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Giant ovarian leiomyoma as a rare cause of acute abdomen and hydronephrosis.

BACKGROUND: Leiomyoma of the ovary is rare, usually small, and rarely induces serious symptoms. CASE: We report a case of a leiomyoma of the ovary that weighed 11.65 kg and led to acute abdomen and bilateral hydronephrosis. To our knowledge, this complication has not been described previously. Transabdominal sonography and computed tomography scan did not identify tumor type or origin. We performed a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Abdominal symptoms and defects in urinary function disappeared completely after surgery. CONCLUSION: In very few cases, benign leiomyoma of the ovary may cause giant pelvic masses and peritoneal irritation.

Abdomen, Acute↗

[Acute abdomen in extensive thrombosis in the inferior vena cava collateral circulation].

Variations of the inferior vena cava (IVC) because of either embryonal malformations or postthrombotic changes are not uncommon. The clinical symptoms include repetitive thrombotic events. We report on an atypical case of acute abdomen resulting from thrombotic occlusion of the IVC and the right renal vein as well as of the collateral vessels.

Abdomen, Acute↗

Ectopic extramammary Paget's disease affecting the upper abdomen.

We present 57-year-old man in whom ectopic extrammary Paget's disease (EMPD) affected the upper abdomen. Although the clinical appearance was suggestive of Bowen's disease or superficial basal cell epithelioma (BCE), the biopsy specimen showed EMPD histologically. Only 12 cases of ectopic EMPD have been reported (including this case). In our 20 year experience of 129 EMPD, this is the first ectopic case. Thus, the frequency of ectopic EMPD is 0.78% (one of 129) in our study. The male/female ratio in the reported 12 cases is 2: 1, nearly the same as EMPD in general (2.1: 1, in our 129 cases). The mean age of the 12 patients is 65.8 years, which is not significantly different from ordinary EMPD (66.4 years, in our 129 cases). Comparing ectopic EMPD to ordinary EMPD, clinically and histologically, we could find no difference. As they appear to be the same disease, ectopic and ordinary EMPD may share similar origins and mechanisms of occurrence. We support the hypothesis that Paget's cells originate from the remaining pluripotential germinative cells which are able to differentiate into many kinds of secreting glands.

Abdomen↗

[Wounds of the abdomen and pelvis with damage to the major vessels].

The results of treatment of 144 patients with major vessels injuries in abdomen and pelvis injuries are performed. They had injuries of 146 vessels and of 220 abdominal organs. Mean blood loss was 2620 ml. 39 persons died (27.1%). The main lethality causes: haemorrhagic shock, late admission to the hospital, non-adequate angiosurgical service. The most characteristic errors in polytrauma: nonremoved major vessels injuries in laparotomy, unsuccessful attempts to stop bleeding and nonprofessional placing of a vascular suture, wrong sequence of operative instruments, defects of surgical service organization.

Abdomen↗

Acute abdomen: an atypical presentation of pubic osteomyelitis.

A 67-year-old woman was admitted with diffuse lower abdominal and suprapubic pain, with diastasis of the pubic symphysis. She developed an acute abdomen necessitating an exploratory laparotomy. During laparotomy, the pubic lesion was explored, and histology confirmed the diagnosis of pubic osteomyelitis and the presence of Staphylococcus aureus. The patient recovered fully with a four-week course of antibiotic therapy. This case confirms the protean presentation of pubic osteomyelitis, alerting physicians of the necessity to institute prompt treatment is such cases.

Abdomen, Acute↗

Fast MR imaging of abdomen: application of the QD body coil and low refocusing flip angle.

The fast spin-echo (FSE) method as applied to abdominal imaging has undergone considerable technical and clinical study over the past several years. However, except in a limited number of institutions, this time-saving sequence has not replaced the conventional spin-echo (CSE) method. In particular, FSE is less frequently employed for examination of the liver because FSE and CSE images of hepatic tumors and normal hepatic tissues differ significantly in terms of contrast. The signal reduction effect of magnetization transfer contrast (MTC) is affected by the number of slice sections and by the specific absorption rate (SAR). We have employed a newly developed quadrature detection (QD) body coil to enhance the signal-to-noise ratio (S/N) and a low refocusing flip angle to suppress SAR and MTC effects. We have also evaluated the effectiveness of this new method by carrying out visual assessment of clinical images and quantitative measurements of signal intensity in these images. Several problems must be overcome before the FSE method is able to replace the CSE method in the clinical examination of the abdomen. The selection of sequences with a low refocusing flip angle combined with the use of the QD body coil promises to be one possible solution to these problems.

Abdomen↗

Laparoscopic cholecystectomy following abdominal surgery of the lower part of abdomen.

In this prospective study, laparoscopic cholecystectomy was performed in patients with previous abdominal surgery of the lower part of abdomen. According to authors experience, the usual method of 'blind' beginning of the laparoscopic procedure, with safety tests, is a safe and reliable method to start the laparoscopic procedure, even in these patients. This method does not carry a higher risk of intra-abdominal injury.

Abdomen↗

Acute abdomen. Is ultrasonography useful, essential or unnecessary?

Abdominal ultrasonography in acute conditions gives sometimes the definite diagnosis or at least indicates a strategy for further examinations. This technique is constantly accurate for the upper part of the abdomen, and its classical indications are dominated by cholecystitis, biliary and urinary lithiasis, pancreatic and aortic painful circumstances. However, its role has been emphasized recently, after famous publications about the usefulness of high resolution ultrasonography for appendicitis and various gut-related acute conditions. The efficacity of abdominal ultrasonography is enhanced by color-doppler and power-doppler, to characterize some inflammatory or ischemic diseases. For the pelvis, endocavitary examination is a "must" for studying uterus and adnexae. The main drawbacks of abdominal ultrasonography are well known: its physical limitations and mainly its operator-dependence.

Abdomen, Acute↗

Contouring the hip and the abdomen.

This article describes the surgical procedures used for the aesthetic improvements of the flanks and abdomen. A clinical classification for patient selection regarding when to use liposuction, surgery, or both, is included. Isolated flankplasty, isolated abdominoplasty, and combined flanks with abdominoplasty performed in the same stage are reviewed. Finally, secondary problems after traditional abdominoplasty are evaluated. Solutions are described and illustrated.

Abdomen↗

[Pheochromocytoma with hemorrhagic necrosis and rupture with symptoms of acute abdomen and shock].

A case of a pheochromocytoma with haemorrhagic necrosis resulting in signs of acute abdomen with shock is reported. Diagnosis of a ruptured adrenal tumor was made by CT scanning. Elevated urine and plasma catecholamines as well as histological examination of the removed tumor confirmed the clinical suspicion of pheochromocytoma. The patient made uneventful recovery and is asymptomatic 2 years after surgery. Ruptured pheochromocytoma as a cause of abdominal emergency is discussed in view of the existing literature.

Abdomen, Acute↗

[Acute abdomen of urologic origin].

Presentation of one case of bladder carcinoma which caused acute abdomen following spontaneous perforation. This presentation is extremely rare and should be taken into account when haematuria and abdominal pain appear simultaneously.

Abdomen, Acute↗

[Acute abdomen in the third trimester].

The authors report a case of acute abdomen in the third trimester of pregnancy as observed at the II Obstetrics and Gynecologic Department of Florence University. Emphasis is laid on the frequent abnormality of the symptomatology and therefore the difficult of early diagnosis. The conclusion is reached that a greater semeiologic accuracy on behalf of the specialist as well as memorization of the several clinical charts responsible for such pathology, allow an earlier diagnosis with consequent improvement of maternal and fetal prognosis.

Abdomen, Acute↗

[Acute abdomen caused by the rupture of a solitary non-parasitic cyst of the liver].

A rare case of acute abdomen caused by the rupture of a solitary, non-parasitic cyst of the liver is reported. Considering the rarity of the event, it was considered interesting to examine the anatomo-pathological, clinical and diagnostic aspects as well as the various surgical and other treatment possibilities for these conditions. Stress is also laid on the fact that surgical treatment is only indicated in the case of complications, while in uncomplicated forms the treatment of choice of alcoholisation.

Abdomen, Acute↗

Acute abdomen. Laboratory evaluation and imaging.

The child with an acute abdomen requires a thorough history and physical examination followed by a focused laboratory and imaging evaluation. The laboratory evaluation is more beneficial in determining management than in establishing diagnosis. Ultrasonography has become increasingly useful in the evaluation of the child with acute abdominal pain.

Abdomen, Acute↗

Acute abdomen. The role of laparoscopy.

The child with an acute abdomen presents the perfect opportunity to take advantage of the benefits of minimal-access surgery. There are a wide variety of conditions, acquired and congenital, for which minimal-access techniques provide the distinct advantages of a cost-effective diagnosis and therapy with minimal discomfort for the patient. In the present report, the management of children with abdominal pain of unclear etiology is outlined, along with discussions of the value of minimal-access surgery in appendicitis and other conditions. Several algorithms are provided as a guideline for suggested approaches to management.

Abdomen, Acute↗

Acute abdomen. Outcomes.

The outcome for children with common surgical conditions that cause an acute abdomen is discussed. These conditions include appendicitis, intussusception, malrotation, inflammatory bowel disease, intestinal obstructions, and nonorganic pain. Emphasis is placed on surgical intervention and disease processes that significantly affect outcome. The outcome of many of the diseases discussed is strongly influenced by the timing of diagnosis and treatment. These children should have prompt care and intervention to prevent morbidity and mortality. In addition, many children who present with common pediatric surgical emergencies have other medical conditions and are best treated in an environment that has a multidisciplinary team to handle their care and decrease the long-term complications.

Abdomen, Acute↗