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At least 1,009 records · Page 56Linked to original sources
PubMed1989

Acute surgical abdomen and myelofibrosis.

Extramedullary hematopoiesis associated with fibrosis is found frequently in the liver and spleen, but seldom in other organs. Acute abdomen due to extramedullary hematopoiesis has been reported in two patients with intestinal obstruction because of heavy infiltration of the terminal ileum. This report describes the case of a 71-year-old woman with myeloid metaplasia involving the gallbladder mimicking acute cholecystitis. As far as we know, involvement of the gallbladder by extramedullary hematopoiesis has never been reported before.

Abdomen, Acute↗
PubMed1989

[Fornix rupture. A contribution to differential acute abdomen diagnosis].

The diffuse retroperitoneal extravasation of urine most often secondary to an ureteric calculus may present as a surgical emergency with localized or general abdominal symptoms. As the clinical signs are intriguing, history and a blurred psoas shadow on the plain film of the abdomen are the best guides to the right diagnosis definitely confirmed by an intravenous urography. Management usually is conservative and the recovery most often uneventful.

Abdomen, Acute↗
PubMed1989

[Boerhaave syndrome, as a cause of acute abdomen].

Boerhaave's syndrome, or spontaneous esophageal perforation, is an infrequent entity with an elevated morbidity and mortality. Its clinical manifestations are such that an extensive differential diagnosis with other entities in necessary, but diagnostic delay worsens the prognosis. We present a new case of Boerhaave's syndrome, that debuted as a picture of acute abdomen which led to the realization of an exploratory laparotomy that failed to evidence the esophageal perforation.

Abdomen, Acute↗
PubMed1989

[Monitoring critically ill patients during transport by helicopter using a patient with abdomen apertum as an example].

Noninvasive continuous monitoring systems are newly emerging as an important means of monitoring during transports in emergency care, e.g. transportation by helicopter. While automatic oscillometric blood pressure monitors have been used in the perioperative area for some time, a similar development can be observed in the field of emergency care and transportation with the availability of light, portable and battery operated systems. For monitoring adequate oxygenation, pulse oximeters have recently been brought into discussion for both the perioperative period and the transport of critically ill patients. In contrast to well-established monitoring techniques during helicopter transports (ECG, inspection, manually measured blood pressure (BP), pulse oximetry reveals an oxygen deficiency due to respiratory and cardiocirculatory problems, enabling precious time to be saved. This concept is illustrated during the helicopter transport of a critically ill patient with abdomen apertum caused by Clostridium perfringens infection. Even with a critical look at the already described mishaps of this method--e.g. overestimation of true O2 saturation (sO2) and additional overestimation caused by Hb-derivatives--pulse oximetry was found to be superior to the established monitoring techniques. Furthermore, oscillometric blood pressure detection was very satisfactory during the 30-min helicopter transport. Based on our results, we believe pulse oximetry and automatic oscillometric BP-measurement to be useful for monitoring during transports in helicopters, thus improving patient safety.

Abdomen↗
PubMed1986

[Emergency laparoscopy in the diagnosis of acute abdomen].

In our Country through the acquired experience, we have reached the 10 more frequent diagnostics in laparoscopies of urgency. 1) Our 10 more frequent diagnosis in laparoscopy were: Salpingitis 27.5%; Appendicitis 18%; Ovarian cyst 18%; Inflammatory localized processes 8.5%; Ectopic pregnancy 4.5%; Peritonitis 4%; Piosalpinx 3.5%; Cholecystitis 3%; Hemoperitoneum 3%; Metritis 2%. 2) That acute abdomen conditions should be diagnosed as early as possible. 3) That the maximum time employed to this diagnostic must not depass of six hours from the onset of the symptomatology. 4) That if at that time a diagnostic has not been established by all resources at the hands of the physician, an emergency laparoscopy shall be indicated. 5) That, this laparoscopy of urgency ought to be performed immediately at an Specialized Service and by a qualified endoscopist. 6) That, a qualified endoscopist shall be able to issue a laparoscopic diagnostic of the pathologies of the different abdominal organs, digestives and gynecological, in adults and children.

Abdomen, Acute↗
PubMedDate not supplied

Diagnostic value of ultrasonography in hydatid disease in abdomen and chest.

A prospective diagnosis of hydatid cyst was made in 90 cases involving abdomen and chest. It was based on the various sonographic signs of hydatid disease described in the literature. Surgery was performed in 60 patients while 30 were lost to follow-up. The diagnosis was confirmed in 55 patients while it was false positive in 5. The liver was the most common organ involved, followed by chest, kidney, peritoneum, spleen and retroperitoneum. Separation of the membrane from the wall, multiple daughter cysts, and collapsed cysts, were found to be diagnostic of hydatid disease. It is stressed that certain signs are specific for hydatid disease and thus do not cause any differential diagnostic problems.

Abdomen↗
PubMed1987

[Spontaneous hematoma syndrome of the abdominal rectus muscles (Differential diagnosis of acute abdomen and other diseases. Personal cases].

The authors examine the problem of the differential diagnosis of spontaneous hematoma of the abdominal rectus muscles versus "surgical" or "non-surgical" acute abdomen and other conditions. The clinical characteristics and investigative methods used are reviewed with a view to avoiding diagnostic errors. In addition, the authors discuss 6 clinical cases which they have observed personally.

Abdomen, Acute↗
PubMed1988

Acute abdomen.

Acute surgical abdomen is the object of urgent surgical attention. The objective of emergency operation is to interrupt a process that has a steadily worsening prognosis on a scale of hours unless effective surgical treatment is rendered. There are basically three processes to address: free or incipient sepsis and peritonitis, gastrointestinal soilage, and hemorrhage.

Abdomen, Acute↗
PubMed1988

Closed peritoneal lavage in the diagnosis of non traumatic acute abdomen.

The records of 22 consecutive patients with a non-traumatic ill-defined acute abdomen having diagnostic closed peritoneal lavage, were reviewed retrospectively. All patients had one or more risk factors. Peritoneal lavage was performed under visual control and its diagnostic value was based on the comparison with the definitive diagnosis, based on laparatomy and complementary tests. There were 12 positive results with 11 true positives (7 cases of peritonitis, and 4 of visceral necrosis) and 1 false positive. There were 10 negative results with 9 true negatives and 1 false negative. Sensitivity of peritoneal lavage was 0.91%, specificity 0.90%, positive predictivity 0.91% and negativity 0.90%. Overall mortality was 45%. The limits of the procedure appear to be the infections or localized abscesses. Peritoneal lavage as a simple and easy method, is suitable for high-risk patients when the choice is between immediate operation with possible side-effects or delay with possible adverse course of the abdominal lesion, and permits immediate indication for surgery in case of positivity.

Abdomen, Acute↗
PubMed1988

Acute abdomen due to granulocytic sarcoma of the terminal ileum.

A 57-year-old patient with chronic granulocytic leukemia in blast crisis and severe neutropenia is presented. This patient developed right sided peritonitis due to an isolated transmural granulocytic sarcoma of the terminal ileum. The affected segment was resected and the patient survived 4 more months. Thus, despite neutropenia, an aggressive surgical approach should be considered in a leukemic patient presenting with unexplained acute abdomen, since, as demonstrated here, a localized lesion which could not have otherwise been detected, was ultimately found and promptly resected.

Abdomen, Acute↗
PubMed1987

A new transducer technology--the annular phased array: comparison with a conventional mechanically rotating sector transducer: the upper abdomen.

During a 3-month period, 285 patients underwent ultrasonographic examination of the upper abdomen. Scanning was done with a new annular phased array transducer, and a conventional rotating sector transducer. Our study indicates that the annular phased array is more effective for outlining boundaries of the liver, spleen and pancreas in the near and far field. Owing to improved lateral resolution, the new technology permits US imaging of parenchymal organs, even in cases of severe bowel gas obscuration.

Abdomen↗
PubMedDate not supplied

MRI of the upper abdomen using motion artifact suppression technique (MAST).

Magnetic resonance imaging of the upper abdomen has been hampered by motion artifacts that cause suboptimal image quality. A promising software solution to this problem, motion artifact suppression technique (MAST), is described. Using mathematically determined refocussing gradients, it has improved image clarity significantly. Unlike alternate techniques such as respiratory gating, there is no increase in scan time, and patient throughput is expedited.

Abdomen↗
PubMed1986

The acute abdomen: management with microcomputer aid.

This paper describes the management consequences of the use of a microcomputer as a special investigation in patients with an acute abdomen. Results in 812 patients seen by 42 junior doctors are compared six monthly and with baseline data from 295 cases from the preceding 2 years. Improvement in diagnostic ability from 48.5% to 71.8% (X2 = 25.8, P less than 0.001) resulted in a fall in negative appendicectomy from 37.5% to 9.71% (X2 = 16.2, P = less than 0.001). Bad management errors were also reduced from 22% to 10% (P = less than 0.01). The number of emergency investigation fell from 4 to 2 and inpatient stay of patients with non-surgical abdominal pain was reduced from 3 to 2 days. These results demonstrate that the use of microcomputers as investigative tools improves the surgical management of patients with acute abdominal pain.

Abdomen, Acute↗
PubMed1987

Bile peritonitis after liver biopsy: nonsurgical management of a patient with an acute abdomen: a case report with review of the literature.

A 67-yr-old anicteric man with esophageal varices underwent a percutaneous liver biopsy. The procedure was complicated by bile peritonitis resulting in an acute abdomen that was successfully managed conservatively with intravenous fluids, antibiotic therapy, and intensive care unit monitoring. The published literature on this complication after liver biopsy is reviewed.

Abdomen, Acute↗
PubMed1987

[90 fine-needle punctures for diagnosis of the upper abdomen under ultrasonic guidance. Contribution of cyto- and histologic analysis].

Fine needle puncture was performed of upper abdomen in 19 cases. The method is rapid, reliable, of low cost and only weakly traumatic. The recent possibility of coupling histologic and cytologic analysis with fine needles provides improved results by increasing diagnostic precision and identification of malignant tumors and benign tumors of difficult cytologic diagnosis.

Abdomen↗
PubMed1987

Acute abdomen in severely mentally retarded patients.

Over 5 years, 25 severely retarded institutionalized patients accounted for 29 admissions for laparotomy due to acute abdomen. The patients' symptoms were always of short duration, yet 38% of operations were judged to be delayed. This was thought to be due to the patients' inability to communicate and to altered pain sensation. Pica (depraved appetite) accounted for 48% of admissions and perforation was common (41%). The death rate was high (4 (14%) of the 29 admissions and 3 (21%) of the admissions associated with pica). An unexpected high incidence (24%) of peptic ulcer was also seen. Unless the patient was admitted in a state of shock, usual clinical determinations often failed to distinguish early from advanced disease. Young males seem at increased risk and a history of pica is ominous.

Abdomen, Acute↗
PubMed1987

Acute abdomen in hemodialysis patients--a diagnostic dilemma.

Nine hemodialysis patients with an intra-abdominal emergency were retrospectively studied to investigate possible disguise of symptoms and signs. Physical examination of the abdomen, body temperature and WBC were assessed and compared with the data (mean and range) recorded one year before, so that each patient could serve as his own control. All patients were in an advanced stage of the disease and presented with signs of peritoneal irritation. Temperature response in all patients was adequate, but most patients had a low basal body temperature. There was either leukocytosis or a shift to the left. Symptoms and signs of acute abdominal disease may be attenuated at the onset of disease, therefore proper interpretation of body temperature and laboratory findings, with the patient as his own control, may facilitate early diagnosis.

Abdomen, Acute↗