted to hospital for the third time. The following false diagnoses had been made during the 4-week course of the condition: "pyelonephritis", "acute appendicitis", "chronic appendicitis" and, most recently "psychosomatic abdominal distress". The patient was initially treated with antibiotics and finally with psychotropic drugs. Eventually ultrasound suggested the diagnosis of invagination of the small intestine, which was then verified by conventional barium follow-through radiography. The patient subsequently underwent resection of a segment of the small intestine. Entero-enteric invagination is a very rare event in adults, in which a single (often malignant) cause is identified as triggering the invagination. Peristalsis and ingested food push the tumor distad, thus acting as a motor for invagination. The preferred localizations are the junctions between freely moving segments to retroperitoneally fixed segments (e.g., ileocecal region). Ultrasound of the abdomen is the examination of choice for diagnosis of enteroenteric invagination. Surgical resection of the invagination and its cause (generally tumors) is indicated in adults.

Abdomen, Acute↗
PubMed1992

[Spieghel hernia--a rare cause of acute abdomen].

Spieghelian hernia is a rare rupture of the abdominal wall along the linea semilunaris. Due to the fact that the rupture is overlain by the aponeurosis of M. externus abdominis, it is often not recognized in its early stage. In most cases the rupture neck is mostly very narrow and in 24.1% of all cases an incarceration of intestinal parts has ensued which may even lead to the development of an acute abdomen. The first choice therapy will consist in an operative support including the reposition of the hernial content and a possible resection of ischaemic organs as well as removal and sealing of the hernia. Because of the rarity of this sickness we report on a patient in our clinic who was operated as an emergency.

Abdomen, Acute↗
PubMedDate not supplied

Laparoscopy for management of nontraumatic acute abdomen.

The diagnostic and therapeutic influence of laparoscopy has been studied in 255 patients presenting with nontraumatic acute abdominal pain. Laparoscopy provided a correct diagnosis in 93% (236 of 255) of the cases, the others requiring a laparotomy. An erroneous preoperative diagnosis was corrected by laparoscopy in 50 patients (20%), which called for a change of treatment in 25 patients (10%). Seventy-three percent (186 of 255) of acute abdominal conditions were treated exclusively by laparoscopy, 23% (58 of 255) by conventional surgery, and 4% (11 of 255) by laparoscopically assisted surgery. Mortality was 2% (5 of 247) and morbidity 11% (28 of 247). We conclude that laparoscopy is a valuable tool for the general surgeon facing a patient with an acute abdomen.

Abdomen, Acute↗
PubMed1996

Lupus peritonitis mimicking acute surgical abdomen in a patient with systemic lupus erythematosus: report of a case.

A 25-year-old Japanese woman who had been suffering from systemic lupus erythematosus (SLE) for 12 years was admitted to our hospital with a suspected diagnosis of peritonitis after suddenly developing severe abdominal pain and distention which could not be relieved by treatment with anodyne. Noninvasive examinations did not provide enough evidence to rule out acute appendicitis, bowel perforation, or ischemia due to vasculitis. Therefore, in consideration of the severity of her uncontrollable abdominal pain, an exploratory laparotomy was performed. The operative findings revealed nonbacterial peritonitis with a large amount of ascites and an edematous small bowel. No perforation of the intestine was found. On post-operative day (POD) 3, the severe abdominal pain redeveloped, but responded well to steroid pulse therapy. Based on the operative findings and her clinical course, the most likely diagnosis was thought to be acute lupus peritonitis. It is often difficult to ascertain whether abdominal pain in an SLE patients is due to lupus peritonitis or to an underlying cause requiring surgery. Thus, it is essential that continuous and careful assessment of the surgical abdomen is performed when a patient with SLE develops acute abdominal pain, and if a surgical condition cannot be ruled out, a laparotomy should be performed without delay.

Abdomen, Acute↗
PubMedDate not supplied

Laparoscopic insufflation of the abdomen depresses cardiopulmonary function.

Recently we have used the laparoscope to remove the gallbladder in critically ill patients in order to spare them the operative trauma of laparotomy. However, increased intraperitoneal pressure may have deleterious cardiopulmonary effects. This was investigated in a dog model. Insufflation of the abdomen with carbon dioxide decreased the mean cardiac output to less than 80% of baseline (P < 0.004). This was aggravated by the reverse Trendelenburg position and partially alleviated by the Trendelenburg position. Mean arterial PCO2 and mean peak airway pressure significantly rose. These effects are of doubtful clinical significance in the majority of patients. However, to extend the benefits of laparoscopy to patients with decreased cardiopulmonary reserve, hemodynamic and carbon dioxide monitoring should be used because measures to improve venous return, augment cardiac output, and counteract the increase in PCO2 and peak airway pressure may be required.

Abdomen↗
PubMed1988

Interactions between the tonic and cyclic postural motor programs in the crayfish abdomen.

1. In the crayfish (Procambarus clarkii) abdomen, the superficial flexor and extensor muscles and the motoneurons that innervate them are employed during two completely different modes of behavior: (1) tonic postural adjustments and (2) cyclic movements associated with backwards terrestrial walking. We have tested the possibility that these two behavioral subsystems share at least some of the same tonic premotor interneurons. 2. Of the 108 tonic flexion- and extension-producing interneurons monitored during cyclic pattern generation, only 25 were recruited while 36 were inhibited. None of the recruited interneurons made a measurable contribution to the cyclic motor output. Similarly, none of the 20 inhibitory interneurons of the tonic subsystem recorded in this study was found to play a role in shaping the cyclic motor pattern. 3. Simultaneous activation of single tonic postural interneurons with the cyclic motor pattern revealed that the two behavioral subsystems interact in complex ways. Some tonic interneurons produced motor outputs that overrode the cyclic motor outputs while the motor outputs of other tonic interneurons were completely overwhelmed by the cyclic motor program. Still other tonic interneurons generated motor outputs that predominated over cyclic patterned outputs in some ganglia but were masked by the cyclic motor pattern in other ganglia. 4. Although weak interactions between the two subsystems occur at the premotor level, they have little effect on the normal generation of the cyclic pattern. Stronger interactions apparently occur at the level of the motoneurons and these interactions presumably may form the basis of switching from one behavior to the other. We conclude, therefore, that each behavioral subsystem relies upon its own unique set of premotor interneurons. Finally, those interneurons contributing to the cyclic motor pattern have not yet been identified.

Abdomen↗
PubMed1987

[Acute abdomen in immunoreaction mediated diseases].

Assessment of the acute abdomen as a real or simulated complication in immunovasculitis is extremely difficult. Despite modern laboratory and imaging procedures, the number of false diagnoses is considerable, and a superfluous, falsely indicated emergency laparotomy can be just as fatal as the failure to perform a necessary surgical intervention. It is important to do a careful follow-up, including sonography and possibly laparoscopy, and to bear in mind the experience of H. Bailey with PSH that complications are often suspected but only seldom found.

Abdomen, Acute↗
PubMed1987

Early experience of aspirative lipoplasty of the abdomen.

The author evaluates his early 2 1/2-year experience with closed aspirative lipoplasty, first introduced in the United States by Illouz. Although his experience with the technique during this period has resulted in good to excellent overall results, the abdomen, however, seems to have inherent problems unique to this area of the torso. He provides the reader with an understanding of these problems and methods to correct them.

Abdomen↗
PubMed1996

Breathhold imaging of the upper abdomen using a circular polarized-array coil: comparison with standard body coil imaging.

Current studies emphasize the use of array coils to decrease noise and increase the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). We applied T1-weighted and T2-weighted standard nonbreathhold spin echo (SE) sequences and T1-weighted FLASH, TurboFLASH, T2-weighted spin-echo time (TSE), and heavily T2-weighted half Fourier acquisition single-shot TSE (HASTE) sequences during breathhold for abdominal imaging in 15 normal volunteers. The breathhold scans were performed using both a standard coil and a circular polarized array coil. We analyzed the signal intensity (SI), SNR, and CNR of abdominal organs in all sequences. SNRs increased in all cases by an overall factor of approximately 3 due to an 8% increase in overall SIs and a 50% decrease in noise when applying the array coil. Although the array-coil FLASH sequence performed at least as well as the respective SE sequence, the SNRs of the array-coil TurboFLASH, TSE breathhold, and HASTE sequences were generally lower. We conclude that array-coil imaging significantly improves fast imaging of the abdomen.

Abdomen↗
PubMed1987

Iliopsoas hypertrophy mimicking acute abdomen in a bodybuilder.

Marked hypertrophy of the psoas muscle in a bodybuilder produced a unilateral extrinsic mass effect upon the medial cecum and adjacent small bowel. The patient had presented with right lower quadrant pain and leukocytosis. Routine contrast studies of the abdomen were misleading, but a computed tomogram suggested the correct diagnosis.

Abdomen, Acute↗
PubMed1992

Fast spin-echo imaging of the abdomen during breath-holding: an alternative to RASE and other fast imaging techniques.

We have developed a rapidly acquired T1-weighted spin-echo pulse sequence that uses gradient echo-like parameters of TR 70 ms, TE 10 ms, NEX-1 (SE 70/10/1) with large pulse angles, and presaturation. This sequence yields two images of the abdomen during a comfortable breath-hold of 9 s. Preliminary phantom studies with this sequence demonstrated that peak signal-to-noise ratios occurred at pulse angles of 120 degrees and 135 degrees. Compared to this rapidly acquired sequence, a conventional T1-weighted spin-echo sequence of TR 140 ms, TE 10 ms, NEX-4 demonstrated 2.8 times the signal-to-noise ratio, 2.6 times the liver-spleen contrast-to-noise ratio but only 1.6 times the contrast-to-artifact ratio. When normalized for the imaging time, however, there was little difference in the signal-to-noise and contrast-to-noise ratios, although the SE 70/10/1 demonstrated 2.0 times the contrast-to-artifact ratio. We conclude that for abdominal imaging the SE 70/10/1 is an excellent alternative to RASE and other fast imaging techniques, and, although there are inherently low signal-to-noise ratios, it may be particularly useful when coupled with a paramagnetic contrast agent.

Abdomen↗
PubMed1988

Exogastric neurilemmoma presenting as acute abdomen: role of computed tomography in diagnosis.

A case of subserosal gastric neurilemmoma is hereby presented. This reported case is unique in its clinical presentation including the appearance of acute abdomen and fever subsequent to unremarkable and uneventful upper gastrointestinal endoscopy. The tendency of neurilemmoma to cause mucosal ulceration with fistula formation probably led to this clinical presentation. The role of computed tomography in establishing diagnosis of exogastric tumor is emphasized.

Abdomen, Acute↗