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PubMed2005

[Diagnosis and treatment of simultaneous injuries of the thorax and abdomen].

Results of examinations and treatment of 167 patients with simultaneous injuries of the thorax and abdomen are presented. It is demonstrated that x-ray and ultrasonic examinations help make choice on right surgical policy. All the patients were divided into two groups. Study group (137 patients) was treated according to proposed curative algorithm. The rest 30 patients were included into control group. Volume of intra-surgical hemorrhage and time of surgery were greater in the control group compared with the study group. Proposed algorithm permitted to reduce number of postoperative complications from 46.7 to 21.2%, and lethality -- from 13.3 to 4.1%.

Abdomen↗
PubMed1992

Contrast materials for cross-sectional imaging of the abdomen.

The development and clinical studies of contrast agents for cross-sectional abdominal imaging presently focus on the diagnosis of liver diseases and suitable oral contrast agents for MR imaging. The well-known paramagnetic agent, gadopentetate dimeglumine is now used for improving the differential diagnosis of liver lesions such as focal nodular hyperplasia in dynamic MR studies. Preclinical studies and initial clinical trials indicate that the new paramagnetic hepatobiliary contrast agent, manganese dipyridoxal diphosphate, might improve the sensitivity of MR imaging in the detection of liver lesions. With respect to dynamic contrast-enhanced CT in the detection of liver lesions, interest has focused on the question of the optimal scanning technique. Promising results have been obtained in initial studies of contrast agents for sonography, called microbubbles. This substance produces good visualization of the vascular status of liver tumors. Nuclear medicine somatostatin receptor imaging may be of special clinical interest because it allows even very small somatostatin-positive metastases to be detected and thus provides specific information for therapy planning in patients with positive scan results. Initial studies have shown that using contrast enhancement with MR imaging of the pancreas improves the contrast between pancreatic tissue and lesions. Manganese dipyridoxal diphosphate is taken up by pancreatic tissue, though the exact mechanism remains to be clarified, and may therefore have potential as a future MR contrast agent for evaluation of the pancreas. A number of oral MR contrast agents have now been tested in larger clinical trials. Both positive and negative oral agents are safe and well tolerated and achieve the aim of reliably delineating the gastrointestinal tract from other organs and pathologies in the abdomen.

Abdomen↗
PubMedDate not supplied

[Acute abdomen from ruptured adrenal pheochromocytoma: case report].

The pheochromocytoma is a very rare neoplasm, which originates in 98% of cases in the adrenal medulla; it is often bilateral in familial syndromes. It is more frequent in syndromes like MEN2, von Hippel-Lindau disease, and neuofribromatosis type 1. In this article the Authors report a case of a young woman with a large adrenal pheochromocytoma, that presented by an acute abdomen; the treatment was explorative laparotomy with unilateral adrenalectomy. Therapy of this tumour is founded on surgery, plus chemiotherapy radiotherapy or treatment with 131I-MIBG (iodine-131-metaiodobenzylguanidine in malignant cases (10%). According with the absence of a correlation between pathological findings and clinical behaviour, a long-term follow up is indispensable.

Abdomen, Acute↗
PubMed2004

Torsion of a pelvic wandering spleen as a cause of acute abdomen in a woman: a case report and review of the literature.

Wandering spleen is a rare clinical condition in which the spleen is devoid of its normal peritoneal attachment associated with a long vascular pedicle. Women between the ages of 20-40 years are more likely affected. The common clinical presentation is abdominal mass with pain. For preoperative diagnosis a high index of suspicion is helpful. Ultrasonography and computerized tomography confirms the diagnosis. Treatment is surgical, splenopexy being the most appropriate. If ischemia is persistent after detorsion splenectomy can be done either laparoscopically or through laparotomy. A 25 year old female patient with torsion of an ectopic spleen presenting as a case of acute abdomen is presented. Review of the literature is done and presented

Abdomen, Acute↗
PubMed2005

[Acute secundary abdomen to pancreatic hydatid cyst].

The hydatidosis is a frequent zoonosis in Spain, but isolated location in pancreas and their onset as acute abdomen is excepcional. We present a boy 14 years old, with abdominal pain and low-grade fever since 1 month. Hemogram shows eosinophilia, and echography an anechoic mass in tail of pancreas beside of free peritoneal liquid. At surgery procedure: a broken hydatid cyst is verified, surrounded of tissues inflammatory reaction that evolved to pancreatic fistula. The differents forms from clinical presentation of the pancreatic hydatid cyst, as well as the complications related to their location are analyzed.

Abdomen, Acute↗
PubMedDate not supplied

Acute abdomen in a case with noncommunicating rudimentary horn and unicornuate uterus.

Unicornuate uterus with a rudimentary horn is the rarest congenital anatomic anomaly of the female genital system, causing many obstetrical and gynecologic complications. The frequency of this pathology is approximately 1/100 000. A rudimentary horn usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

Abdomen, Acute↗
PubMed2004

Technique for the direct measurement of DC-like magnetic biosignals demonstrated by the cold reflex of the abdomen.

Very low frequency dc-like signals, such as the cold reflex, could only be measured up to now by moving the subject repeatedly, up to the magnetic detector. PTB's novel magnetically shielded room BMSR 2, together with a low noise 16 channel SQUID magnetometer, allow the recording of dc-like signals without moving the subject; these are direct measurements. The total observed magnetic drifts are limited by 1/f-noise and external disturbances to a value below 6 pT/h. The measurement is continuous in time, therefore provides frequency resolution from dc to several kHz. This allows us to also observe the changing pattern between two different static magnetic states. As an example, the measurement of the cold reflex of the abdomen is shown and discussed. Not only the expected cold reflex, but other periodic and spontaneous signals from the human body can be seen with this method.

Abdomen↗
PubMedDate not supplied

Wandering spleen as a cause of acute abdomen: a case report.

We report a case of acute abdomen due to torsion of the long vascular pedicle of a wandering spleen, displaced in the abdominal cavity, and caused by partial infarction of the spleen. The 46-year-old patient presented to the casualty department with piercing abdominal pain, fever, vomiting, leukocytosis, thrombocytopenia, and a palpable mass in the mesogastric region. US and CT scan revealed the presence of a mass compatible with an ectopic spleen in the mesohypogastric region, featuring necrotic-haemorrhagic areas, a long, contorted vascular pedicle twisted on its axis, and an empty splenic space. We performed an emergency laparoscopic splenectomy. Conservative surgery (splenopexy) could not be done because of the severe impairment of the vascular supply to the organ. Nowadays, conservative surgery is preferred in cases without vascular impairment, especially in children, by creating an omental or synthetic pouch after fixing the organ in the splenic space.

Abdomen, Acute↗
PubMed2005

A case of bronchogenic carcinoma presenting with acute abdomen.

Colonic metastasis of the bronchogenic carcinoma is quite rare. Here we document an extremely rare presentation of the lung cancer that presented with acute abdomen and was diagnosed as intestinal obstruction due to colon carcinoma initially. He underwent an urgent operation and the obliterating mass in the colon was resected and reported as "colon metastasis from epidermoid carcinoma probably of the lung". Afterwards bronchoscopy revealed an endobronchial lesion in the right lower lobe that was diagnosed as poorly differentiated squamous cell lung carcinoma. In this case, colon metastasis was diagnosed before the diagnosis of the primary disease.

Abdomen, Acute↗
PubMed2005

[Gallbladder torsion as a rare cause of acute abdomen; a case report and review of literature.].

Torsion of the gallbladder is a rare cause of acute surgical abdomen. Less than 300 patients have been reported so far. On the other hand incidence seems to be higher than expected especially in elderly patients. This condition must be suspected in an elderly patient who represents signs and symptoms of toxemia and cholecystitis . Diagnosis is usually established during laparotomy. Torsion occurs at the base of the gallbladder around cystic duct and artery. Treatment is emergent cholecystectomy.

Abdomen, Acute↗
PubMedDate not supplied

Roundworm infestation presenting as acute abdomen in four cases--sonographic diagnosis.

Infestation with Ascaris lumbricoides (roundworm) is very common in the tropics and subtropics. Patients with ascariasis can be asymptomatic or may present with different clinical features in the form of simple nausea, decreased appetite, abdominal pain or more severe bowel obstruction, perforation, intussusception, biliary colic etc. Ultrasonography (USG) can be quick, safe, noninvasive and relatively inexpensive tool in diagnosing the presence of worms and also evaluating response to treatment (1, 2, and 3). Here we present four cases of roundworm infestation presenting with acute abdomen in the emergency department, which were diagnosed by USG and further imaging features of ascariasis on USG is described.

Abdomen, Acute↗
PubMed2005

[Acute abdomen states in geriatric patients in the intensive care unit complicated by hypovolemic shock].

UNLABELLED: Elderly patients suffering from acute pathology and severe medical comorbidities present serious "mix-cases" and their multiple organ deterioration requires intensive care. GOAL OF THE STUDY: analysis of outcome of elderly patients, aged 65 years and over, suffering from acute abdominal surgical pathology associated with hypovolemic shock. MATERIALS AND METHODS: 2 244 patients aged 65 yrs and over were treated with an acute abdomen state in the 2nd Chair and Department of Surgery in Jagiellonian University Hospital within 01.07.1997 and 30.06.2004. 618 patients, aged > 65 yrs underwent surgery because of acute abdominal pathology with hypovolemic shock. Out of this group 239 cases presented peritoneal diffuse inflammation and 104 were diagnosed with bowel obstruction. The principles of the diagnosis and the therapy were common for both groups. The analysis included: mortality rate, duration of hospital and intensive care unit (ICU) stay, continuos assessment based on APACHE II (Acute Physiology And Chronic Health Evaluation) and TISS-28 (Therapeutic Intervention Scoring System) scales, and on modification of MODS (Multiple Organ Dysfuction Score) system. RESULTS: mortality rate patients with peritoneal diffuse inflammation was 51.05%, and was higher than patients with bowel obstruction 48.08%. The difference in these values was caused by infection by pathogenic bacteria of gastrointestinal tract and most frequently by the appearance of multiorgan dysfunction in the group with peritoneal diffuse inflammation, despite lower punctation in the APACHE II and TISS-28 score system.

Abdomen, Acute↗
PubMed2006

[Early transplantation of double rectus abdominis musculo-cutaneous flaps from upper abdomen for the repair of patients with electrical injury in the wrist].

OBJECTIVE: To observe the effect of the early transplantation of double rectus abdominis musculo-cutaneous flaps on the repair of electrical injury of the wrist. METHODS: The study involved six patients suffering from circumferential deep electrical burn with only small amount of normal skin left on the dorsal side. The wounds were covered with double rectus abdominis musculo-cutaneous flaps raised from the upper abdomen with pedicles in both proximal and distal ends at an early postburn stage. The postoperative recovery of wrist function and wound repair were evaluated. RESULTS: The wrist wounds in all the 6 patients were primarily healed, with perfect function and appearance. CONCLUSION: Early application of double rectus abdominis musculocutaneous flaps on the electrically injured wrists can promote the wound healing processes and plays important roles in the preservation of wrist function.

Abdomen↗
PubMedDate not supplied

Acute abdomen caused by a perforated inflammatory myofibroblastic tumor of the jejunum.

Inflammatory myofibroblastic tumors are rare pseudosarcomatous tumors found in virtually all anatomic sites. Our case report describes an elderly female patient with an inflammatory myofibroblastic tumor in the proximal jejunum, accidentally discovered at laparotomy for an acute abdomen. The localization in the jejunum is a very rare finding, and perforation has not been described before.

Abdomen, Acute↗
PubMed2006

Emergency general surgical admissions. Prospective institutional experience in non-traumatic acute abdomen: implications for education, training and service.

OBJECTIVE: To assess the pattern of non-traumatic acute abdomen (NTAA) in emergency general surgical admissions in Saudi Arabia (SA) and highlight the implications for education, training and patient care. METHODS: A prospective study including all emergency general surgical admissions with NTAA at King Fahd Hospital of the University, Al-Khobar, SA over a 2-year period from October 2001 to September 2003. RESULTS: There were 3,706 general surgical admissions; 1,661 (45%) electives and 2,045 (55%) emergencies. A total of 1,096 admissions (mean age 27.6 years, 73% males) with NTAA were analyzed. Acute appendicitis was the most common diagnosis (47%), followed by non-specific abdominal pain (19%), gallstone disease (11%) and intestinal obstruction (8%). Surgical intervention was indicated in 65% of the admissions; 77% of these had appendectomy. There were 35 patients (3%) with malignancy, and 12 hospital deaths (1%). The mean length of hospital stay (LOS) was 6.6 days. The LOS increased significantly with age. CONCLUSION: In our setting, NTAA was the most common cause for general surgical admissions, accounting for 30% and 54% of the total surgical and emergency surgical admissions respectively. Most of the patients were young and acute appendicitis was the most common diagnosis. Further National/regional multicenter studies are needed to assess the trend of emergency surgical admissions and their impact on surgical practice, overall health care costs, medical education and training in SA.

Abdomen, Acute↗
PubMed2006

[Management of soft tissue defects in the region of finger PIP joints by means of pedicular skin flaps taken from abdomen].

Management of soft tissue defects in the region of finger PIP joints makes a serious operative problem. Commonly recommended skin plastics require a wide experience in hand surgery. There is also lack of a comprehensive doctrine of surgical therapy depending on the extent of the mutilations. The paper presents the results of treatment of 17 mutilated fingers of 11 patients (8 men, 3 females) treated over the period of 2 years (2002-2004). The method applied was pediculated skin flaps taken from an abdomen. According to the extent of lesions three groups of patients were created. Eight patients were treated as emergencies, three appeared from 4 to 11 weeks after the accident. Flaps were cut off after 20.4 days on average. The secondary plastic was performed after the following 9.5 weeks. In 2 patients tendon plastics were performed. Fingers were mobilized during the whole period of the therapy. No complications in healing of the flaps were observed. The functional results were assessed 6 months on average after the primary operation. The average TAM and TPM were evaluated as follows: group I (no, or minor tendon lesions) TAM--186 degrees, group II.

Abdomen↗