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At least 19 recordsLinked to original sources
PubMed1990

Modern aids to clinical decision-making in the acute abdomen.

Acute abdominal pain continues to provide not only a large workload for the general surgeon but also many diagnostic and management problems. Many different techniques have been introduced over the past two decades to help in the management of the acute abdomen and this review considers their relative claims to become incorporated into the process of clinical decision-making. The evidence in support of formally structured patient interview pathways with or without computer-aided diagnostic programs is now overwhelming and should become routine. Both laparoscopy and peritoneal cytology have an important role to play in the management of patients in whom the decision to operate is in doubt, and a combination of the two would be complementary. Ultrasonography has become increasingly popular for investigating the acute abdomen, and results from specialist centres are impressive. However, the problems of operator variation and the difficulties in providing a 24-h service will probably prevent it from becoming a first-line investigation in most hospitals. Although plain radiography has been available for many years, its routine use in the management of the acute abdomen remains controversial. Recent studies have confirmed that contrast radiography is an important adjunct to decision-making, particularly in the management of large bowel obstruction, and there is increasing evidence to support its use in suspected small bowel obstruction, perforated peptic ulcer and acute diverticular disease.

Abdomen, Acute↗
PubMed2000

Ruptured metastatic ovarian carcinoma presenting as acute abdomen.

Acute abdomen is a challenge to first-line physicians because of frequently missed diagnoses and potential follow-on legal problems. Improving the management of these patients is of paramount importance, not only for saving lives, but also for reducing untoward problems associated with improper management. We present a case of a patient with acute abdomen due to intraperitoneal hemorrhage secondary to rupture of an ovarian tumor. Following emergency surgery, the patient was diagnosed with metastatic ovarian carcinoma. Because of improper preparation of the gastrointestinal tract, the patient underwent repeat exploratory laparotomy for colon carcinoma. Although this situation did not affect the outcome of the patient in this case, we are concerned that the patient did not benefit from a single operation, with primary complete excision of the tumor plus a colostomy. The outcome of patients with pelvic malignancy, especially those with ovarian carcinoma, might be better if initial surgery achieved optimal tumor debulking. This is possible with good preoperative planning and preparation. We emphasize the importance of preoperative preparation in spite of urgently needed care. Furthermore, every first-line physician should communicate the possibility of malignancy to patients and their families.

Abdomen, Acute↗
PubMed1994

The acute abdomen.

Acute abdomen patients present a diagnostic and therapeutic challenge to emergency clinicians. The decision to perform surgery or to treat medically is often difficult to make and requires assimilating patient information, laboratory findings, radiological studies, and DPL. The importance of careful and repetitive PE cannot be overemphasized when managing these patients. If all diagnostics performed are not definitive and the patient continues to exhibit signs of abdominal pain, it is advisable to explore the abdominal cavity while administering supportive measures. Abdominal ultrasonography is emerging as a valuable diagnostic tool for the acute abdomen patient. Laparoscopy, CT, and CAD may also prove useful in certain cases.

Abdomen, Acute↗
PubMed1986

Pyogenic sacroiliitis: another imitator of the acute abdomen.

Acute suppurative infection of the sacroiliac joint can mimic the acute abdomen. Experience with a patient who had exploratory laparotomy for acute appendicitis prompted a review of the literature, which indicated that 12.6% of patients with pyogenic sacroiliitis have acute abdominal pain. A high index of suspicion is necessary to establish this diagnosis.

Abdomen, Acute↗
PubMed1997

Gynecologic causes of the acute abdomen and the acute abdomen in pregnancy.

Evaluation of a female patient who presents with an acute abdomen must always consider surgical and gynecologic disorders. Laparoscopy and pelviscopy have had a major impact on the surgical approach in gynecology. Most acute abdomens can now be approached laparoscopically. Certain conditions that are discussed require the traditional laparotomy. Preservation of reproductive capability has a major impact on the wellness of a woman.

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↗
PubMed1981

The acute abdomen. Part II: Acute abdomen arising from vascular disorders in the elderly.

The frequency of the "acute abdomen" has increased with the ageing of the population. In this chapter, we have examined syndromes of primary vascular origin, caused by vascular dysfunction, such as alterations in the vascular walls or haemodynamic disorders. We have left aside secondary vascular problems such as strangulation, obstruction or compression of vessels by tumours, which are easier to treat and diagnose and have a better prognosis. The symptoms of acute ischaemia caused by intrinsic vascular deficiency are not specific and clinical tests are untrustworthy. Despite progress in our knowledge of splanchnic haemodynamics, in radiology, vascular surgery and endoscopy, the prognosis remains poor. In view of the cataclysmic nature of the haemorrhage or the damage to the intestinal walls which evolves swiftly towards gangrenous necrosis, very rapid diagnosis of any of these various syndromes is essential if the patient is to be saved.

Abdomen, Acute↗
PubMed1994

[Abdominal pain in the differential diagnosis of acute abdomen-- common imitators of acute abdomen].

The authors analysed abdominal pains in diagnosis of acute abdomen, and the importance of that problem for the beginning of therapy in time. Here were elaborated the anamnestic, symptomatologic, diagnostic and differential diagnostic details, which make sure the recognition of acute abdomen and an early diagnosis of this state. The numerous data, rightly interpreted, enable an early diagnosis of acute abdomen, also by the general practitioner who is the first to meet those patients. We reported especially cases who imitate acute abdomen. These diseases are very important in differential diagnosis of acute abdomen. Both doctors, the general practitioner and the clinical one, have a big responsibility for an early recognition of the disease, in order to be able to do the in time and prognostically good surgical therapy.

Abdomen, Acute↗
PubMedDate not supplied

Laparoscopic diagnosis and treatment of an acute epiploic appendagitis with torsion and necrosis causing an acute abdomen.

Acute epiploic appendagitis is not as rare as previously thought; but, since the presenting signs and symptoms are not specific, preoperative diagnosis has been rarely made. At the present time, a laparoscopic exploration of the peritoneal cavity will establish the correct diagnosis, and the treatment can be provided during the same procedure. Herein, a case of a 63-year-old female patient with acute abdominal syndrome caused by a necrotic epiploic appendix that was successfully diagnosed and treated laparoscopically is described. A review of the literature is made, as well.

Abdomen, Acute↗
PubMed2000

Approach to the acute abdomen.

Acute abdominal pain is a clinical sign associated with several underlying disease processes, many of which can be life threatening. Abdominal pain requires efficient diagnostic evaluation to determine the appropriate course of treatment. Definitive treatment involves medical and/or surgical management. The emergency clinician must be well versed in the diagnostic approach to these patients to facilitate appropriate therapy.

Abdomen, Acute↗
PubMed1988

Gynecologic causes of the acute abdomen.

Acute surgical emergencies of gynecologic origin occur for the most part in women of reproductive age but occasionally in newborn and adolescent patients and rarely in the postmenopausal patient. The most common and most important conditions to be considered include pelvic inflammatory disease (PID) with abscess, ectopic pregnancy, hemorrhage from a functional ovarian cyst, and adnexal or ovarian torsion.

Abdomen, Acute↗