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At least 757 records · Page 42Linked to original sources
PubMed2003

Surgical complications of selected gastrointestinal emergencies: pitfalls in management of the acute abdomen.

Complaints referable to the abdomen are common emergency department presentations. Many of these conditions prove to be benign and self-limited, whereas others are potentially catastrophic. Because serious and benign intra-abdominal conditions share many relatively nonspecific symptoms, it is often difficult to identify patients who have life-threatening problems early in the course of their disease. Apart from relieving the patient's symptoms, the emergency physician's primary role is to detect and stabilize life-threatening conditions in a rapid and cost-effective manner.

Abdomen, Acute↗
PubMed2002

The surgical abdomen associated with cocaine abuse.

Cocaine use is common and is associated with gastrointestinal complications that can present as a surgical abdomen. We report a case of a previously healthy 25-year-old man who presented to the Emergency Department with severe abdominal pain and vomiting after using IV cocaine. Exploratory celiotomy revealed massive free intraperitoneal (IP) clotted blood with no evidence of underlying pathology. This unusual case underscores the possibility of life-threatening hemorrhage in cocaine consumers.

Abdomen, Acute↗
PubMed1986

Diseases of the abdomen.

Because the abdomen of the adult horse is too thick to obtain good-quality radiographs, diagnostic ultrasound is a particularly valuable imaging modality in the diagnosis of abdominal disease. The size, shape, position, and texture of the liver, spleen, kidneys, urinary bladder, gravid uterus, and gut wall can be determined by scanning the abdominal surface. The presence or absence of abdominal fluid can be determined efficiently. Gut motility as well as ileus secondary to peritonitis or obstruction can be assessed. Suspected adhesions of the bowel can often be documented, and primary or secondary neoplastic processes can be identified and biopsied.

Abdomen↗
PubMed1991

[Pseudosurgical acute abdomen syndrome in primary pulmonary hypertension].

The case is reported of a 49-year-old chronic alcoholic woman, who presented with severe pulmonary arterial hypertension (PAH) mimicking as an acute abdomen. She was admitted with right-sided hypochondrial abdominal pain and hepatomegaly, with a moderate jaundice. On admission to intensive care unit, she had an arterial blood pressure of 110/70 mmHg, a heart rate of 100 b.min-1, and a respiratory rate of 36 c.min-1. An electrocardiogram showed sinus rhythm and right-sided heart failure. Whilst breathing 6 l.min-1 oxygen, her arterial blood gases were: PaO2 47 mmHg PaCO2 29 mmHg. Severe PAH was confirmed by measuring her mean pulmonary arterial pressure, which was 46 mmHg, whilst her pulmonary wedge pressure was 7 mmHg. Hepatic function was also altered: total bilirubin 41 mumol.l-1, alkaline phosphatase 145 UI.l-1 and gamma glutamyl transferase 1 340 UI.l-1. She developed arterial hypotension, which did not respond to increasing doses of isoproterenol. She died on the third day. Necropsy confirmed the diagnosis of primary PAH, with acute "cardiac liver".

Abdomen, Acute↗
PubMed1998

Radiologic evaluation of the acute abdomen in the patient with acquired immunodeficiency syndrome (AIDS): the role of CT scanning.

Abdominal complaints are common in the HIV-infected patient, and the signs and symptoms of disease may be masked by concurrent illness and a weak immune response, making accurate diagnosis difficult. Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to diseases common to the general population; however, their generalized state of immunodeficiency places them at increased risk for many unusual disorders, predominately infectious and neoplastic. Radiologic evaluation, in particular, computed tomography (CT) with its ability to image the entire abdomen and pelvis, plays a crucial role in the prompt and accurate diagnosis and treatment of these patients.

AIDS-Related Opportunistic Infections↗
PubMed1998

Sonographic borderlands in the fetal abdomen.

Ultrasonographic examination of the fetal abdomen is an integral part in all routine fetal sonograms and can provide significant information about the status and prognosis of the fetus. Although many types of fetal anomalies can be identified (i.e., gastroschisis, omphalocele, or congenital diaphragmatic hernia), there are several sonographic findings that are not clearly anomalous, but may be associated with poor fetal outcome. Echogenic fetal bowel, small or absent fetal stomach and fetal intra-abdominal calcifications all fall into this category. This article reviews the recent literature as it relates to these topics, including suggestions regarding the need for further action, and the types of further actions that are available to help identify abnormal fetuses and prevent unnecessary and/or invasive testing of normal ones.

Abdomen↗
PubMed1999

The acute abdomen: current CT imaging techniques.

Currently, CT plays a pivotal role in the evaluation of the patient with an acute abdomen. Several competing techniques have been described and investigated. Each appears to possess advantages and disadvantages which will be examined. Each imaging center needs to modify these protocols to satisfy local scanner availability, patient demographics, radiologic expertise, and economic considerations.

Abdomen, Acute↗
PubMedDate not supplied

High resolution breath-holding MR imaging of the abdomen with a phased-array multicoil.

We prospectively compared standard resolution and high resolution breath-hold T1- and T2-weighted images of the upper abdomen with use of a body phased-array multicoil in 30 patients. The image quality of high resolution T1-weighted FLASH sequence was equal to that of standard resolution sequence, while the quality of high resolution T2-weighted turbo spin-echo sequence was slightly inferior to that of standard resolution sequence. The merit of high resolution image is appreciated especially on a T1-weighted FLASH sequence.

Abdomen↗
PubMed2002

Magnetic resonance angiography of the pediatric abdomen and pelvis.

Although abdominal and pelvic vascular disease is much less common in children than in adults, MR angiographic techniques widely used in adults can also be readily applied in the pediatric population with suspected vascular disease. MR techniques, equipment, and image analysis software are in a continual state of development and refinement. Given the advantages of MR angiography (i.e., its absence of ionizing radiation, capability to obtain images without iodinated contrast material, and limited invasiveness), the applications of MR angiography in the pediatric abdomen and pelvis are likely to continue to increase.

Abdomen↗
PubMed2001

Accuracy of the preoperative diagnosis in 100 emergency laparoscopies performed due to acute abdomen in nonpregnant women.

STUDY OBJECTIVE: To assess the validity of preoperative diagnosis in the emergency room in relation to the surgical diagnosis at laparoscopy. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: One hundred consecutive nonpregnant women who underwent emergency laparoscopy for acute abdomen between 1997 and 1999. Intervention. Emergency diagnostic laparoscopy. MEASUREMENTS AND MAIN RESULTS: The preoperative diagnosis was confirmed by laparoscopy in 29 (44%) of 66 cases of ovarian torsion, 9 (82%) of 11 cases of ovarian cyst, and 12 (80%) of 15 cases of bleeding corpus luteum. Unsuspected diagnoses among nonconfirmed cases were ovarian cysts (24), adhesions (5), bleeding corpus luteum (3), degenerative myomas (3), pelvic inflammatory disease (2), and appendicitis (1). The preoperative diagnosis was confirmed by emergency laparoscopy in 56% of all patients. Diagnoses most likely to be predicted accurately were ovarian cysts and bleeding corpora lutea. Ovarian torsion was most difficult to diagnose preoperatively, as it was not confirmed during laparoscopy in over half patients. Ovarian cysts and adhesions were the most common unsuspected findings. CONCLUSION: Patients and surgeons alike should be aware of difficulty making accurate preoperative diagnoses of acute gynecologic pathologies in the emergency room. (J Am Assoc Gynecol Laparosc 8(1):92-94, 2001)

Abdomen, Acute↗
PubMedDate not supplied

Idiopathic segmental infarction of the greater omentum: a rare cause of acute abdomen.

Idiopathic segmental infarction of the greater omentum is a rare cause of acute abdomen. Patients, typically children or obese males in their fifties, present with abdominal pain located in the right upper or lower quadrant, mimicking cholecystitis and appendicitis. CT scanning and ultrasound imaging both may show a well-circumscribed soft tissue mass. Retrospective review of all patients treated for idiopathic segmental infarction of the greater omentum occurred from January 1993 to December 2001. Nine patients were treated successfully, six surgically and three medically. Conservative management of segmental infarction of the greater omentum can be proposed when correctly diagnosed by ultrasound imaging or CT scanning and the patient's condition is stable. If not, laparoscopic removal of the involved segment of the greater omentum is the treatment of choice.

Abdomen, Acute↗
PubMed1978

Motion of the rib cage and the abdomen in tetraplegic patients.

1. We have studied the motion of the abdomen and the rib cage in patients with a transection of the lower cervical spinal cord during normal breathing both in the supine and sitting posture, and compared it with that of normal subjects. 2. In the supine posture the rib cage of a patient moves paradoxically inward, therefore his chest wall is deformed, which explains the high work of breathing. 3. During expiration, beside the recoil of the respiratory system, there is also the recoil of the deformed chest wall, toward its passive configuration, with an expansion of the rib cage above its resting position during the first part of expiration and an alteration of the expiratory flow profile. 4. In a sitting 'relaxed' posture the paradoxical inward motion disappears in the lower rib cage, and it is reduced but still present in the higher rib cage. 5. We conclude that contraction of the diaphragm constricts the 'passive rib cage', either directly through its insertions or indirectly through the reduction of intrathoracic pressure. In seated subjects the diaphragm causes some expansion of the rib cage at its lower level. Therefore the motion of the rib cage is not only related to the balance between the forces developed by the diaphragm and the intercostal muscles, but also to the diaphragm dome configuration, the geometry of the rib cage and the lung volume.

Abdomen↗
PubMed1985

Some observations on the role of the abdomen in breathing in patients on peritoneal dialysis.

We studied a total of 29 patients on continuous ambulatory peritoneal dialysis (CAPD), who had no present or past respiratory impairment, before and after drainage of dialysate (2.324 +/- SE 0.033 litres). We measured spirometry, lung volumes and carbon monoxide transfer sitting and supine in 20 patients. The only statistically significant changes on drainage were a small increase in supine functional residual capacity (+214 +/- SE 61 ml, P less than 0.01) and a small fall in supine peak expiratory flow rate (-26.6 +/- SE 12.1 litres/min, P less than 0.05). Measurement of maximal mouth and transdiaphragmatic pressures in ten patients made under the same circumstances showed no statistically significant changes on drainage. A model of the abdomen demonstrates that fluid distension is likely to be better tolerated than gaseous distension, and review of previous studies suggests that a wide range of changes in intraabdominal fluid volume can be tolerated without respiratory embarrassment. These results suggest that fluid volumes used for CAPD do not interfere with breathing in patients with previously normal lungs. The nature of the mechanisms compensating for the fluid suggests that patients with chest disease should be able to tolerate this form of dialysis.

Abdomen↗
PubMed2001

Relative kinematics of the rib cage and abdomen during speech and nonspeech behaviors of 15-month-old children.

Speech motor control emerges in the neurophysiologic context of widely distributed, powerful coordinative mechanisms, including those mediating respiratory function. It is unknown, however, whether developing children are able to exploit the capabilities of neural circuits controlling homeostasis for the production of speech and voice. Speech and rest breathing were investigated in eleven 15-month-old children using inductance plethysmography (Respitrace). Rib cage and abdominal kinematics were studied using a time-varying correlational index of thoracoabdominal coupling (i.e., reflecting the synchrony of movement of the rib cage and abdomen) as well as simple classification of the moment-to-moment kinematic relationship of these two functional components (i.e., concurrent expansion or compression, or oppositional movement). Results revealed markedly different patterns of movement for rest breathing and speech breathing, although within types of vocalization (nonspeech vocalization, babbling, true word production) no differences were apparent. Whereas rest breathing was characterized by tight coupling of rib cage and abdominal movement (average correlation coefficients usually exceeded .90), speech breathing exhibited weak coupling (the correlation coefficient ranged widely, but averaged about .60). Furthermore, speech production by these toddlers included the occurrence of both rib cage and abdominal paradoxing, which are observed infrequently in adult speakers. These results fail to support the suggestion that speech emerges from the extant coordinative organization of rest breathing. Rather, even in its earliest stages breathing for speech and voice exhibits kinematic properties distinct from those of other observed behaviors.

Abdomen↗
PubMed2004

Severe acute respiratory syndrome mimicking acute abdomen.

Severe acute respiratory syndrome (SARS) is a novel epidemic disease. The clinical presentation can sometimes be very non-specific. The present study reports a case of SARS, which presented as acute abdomen, warranting laparotomy. The atypical presentation in the present case reminded us of the importance of strict infection control measures in all surgery-related specialist workplaces.

Abdomen, Acute↗
PubMed2004

Retained surgical materials in the postoperative abdomen and pelvis.

The imaging appearances of surgical materials in the postoperative abdomen and pelvis can be confusing and difficult to interpret. With the increasing complexity of surgical procedures and more frequent use of postoperative imaging, the radiologist needs to be familiar with the imaging characteristics of a variety of intentionally and unintentionally placed surgical materials and devices. In addition, they must be differentiated from postoperative complications such as hematoma or abscess.

Abdomen↗
PubMed2001

Acute abdomen caused by Salmonella typhimurium infection in children.

Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with Salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. Serology results showed that both patients' titers for BO ("B and O agglutinating [BO]") antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852.

Abdomen, Acute↗