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Sample records for abdomen acute

  1. Acute abdomen

    Acute abdomen may be connected with the injury of one of the internal organs, injury of large blood vessels, with the spreading of pains from some other area. It may also be a manifestation of systemic disease or poisoning. The main purposes of radiodiagnosis are: determination of the cause of clinical syndrome; determination of the localization and spreading of pathological changes in abdominal organs; finding out the character of complications. If the data of the ordinary roentgenological investiagtion and isn't complete, the computer tomography of abdominal and pelvic cavities is needed

  2. Acute abdomen

    The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis. One chapter presents a complete survey of the processes involving the entire abdomen - as e.g. peritonitis, ileus, abdominal trauma, intraperitoneal hemorrage. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery. Problems requiring consultation among varous specialists, in internal medicine, gynecology, urology, or pediatrics, are discussed in great detail. Information for the anesthetist is given for cases of emergency. More than one third of the book is devoted to organ-specific information, dicussing the pathogenesis, diagnostics, and therapy of the oesophagus, stomach, large and small intestine, bile ducts, pankreas, liver, spleen, and the abdominal vessels and the abdominal wall. (orig.) With 153 figs., 90 tabs

  3. Radiological aspects of acute abdomen

    This work demonstrates the main roentgen signs of the most common causes of acute abdomen, through some cases chosen from H.N.M.D. Roentgen Department-Learning Register. First, we will show the normal roentgen anatomy of the abdomen. Then, we will discuss about the basic roentgen routine of acute abdomen and some technical changes depending on the suspected illness, the clinical conditions of the patient and certain roentgen findings. Finally, we will show the most important roentgen signs of the most familiar effects accurate abdomen, putting emphasis on the next things: intestinal obstructions, peritonitis, acute cholecustitis, acute pancreatitis, acute appendicitis, subphrenic abscesses, toxic megacolon of ulcerative retocolitis, gastric or duodenal ulcer perforation and renal colic. (author)

  4. [Acute abdomen in gynecology].

    von Hugo, R; Meyer, B; Loos, W; Dirmeier, H

    1988-09-01

    The aim of the present study is, to describe the morbidity and mortality of 196 patients with an acute abdominal condition who underwent surgery at the Department of Gynecology and Obstetrics of the TU Munich between 1982 and 1986. This is a percentage of 2.7 of all 7,167 operations carried out during this period. 118 of these patients had an extrauterine pregnancy and were therefore excluded from the study. The second group of 79 patients, mostly with inflammatory diseases, were analyzed. In most of these cases the acute abdominal condition was caused by a tuboovarian abscess (48.1%), followed by peritonitis because of a bowel-disease (11.4%). 6 patients suffered from an abscessing endometritis due to a caesarean section with sepsis in 5 cases. A generalized peritonitis occurred in 5 cases and was treated with a planned relaparatomy with lavage. 63% of the patients had no complications within 28 days after operation, 13% developed a subileus; in 7% a relaparatomy was necessary. 6% of the patients had problems of wound-healing. One patient with stomach-cancer died 3 weeks after the operation because of a fulminant lung-embolism. Thus the mortality rate was 1.5%. A further 27% were treated at the intensive care-unit and 18% needed artificial respiration. The average postoperative period of hospitalisation was 15 days. In comparison, patients with elective operations remained 13 days. The morbidity and mortality of patients due to surgery of an acute abdominal condition was relatively small; postoperative complications could be well treated in all cases and is probably the result of a positive and early indication for surgical intervention. PMID:3181709

  5. Radiological aspects of acute abdomen; Aspectos radiologicos do abdomen agudo

    Toledo, Renato Muller de; Lacerda, Jose Carlos Teixeira; Georg, Bruno Rigueira; Ramos, Alexandre Ferreira [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil). Servico de Radiodiagnostico

    1994-12-31

    This work demonstrates the main roentgen signs of the most common causes of acute abdomen, through some cases chosen from H.N.M.D. Roentgen Department-Learning Register. First, we will show the normal roentgen anatomy of the abdomen. Then, we will discuss about the basic roentgen routine of acute abdomen and some technical changes depending on the suspected illness, the clinical conditions of the patient and certain roentgen findings. Finally, we will show the most important roentgen signs of the most familiar effects accurate abdomen, putting emphasis on the next things: intestinal obstructions, peritonitis, acute cholecustitis, acute pancreatitis, acute appendicitis, subphrenic abscesses, toxic megacolon of ulcerative retocolitis, gastric or duodenal ulcer perforation and renal colic. (author) 4 refs., 13 figs.

  6. The acute abdomen in childhood

    The acute abdomen in childhood demands early diagnosis for the sake of appropriate and early therapy. A high number of differential diagnosis in the assessment of acute abdominal pain and problems, as well as different causes of diseases in different age of the children, make a partition with respect to the age of the children considerable. A partition in diseases, which are leading to acute abdominal pain in neonates, in toddlers and small infants and in schoolchildren makes sense. In older schoolchildren and adolescents also diseases of the grown up generation are possible as a cause of acute abdominal pain. The lack of compliance (cooperation and communication) in small children obstructs clinical and radiological assessment and elucidates the necessity of knowledge of causes of acute abdominal pain as much as possible. A lot of patience and experience are mandatory in the evaluation of small children and therefore make a dedicated, trained and experienced stuff necessary. A dedicated paediatric radiologist will find a safe and proper technique, and in cooperation with the referring clinician the necessary decision for therapy will be made. (orig.)

  7. Obstructive acute abdomen: reviewing important points

    The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

  8. Scrub typhus presenting as an acute abdomen

    PP Abhilash Kundavaram; Sohini Das; M Varghese George

    2014-01-01

    Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigatio...

  9. Scrub typhus presenting as an acute abdomen

    PP Abhilash Kundavaram

    2014-01-01

    Full Text Available Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.

  10. Dengue Haemorrhagic Fever presenting as Acute Abdomen

    Al-Araimi, Hanaa; Al-Jabri, Amal; Mehmoud, Arshad; Al-Abri, Seif

    2011-01-01

    We describe a case of a 38 year-old Sri Lankan female who was referred to the surgeon on call with a picture of acute abdomen. She presented with a three-day history of fever, headache, abdominal pain and diarrhoea; however, the physical examination was not consistent with acute abdomen. Her platelet count was 22 ×109/L. A diagnosis of dengue haemorrhagic fever (DHF) was made and dengue serology was positive. Dengue epidemics have been associated with a variety of gastrointestinal symptoms an...

  11. Intestinal tuberculosis presenting as acute abdomen

    Objectives: To study the outcome of intestinal tuberculosis presenting as acute abdomen. Study design: Descriptive Study. Place and Duration: Bolan Medical Complex Hospital (BMC) Quetta and Combined Military Hospital (CMH) Quetta from Nov 2003 to Nov 2005 from Bolan Medical Complex and from Nov 2005 to Nov 2006 in CMH Quetta. Material and Method: Thirty seven patients of acute abdomen presenting with intestinal obstruction were admitted; 28 from emergency department and 9 from out patient department. Twenty seven patients were from BMC and 10 from CMH Quetta. Patients were diagnosed as having abdominal tuberculosis on the basis of operative findings and histopathological reports. Results: Out of 37 patients presenting with acute abdomen due to intestinal obstruction, 54% were male and 46% were female with M: F ratio of 1: 1.2. Age of the patient ranged from 20 to 50 years, with maximum frequency between 30 to 40 years. Abdominal pain was the commonest presenting feature in all patients followed by constipation in 81.1% patients. Peritonism was seen in 27% patients. Different operative procedures performed were adhesionolysis 65.8%, segmental resection 7.9%, right hemicolectomy 10.5%, stricturoplasty 7.9% and ileostomy 1.3%. Mesenteric lymph node biopsy 40.8%. Conclusion: Intestinal tuberculosis is still a very important surgical problem in our country presenting as acute abdomen. A suspicion must always be kept during laparotomy and adequate tissue histopathology should supplement the diagnosis. (author)

  12. Recurring Acute Abdomen, Ovarian Cyst and Hypothyroidism

    T Rohatgi, N Rohatgi and K Buckshee

    2007-01-01

    Spontaneous ovarian hyperstimulation, large ovarian cyst and multicystic ovaries associated with primaryhypothyroidism is infrequently reported and not widely recognized in gynaecologic literature. We reporta case of a 15 year old girl who had an acute abdomen and emergency laparotomy revealed bilaterallyenlarged ovaries, a large ovarian cyst with torsion in the right ovary and ascites. Thus right adnexa wasremoved. At that time thyroid dysfunction was neither suspected nor investigated. Five...

  13. Surgical acute abdomen in elderly patients.

    Itengré Ouédraogo

    2004-08-01

    Full Text Available Fundaments : The surgical acute abdomen usually is the most frequent cause of abdominal surgery of urgency in t he old one, with the high mortality in spite of the modern surgical technologies. Objective: To evaluate the surgery of the surgical acute abdomen in the old one. Method: Appears a prospectivo descriptive study that includes 102 patients of 60 years or more who underwent surgery at the ¨Dr Gustavo Aldereguía Lima¨ University Hospital of Cienfuegos with this diagnostic. The primary data were obtained from clinical cards of the patients and the daily clinical observation until the debit. Results: The patients presented an average age of 74 years, being the most frequent causes of the syndrome intestinal obstruction (32,4%, the biliary tract affections (22,5%, and acute appendicitis (21,6%. The most frequent symptom was abdominal pain (96,08%, and we noticed tachycardia in 80,4%. Postoperating complications in 47,06% of the patients appeared and was observed a mortality of 26,5% with statistically significant relation with the age, ASA classification, surgical risk, time of evolution and the surgical time. The peritonitis heads the direct causes of death.

  14. Surgical acute abdomen in elderly patients. Abdomen agudo quirúrgico en el anciano.

    Lidia Torres Ajá; Angel Delfín Rodríguez Sarria; Julio Pablo Miñoso Andina; Itengré Ouédraogo

    2004-01-01

    Fundaments : The surgical acute abdomen usually is the most frequent cause of abdominal surgery of urgency in t he old one, with the high mortality in spite of the modern surgical technologies. Objective: To evaluate the surgery of the surgical acute abdomen in the old one. Method: Appears a prospectivo descriptive study that includes 102 patients of 60 years or more who underwent surgery at the ¨Dr Gustavo...

  15. Acute Abdomen; Pre and Post-Laparotomy Diagnosis

    Marjan Laal

    2009-07-01

    Full Text Available Background: Abdominal pain is a common presentation that requires almost immediate management. It is sometimes crucial to diagnose at the earliest and make a decision as to operate. Therefore it is necessary for the physician to be familiar both with the presentations of common causes of abdominal pain and the validity of diagnostic tests.  Diagnosis of acute abdomen before laparotomy is essential in reducing the morbidity and mortality while preventing from unnecessary operations especially where the diagnostic facilities are limited and clinical awareness plays an important role in the diagnosis and management. Objectives: This study attempted to compare pre and post-operative diagnosis in acute abdomen.Materials & Methods: This was an observational study, conducted from February to December 2005. The study included 139 consecutive patients referred to Sina hospital (Tehran, Iran presented with symptoms of acute abdomen, operated to see the negative laparotomy rate, the diagnostic accuracy and predictive values of different investigations in acute abdomen. Statistical analysis was performed using SPSS software version 11.5. P value of Results: All 139 patients with diagnosis of acute abdomen underwent emergency laparotomy. Acute abdomen was most common in the age group 20-29 years with male predominance. Acute appendicitis (57.6% was the most common cause of surgical condition, and then the most common causes of acute abdomen were peritonitis (14.4% and bowel obstruction (7.9% in male and ovarian cyst torsion (24.5% in female patients. The negative laparotomy rate was 12.2% (P value Conclusion: The decision to operate is based on the results of a good history and thorough physical examination(s with the guidance of investigative tools. Diagnostic modalities could guide the physician in confirming the diagnosis. An accurate diagnosis of acute abdomen can avoid from unnecessary operations so reduces the rate of negative laparotomies.

  16. Examination of the Acute Abdomen in Children.

    Nakayama, Don K

    2016-01-01

    The history and physical examination (H&P) on a child with an acute abdomen is an opportunity to build a solid relationship with the child and parents. Building confidence and trust under fraught circumstances requires a genuine affection for children, and sympathy for the anxiety of the parents. Arrival of a surgeon is a signal that the illness is serious and not likely to respond to the usual remedies. The surgeon therefore must have a gentle, unhurried approach. Obtaining the history should be non-directive and allow both parent and child to describe the entire timeline of the illness without interruption. The physical examination should be done without hurting the child, first observing how the child moves about in bed and undresses, then having the child control palpation by holding the examiner's hand and pulling it away should undue pain be elicited. Even though a diagnosis and a plan for surgery may already have been made, exiting the exam room after the H&P to review lab and radiological images gives the family time to regroup information. The diagnosis and decision for operation require simple and direct explanations that communicate patience, have a tone of reassurance, and affirm repeatedly that parents understand what is being said. The message is that surgery is a shared decision, and safety and the child's wellbeing always foremost. To the child three points have to be paramount: They won't feel pain during or after the procedure; after the operation they will feel better; and they won't be alone. The goal is to build a trusting relationship so that the child has some calm in departing to the operating room and the parents willingly see them leave. PMID:26966084

  17. A Rare Cause of Acute Abdomen: Intrauterine Device (IUD

    Yavuz Koca

    2014-06-01

    Full Text Available Uterus perforation due to intrauterine device (IUD can occur for several reasons. IUD migration into the abdominal cavity is a complication that can cause acute abdomen conditions such as pelvic and intra-abdominal abscess, intra-abdominal organ perforation and fistula. In such cases, the laparoscopic approach is recommended as the first choice. Thirty-six-year-old female patient with clinical acute abdomen caused by the IUD, was presented with the literature.

  18. A Rare Cause of Acute Abdomen: Intrauterine Device (IUD)

    Yavuz Koca

    2014-01-01

    Uterus perforation due to intrauterine device (IUD) can occur for several reasons. IUD migration into the abdominal cavity is a complication that can cause acute abdomen conditions such as pelvic and intra-abdominal abscess, intra-abdominal organ perforation and fistula. In such cases, the laparoscopic approach is recommended as the first choice. Thirty-six-year-old female patient with clinical acute abdomen caused by the IUD, was presented with the literature.

  19. Evaluating the Acute Abdomen in the Pregnant Patient.

    Masselli, Gabriele; Derme, Martina; Laghi, Francesca; Framarino-dei-Malatesta, Marialuisa; Gualdi, Gianfranco

    2015-11-01

    Acute abdominal pain in pregnancy presents diagnostic and therapeutic challenges. Ultrasound remains the primary imaging investigation of the pregnant abdomen because of its availability, portability, and lack of ionizing radiation. MR imaging has been shown to be useful in the diagnosis of gynecologic and obstetric problems and in the setting of acute abdomen during pregnancy. MR imaging is often used when ultrasound is inconclusive. Computed tomography is the investigation of choice when there is a life-threatening situation and in case of traumatic injuries, when a rapid diagnosis is required. PMID:26526440

  20. Analysis of the computed tomography in the acute abdomen

    Introduction: This study tends to test the capacity of the computed tomography in assist in the diagnosis and the approach of the acute abdomen. Material and method: This is a longitudinal and prospective study, in which were analyzed the patients with the diagnosis of acute abdomen. There were obtained 105 cases of acute abdomen and after the application of the exclusions criteria were included 28 patients in the study. Results: Computed tomography changed the diagnostic hypothesis of the physicians in 50% of the cases (p 0.05), where 78.57% of the patients had surgical indication before computed tomography and 67.86% after computed tomography (p = 0.0546). The index of accurate diagnosis of computed tomography, when compared to the anatomopathologic examination and the final diagnosis, was observed in 82.14% of the cases (p = 0.013). When the analysis was done dividing the patients in surgical and nonsurgical group, were obtained an accuracy of 89.28% (p 0.0001). The difference of 7.2 days of hospitalization (p = 0.003) was obtained compared with the mean of the acute abdomen without use the computed tomography. Conclusion: The computed tomography is correlative with the anatomopathology and has great accuracy in the surgical indication, associated with the capacity of increase the confident index of the physicians, reduces the hospitalization time, reduces the number of surgeries and is cost-effective. (author)

  1. Role of Ultrasonography in Acute Abdomen

    An, Ji Hyun; Lee, Yeon Hee; Kim, Tae Hoon; Yu, Pil Mun; Choi, Young Hi; Kim, Sang Joon; Kim, Seung Cheul; Cho, Jeong Hee [Dankook University College of Medicine, Cheonan (Korea, Republic of); Jung, Jae Un [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1996-12-15

    Authors analyzed the distribution of diseases and compared ultrasonographic conclusions with confirmed diagnoses of emergency abdominal ultrasonographies in acute abdominal conditions. We evaluated the role of emergency abdominal ultrasonography especially in the decision of emergency operation. In one hundred and forty five patients, emergent abdominal ultrasonography was performed within on admission. We compared the sonographic conclusion with postoperative pathology and analyzed the diagnoses of medically treated diseases. Twenty-eight patients underwent surgery and 117 patients were treated conservatively. Among the surgically treated patients, 19 patients (70.4%) were correctly diagnosed by preoperative ultrasonography.These included acute appendicitis (N = 8), acute cholecystitis (n = 7), ovarian cyst torsion (n = 2), and liver abscess (n = 1). Correct preoperative diagnosis was not made in 9 patients, including acute appendicitis (n = 4), peritonitis due to bowel perforation (n = 2), ectopic pregnancy (n = 1), colonic diverticulitis (n = 1) and pelvic inflammatory disease (n = 1). Clinical follow up was possible in 50 patients among the non-operative patient group, and the clinical diagnoses were chronic liver disease (n = 14), acute pyelonephritis (n = 10), and biliary stone (n = 10). Emergent ultrasonography plays an important role in acute abdominal conditions by supporting the differential diagnosis of medical and surgical disease

  2. Solitary mesenteric vascular anomaly presenting as acute abdomen

    Thambidorai C

    2008-01-01

    Full Text Available A 4-year-old girl with a solitary vascular anomaly of the mesentery presented with acute lower abdominal pain. Despite the use of ultrasound, computed tomography scan and image-guided core biopsies, the lesion was initially mistaken for an inflammatory intra-abdominal mass. The correct diagnosis was made at laparotomy. Solitary vascular anomaly of the mesentery is rare and its presentation as an acute abdomen has not been reported before.

  3. Guillain-Barre Syndrome Presenting as Acute Abdomen

    Faruk incecik

    2015-09-01

    Full Text Available Guillain-Barr and eacute; syndrome (GBS is the most common cause of acute flaccid paralysis in childhood. Symmetric weakness, headache, respiratory symptom, neuropathic pain, muscle pain, paresthesia, and facial palsy were the most common clinical presentations. We report 13-year-old boy with GBS who presented with acute abdominal pain. This is the first report, to our knowledge, first presented of acute abdomen of a pediatric patient with GBS. [Cukurova Med J 2015; 40(3.000: 601-603

  4. IDIOPATHIC OMENTAL INFARCTION : A RARE CAUSE OF ACUTE PAIN ABDOMEN

    Narendra Nath

    2015-02-01

    Full Text Available Omental torsion leading on to omental infarction is an unusual cause of acute abdominal pain in adults. Often the condition mimics common causes of acute abdomen like acute cholecystitis, acute appendicitis or acute pancreatitis. A review of literature reveals that this enigmatic condition has been managed both non - operatively and by surgery in the past. We report the case of a 46 - year - old man who presented with a 4 - day history of severe right - sided abdominal pain mimicking acute cholecystitis. Abdominal CT scan revealed a right upper quadrant mass with a whirl - like appearance, suspicious for omental infarction. He was started on conservative management with analgesics and antibiotics. He improved symptomatically and was discharged

  5. Marfan syndrome with acute abdomen: a case report

    Beyazit Zencirci

    2010-01-01

    Beyazit ZencirciKahramanmaras Sutcu Imam University Medical Faculty, Department of Anesthesiology and Reanimation Kahramanmaras, TurkeyIntroduction: Marfan syndrome is an autosomal dominant connective tissue disorder characterized by a combination of clinical manifestations in different organ systems. Patients with Marfan syndrome (MFS) whose lifetimes are extended may be encountered as acute abdomen (appendicitis) cases apart from the obligatory reasons and emergencies arising naturally out ...

  6. Lassa fever presenting as acute abdomen: a case series

    Andrew E. Dongo; Kesieme, Emeka B.; Iyamu, Christopher E; Okokhere, Peter O; Akhuemokhan, Odigie C.; Akpede, George O.

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefo...

  7. Lassa fever presenting as acute abdomen: a case series.

    Dongo, Andrew E; Kesieme, Emeka B; Iyamu, Christopher E; Okokhere, Peter O; Akhuemokhan, Odigie C; Akpede, George O

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission. PMID:23597024

  8. Lassa fever presenting as acute abdomen: a case series

    2013-01-01

    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission. PMID:23597024

  9. Surgical acute abdomen in elderly patients. Abdomen agudo quirúrgico en el anciano.

    Lidia Torres Ajá

    Full Text Available Fundaments : The surgical acute abdomen usually is the most frequent cause of abdominal surgery of urgency in t he old one, with the high mortality in spite of the modern surgical technologies. Objective: To evaluate the surgery of the surgical acute abdomen in the old one. Method: Appears a prospectivo descriptive study that includes 102 patients of 60 years or more who underwent surgery at the ¨Dr Gustavo Aldereguía Lima¨ University Hospital of Cienfuegos with this diagnostic. The primary data were obtained from clinical cards of the patients and the daily clinical observation until the debit. Results: The patients presented an average age of 74 years, being the most frequent causes of the syndrome intestinal obstruction (32,4%, the biliary tract affections (22,5%, and acute appendicitis (21,6%. The most frequent symptom was abdominal pain (96,08%, and we noticed tachycardia in 80,4%. Postoperating complications in 47,06% of the patients appeared and was observed a mortality of 26,5% with statistically significant relation with the age, ASA classification, surgical risk, time of evolution and the surgical time. The peritonitis heads the direct causes of death.

    Fundamento : El abdomen agudo quirúrgico suele ser la causa más frecuente de cirugía abdominal de urgencia en el anciano, se asocia con una alta mortalidad a pesar de las tecnologías quirúrgicas modernas. Objetivo : Evaluar la cirugía del abdomen agudo quirúrgico en el anciano. Método : Estudio descriptivo prospectivo que incluye a 102 pacientes de 60 años o más operados en el Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos entre agosto y diciembre del 2002 con el diagnóstico de abdomen agudo quirúrgico. Los datos primarios se obtuvieron de las fichas clínicas de los pacientes y de la observación clínica diaria hasta el egreso

  10. Acute abdomen as atypical presentation of brucellosis: report of two cases and review of literature.

    al Faraj, S

    1995-01-01

    Abdominal involvement in brucellosis is seen in the acute, subacute and chronic disease. It is not typical, however, that acute abdomen is the presenting feature of brucellosis. In this paper, two cases of serologically diagnosed brucellosis are reported, both presenting initially with acute abdomen and fever. In brucella-endemic regions of the world, brucellosis has to be considered in the differential diagnosis of acute abdomen and fever. With definitive diagnosis, unnecessary laparotomy ca...

  11. Roentogenologic diagnosis of an acute abdomen in children

    Oka, Makio; Chiba, Nobuyuki; Miyagi, Tetsuo (Kanagawa Children' s Medical Center, Yokohama (Japan))

    1983-05-01

    An acute abdomen is one of the main topics among emergency practice for children. We have experienced about 300 acute abdomen cases per year at our Children's Hospital since 1970. Radiological technologists provide a 24-hour emergency service using special knowledge and techniques in our radiological investigation. In the noenatal period esophageal atresia should be diagnosed by plain up-right film with a coiled-up rubber tube, and a contrast examination is contraindicated to prevent severe aspiration pneumonia. In the cases with intestinal atresia, the contrast examination is not necessary again, because the findings of plain film such as the distribution of air-filled intestinal loops, dilated bowel with air-fluid level gives us enough information for the diagnosis of these congenital anomalies. On the contrary, barium enema is useful and harmless for the neonatal age group. It is practical for diagnosing Hirschsprung's disease, midgut malrotation with volvulus, ileal and colonic atresia and necrotizing enterocolitis. An imperforate anus should be classified into the high and low type in the neonatal period to define the treatment. Invertogram is an only way for the differentiation of a baby without external fistula, and we have established the technique for this. The level is diagnosed by the relationship between the gas-filled rectal pouch and ischiac bone. In the infant group intussusception is the most common and urgent acute abdomen. We use a special device to fix the bady, dilute the barium with warm saline (to avoid water intoxication), limit the water pressure to within one meter, and avoid abdominal manipulation and longtime exposure. The successful reduction rate that our team has obtained is almost 85%.

  12. Rare Hernias Presenting as Acute Abdomen- A Case Series

    Ulahannan, Sansho Elavumkal; Kurien, John S; Joseph, Aneesh; Kurien, Annie Sandhya; Varghese, Sandeep Abraham; Thomas, Bindhya; Varghese, Fobin

    2016-01-01

    Hernia is an abnormal protrusion of an organ or tissue through a defect in its surrounding walls. It can be divided into internal, external and diaphragmatic hernias. Most of them can be asymptomatic. If they become symptomatic they can present with features of intestinal obstruction, incarceration or strangulation. In this case series we compare the incidence of these rare presentations of hernias with world literature and to warn surgeons not to cut the obstructing band in cases of internal hernias. In this case series, we review the clinical details of 7 rare presentations of hernia, who presented with various types of hernias to a tertiary care centre in Kerala over a period of one year. Of these 7 cases 6 cases were internal hernias (3 left paraduodenal hernias, 2 transmesentric hernias, and 1 pericaecal hernia) and a case of spigelian hernia above the level of umbilicus. All of them presented as acute abdomen in the emergency department. Among these 7 cases, only one case was diagnosed preoperatively. Three patients had bowel gangrene and had to undergo resection- anastomosis of the bowel. The survival rate among these cases was 100% as compared to 50% in the world literature if they had been left untreated. Even though internal hernias are a rare entity, we need to have it as a differential diagnosis in case of intestinal obstruction, in a previously non-operated abdomen.

  13. Desmoid tumor in Gardner's Syndrome presented as acute abdomen

    Hatzimarkou, Andreas; Filippou, Dimitrios; Papadopoulos, Vasilios; Filippou, Georgios; Rizos, Spiros; Skandalakis, Panagiotis

    2006-01-01

    Background Gardner's syndrome can occasionally be complicated with intra-abdominal desmoid tumor. These tumors usually remain asymptomatic but can exhibit symptoms due to intestinal, vascular and ureteral compression and obstruction. Case presentation A rare case of a 41-year-old male patient with Gardner's syndrome complicated with intra-abdominal desmoid tumor, which first presented as acute abdomen, is presented. Conclusion Extra-abdominal manifestations of Gardner's syndrome along with a palpable abdominal mass would raise suspicion for the presence of a desmoid tumor in the majority of cases. In life-threatening cases, surgical treatment should be considered as a palliative approach, though the extent of excision remains debatable PMID:16569244

  14. Desmoid tumor in Gardner's Syndrome presented as acute abdomen

    Rizos Spiros

    2006-03-01

    Full Text Available Abstract Background Gardner's syndrome can occasionally be complicated with intra-abdominal desmoid tumor. These tumors usually remain asymptomatic but can exhibit symptoms due to intestinal, vascular and ureteral compression and obstruction. Case presentation A rare case of a 41-year-old male patient with Gardner's syndrome complicated with intra-abdominal desmoid tumor, which first presented as acute abdomen, is presented. Conclusion Extra-abdominal manifestations of Gardner's syndrome along with a palpable abdominal mass would raise suspicion for the presence of a desmoid tumor in the majority of cases. In life-threatening cases, surgical treatment should be considered as a palliative approach, though the extent of excision remains debatable

  15. Varicella Zoster Infection: A Rare Cause of Abdominal Pain Mimicking Acute Abdomen

    Olmez, Deniz; Boz, Alper; Erkan, Nazif

    2009-01-01

    Varicella zoster is an acute viral infection that results from reactivation of a latent varicella zoster virus. It usually occurs in adult population and immune compromised patients. It rarely occurs in healthy children. Here we present a 14 years old male with varicella zoster that had abdominal pain mimicking acute abdomen to alert others who are consulted for the differentiation of acute abdomen and others who may be consulted for pain management. Keywords Varicella zoster; Abdominal pain PMID:22461879

  16. Varicella Zoster Infection: A Rare Cause of Abdominal Pain Mimicking Acute Abdomen

    Olmez, Deniz; Boz, Alper; Erkan, Nazif

    2009-01-01

    Varicella zoster is an acute viral infection that results from reactivation of a latent varicella zoster virus. It usually occurs in adult population and immune compromised patients. It rarely occurs in healthy children. Here we present a 14 years old male with varicella zoster that had abdominal pain mimicking acute abdomen to alert others who are consulted for the differentiation of acute abdomen and others who may be consulted for pain management. Keywords Varicella zoster; Abdominal pain

  17. Perforated Duodenal Ulcer –A Rare Cause of Acute Abdomen in Pregnancy

    Goel, Bharti; Rani, Jyotsna; Huria, Anju; Gupta, Pratiksha; Dalal, Usha

    2014-01-01

    Acute abdomen during pregnancy is a medico-surgical emergency demanding concerted, synchronized specialties approach of obstetrician, surgeon and gastroenterologist. Duodenal perforation is one of the rarer causes of acute abdomen in pregnancy. Here, we report a case of duodenal perforation with peritonitis in third trimester of pregnancy requiring surgical management. Our aim of reporting this case is to stress the physicians to keep the differential of duodenal perforation also in mind whil...

  18. COMPARISON OF CLINICAL JUDGMENT AND RADIOLOGICAL CORRELATION IN EVALUATION OF ACUTE ABDOMEN

    Karunya Lakshmi; Abubacker Sulaiman; Ashwin Kumar; Shriranjani

    2015-01-01

    BACKGROUND: The aim of the study is to assess the accuracy of clinical examination in acute abdomen with radiological imaging. DESIGN: Retrospective trail . INTRODUCTION: Acute abdominal pain may be caused by a variety of conditions ranging from benign self - limiting disease to surgical emergencies. Accurate diagnoses of acute abdominal pain require detailed patient history, thorough physical examination, laboratory tests and diagnostic ima ging. Tak...

  19. Non Obstetric Acute Abdomen in Pregnancy – An Experience from Kashmir

    Ajaz Ahmad Rather

    2013-11-01

    Full Text Available Objectives: The objective of this study was to study the profile of pregnant patients who were managed by general surgical unit of a referral hospital in Kashmir valley for non obstetric causes of acute abdomen over a period of seven years. Methods: The study was done retrospectively after acquiring data from databank related to pregnant patients managed for acute abdomen over a period of seven years (from January 2006 to December 2012 in the general surgical department of the medical college of SK Institute of Medical Sciences, Srinagar, Kashmir. Results: 49 non obstetric acute abdomen were managed in pregnant females over a period of seven years. 23 (46.9% patients reported with a delay of more than 12 hours and 34 (69.4% cases underwent surgical interventions. Appendicitis was the commonest cause of acute abdomen and Ultrasonography was the only imaging modality utilized. Only 3 cases had preterm labor. Conclusions: Acute abdomen in pregnant females should be assessed with high level of suspicion .Delay in presentation and intervention leads to adverse outcomes.

  20. Obstructive acute abdomen: reviewing important points; Abdome agudo obstrutivo: revisando pontos fundamentais

    Francisco, Marina Celli; Abud, Thiago Giansante; Reibscheid, Samuel; Szejnfeld, Jacob; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: nana_celli@hotmail.com; Neves, Felipe Trentin [Hospital Ipiranga, Sao Paulo, SP (Brazil); Colleone Neto, Ramiro [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

    2008-07-01

    The obstructive acute abdomen is a common presentation, for which safe and effective management depends on a fast and accurate diagnosis. Conventional radiograph remains the first choice among the imaging exams because of its availability, low cost and the possibility to be done serially to follow the patient's clinical progression. The ultrasonography does not require ionizing radiation. It is a dynamic and in realtime exam. Computed tomography is used increasingly due to the provision of essential diagnostic information not apparent from radiographs, such as the confirmation of the obstruction, degree and place of the occlusion, presence of ischemia as well as the causes of the obstruction. Magnetic resonance imaging has presented great technological advances and it may play a role in the future of obstructive acute abdomen diagnosis. The objective of this pictorial essay is to review the different imaging techniques used on diagnosing obstructive acute abdomen. (author)

  1. Diagnostic difficulty in mesenteroaxial gastric volvulus— A rare cause of acute abdomen in a child

    Saifullah Khalid; Samreen Zaheer; Mohd Khalid,; Ekram Ullah; Sarfaraz A. Khan

    2014-01-01

    Gastric volvulus as a cause of acute abdomen is uncommon, especially in children. This increases the likelihood of missed or delayed diagnosis leading to increased morbidity and mortality. Acute gastric volvulus is a potentially life- threatening condition and timely diagnosis and management significantly reduces the chances of complications. We report a case of an adolescent male child, who presented to the casualty with acute abdominal pain in the epigastric region, associated w...

  2. When and why use unenhanced computed tomography in patients with acute abdomen

    The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed. (author)

  3. Acute abdomen: An uncommon presentation of a common intestinal nematode.

    Rizvi, Ghazala; Rawat, Vinita; Pandey, Hari Shankar; Kumar, Mukesh

    2015-01-01

    Enterobius vermicularis is a common parasitic infection of the intestine which is rarely symptomatic. It is unusual to find it in the wall or outside the gastrointestinal tract. We encountered five such cases where we observed the worm outside the lumen of the intestine. The pathological findings and the clinical features are discussed. This case series highlight that E. vermicularis can be the cause of pathology within the abdomen and should be considered in the differential diagnosis of some commonly encountered abdominal conditions. PMID:26629456

  4. ACUTE ABDOMEN SECONDARY TO NEOPLASM IN A HIV/SIDA PATIENT (IN SPANISH

    Herrera-Lomónaco Sandra

    2014-06-01

    Full Text Available Introduction: patients with HIV/SIDA might present as complications, symptoms of acute abdomen that could be of infectious, neoplasic or idiopathic etiology. The frequency of epithelial, mesenchymal and hemato-lymphoid neoplasm, tend to be increased in the HIV/SIDA patients. Case report: a 23-year-old male with diagnosis of HIV since three years ago and without regular antiretroviral treatment due to voluntary suspension. He presented symptoms of two days of evolution consistent in diarrhea, pain in right iliac region, vomiting and clinical signs of peritoneal irritation. Then, with diagnosis of acute abdomen secondary to acute appendicitis, he was carried to laparotomy. During the surgery procedure, intestinal perforation in the ileocecal region was found. Debridement, enterorrhaphy and appendicectomy were done, with adequate postoperative improvement. The histopathological diagnosis was Diffuse Large-B-cell Non-hodgkin Lymphoma of the ileocecal region. He was discharged for the oncological and integral management of the HIV/SIDA. Conclusion: the Diffuse Large-B-cell Non-Hodgkin Lymphoma is the type of lymphoma most frequently reported in association with the HIV/SIDA. The presented case is unusual, where the intestinal perforation caused acute abdomen imitating appendicular event. The lack of use of antiretroviral treatment probably contributed to the development and evolution of the Diffuse Large-B-cell Non-Hodgkin Lymphoma. Rev. cienc.biomed.2014;5(2:351-356. KEYWORDS Acute abdomen, Neoplasm, Non-Hodgkin lymphoma, HIV.

  5. Radiological interventional procedures for the acute abdomen; Radiologisch-interventionelle Massnahmen beim akuten Abdomen

    Trumm, C.; Hoffmann, R.T.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2010-03-15

    In patients with acute thrombo-embolic occlusion of the superior mesenteric artery, catheter-assisted thrombolytic therapy represents a procedure of increasing importance in addition to surgery and intensive care treatment. The thrombolytic drugs utilized for this purpose are urokinase, streptokinase and recombinant tissue plasminogen activator (rtPA). Therapeutic embolization is predominantly used in the treatment of arterial bleeding from the gastro-intestinal tract, the liver, the intestines (due to an aneurysm or vascular malformation) and in bleeding from intestinal anastomoses. Polyvinyl alcohol particles, embospheres, gelfoam and microcoils can be utilized as embolic agents. Percutaneous transhepatic cholangiodrainage and stent implantation are applied in patients with biliary obstructions caused by inoperable tumors of the gall bladder or bile ducts, of the pancreatic head or duodenum and by metastases located in the liver parenchyma or hepatic hilum. Image-guided percutaneous drainage is a valuable option in the management of abscesses in the peritoneal cavity; less common indications are lymphoceles, biliomas, urinomas, hematomas, necrosis and pseudocysts. (orig.) [German] Die kathetergestuetzte thrombolytische Therapie stellt im Kontext einer chirurgischen und intensivmedizinischen Versorgung von Patienten mit thrombembolisch bedingter mesenterialer Ischaemie ein unterstuetzendes Behandlungsverfahren von zunehmender Bedeutung dar. Als thrombolytische Agenzien werden Urokinase, Streptokinase und der rekombinante Gewebeplasminogenaktivator (rtPA) verwendet. Die therapeutische Embolisation kommt neben der endoskopischen und chirurgischen Blutungsstillung bei arteriellen Blutungen im Gastrointestinaltrakt, aus der Leber, im Darm (als Folge eines Aneurysmas oder einer vaskulaeren Malformation) sowie bei blutenden intestinalen Anastomosen zum Einsatz. Zur Embolisation koennen Polyvinylalkoholpartikel, Embosphaeren, Gelfoam oder Mikrocoils verwendet werden. Die

  6. Detection of Hyperechoic Inflammatory Fatty Tissue during Transabdominal Ultrasonography: Diagnostic Role in Acute Abdomen

    Park, Seong Jin; Lee, Hae Kyung; Yi, Bum Ha [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kim, Hyun Cheol [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2005-12-15

    To assess the incidence and diagnostic role of hyperechoic inflammatory fatty tissue (HIFT) in transabdominal ultrasonography (TAUS) for acute abdomen. With TAUS, we examined 98 consecutive patients (68 women, 30 men: mean age, 32 years: age range, 4-84 years) having acute abdominal pain. We examined the abdomen and pelvis by TAUS to determine the cause of acute abdomen, to check for the presence of HIFT, and to investigate whether it was easier and earlier to find the main cause and HIFT presence. We also prospectively evaluated the shape, distribution, and diagnostic role of HIFT. Final diagnoses consisted of 47 cases of acute appendicitis, 14 of enterocolitis, 13 of PID, 7 of gynecological hemoperitoneum, 5 of colonic diverticulitis, 3 of ovarian torsion, 2 of colon perforation, 2 of only presence of non-specific HIFT, 1 of mesenteric lymphadenitis, and 4 of normal. HIFT were seen in 67 patients (68.4%), including 44/47(93.6%) of acute appendicitis, 2/14(14.3%) of enterocolitis, 11/13(84.6%) of PID, 0/7 of hemoperitoneum, 5/5 of colonic diverticulitis, 0/3 of ovarian torsion, 2/2 of colon perforation, and 1/1 mesenteric lymphadenitis. HIFT were detected earlier than the main cause in 17/44 of acute appendicitis, 6/11 of PID, and 4/5 of colonic diverticulitis. In acute appendicitis, the shape of HIFT appeared as fat thickening along the mesoappendix in 12/44, fat thickening along the mesoappendix and the opposite side in 13/44, fat encircled appendix in 6/44, fatty mass wrapping abscess in 10/44, and diffuse intraperitoneal fat thickening in 3/44. In PID, HIFT appeared as a single fatty mass in the pelvis and lower abdomen in 6/11, wrapping pelvic abscess in 2/11, and multiple fatty masses scattered in abdomen and pelvis in 3/11. In colonic diverticulitis, all 5 cases appeared as hyperechoic hemispheric mass covering the inflamed diverticulum. HIFT are a usual US finding in patients with acute abdomen, particularly on abdominal and pelvic inflammatory conditions

  7. Infarction of a polyp within a mesenteric cyst: An unusual presentation as an acute abdomen

    Gon Sonia

    2010-01-01

    Full Text Available A case of mesenteric cyst in a five-year-old male child who presented with acute abdomen due to an infarcted polyp present within the cyst is reported. To the best of our knowledge, such an event has never been reported in the literature previously.

  8. Spontaneous rupture of pyometra manifesting as an acute abdomen: a case report.

    Singh, Alpana; Mundhra, Rajlaxmi; Agarwal, Tannavi; Radhakrishnan, Gita

    2015-07-01

    Spontaneous perforation of pyometra is a rare entity with a reported incidence in the range of 0.01-0.05%. The clinical picture is similar to peritonitis arising from intestinal perforation and commonly the correct diagnosis is only made perioperatively. We report a case in an elderly postmenopausal woman presenting with an acute abdomen. PMID:25999354

  9. Hereditary angioderma: an uncommon cause of acute abdomen. Abdominal computed tomography and ultrasound findings

    We present an uncommon case of acute abdomen in a patient with hereditary angioderma. The ultrasound and CT findings described may suggest this diagnosis, thus avoiding useless surgical interventions in patients in whom the disease has not been previously diagnosed. (Author) 19 refs

  10. Ultrasound of the acute abdomen performed by surgeons in training

    Eiberg, J.P.; Grantcharov, T.P.; Eriksen, J.R.;

    2008-01-01

    perform valid abdominal ultrasound examinations of patients referred with acute abdominal pain. METHODS: Patients referred with acute abdominal pain had an ultrasound examination by a surgeon in training as well as by an experienced consultant radiologist whose results served as the gold standard. All...... participating surgeons were without any pre-existing ultrasound experience and received one hour of introduction to abdominal ultrasound. RESULTS: Thirty patients underwent 40 surgeon performed and 30 radiologist performed ultrasound examinations. Regarding gallstone and cholecholecystitis the sensitivity...

  11. Two Cases of Acute Abdomen after an Intravitreal Injection of Bevacizumab

    Onoda, Yasutaka; Shiba, Tomoaki; Hori, Yuichi; Maeno, Takatoshi; Takahashi, Mao

    2015-01-01

    We report on a patient with ischemic colitis and another with paralytic ileus, both of whom experienced an acute abdomen after intravitreal injection of bevacizumab (IVB). Case 1 was a 78-year-old woman. Her medical history included surgery for colon carcinoma 10 years earlier. The patient developed acute severe abdominal pain and nausea the day after IVB for retinal vein occlusion with macular edema, and massive lower gastrointestinal bleeding occurred. Ischemic colitis was diagnosed. Case 2...

  12. Bilateral ovarian teratoma presenting with a clinical picture of acute abdomen

    Massimiliano Rocchietti March

    2012-12-01

    Full Text Available We describe the case of a 30-year-old patient with bilateral mature cystic teratoma (MCT of the ovaries. The patient had been complaining of mild abdominal pain for several months that had suddenly become severe. Early diagnosis at the emergency room was acute appendicitis, but definitive diagnosis was bilateral ovarian teratoma. We therefore recommend considering ovarian teratomas in the differential diagnosis of acute abdomen in young women in an emergency care setting.

  13. Spontaneous Spleen Rupture in a Teenager: An Uncommon Cause of Acute Abdomen

    Verroiotou Maria

    2013-01-01

    Full Text Available Spontaneous spleen rupture is a rare complication of infectious diseases and it can become a potentially life-threatening condition if not diagnosed in time. A 17-year-old Greek female presented to the ER due to acute abdominal pain, mainly of the left upper quadrant. She had no recent report of trauma. The patient was pale, her blood pressure was 90/70 mmHg, and her pulse was 120 b/min. Clinical examination of the abdomen revealed muscle contraction and resistance. The patient was submitted to an ultrasound of the upper abdomen and to a CT scanning of the abdomen that revealed an extended intraperitoneal hemorrhage due to spleen rupture. Due to the patient’s hemodynamic instability, she was taken to the operation room and splenectomy was performed. Following a series of laboratory examinations, the patient was diagnosed to be positive for current cytomegalovirus infection. The postoperative course was uneventful, and in a two year follow-up the patient is symptom-free. Spontaneous spleen rupture due to Cytomegalovirus infection is a rare clinical entity, described in few case reports in the world literature and should always be taken into consideration in differential diagnosis of acute abdomen, especially in adolescents with no recent report of trauma.

  14. A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

    Ender Özer

    2015-03-01

    Full Text Available Idiopathic isolated cecal necrosis is a clinical problem characterized by right-sided inferior abdominal pain. It is rarely seen, develops due to decreased blood flow to the colon and, imitates acute appendicitis. Its clinical signs are similar to many illnesses causing sensitivity in the right inferior quadrant and, the diagnosis is generally determined during surgery. An 86-year-old male patient presented with the complaints of abdominal pain, trichiniasis, nausea and vomiting. Surgical intervention was decided when physical examination and laboratory results were taken into consideration. After diagnostic laparoscopy, right hemicolectomy was performed because of cecal necrosis. While the mortality and morbidity rates for ischemic bowel disease are high, prognosis for early diagnosed patients with isolated cecal necrosis is better, provided that timely surgical treatment is decided.

  15. Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen.

    Colak, Tahsin; Olmez, Tolga; Turkmenoglu, Ozgur; Dag, Ahmet

    2013-01-01

    Gossypiboma, an infrequent surgical complication, is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. In this case report, we describe gossypiboma in the abdominal cavity which was detected 14 months after the hysterectomy due to acute abdominal pain. Gossypiboma was diagnosed by computed tomography (CT). The CT findings were a rounded mass with a dense central part and an enhancing wall. In explorative laparotomy, small bowel loops were seen to be perforated due to inflammation of long standing gossypiboma. Jejunal resection with end-to-end anastomosis was performed. The patient was discharged whithout complication. This case was presented to point to retained foreign body (RFB) complications and we believed that the possibility of a retained foreign body should be considered in the differential diagnosis of who had previous surgery and complained of pain, infection, or palpable mass. PMID:24288645

  16. Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen

    Loabat Geranpayeh

    2006-01-01

    Full Text Available Spontaneous perforation of the uterus is rare, its incidence being about 0.01%–0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, liver, or gallbladder. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, a perforated pyometra should therefore also be considered when elderly women present with acute abdominal pain.

  17. Non Obstetric Causes and Presentation of Acute Abdomen among the Pregnant Women.

    Monoarul Haque

    2014-09-01

    Full Text Available To identify the non-obstetric causes and presentation of acute abdomen among pregnant women.This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS version 11.5 (SPSS, Inc., Chicago, IL, USA.Mean age of participants was 25±4 years. Our findings showed that 81% were Muslim, 67% were lower middle income group, as well as 47% completed primary level of education. The results revealed that 28% had biliary ascariasis, 24% had peptic ulcer disease and 10% had lower urinary tract infection. We also found that 6% had acute pyelonephritis, 6% had acute gastroenteritis, 6% had acute cholecystitis, 6% had acute appendicitis, 2% had acute pancreatitis, 3% had choledocolithiasis, 2% had ovarian solid mass, 2% had twisted ovarian cyst, 4% had renal colic, and 1% had renal calculus. In non-obstetrical presentation of acute abdomen, the study found that 84% of respondents complained their pain lasting more than 24 hours. Besides, half of respondents felt pain in epigastrium and right hypochondrium. Cramping, prickling and aching type of pain were more, while 66% suffered from continuous pain. Our results also showed that 73% did not explain any aggravating factor and relieving factor, and the rest said food, fasting state and position change aggravated pain as well as relieved pain.The study concludes that precise diagnosis of the acute abdomen in pregnant women by continual updating of abdominal assessment knowledge, and clinical skills is necessary in the management of abdominal pain in obstetric settings.

  18. Acute Abdomen in Interstitial Ectopic Pregnancy, An Emergency Laparoscopic Treatment

    E. Picardo

    2014-01-01

    Full Text Available The present case report demonstrates a laparoscopic approach to treat interstitial cornual pregnancy in emergency. Interstitial ectopic pregnancy develops in the uterine portion of the fallopian tube which accounts for 2–4% of all ectopic pregnancies and has the potential to cause life-threatening hemorrhage at rupture. The mortality rate for a woman diagnosed with such a pregnancy is 2–2.5%. Diagnosis of interstitial pregnancy is made by ultrasound. In this case a 32 year-old woman, Gravida 0 Parity 0 Living 0 Ectopic 1, presented to the emergency obstetrical room complaining acute abdominal pain. There was a history of 10 weeks of pregnancy but no pelvic ultrasound scan was performed before the access. A transvaginal ultrasound scan immediately performed demonstrated a gestational sac with viable fetus in the right interstitial region. Moreover there was an ultrasound evidence of hemoperitoneum. She was transferred to the operating room and an emergency laparoscopy surgery was performed. The postoperative course was uneventful and the patient was discharged two days after the surgery. Interstitial pregnancies present a difficult management problem with no absolute standard of care in literature. Laparoscopic technique is under study with favorable results. For our personal point of view a treatment via laparoscopy could be performed both in elective and in emergency cases.

  19. Spontaneous perforation of pyometra presenting as acute abdomen: a rare condition with considerable mortality.

    Yin, Wan-Bin; Wei, Yan-Hua; Liu, Guang-Wei; Zhao, Xiao-Tang; Zhang, Mao-Shen; Hu, Ji-Lin; Zhang, Nan-Yang; Lu, Yun

    2016-04-01

    Pyometra is an uncommon and potentially lethal disease that occurs mainly in postmenopausal women. Spontaneous perforation of pyometra presenting as acute abdomen is an extremely rare complication of pyometra, and the patients are always admitted to the emergency department. An additional case is reported herein. In addition, a literature review was performed between 1949 and 2015. A correct preoperative diagnosis was made in 21.05% of all the cases. Of all cases, 25.71% were associated with malignant disease. The mortality rate of spontaneous perforation of pyometra is 31.88%. Thus, it should be considered in the differential diagnosis of acute abdomen in elderly women. Total hysterectomy along with bilateral salpingo-oophorectomy is the preferred treatment. Administration of broad-spectrum antibiotics and postoperative intensive care support are essential to reduce the high mortality. PMID:26365324

  20. Diseases of the hepatobiliary system as a cause of acute abdomen; Erkrankungen des hepatobiliaeren Systems als Ursache des akuten Abdomens

    Schima, W.; Eisenhuber-Stadler, E. [Krankenhaus Goettlicher Heiland, Abteilung fuer Radiologie und bildgebende Diagnostik, Wien (Austria); Koelblinger, C.; Kulinna-Cosentini, C.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2010-03-15

    Diseases of the liver and biliary system are common causes of acute abdominal pain and gallstone disease predisposes to cholecystitis and cholangiolithiasis. Sonography is the method of choice for the assessment of cholecystitis, whereas magnetic resonance cholangiopancreaticography (MRCP) is the standard technique to detect stones in the common bile duct. Multi-detector computed tomography (MDCT) is ideal for detection of associated complications, including abscess formation and gall stone ileus. Pyogenic, amebic and fungal liver abscesses are reliably diagnosed with MDCT which can also be used for interventional radiologic therapy of liver abscesses by percutaneous aspiration or drainage procedures. The second most common cause of liver rupture after blunt trauma is spontaneous rupture of hypervascular liver tumors (i.e., HCC, adenoma, angiosarcoma) and due to medical procedures. Multi-phase contrast-enhanced MDCT can reliably detect active bleeding to guide further therapy in these cases. (orig.) [German] Die Cholezystitis ist eine der haeufigsten Ursachen fuer ein akutes Abdomen. Waehrend die Sonographie die Methode der Wahl zum Nachweis einer Cholezystolithiasis und Cholezystitis ist, steht bei der Entwicklung von Komplikationen die Multidetektorcomputertomographie (MDCT) diagnostisch im Vordergrund. Die Magnetresonanzcholangiopankreatikographie (MRCP) hat einen hohen Stellenwert bei der Abklaerung der Cholangiolithiasis, v. a. bei der Differenzialdiagnose zu anderen Ursachen einer Cholestase. Die Diagnose bakterieller, Amoeben- oder fungaler Leberabszesse kann mittels Sonographie oder MDCT rasch gestellt werden, wobei diese Methoden auch fuer die interventionelle radiologische Therapie von Leberabszessen (Punktion oder Drainage) gut geeignet sind. Die mehrphasige, kontrastmittelverstaerkte MDCT ist die Methode der Wahl fuer den Nachweis von Leberinfarkten oder -rupturen, da bei diesen Erkrankungen bzw. Verletzungsfolgen die Darstellung der

  1. Delayed diagnosis of a heterotopic pregnancy as a cause of acute abdomen: A case report

    Ayan, Fatma Türkan; Çakmak, Bülent

    2013-01-01

    Introduction: Heterotopic pregnancy is a life threating condition of intrauterine and extrauterine gestations which occur at the same time. We report a delayed diagnosed case of heterotopic pregnancy. Case: A 31 year-old primigravida was referred to our Emergency Gynaecology Service complicated by acute abdomen. She had been treated with clomiphene citrate and on admission intrauterine a missed abortus of about 8 weeks complicated by a large subchorionic hematoma was detected. Emergency lap...

  2. Predictive value of POSSUM score in surgery of acute abdomen in cirrhotic patients

    Banu, P; Popa, F; Constantin, VD; Balalau, C

    2013-01-01

    Abstract Introduction: As liver cirrhosis has an increasing incidence in the general population and the life expectancy for these patients has increased, surgery procedures practiced for acute abdomen in such category of patients are more frequent. Aim: To evaluate the predictive value of POSSUM score in cirrhotic patients undergoing abdominal surgery in emergency cases. Material and method: A prospective study based on 115 consecutive patients with liver cirrhosis hospitalized and operated i...

  3. Huge bilateral polycystic kidneys with suspicion of malignancy, recurrent bleeding in cysts, and acute abdomen

    Bhatty, TAN; Moazin, MS; Haque, R.

    2012-01-01

    We present a case of huge bilateral polycystic kidneys, with suspicion of malignancy and repeated admissions with acute abdomen, secondary to bleeding in cysts, and anaemia, requiring affected side nephrectomy. Key message Autosomal dominant polycystic kidney disease (ADPKD) mostly ends up with end stage renal disease (ESRD), requiring haemodialysis, with increased risk of malignancy and enlargement of kidneys with its associated complications, mostly dealt with conservatively, except maligna...

  4. Spontaneous Perforation of Pyometra Presenting as Acute Abdomen and Pneumoperitoneum Mimicking Those of Gastrointestinal Origin

    Takahiro Yamada; Nanako Ando; Naoshi Shibata; Motomu Suitou; Hiroshi Takagi; Kazutoshi Matsunami; Satoshi Ichigo; Atsushi Imai

    2015-01-01

    Gastrointestinal (GI) perforation accounts for over 90% of acute abdomen and pneumoperitoneum. The presence of pneumoperitoneum secondary to spontaneously perforated pyometra is an interesting yet confusing finding given the absence of gastrointestinal (GI) perforation, because pyometra is more common in postmenopausal women. We report an instructive case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 70-year-old postmenopausal female was admitted to surgical emergenc...

  5. Analysis of the computed tomography in the acute abdomen; Analise da tomografia computadorizada no abdome agudo

    Hochhegger, Bruno [Complexo Hospitalar Santa Casa de Porto Alegre, RS (Brazil); Moraes, Everton [Universidade Federal de Santa Maria (UFSM), RS (Brazil); Haygert, Carlos Jesus Pereira; Antunes, Paulo Sergio Pase [Hospital Universitario de Santa Maria, RS (Brazil); Gazzoni, Fernando [Pontificia Universidade Catolica de Porto Alegre (PUC-RS), Porto Alegre, RS (Brazil). Hospital Sao Lucas; Andrade, Rubens Gabriel Feijo [Fundacao Universitaria de Cardiologia de Porto Alegre, RS (Brazil). Inst. de Cardiologia; Bueno, Leticia Rossi [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil); Lopes, Luis Felipe Dias [Universidade Federal de Santa Maria (UFSM), RS (Brazil). Dept. de Estatistica]. E-mail: brunorgs@pop.com.br

    2007-07-01

    Introduction: This study tends to test the capacity of the computed tomography in assist in the diagnosis and the approach of the acute abdomen. Material and method: This is a longitudinal and prospective study, in which were analyzed the patients with the diagnosis of acute abdomen. There were obtained 105 cases of acute abdomen and after the application of the exclusions criteria were included 28 patients in the study. Results: Computed tomography changed the diagnostic hypothesis of the physicians in 50% of the cases (p < 0.05), and the confidence index in 85.71% of the cases (p 0.014). Computed tomography also altered the management in 46.43% of the cases (p > 0.05), where 78.57% of the patients had surgical indication before computed tomography and 67.86% after computed tomography (p = 0.0546). The index of accurate diagnosis of computed tomography, when compared to the anatomopathologic examination and the final diagnosis, was observed in 82.14% of the cases (p = 0.013). When the analysis was done dividing the patients in surgical and nonsurgical group, were obtained an accuracy of 89.28% (p 0.0001). The difference of 7.2 days of hospitalization (p = 0.003) was obtained compared with the mean of the acute abdomen without use the computed tomography. Conclusion: The computed tomography is correlative with the anatomopathology and has great accuracy in the surgical indication, associated with the capacity of increase the confident index of the physicians, reduces the hospitalization time, reduces the number of surgeries and is cost-effective. (author)

  6. Melioidosis as a cause of acute abdomen in immuno-competent male from eastern India.

    Karuna, Tadepalli; Khadanga, Sagar; Dugar, Dharmendra; Sau, Biyanka; Bhoi, Priyadarshini

    2015-01-01

    Though melioidosis is rare in India, it has gained importance as one of the most potent emerging infections. In India, the cases have been under-reported because of the lack of awareness. The majority of cases present with multifocal pyogenic infections with septicemia. We present an unusual case of melioidosis presenting as acute intestinal perforation. The organism was ceftazidime resistant, and we successfully treated the case with imipenem and doxycyclin. This case highlights ruling out the possibility of melioidosis in acute abdomen and existence of ceftazidime resistant cases in India. PMID:25949062

  7. OHVIRA syndrome presenting with acute abdomen: a case report and review of the literature.

    Gungor Ugurlucan, Funda; Bastu, Ercan; Gulsen, Gokce; Kurek Eken, Meryem; Akhan, Suleyman Engin

    2014-01-01

    Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) or Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital urogenital anomaly. A 13-year-old female presented with acute abdominal pain and dysmenorrhea. Ultrasonography and magnetic resonance imaging showed uterus didelphys, hematometrocolpos, obstructed hemivagina, and right renal agenesis. Hemivaginal septal resection and anastomosis between the obstructed hemivagina and the normal vagina was tried, but it was not possible. Unilateral hysterectomy was performed. HWW syndrome may present with acute abdomen and is usually treated with vaginal septum resection and drainage of the hematometrocolpos. PMID:24461469

  8. An unusual case of intraabdominal abscess and acute abdomen caused by axial torsion of a Meckel's diverticulum

    İhsan Yıldız

    2016-03-01

    Conclusion: Although MD is known as a pediatric disease, it is likely to occur in adults as well. Axial torsion of Meckel's diverticulum should be kept in mind the adults presenting with symptoms of acute abdomen.

  9. The role of US examination in the management of acute abdomen.

    Mazzei, Maria Antonietta; Guerrini, Susanna; Cioffi Squitieri, Nevada; Cagini, Lucio; Macarini, Luca; Coppolino, Francesco; Giganti, Melchiore; Volterrani, Luca

    2013-07-15

    Acute abdomen is a medical emergency, in which there is sudden and severe pain in abdomen of recent onset with accompanying signs and symptoms that focus on an abdominal involvement. It can represent a wide spectrum of conditions, ranging from a benign and self-limiting disease to a surgical emergency. Nevertheless, only one quarter of patients who have previously been classified with an acute abdomen actually receive surgical treatment, so the clinical dilemma is if the patients need surgical treatment or not and, furthermore, in which cases the surgical option needs to be urgently adopted. Due to this reason a thorough and logical approach to the diagnosis of abdominal pain is necessary. Some Authors assert that the location of pain is a useful starting point and will guide a further evaluation. However some causes are more frequent in the paediatric population (like appendicitis or adenomesenteritis) or are strictly related to the gender (i.e. gynaechologic causes). It is also important to consider special populations such as the elderly or oncologic patients, who may present with atypical symptoms of a disease. These considerations also reflect a different diagnostic approach. Today, surely the integrated imaging, and in particular the use of multidetector Computed Tomography (MDCT) has revolutionised the clinical approach to this condition, simplyfing the diagnosis but burdening the radiologists with the problems related to the clinical management. However although CT emerging as a modality of choice for evaluation of the acute abdomen, ultrasonography (US) remains the primary imaging technique in the majority of cases, especially in young and female patients, when the limitation of the radiation exposure should be mandatory, limiting the use of CT in cases of nondiagnostic US and in all cases where there is a discrepancy between the clinical symptoms and negative imaging at US. PMID:23902801

  10. Rare cause of acute surgical abdomen with free intraperitoneal air: Spontaneous perforated pyometra. A report of 2 cases

    Lim, Siew Fung; Lee, Song Liang; Chiow, Adrian Kah Heng; Foo, Chek Siang; Wong, Andrew Siang Yih; Tan, Su-Ming

    2012-01-01

    Summary Background: The acute abdomen accounts for up to 40% of all emergency surgical hospital admissions and a large proportion are secondary to gastrointestinal perforation. Studies have shown the superiority of the abdominal CT over upright chest radiographs in demonstrating free intraperitoneal air. Spontaneous perforated pyometra is a rare cause of the surgical acute abdomen with free intraperitoneal air. Only 38 cases have been reported worldwide. Case Report: We report 2 cases of spon...

  11. Diagnostic difficulty in mesenteroaxial gastric volvulus— A rare cause of acute abdomen in a child

    Saifullah Khalid

    2014-05-01

    Full Text Available Gastric volvulus as a cause of acute abdomen is uncommon, especially in children. This increases the likelihood of missed or delayed diagnosis leading to increased morbidity and mortality. Acute gastric volvulus is a potentially life- threatening condition and timely diagnosis and management significantly reduces the chances of complications. We report a case of an adolescent male child, who presented to the casualty with acute abdominal pain in the epigastric region, associated with vomiting and epigastric belching and was being managed with a clinical diagnosis of acute pancreatitis. Eventration of left hemi-diaphragm was missed and gastric volvulus was not suspected in the initial differential diagnosis leading to delay in the diagnosis and management. The child was diagnosed using upper gastrointestinal barium study and was immediately operated upon with favourable outcome.

  12. Evaluation of the usefulness of computed tomography on diagnosis and management of acute abdomen

    We evaluated the usefulness of computed tomography (CT) in diagnosing and managing acute abdomen. Subjects were 91 patients admitted complaining of acute abdominal pain and divided into two groups-those undergoing CT within 24 hours of admission (emergency CT group, n=70), those without CT (Non-CT group, n=21). The emergency CT group was subdivided into those with bowel obstruction (bowel obstruction group, n=29), those with acute appendicitis and other diseases necessitating differential diagnosis (appendicitis group, n=36), those with perforation of the digestive tract (perforation group, n=4), and other disease (n=1). We evaluated the accuracy of admission diagnosis retrospectively in each group. The final diagnosis of the bowel obstruction group was adhesive bowel obstruction in 16, colon cancer in 5, external hernia in 3 and other in 5. That in the appendicitis group was acute appendicitis in 25, colonic diverticulitis in 3, pelvic inflammatory disease in 3, ovarian hemorrhage in 2 and other in 5. The origin of perforation in the perforation group was upper digestive tract in 2 and lower digestive tract in 2. The sensitivity, specificity and accuracy of admission diagnosis in the emergency CT group was 91.1, 100 and 91.4%, respectively. The accuracy of admission diagnosis was 96.5% in the bowel obstruction group, 88.9% in the appendicitis group and 75.9% in the perforation group. Patients who could not be diagnosed precisely consisted of 6 patients in the emergency CT group. Those who could not be diagnosed precisely included 3 with pericecal abscess, 1 with acute appendicitis, 1 with stercoral perforation of the sigmoid colon and 1 with impacted bezoar in the small intestine. Evaluated retrospectively, 4 patients were able to be diagnosed by CT on admission. In diagnosis of acute abdomen, CT was useful in differential diagnosis of bowel obstruction and acute appendicitis, detection of fine free air, and determine of perforated sites. Emergency CT was thus

  13. An unusual cause of the acute abdomen: computed tomography angiography findings of the intestinal intramural hematoma

    Full text: Introduction: The intestinal intramural hematoma is a rare abdominal emergency condition resulting from submucosal or subserosal hemorrhage. The various causes of this condition are anticoagulant therapy, trauma, surgery, biopsy and spontaneous. The most common cause of this condition is blunt abdominal trauma. Objectives and tasks: In this report we aimed to present computed tomography (CT) angiography findings of the intestinal wall hematoma which is an unusual cause of acute abdomen. Materials and methods: A 67-year-old man presented to our emergency department complaining of severe abdominal pain, nausea and vomiting. The physical examination revealed right upper quadrant and epigastric abdominal tenderness. Sonographic examination revealed free fluid in the right paracolic area and minor pelvis. Due to these findings, the patient underwent CT angiography examination with suspicion of acute intestinal ischemia. Results: Diffuse atherosclerotic calcified plaques in the abdominal aorta and moderate degree stenosis proximal celiac truncus were determined on CT angiography images. Mesenteric arterial system was patent. On CT images most remarkable finding was diffuse wall thickening reaching up to 1.5 cm at the widest part in small intestinal segments. These findings were seen in the right half of abdomen and pelvis, approximately 12 cm and 20 cm small intestinal segment, respectively. The patient was using warfarin and acetylsalicylic acid medication due to heart valve replacement surgery. This history and CT angiography findings were consistent with intestinal mural hematoma. Conclusion: In the differential diagnosis of the acute abdomen, intestinal intramural hematoma must be kept in mind, especially in patients using anticoagulant drugs. In such cases, CT angiographic examination is rapid, effective and reliable method in both determination of the vascular abnormality and evaluation of the intestinal wall pathologies

  14. Pattern and presentation of acute abdomen in a Nigerian teaching hospital

    John Owoade Agboola

    2014-01-01

    Full Text Available Background: Abdominal pain of sudden onset is the hallmark of most non-traumatic emergency surgical presentations. This presents a scenario of urgency to the young surgeon who has to determine which of a myriad of disease conditions the patient is presenting with. Such a physician has to rely on experience and a sound knowledge of the local aetiological spectrum in making a clinical diagnosis. Objective: To determine the epidemiology and aetiological spectrum of diseases presenting as acute abdomen in the adult population at the hospital surgical emergency unit. Patients and Methods: Two hundred and seventy-six patients presenting at the University of Ilorin Teaching Hospital emergency unit and managed by the general surgeons between 1 st of May 2009 and 30 th of April 2010 were recruited and followed-up throughout the period of admission. The biodata and clinical information inclusive of diagnosis, investigations, treatment modality and outcome were entered in a structured questioner. Standardised treatment was given to all patients and difficulties encountered in their management were also noted. The data collected was evaluated using SPSS16. Results: Acute abdomen constituted 9.6% of total surgical emergency admissions with patients aged 16-45 years constituting 78.3%. The commonest cause of acute abdomen was appendicitis (30.3% followed by intestinal obstruction (27.9%, perforated typhoid ileitis 14.9% and peptic ulcer disease (7.6%, respectively. Conclusion: The result from the study is similar to what has been reported in other tropical settings with inflammatory lesions being the major problem. There is also a rising incidence of post-operative adhesions and gradual decline in incidence of obstructed hernia.

  15. Usefulness of the helical CT in gastro intestinally caused acute abdomen

    At present, there is a vivid debate on the role of the Helical CT (HCT) in the acute abdomen, principally on the usefulness of the non contrast HCT. We aim to present the most common semiological findings and the differential diagnoses, and to give a short description of the indications and protocols, according to the existing literature and to our experience with HCT during the last three years. We believe that the generalization of the use of HCT in emergencies avoid unnecessary surgery and shorten observation times on many occasions, with clear benefits in the clinical management of the patients. (Author) 30 refs

  16. [Acute abdomen in patients with HIV/AIDS seen in a national hospital of Lima, Peru].

    Montoya, Leonor; Rodríguez, Ericka; Zúñiga, Grace; Yamamoto, Gaby; González, Elsa

    2014-01-01

    The aim of this study was to describe the features in the presentation and management of acute abdomen (AA) in patients with human immunodeficiency virus (HIV). We reviewed the medical records of 97 HIV patients who presented with AA and were seen in 2006-2011 at Cayetano Heredia National Hospital in Lima, Peru. 1.6% of immunosuppressed patients underwent surgery. Appendectomy was the most common surgical procedure (33.3%). Morbidity was 28.1% and postoperative mortality was 9.4%. Infection by mycobacterium tuberculosis was the most common cause of acute abdominal pain, at 26.8%. Data suggest that an early surgical decision for cases of AA in HIV patients may prevent significant morbidity and mortality. PMID:25418651

  17. A rare cause of acute abdomen: spontaneous common hepatic duct perforation.

    Pülat, Hüseyin; Karaköse, Oktay; Benzin, Mehmet Fatih; Sabuncuoğlu, Mehmet Zafer; Çetin, Recep

    2016-01-01

    Spontaneous extrahepatic bile duct perforation is generally seen in infants. Although rarely seen in adults, it may be seen with fatal bile peritonitis. Therefore, for a patient presenting with acute abdominal symptoms, differential diagnosis must be made with radiological imaging such as abdominal ultrasonography or computed tomography, without any loss of time. In these imaging tests, in cases of gallstone disease together with perihepatic free fluid or choledocus which can not be monitored, it should be considered in the differential diagnosis. An emergency surgical intervention should be planned to avoid serious complications. The aim of this paper was to present the rare cause of acute abdomen which developed associated with spontaneous common hepatic canal perforation in an adult. PMID:27135087

  18. Usefulness of the helical CT in gastro intestinally caused acute abdomen; Utilidad de la TC helicoidal en el abdomen agudo de origen gastrointestinal

    Cruz, R. A. de la; Martel, J.; Albillos, J. C.; Oliver, J. M.; Lopez, J.; Trapero, M. A. [Fundacion Hospital Alcorcon. Madrid (Spain)

    2000-07-01

    At present, there is a vivid debate on the role of the Helical CT (HCT) in the acute abdomen, principally on the usefulness of the non contrast HCT. We aim to present the most common semiological findings and the differential diagnoses, and to give a short description of the indications and protocols, according to the existing literature and to our experience with HCT during the last three years. We believe that the generalization of the use of HCT in emergencies avoid unnecessary surgery and shorten observation times on many occasions, with clear benefits in the clinical management of the patients. (Author) 30 refs.

  19. The value of the abdominal radiograph in the assessment of the acute abdomen- work in progress

    Full text: The value of the abdominal radiograph in the assessment of the acute abdomen was evaluated for those patients who also had abdominal ultrasound and/or CT. The value of each modality in patient management is reviewed. Retrospective review of 52 consecutive patients presented to a tertiary hospital emergency department with acute abdominal pain who underwent abdominal radiographs (AXR) and abdominal ultrasound (US) and / or computed tomography (CT) within 24 hours of presentation was undertaken. There were 37 males and 15 females. The mean age was 53 years (range 18-95y). Abdominal radiographs were reviewed by two radiologists.Two patients had two separate admissions one week apart. There were 35 normal abdominal radiographs. 19 studies showed clinically relevant abnormalities. Of the normal group, 14 out of 21 patients had abnormal findings on CT and 8 out of 16 had abnormal US examinations. Of the 19 patients with abnormal AXR, 17 out of 19 patients had abnormal CT and 2 out of 5 had abnormal ultrasound examinations. There were 5 cases where both CT scan and US was performed. The positive and negative predictive value for AXR vs CT scan was 89% and 33% respectively and for AXR vs US scan was 40% and 50% respectively. For patients with normal AXR and abnormal CT, there was only one case (a non calcified abdominal aortic aneurysm) which might have required immediate surgical intervention. The preliminary results suggest that the abnormal radiograph is sensitive in the detection of relevant abnormalities in the acute abdomen in the context of appropriate clinical selection. Both CT and ultrasound provide additional diagnostic accuracy for some indications.A further 50 patients are being reviewed and the combined results will be presented. Copyright (2002) Blackwell Science Pty Ltd

  20. Cisto de úraco em adultos simulando abdômen agudo Adults urachal cyst simulating acute abdomen

    Emanuel da Silva Vieira Júnior; Rone Antônio Alves de Abreu; Manlio Basilio Speranzini

    2007-01-01

    Urachus anomalies are generally asymptomatic, but when infected can simulate acute abdomen. This anomaly has to be deemed when abdominal tenderness is associated with inflammation signs in parumbilical or hypogastric regions. Ultrasonography has great sensibility to settle down the diagnosis as observed from our three cases. Ultrasonography images with air suggest intestinal fistula in most cases with sigmoid or ileum as shown here.

  1. Two cases of acute abdomen after an intravitreal injection of bevacizumab.

    Onoda, Yasutaka; Shiba, Tomoaki; Hori, Yuichi; Maeno, Takatoshi; Takahashi, Mao

    2015-01-01

    We report on a patient with ischemic colitis and another with paralytic ileus, both of whom experienced an acute abdomen after intravitreal injection of bevacizumab (IVB). Case 1 was a 78-year-old woman. Her medical history included surgery for colon carcinoma 10 years earlier. The patient developed acute severe abdominal pain and nausea the day after IVB for retinal vein occlusion with macular edema, and massive lower gastrointestinal bleeding occurred. Ischemic colitis was diagnosed. Case 2 was a 64-year-old man who presented with neovascular glaucoma with proliferative diabetic retinopathy. We performed vitreous surgery on the 9th day after IVB, and we reperformed IVB at the end of the vitreous surgery. On the first postoperative day, severe abdominal distension, vomiting and abdominal pain were observed, and paralytic ileus was diagnosed. It is possible that gastrointestinal disorders are induced after IVB, depending on the patient's background, including for example severe diabetes or a history of surgery for gastrointestinal cancer. Thus, ophthalmologists should apply alternative therapies instead of IVB to patients with severe diabetes mellitus or a history of gastrointestinal cancer. PMID:25960733

  2. Spontaneous Perforation of Pyometra Presenting as Acute Abdomen and Pneumoperitoneum Mimicking Those of Gastrointestinal Origin

    Takahiro Yamada

    2015-01-01

    Full Text Available Gastrointestinal (GI perforation accounts for over 90% of acute abdomen and pneumoperitoneum. The presence of pneumoperitoneum secondary to spontaneously perforated pyometra is an interesting yet confusing finding given the absence of gastrointestinal (GI perforation, because pyometra is more common in postmenopausal women. We report an instructive case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 70-year-old postmenopausal female was admitted to surgical emergency with signs of diffuse peritonitis. After resuscitation, an emergency laparotomy was performed because of suspicion of GI perforation. At laparotomy, about 2,000 mL of purulent fluid was found to be present in peritoneal cavity, while GI tract was intact. A rent with a diameter of 5 mm was found on anterior fundus of uterus. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on postoperative day 16. Our case illustrates the importance of clinical knowledge of acute gynecological diseases, which are not uncommonly encountered by the general surgeon. Moreover, good appreciation of pelvic anatomy and close collaboration with gynecology and GI surgery colleagues is essential as operative intervention is often required.

  3. Spontaneous perforation of pyometra presenting as acute abdomen and pneumoperitoneum mimicking those of gastrointestinal origin.

    Yamada, Takahiro; Ando, Nanako; Shibata, Naoshi; Suitou, Motomu; Takagi, Hiroshi; Matsunami, Kazutoshi; Ichigo, Satoshi; Imai, Atsushi

    2015-01-01

    Gastrointestinal (GI) perforation accounts for over 90% of acute abdomen and pneumoperitoneum. The presence of pneumoperitoneum secondary to spontaneously perforated pyometra is an interesting yet confusing finding given the absence of gastrointestinal (GI) perforation, because pyometra is more common in postmenopausal women. We report an instructive case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 70-year-old postmenopausal female was admitted to surgical emergency with signs of diffuse peritonitis. After resuscitation, an emergency laparotomy was performed because of suspicion of GI perforation. At laparotomy, about 2,000 mL of purulent fluid was found to be present in peritoneal cavity, while GI tract was intact. A rent with a diameter of 5 mm was found on anterior fundus of uterus. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on postoperative day 16. Our case illustrates the importance of clinical knowledge of acute gynecological diseases, which are not uncommonly encountered by the general surgeon. Moreover, good appreciation of pelvic anatomy and close collaboration with gynecology and GI surgery colleagues is essential as operative intervention is often required. PMID:25628913

  4. Acute abdomen in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

    Petrić Aleksandra

    2008-01-01

    Full Text Available Background. Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome is a malformation of female genital tract (incidence 1 in 4000 female newborn children. It appears as a result of a disorder in the development of Millerian cannals. Etiology is unknown. Syndrome MRKH is the most frequent cause of primary amenorrhoea (90%. Patients with MRKH have a normal female phenotype, with normal pubic hairness and thelarche, and female karyotype (46XX followed by primary amenorrhoea. Hormonal status corresponds to healthy women, where the appearance of ovarian tumors and tumors on rudiment parts of uterus is possible. Case report. We presented a case of acute abdomen in a patient with previously not diagnosed MRKH. The diagnosis was done during the operation. Small pelvis and an abdominal part were filled with torquated tumor lump, where ovaries, oviducts, uterus or something resembling rudiment of uterus were not recognized through careful examination. Furthemore, the patient had a short, dead-end vagina. Tumorectomy was done and hystopathological finding showed the presence of vascular leiomyoma. Conclusion. The diagnosis of complex syndromes, such as MRKH, can, despite modern diagnostics, be absent for non-medical and psycho-social reasons. We can expect ovarian and uterine pathology on hypoplastic structures in these patients, as well as in healthy women. Vascular leiomyoma in the patients with MRKH was not found in the available literature.

  5. A Rare Cause of Acute Abdomen: Urinary Bladder Rupture due to Foley Catheter

    Ömer Engin

    2013-07-01

    Full Text Available Urinary bladder rupture is usually found due to blunt or penetrating traumas and iatrogenic injuries, and spontaneous intraperitoneal perforation is very rare. 57 years old male patient was consulted to general surgery department due to abdominal pain, nausia-vomiting and fever. He had Diabetes Mellitus, Multiple Sclerosis, Leriche Syndrome and operation for benign prostatic hypertrophy 5 years ago on his medical history which the case catheterised him urinary bladder himself frequently in nonsterile conditions. He did not care about sterility. On physical examination, suprapubic defence and rebound was noted more prominently on right lower quadrant. He was taken to operating room with the diagnosis of acute abdomen. On exploration, infection was seen on all layers of the whole urinary bladder, abscess formation and necrosis causing a microperforation which is detected by methylene blue was also present. Intraabdominal abscess drainage, cystostomy and primary suturing of the urinary bladder was performed. Patient died due to sepsis at the 9.th post operative day.

  6. Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report

    Fidan, Nurdan; Mermi, Esra Ummuhan; Acay, Mehtap Beker; Murat, Muammer; Zobaci, Ethem

    2015-01-01

    Summary Background Jejunal diverticulosis is a rare, usually asymptomatic disease. Its incidence increases with age. If symptomatic, diverticulosis may cause life-threatening acute complications such as diverticulitis, perforation, intestinal hemorrhage and obstruction. In this report, we aimed to present a 67-year-old male patient with jejunal diverticulitis accompanying with abdominal pain and vomiting. Case Report A 67-year-old male patient complaining of epigastric pain for a week and nausea and fever for a day presented to our emergency department. Ultrasonographic examination in our clinic revealed diverticulum-like images with thickened walls adjacent to the small intestine loops, and increase in the echogenicity of the surrounding mesenteric fat tissue. Contrast-enhanced abdominal computed tomography showed multiple diverticula, thickened walls with showing contrast enhancement and adjacent jejunum in the left middle quadrant, increased density of the surrounding mesenteric fat tissue, and mesenteric lymph nodes. The patient was hospitalized by general surgery department with the diagnosis of jejunal diverticulitis. Conservative intravenous fluid administration and antibiotic therapy were initiated. Clinical symptoms regressed and the patient was discharged from hospital after 2 weeks. Conclusions In cases of diverticulitis it should be kept in mind that in patients with advanced age and pain in the left quadrant of the abdomen, diverticular disease causing mortality and morbidity does not always originate from the colon but might also originate from the jejunum. PMID:26715947

  7. Laparoscopic Excision of a Pedunculated Uterine Leiomyoma in Torsion as a Cause of Acute Abdomen at 10 Weeks of Pregnancy

    Kosmidis, Christophoros; Pantos, George; Efthimiadis, Christopher; Gkoutziomitrou, Ioanna; Georgakoudi, Eleni; Anthimidis, George

    2015-01-01

    Patient: Female, 31 Final Diagnosis: Acute abdomen due to pedunculated uterine leiomyoma in torsion Symptoms: Abdominal pain • vomiting Medication: Cefoxitin 2gr Clinical Procedure: Laparoscopic excision of the pendunculated uterine leiomyoma – laparoscopic appedicectomy Specialty: Surgery Objective: Unusual clinical course Background: Pregnancy outcomes after laparoscopic myomectomy are generally favorable, with a pregnancy rate that is comparable to or even higher than the rate associated w...

  8. Multiparasitic Infection (Hydatid Cyst of the Spleen and Ascaris Lumbricoides Infestation) Mimicking an Acute Surgical Abdomen – Case Report

    Molnar Călin; Vizitiu Alexandru; Deak Karoly; Russu Cristian; Tudor Adrian; Suciu Bogdan; Stolnicu Simona; Hulub Marius; Molnar Claudiu

    2016-01-01

    Hydatid cyst involving the spleen is a rare clinical condition (0.5-4%). We report a case of multi-parasitic infection in a 62 year old female (hydatid cyst and ascaris lumbricoides infestation), confirmed during surgery. The purpose of the paper is to emphasize on the rare association of the two parasitic infections, affecting two different organs (spleen and jejunum). The combined symptomatology of the two parasites could mimic an acute surgical abdomen.

  9. Cisto de úraco em adultos simulando abdômen agudo Adults urachal cyst simulating acute abdomen

    Emanuel da Silva Vieira Júnior

    2007-02-01

    Full Text Available Urachus anomalies are generally asymptomatic, but when infected can simulate acute abdomen. This anomaly has to be deemed when abdominal tenderness is associated with inflammation signs in parumbilical or hypogastric regions. Ultrasonography has great sensibility to settle down the diagnosis as observed from our three cases. Ultrasonography images with air suggest intestinal fistula in most cases with sigmoid or ileum as shown here.

  10. Management of the open abdomen: clinical recommendations for the trauma/acute care surgeon and general surgeon.

    Fernández, Luis G

    2016-09-01

    Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challenges has a comprehensive knowledge of this complex subject. The purpose of this article is to provide guidance to the acute care and general surgeon on the use of OA negative pressure therapy (OA-NPT; ABTHERA™ Open Abdomen Negative Pressure Therapy System, KCI, an ACELITY Company, San Antonio, TX) for OA management. A literature review of published evidence, clinical recommendations on managing the OA and a case study demonstrating OA management using OA-NPT have been included. PMID:27547961

  11. Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report

    Klimek Peter

    2012-12-01

    Full Text Available Abstract Introduction Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen. Case presentation A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix. Conclusion This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations.

  12. Hereditary angioderma: an uncommon cause of acute abdomen. Abdominal computed tomography and ultrasound findings; Angioedema hereditario: una causa infrecuente de abdomen agudo. Hallazgos en la TC e ecografia abdominal

    Cruz, R.A. de la; Oliver, J. M.; Bueno, A.; Albillos, J. C. [Fundacion Hospital Alcorcon. Madrid (Spain)

    2002-07-01

    We present an uncommon case of acute abdomen in a patient with hereditary angioderma. The ultrasound and CT findings described may suggest this diagnosis, thus avoiding useless surgical interventions in patients in whom the disease has not been previously diagnosed. (Author) 19 refs.

  13. Abdomen - swollen

    Swollen belly; Swelling in the abdomen; Abdominal distention; Distended abdomen ... Abdominal swelling, or distention, is more often caused by overeating than by a serious illness. This problem also can be caused by: Air ...

  14. When and why use unenhanced computed tomography in patients with acute abdomen; Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar

    Freire Filho, Edison de Oliveira; D' Ippolito, Giuseppe; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: eofilho@ig.com.br; Jesus, Paulo Eduardo Marinho de [Clinica Radiologica de Anapolis, GO (Brazil)

    2006-01-15

    The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed. (auth0008.

  15. Abdome agudo: ruptura espontânea de bexiga como um importante diagnóstico diferencial Acute abdomen: spontaneous bladder rupture as an important differential diagnosis

    Carlos Augusto Gomes; André Avarese de Figueiredo; Cleber Soares Júnior; José Murillo Bastos Netto; Fabrício Rodrigues Tassi

    2009-01-01

    A case of spontaneous perforation of the bladder in a diabetic female patient is reported. It is a rare clinical condition, that should be suspected in patients with a past history of radiotherapy to the pelvis, enterocystoplasty and those suspected of having a tumor in the bladder. A general surgeon should be aware of this possibility in the differential diagnosis of an acute abdomen.

  16. Expression and Significance of Toll-like Receptor 2, 4 of Peripheral Blood Mononuclear Cells in Acute Abdomen Patients Associated with Systemic Inflammatory Response Syndrome

    XIONG Jing; WANG Yang; ZHU Zhonghua; LIU Jianshe

    2006-01-01

    The changes of Toll-like receptor (TLR) 2, 4 of peripheral blood mononuclear cells (PBMCs) in the acute abdomen patients associated with systemic inflammatory response syndrome (SIRS) and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-αand IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group (P<0.01).TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-α could be detected with low value in normal controls,but they were up-regulated markedly on the 1 st day after admission. Then TLR4 mRNA, IL-6 and TNF-α were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group (P<0.01). The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-α and IL-6, and the hospital stay. The results of Logistic regression demonstrated that overexpression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome (MODS). It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.

  17. Fibroid degeneration in a postmenopausal woman presenting as an acute abdomen

    Rajesh Shrestha

    2015-02-01

    Full Text Available Uterine fibroid, one of the most common tumors in women, is estrogen dependent, which commonly regresses after menopause. Fibroid degeneration after menopause, therefore, is rare. Here the authors report a case of 56-year-old postmenopausal woman who presented with acute abdominal pain, low grade fever, and leukocytosis as a result of fibroid degeneration.

  18. Acute Abdomen in a Case With Noncommunicating Rudimentary Horn and Unicornuate Uterus

    Atmaca, Rusen; Germen, Aysegul Tezcan; Burak, Feza; Kafkasli, Ayse

    2005-01-01

    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 torsi...

  19. Spontaneously perforated pyometra: an unusual cause of acute abdomen and pneumoperitoneum

    Shapey, IM; Nasser, T; Dickens, P; Haldar, M; Solkar, MH

    2012-01-01

    Pneumoperitoneum is usually associated with gastrointestinal perforation or following surgical and endoscopic procedures. We report a rare case of spontaneously perforated pyometra presenting with generalised peritonitis and pneumoperitoneum. Perforation of the uterus is also unusual and often associated with the presence of an intrauterine device, a gravid uterus or malignancy. Our case illustrates the importance of clinical knowledge of acute and neoplastic gynaecological diseases, which ar...

  20. Diagnostic Algorithm in the Management of Acute Febrile Abdomen in Patients with Autosomal Dominant Polycystic Kidney Disease

    Neuville, Marie; Hustinx, Roland; Jacques, Jessica; Krzesinski, Jean-Marie

    2016-01-01

    Background Acute febrile abdomen represents a diagnostic challenge in patients with autosomal dominant polycystic kidney disease (ADPKD). Although criteria have been proposed for cyst infection (CyI) and hemorrhage (CyH), there is a lack of comparative assessments. Furthermore, distinguishing cystic from non-cystic complications remains problematic. Design ADPKD patients presenting with abdominal pain and/or fever between 01/2005 and 06/2015 were retrospectively identified in a systematic computerized billing database. CyH was defined as spontaneous intracystic density above 50 Hounsfield units on computed tomography (CT). CyI was definite if confirmed by cyst puncture, and probable if 4 criteria were met: 3-day fever, loin/liver tenderness, C-reactive protein (CRP) plasma levels >50mg/L and no CT evidence for CyH. Other episodes were grouped as inflammation of unknown origin (IUO). Results Among a cohort of 173 ADPKD patients, 101 presented with 205 episodes of abdominal pain (n = 172) and/or fever (n = 33). 20 patients experienced 30 CyH, whereas 16 presented 23 episodes of definite (n = 11) or probable (n = 12) CyI. 35 IUO were observed in 31 patients. Clinically, fever was observed in 7% vs. 100% vs. 66% of CyH, CyI and IUO, respectively. Biologically, CRP cut-off at 70 mg/dl showed 92% sensitivity and 81% specificity in CyI diagnosis. Urine or blood cultures remained sterile in >90% of CyH, but were contributive in 53.4% of CyI and IUO, with a 74.2% prevalence for E. coli. Radiologically, ultrasounds, CT and magnetic resonance diagnosed CyI in 2.6%, 20% and 16.7% of cases, respectively. 18F-FDG positron-emission tomography (PET)/CT was done within a median period of 7 days post antibiotics, and significantly changed patient management in 71.4%. Conclusions This retrospective single-center series underscores the usefulness of clinical–fever–and biological–CRP–parameters, but emphasizes the limitations of bacteriological and radiological investigations

  1. Acute abdomen in early pregnancy caused by torsion of bilateral huge multiloculated ovarian cysts

    Sathiyakala Rajendran; Suthanthira Devi

    2015-01-01

    The association of pregnancy and torsion of bilateral huge benign ovarian cyst is rare. We report a case of multigravida at 13 weeks of pregnancy presenting with acute onset of lower abdominal pain. Ultrasound revealed bilateral multiloculated ovarian cysts of size 10x10 cm on right side and 15x10cm on left side with evidence of torsion and a single live intrauterine fetus of gestational age 13 weeks 4 days. Emergency laparotomy was done with vaginal susten 200 mg as perioperative tocolysis. ...

  2. Torsion of para-ovarian cyst : a cause of acute abdomen.

    Puri Manju; Jain Kanika; Negi Rinku

    2003-01-01

    Torsion of uterine adnexa is an important cause of acute abdominal pain. Torsion of ovarian masses is quite common and isolated torsion of fallopian tube has also been reported in literature. However, torsion of para ovarian cyst is a very rare. We report a rare case of twisted para ovarian cyst resulting in secondary torsion of the fallopian tube. Torsion of fallopian tube and para ovarian cyst are usually seen in the reproductive age group. Physicians need to maintain a high index of suspic...

  3. Epstein-Barr Virus Myocarditis Presenting as Acute Abdomen in a Child: a Case Report

    Roshni Chakraborty

    2015-10-01

    Full Text Available Introduction Epstein-Barr  virus  (EBV  infection  can  present  with  a  variety  of  manifestation. Case Report  Here  we  present  a  case  of  a  7  year- old  immunocompetent  girl  who  came  with  acute  abdominal  pain ,  had  echocardiographic  evidence  of  myocardial  dysfunction  and  finally  was  diagnosed  as  a  case  of  serologically  proven  acute  EBV  infection. Conclusion Isolated  gastrointestinal  symptoms  can  be  a  presentation  of  Epstein-Barr  virus  myocarditis.

  4. Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults

    AIM: To determine the impact of computed tomography (CT) on the diagnosis and treatment plan in patients with acute abdominal pain. MATERIALS AND METHODS: A prospective study was undertaken in 125 adult patients presenting with acute abdominal pain (74 men and 51 women; 40.2 ± 19.3 years; range, 18-92). Changes in diagnosis, gain in percentage diagnostic certainty and changes of treatment plan of the surgeons in the emergency department before and after CT were evaluated. Pre- and post-CT diagnoses were compared with the final diagnoses. RESULTS: CT findings changed the initial diagnosis in 40 (32.0%) patients. The diagnostic certainty was 58.3 ± 22.9% before CT, and its gain after CT was 21.9 ± 18.5 points (P < 0.0001). Post-CT diagnoses were consistent with the final diagnosis in 116 patients (92.8%), while pre-CT diagnoses were correct in 89 patients (71.2%; P < 0.0001). Initial treatment plans were changed in 31 (24.8%) patients after CT. In 57 (45.6%) patients, CT information changed diagnoses and/or treatment plans. No significant differences were observed in the diagnosis, diagnostic certainty and treatment plan among four surgeons. CONCLUSION: Contrast-enhanced CT frequently changed the clinical diagnoses with increased diagnostic certainty and the initial treatment plans. Tsushima, Y. et al. (2002)

  5. Acute abdomen in early pregnancy caused by torsion of bilateral huge multiloculated ovarian cysts

    Sathiyakala Rajendran

    2015-10-01

    Full Text Available The association of pregnancy and torsion of bilateral huge benign ovarian cyst is rare. We report a case of multigravida at 13 weeks of pregnancy presenting with acute onset of lower abdominal pain. Ultrasound revealed bilateral multiloculated ovarian cysts of size 10x10 cm on right side and 15x10cm on left side with evidence of torsion and a single live intrauterine fetus of gestational age 13 weeks 4 days. Emergency laparotomy was done with vaginal susten 200 mg as perioperative tocolysis. Intra operatively, uterus was enlarged to 14 weeks size. Both ovaries were replaced with multiloculated cysts of size 15x10 cm on left side and 10x10 cm on right side. Ovarian pedicle was found to be twisted once on right side and twice on left side. On right side, untwisting of pedicle was done and the ovarian cyst was punctured at multiple sites to drain the clear fluid. Biopsy was taken from the right ovarian cyst wall. On left side, ovariotomy was done. Histopathology revealed mucinous cyst adenoma of left ovary and multiple corpus luteum in right ovarian biopsy specimen. The patient was followed up with regular antenatal check-ups and ultrasound to rule out the recurrence of ovarian cyst on right side. The patient successfully delivered a term male baby at 39 weeks. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1598-1601

  6. Abdome agudo: ruptura espontânea de bexiga como um importante diagnóstico diferencial Acute abdomen: spontaneous bladder rupture as an important differential diagnosis

    Carlos Augusto Gomes

    2009-08-01

    Full Text Available A case of spontaneous perforation of the bladder in a diabetic female patient is reported. It is a rare clinical condition, that should be suspected in patients with a past history of radiotherapy to the pelvis, enterocystoplasty and those suspected of having a tumor in the bladder. A general surgeon should be aware of this possibility in the differential diagnosis of an acute abdomen.

  7. Analgesia in patients with acute abdomen: does danger persist? Analgesia en el paciente con abdomen agudo: ¿persiste el peligro?

    Juan Camilo Correa Gallego; Edward Alexander Blandón Castaño

    2006-01-01

    INTRODUCTION: Acute abdominal pain is a very frequent cause of medical consultation. Early analgesia is not usually given to patients that present with it as their chief complaint, because of the many differential diagnoses that must be taken into consideration and also because of fear of the potential complications that may ensue if an early and accurate diagnosis is not made. Nowadays medical practice is evolving and it is pertinent to ask and answer whether it is still adequate to keep the...

  8. Improving the diagnosis of acute appendicitis in children with atypical clinical findings using the technetium-99m hexamethylpropylene amine oxime-labelled white-blood-cell abdomen scan

    Heading AbstractBackground. Diagnosing acute appendicitis in children with equivocal signs and symptoms may be difficult. The usual approach is hospital observation and frequent re-examination. However, many surgeons are reluctant to delay surgery because of the risk of perforation and a negative laparotomy.Objective. To assess and compare the value of the technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO)-labelled white-blood-cell (WBC) abdomen scan in the diagnosis of acute appendicitis in children with atypical clinical presentation.Patients and methods. Fifty children with acute right lower quadrant abdominal pain and possible acute appendicitis, but atypical findings were included. After IV injection of 99mTc-HMPAO-labelled WBCs, serial anterior abdomen scans were obtained using a gamma camera.Results. Thirty-three children underwent surgery, while 17 children were managed conservatively and were followed up for at least 1 month. Four children had false-positive results and one child had a false-negative scan result. The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the scan to diagnose acute appendicitis in children with atypical findings was 96.7, 80.0, 90.0, 87.8 and 94.1%, respectively.Conclusions. The 99mTc-HMPAO WBC abdomen scan is a potential tool for diagnosing acute appendicitis in children with atypical clinical findings. The high sensitivity and negative predictive value allows early discharge from the emergency department to avoid costly observation in hospital and potentially unnecessary surgery in those patients with negative scans. (orig.)

  9. Clinical analysis of ovarian tumor in gynecologic acute abdomen%妇科急腹症中卵巢恶性肿瘤临床分析

    岳艳; 周希; 高霞; 黄光荣

    2012-01-01

    Objective To analyze the clinical features, diagnosis and treatment methods for ovarian malignant carcinoma in gynecologic acute abdomen. Methods Retrospectively analyze the clinical data of nine cases of malignant and borderline ovarian carcinoma which were hospitalized from March 2006 to February 2011 because of acute abdomen and summarize their clinical features. Results The intraoperative rapid frozen section pathological examination confirmed ovarian cancer in seven eases. Among the seven cases there were one cases of serous cystadenocarcinoma, two cases of borderline mucinous cystadenoma, three cases of yolk sac tumor and one cases of ovarian endometrioid carcinoma , and they were treated by staging surgery or cytoreductive surgery respectively. The other two cases were confirmed immature terato-mas by pathologic examination and then conducted a secondary staging surgery. Conclusion Ovarian malignant carcinoma could be found in gynecological acute abdomen, so it is of great importance in preoperative preparation, surgical incision selection, and operation method option.%目的 探讨妇科急腹症中卵巢恶性肿瘤的临床特点、诊断及治疗措施.方法 我院2006年3月至2011年2月收治的急腹症患者术后病检证实为卵巢恶性及交界性肿瘤9例,回顾性分析这9例的临床资料,总结其临床特点.结果 术中快速冰冻切片病理检查证实为卵巢恶性肿瘤7例,其中浆液性囊腺癌1例,交界性粘液性囊腺瘤2例,卵黄囊瘤3例,子宫内膜样肿瘤1例,分别行分期手术或肿瘤细胞减灭术;另2例术后病检证实为未成熟性畸胎瘤,再次行分期手术.结论 卵巢恶性肿瘤可见于妇科急腹症中,因此,急诊手术时对术前准备、手术切口选择及手术方式应有充分预见.

  10. Laparoscopia no abdome agudo inflamatório de difícil diagnóstico Laparoscopy in inflamatory acute abdomen of difficult diagnosis

    Antonio Carlos Valezi

    2003-08-01

    Full Text Available OBJETIVOS: O objetivo deste estudo foi analisar a eficácia do método laparoscópico em casos de abdome agudo inflamatório de difícil avaliação, quanto à acurácia, sensibilidade, especificidade e valores preditivos positivo e negativo. MÉTODO: Foram examinados, prospectivamente, 29 doentes com suspeita clínica de abdome agudo inflamatório, que após exames clínico e complementares não esclarecedores, foram submetidos à laparoscopia diagnóstica e/ou terapêutica. RESULTADOS: A precisão diagnóstica do exame foi de 96,5%. Com relação à terapêutica, 58,6 % dos doentes foram tratados por laparoscopia, 34,4% clinicamente e 6,8 % por laparotomia. A taxa de complicação foi de 10,3%, com ausência de mortalidade nesta série. Os doentes submetidos ao tratamento laparoscópico, tiveram alta hospitalar em média 36 horas após o procedimento. CONCLUSÕES: A laparoscopia mostrou-se um método de elevada acurácia diagnóstica, que permitiu manejo terapêutico satisfatório, associado à baixa morbidez e à recuperação pós-operatória precoce.OBJECTIVE: The aim of this study is to analize the efficacy of laparoscopy in cases of acute inflamatory abdomen of difficult diagnosis, according to accuracy, sensitivity, specificity and negative and positive predictive values. METHODS: The authors studied, prospectively, 29 patients with clinical suspicion of inflamatory acute abdomen, that, after inconclusive clinical and complemental investigations were submitted to diagnostic and / or therapeutic laparoscopy. RESULTS: In 96,5 % of the patients the procedure confirmed the diagnosis; 58,6 % of the patients were treated by laparoscopy, 6,8% by laparotomy and 34,4% received clinical treatment. The complication rate was 10,3 %, with no mortality in this study. Patients treated by laparoscopy were discharged from hospital in 36 hours after the procedure. CONCLUSIONS: Laparoscopy proved to be a good diagnostic and therapeutic method in acute

  11. Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis

    Yetisir, Fahri; Sarer, Akgün Ebru; Acar, Hasan Zafer; Osmanoglu, Gokhan; Özer, Mehmet; Yaylak, Faik

    2016-01-01

    Introduction. We report the management of a septic Open Abdomen (OA) patient by the help of negative pressure therapy (NPT) and abdominal reapproximation anchor (ABRA) system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S) with confounding factor of mild acute pancreatitis (AP). Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR). There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU) with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF) to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient. PMID:27006853

  12. Management of a Septic Open Abdomen Patient with Spontaneous Jejunal Perforation after Emergent C/S with Confounding Factor of Mild Acute Pancreatitis

    Fahri Yetisir

    2016-01-01

    Full Text Available Introduction. We report the management of a septic Open Abdomen (OA patient by the help of negative pressure therapy (NPT and abdominal reapproximation anchor (ABRA system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S with confounding factor of mild acute pancreatitis (AP. Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR. There were only ash-colored serosanguinous fluid within abdomen during C/S. After C/S, she was transferred to intensive care unit (ICU with vasopressor support. On postoperative 1st day, she underwent reoperation due to fecal fluid coming near the drainage. Leakage point could not be identified exactly and operation had to be deliberately abbreviated due to hemodynamic instability. NPT was applied. Two days later source control was provided by conversion of enteroatmospheric fistula (EAF to jejunostomy. ABRA was added and OA was closed. No hernia developed at 10-month follow-up period. Conclusion. NPT application in septic OA patient may gain time to patient until adequate source control could be achieved. Using ABRA in conjunction with NPT increases the fascial closure rate in infected OA patient.

  13. Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar When and why use unenhanced computed tomography in patients with acute abdomen

    Edison de Oliveira Freire Filho

    2006-02-01

    Full Text Available A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discutem quais as vantagens e limitações desta técnica de exame, bem como seus aspectos práticos.The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. The advantages and limitations of this technique are also discussed.

  14. Sonographische Diagnostik beim akuten Abdomen bei Kindern und Erwachsenen

    Vauth, C; ENGLERT, H; Fischer, T.; Kulp, W; Greiner, W; Willich, SN; Stroever, B; Graf von der Schulenburg, JM

    2005-01-01

    Introduction The acute abdomen is the main term for an at first unclear emergency situation of the abdominal cavity. The acute abdomen belongs to the three most important reasons for the admission of patients into the emergency room. Further, this illness ranks 40% of all consultations in the ambulant care sector. The acute abdomen requires an early and direct diagnosis because of its potential of having a life threatening differential diagnosis. This HTA report aimed to assess the ultrasoun...

  15. Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report

    Klimek Peter; Klimek Miriam; Kessler Ulf; Oesch Valerie; Wolf Rainer; Stranzinger Enno; Mueller Michael D; Zachariou Zacharias

    2012-01-01

    Abstract Introduction Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case ...

  16. Hematometra presenting as an acute abdomen in a 13-year-old postmenarchal girl: a case report

    Klimek, Peter Michael; Klimek, Miriam; Kessler, Ulf; Oesch, Valerie; Wolf, Rainer; Stranzinger, Enno; Michael D. Mueller; Zachariou, Zacharias

    2012-01-01

    Introduction Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where...

  17. Acute abdomen due to group A streptococcus bacteremia caused by an isolate with a mutation in the csrS gene.

    Kaneko, Masahiko; Maruta, Masaki; Shikata, Hisaharu; Hanayama, Masakazu; Ikebe, Tadayoshi

    2015-11-01

    Streptococcus pyogenes (group A streptococcus) is an aerobic gram-positive coccus that causes infections ranging from non-invasive pharyngitis to severely invasive necrotizing fasciitis. Mutations in csrS/csrR and rgg, negative regulator genes of group A streptococcus, are crucial factors in the pathogenesis of streptococcal toxic shock syndrome, which is a severe, invasive infection characterized by sudden onset of shock and multiorgan failure, resulting in a high mortality rate. Here we present a case of group A streptococcal bacteremia in a 28-year-old Japanese woman with no relevant previous medical history. The patient developed progressive abdominal symptoms that may have been due to spontaneous bacterial peritonitis, followed by a state of shock, which did not fulfill the proposed criteria for streptococcal toxic shock. The isolate was found to harbor a mutation in the negative regulator csrS gene, whereas the csrR and rgg genes were intact. It was noteworthy that this strain carrying a csrS mutation had caused group A streptococcal bacteremia characterized by acute abdomen as the presenting symptom in a young individual who had been previously healthy. This case indicates that group A streptococcus with csrS mutations has potential virulence factors that are associated with the onset of group A streptococcal bacteremia that does not meet the diagnostic criteria for streptococcal toxic shock syndrome. PMID:26231317

  18. MDCT of the abdomen

    Multi-detector row computed tomography (MDCT) enables fast and thin acquisition of the abdominal anatomy. This allows multi-pass multi-planar studies that can be obtained during defined circulatory phases. When bolus timing is adequate, arterial phases with high contrast levels provide ''free lunch'' CT angiographies eliminating the need for diagnostic angiographies in most cases. In addition to established clinical indications for abdominal CT such as preoperative MDCT of the liver or pancreas, MDCT of the abdomen is especially gaining ground in the work up for acute abdominal pain and abdominal trauma and is opening new indications for MDCT of the gastrointestinal tract. Indications for gastrointestinal MDCT include tumors, bleeding and ischemia of the small and large bowel as well as diverticulitis. The question of whether to use positive or negative contrast material for bowel distention for MDCT of the gastrointestinal tract is still a controversial issue. In selected cases, modifying the protocol to perform a ''CT enteroclysis'' might improve sensitivity and specificity in depicting small bowel tumors or inflammatory changes such as in Crohn's disease. The most common gastrointestinal mesenchymal tumor is the gastrointestinal stromal tumor (GIST). MDCT may show hypervascular submucosal masses. Acute gastrointestinal (GI) bleeding is common with patients presenting with melena, hematemesis or hematochezia. In addition to the established initial work-up MDCT is beginning to establish itself for this indication. It may be especially helpful in the work up of obscure bleeding. Another relatively rare but important cause for acute abdominal pain is mesenteric ischemia. It may be caused by many conditions and may mimic various intestinal diseases. Bowel ischemia severity ranges from transient superficial changes of the intestinal mucosa to life-threatening transmural bowel wall necrosis. CT can demonstrate changes in ischemic bowel segments accurately, is often

  19. MDCT of the abdomen

    Aschoff, A.J. [Dept. for Diagnostic Radiology, Univ. Hospitals of Ulm (Germany)

    2006-01-10

    Multi-detector row computed tomography (MDCT) enables fast and thin acquisition of the abdominal anatomy. This allows multi-pass multi-planar studies that can be obtained during defined circulatory phases. When bolus timing is adequate, arterial phases with high contrast levels provide 'free lunch' CT angiographies eliminating the need for diagnostic angiographies in most cases. In addition to established clinical indications for abdominal CT such as preoperative MDCT of the liver or pancreas, MDCT of the abdomen is especially gaining ground in the work up for acute abdominal pain and abdominal trauma and is opening new indications for MDCT of the gastrointestinal tract. Indications for gastrointestinal MDCT include tumors, bleeding and ischemia of the small and large bowel as well as diverticulitis. The question of whether to use positive or negative contrast material for bowel distention for MDCT of the gastrointestinal tract is still a controversial issue. In selected cases, modifying the protocol to perform a 'CT enteroclysis' might improve sensitivity and specificity in depicting small bowel tumors or inflammatory changes such as in Crohn's disease. The most common gastrointestinal mesenchymal tumor is the gastrointestinal stromal tumor (GIST). MDCT may show hypervascular submucosal masses. Acute gastrointestinal (GI) bleeding is common with patients presenting with melena, hematemesis or hematochezia. In addition to the established initial work-up MDCT is beginning to establish itself for this indication. It may be especially helpful in the work up of obscure bleeding. Another relatively rare but important cause for acute abdominal pain is mesenteric ischemia. It may be caused by many conditions and may mimic various intestinal diseases. Bowel ischemia severity ranges from transient superficial changes of the intestinal mucosa to life-threatening transmural bowel wall necrosis. CT can demonstrate changes in ischemic bowel segments

  20. Laparoscopia no abdome agudo não traumático: estudo retrospectivo Laparoscopy in nontraumatic acute abdomen: retrospective study

    Marcos Bettini Pitombo

    1999-08-01

    Full Text Available Os autores analisaram, retrospectivamente, 117 pacientes portadores de abdome agudo não-traumático, submetidos à laparoscopia diagnóstica e/ou terapêutica, na Casa de Saúde Santa Martha, em Niterói. A precisão diagnóstica do exame laparoscópico foi de 96,6%. Com relação à terapêutica, 74,4% dos pacientes foram tratados por laparoscopia, 21,4% por laparotomia e 4,3% foram tratados clinicamente. A precocidade na realização da laparoscopia relacionou-se à maior taxa de sucesso com o tratamento laparoscópico (valor p The authors studied restropectively 117 patients with nontraumatic acute abdomen, who were submitted to diagnostic and therapeutic laparoscopy, at Casa de Saúde Santa Martha - Niterói. In 96,6% of the patients lhe procedure confirmed the diagnosis. 74,4% were treated by this method, 21,4% by laparotomy and 4,3% received clinical treatment. It was noted that the earlier the diagnostic laparoscopy was performed, the bigger were the chances of doing therapeutic laparoscopy (p value < 0,05. The patients treated by laparoscopic surgery were fed and were discharged from hospital earlier than the patients treated by laparotomy (p value < 0,05 and p < 0,01. The complication rate was 13,7% and the mortality rate was 2,6%. The authors conclude that laparoscopy is a good diagnostic and therapeutic method. There is also a good correlation with this method and a quicker recovering of the patients.

  1. Abdome agudo perfurativo por corpo estranho em paciente com situs inversus totalis Perfurative acute abdomen due to foreign body in patient with situs inversus totalis

    André Vitorio Câmara Oliveira

    2008-12-01

    dyspnea, dehydration (++/4++, blood pressure= 70X40mmHg, anicteric, tense abdomen, diffusely painful, distended and hypertympanic, hydroaerial sounds absent. The thorax X-ray evidenced cardiac dextroversion, pneumoperitoneum bilaterally with gastric bubble on the right. Due to the general serious condition and confirmed diagnosis of acute abdomen perforation, a hydroelectrolytic vein replacement was held and the patient was submitted to an exploratory celiotomy, observing fecaloid diffuse peritonitis and perforation of sigmoid colon for foreign body taken away followed by mechanical cleaning, washing peritoneal cavity, Hartmann retossigmoidectomy, and bilateral drainage. CONCLUSION: Although a rare entity, the diagnosis of situs inversus totalis must be suspected in a physical examination and confirmed through image examinations, since the anatomic variations can disrupt the performance of clinical surgery.

  2. Análise retrospectiva de 287 casos de abdome agudo em ginecologia e obstetrícia Retrospective analysis of 287 cases of acute abdomen in gynecology and obstetrics

    Eddie Fernando Candido Murta

    2001-02-01

    Full Text Available OBJETIVO: O abdome agudo em ginecologia e obstetrícia apresenta baixo risco de vida para a paciente, entretanto, o retardo no diagnóstico e tratamento influencia na morbi-mortalidade. O objetivo deste trabalho foi estudar as principais causas de abdome agudo em tocoginecologia. MÉTODOS: Foram revisados 287 casos de abdome agudo em tocoginecologia de janeiro de 1987 a dezembro de 1997 atendidos na Disciplina de Ginecologia e Obstetrícia da Faculdade de Medicina do Triângulo Mineiro. RESULTADOS: Os resultados mostraram que a prenhez ectópica foi a mais freqüente causa de abdome agudo hemorrágico com 98,5% dos casos. Nestes casos, a dor pélvica foi o sintoma mais comum (69,1%. Todas as pacientes foram submetidas à laparotomia e salpingectomia foi realizada em 92,6% dos casos. A causa mais freqüente de abdome agudo inflamatório foi a doença inflamatória pélvica com 94,8%. A dor pélvica aguda estava presente em 91,5% dos casos e a febre em 56,2% casos. A penicilina foi usada com sucesso em 92,1% dos casos. Do total de 201 casos de doença inflamatória pélvica, 13 (6,5% foram submetidos à laparotomia. CONCLUSÕES: Os autores concluem que o abdome agudo de causa tocoginecológica apresenta quadro clínico variável, portanto, o ginecologista deve estar atento para estabelecer diagnóstico e tratamento precisos.BACKGROUND: The gynecology or obstetric acute abdomen in woman present a low risk, although the diagnosis and treatment may be a challenge. The aim of this study was to analize the most frequent causes of acute abdomen in gynecology and obstetrics. METHODS: We reviewed 287 cases, from January 1987 to December 1997, attending in Discipline of Gynecology and Obstetrics of the Faculty of Medicine of "Triângulo Mineiro". RESULTS: Ouur results showed that ectopic pregnancy was the most frequent cause of hemorrhagic acute abdomen, with 98.5% of the cases. Pelvic pain was the most common symptom (69.1%. All patients were submitted to

  3. Endocardite infecciosa com apresentação inicial de abdome agudo Endocarditis infecciosa con presentación inicial de abdomen agudo Infective endocarditis with initial presentation of acute abdomen

    Humberto F. G Freitas

    2010-04-01

    Full Text Available Paciente de 35 anos de idade foi atendido em Serviço de Emergência com seis horas de dor em fossa ilíaca direita e febre. Feita hipótese diagnóstica de apendicite aguda e realizada laparotomia exploradora. com apendicectomia. O paciente retornou ao hospital três dias após alta hospitalar. prostrado. febril. com alteração de fala. diminuição de nível de consciência e com hemiparesia completa à esquerda. CT scan de crânio e punção de líquor normal. RMN de encéfalo revelou aspectos compatíveis com AVC isquêmico vertebro-basilar. Ecocardiograma transesofágico demonstrou vegetação em valva aórtica e insuficiência aórtica moderada e hemoculturas foram positivas para Enterococcus bovis.Paciente de 35 años de edad ingresó en el servicio de emergencia con seis horas de dolor en fosa ilíaca derecha y fiebre. Se llevó a cabo la hipótesis diagnóstica de apendicitis aguda y realizada laparotomía exploradora, con apendicectomía. El paciente regresó al hospital tres días tras alta hospitalaria, prostrado, febril, con alteración de habla, disminución de nivel de conciencia y con hemiparesia izquierda completa. Scanner de cráneo y punción de líquido cefalorraquídeo (LCR normal. RMN de encéfalo reveló aspectos compatibles con ACV isquémico vertebrobasilar. El ecocardiograma transesofágico demostró vegetación en válvula aórtica y insuficiencia aórtica moderada y hemocultivos fueron positivas para Enterococcus bovis.A 35-year-old patient was seen in an Emergency Department. with six hours of pain in the right iliac fossa and fever. The hypothesis diagnosis was acute appendicitis and an exploring laparotomy for appendectomy was carried out. The patient returned to the hospital three days after having been discharged. debilitated. feverish. having alterations in speech. reduction in the level of consciousness and complete hemiparesis to the left. The computed tomography scan of the skull and the liquor puncture were

  4. 小儿急腹征的早期诊断与手术时机的选择%Early diagnosis and selection of the operation occasion on the pedo-acute abdomen

    金恩鸿; 李林虎; 李光燮

    2012-01-01

    OBJECTIVE To summary the experience of early diagnosis and operation on pedo-acute abdomen. METHODS We retrospectively analyzed the clinical data on 318 pedo-patients with the actue abdomen treated in the general surgery of our hospital from May 2003 to July 2008. RESULTS 175 cases were treated by operation. Among them, 3 cases had the postoperative infection, and cured by the change dressings; 1 cage with the periappendiceal abscess occurred the stump fistula after the operation , and cured by the expectant treatment ; 1 case with the acute hemorrhagic enteritis died after the intestinal resection because of the toxic shock and the MODS. Non-operation cases were all cured after the expectant treatment. CONCLUSION Detail ask the case history, micromesh medical examination, is the base of the early diagnosis aad treatment for the pedo-acute abdomen; operating in time is a important treatment%目的 总结小儿急腹症的早期诊断及手术治疗的经验.方法 回顾性分析2003年5月~2010年7月某院普外科收治的318例小儿外科急腹症的临床资料.结果 行手术治疗175例,其中3例术后切口感染,均经切口开放换药后治愈,1例阑尾周围脓肿引流术后残端瘘,保守治疗治愈,1例因急性出血性肠炎伴腹膜炎、肠坏死行肠切除术,术后因中毒性休克、脏器衰竭死亡;非手术治疗的患儿经积极保守治疗后均治愈.结论 详细询问病史,细致的查体,结合必要的辅助检查是小儿急腹症早期诊断及治疗的基础;及时手术是小儿惠腹症的重要治疗方法.

  5. The value of vaginal colour to exceed in gynecologic acute abdomen%阴道彩超检查在诊断妇科急腹症方面的临床价值

    邵立志

    2014-01-01

    目的:分析阴道彩超检查在诊断妇科急腹症方面的临床价值。方法:对2014年3月~2014年6月某院收治的400例妇科急腹症患者的临床资料进行回顾性分析,将其平均分为观察组和对照组。为观察组患者进行阴道彩超检查,为对照组患者进行腹部彩超检查,并对比分析其病情的误诊率。结果:在观察组患者中,有9例患者的病情被误诊。在对照组患者中,有21例患者的病情被误诊。两组患者的误诊率相比较,差异显著,有统计学意义(P<0.05)。结论:与腹部彩超检查相比,阴道彩超检查在诊断妇科急腹症方面具有更高的临床价值,值得在临床上推广使用。Results: the observation group and control group,compared to the patient's diagnosis rate is higher than the control group,and the misdiagnosis rate is less than the control group,the differences between the two groups have statistical significance (P<0.05). Conclusion: vaginal colour to exceed and abdomen colour to exceed diagnose,compared in clinical diagnosis of acute abdominal pain of department of gynaecology diagnosis rate is high,has a strong application value.%Objective: to study the analysis of the vagina color ultrasound examination in clinical diagnosis of gynecologic acute abdomen effect and application value,and aims to improve the level of the clinical treatment of the disease. Methods: a retrospective analysis of a certain hospital in March 2014 to June 2014,400 cases treated by through the pathological diagnosis of gynecologic acute abdomen patients,the average is divided into two groups,observation group and control group respectively. Observation group of patients with vagina colour to exceed check,control group patients take abdominal colour to exceed,two diagnosis and pathological diagnosis,in comparison with the results of analysis to summarize the reasons for misdiagnosis Results: the observation group and control

  6. Reirradiation to the abdomen for gastrointestinal malignancies

    Reirradiation to the abdomen could potentially play a role in palliation of symptoms or local control in patients with gastrointestinal malignancies. Our goal was to retrospectively determine rates of toxicity, freedom from local progression and overall survival in gastrointestinal cancer patients treated with reirradiation to the abdomen. Between November 2002 and September 2008, 13 patients with a prior history of abdominal radiotherapy (median dose 45 Gy) were treated with reirradiation for recurrent or metastatic gastrointestinal malignancies. The median interval between the two courses of radiotherapy was 26 months. Patients were treated with a hyperfractionated accelerated regimen, using 1.5 Gy fractions twice daily, with a median dose of 30 Gy (range 24-48 Gy). Concurrent chemotherapy was administered to 8 (62%) patients. The 1-year rate of freedom from local progression was 50%, and the median duration of freedom from local progression was 14 months. The 1-year rate of overall survival was 62%, and the median duration of overall survival was 14 months. One patient developed grade 3 acute toxicity (abdominal pain and gastrointestinal bleeding), requiring hospitalization during radiotherapy; subsequently, that patient experienced a grade 4 late toxicity (gastrointestinal bleeding). No other patients developed grade 3-4 acute or late toxicity or required hospitalization during radiotherapy. Hyperfractionated accelerated reirradiation to the abdomen was well-tolerated with low rates of acute and late toxicity. Reirradiation could play a role in providing a limited duration of local control in gastrointestinal cancer patients with a history of prior abdominal radiotherapy

  7. Laparoscopy rol in acute cases of lower abdomen in women. Review of the last 10 years in the British Hospital Gynecology Service

    Acute lower abdominal episodes in women are the most frequent cause of consultation at the emergency room. The role of laparoscopy as a diagnostic and therapeutic tool, especially in women, has been well established. It allows the visualization of the entire abdominal cavity as well as the diagnosis delays and its complications in the evolution

  8. Acute abdomen due to ovarian congestion caused by coiling of the fallopian tube accompanied by paratubal cyst around the utero-ovarian ligament

    Kim, Juyoung; Park, Daehyun; Han, Won Bo; Jeong, Hyangjin; Park, Youngse

    2014-01-01

    Torsion of uterine adnexa is an important cause of acute abdominal pain in females. The main organ which can cause torsion is the ovaries, but torsions of the fallopian tube, subserosal myoma, paratubal cyst, and even the uterine body have been reported. The incidence of isolated fallopian tubal torsion is very rare. Even more rarely, it can coil around nearby organs such as the utero-ovarian ligament, showing similar clinical manifestations with those of adnexal torsion. We experienced an ex...

  9. Clinical effect of fast track surgery nursing for acute abdomen complicated with depression%快速康复外科护理应用于急腹症并发抑郁症患者的临床成效

    古金花; 邹艳花; 陈小银

    2015-01-01

    Objective To explore the effect of implementing fast rehabilitation surgery nursing on the postoperative condition and mood of acute abdomen complicated with depressive disorder,and accumulate experience for the high quality of nursing service in this group. Methods 39 cases of acute abdomen complicated with depression patients were selected in our hospital in 2010 August to 2012year in July in Department of general surgery were set as the control group,routine nursing intervention,the implementation of the department of general surgery;43 cases of acute abdomen complicated with depression patients were selected in our hospital in 2012 August to 2014 year in July in department of general surgery were set as the study group,the implementation of fast track surgery,nursing intervention.Two groups of patients in hospitalization day and intervention the end of 5D underwent brief depression rating scale(BPRS)assessment,two patients were also recorded after the group eating time,ambulation time,medical expenses,hospitalization time,complications rate. Results The study group the next activity time,postoperative eating time,hospitalization time was shorter than the control group(P 0.05)after the intervention,the study group;anxiety depression factor,lack of energy factor,thinking disorder factor and hostile factors were lower than the control group(P < 0.05),activated factor was higher than that in control group(P < 0.05). Conclusion For patients with acute abdomen complicated with depression,the concept of rapid rehabilitation surgery can promote the rehabilitation of patients with the disease prognosis,reduce the incidence of complications,and help to improve the emotional state of patients, promote the social function of the early return, achieved satisfactory clinical results.%目的:探究急腹症并发抑郁症患者实施快速康复外科护理对其术后病情康复及情绪状况的影响,并为这类人群的优质护理服务积累经验。

  10. Cálculo biliar "perdido": um novo problema para o ginecologista na abordagem do abdome agudo? "Lost" gallstone: a new problem for the gynecologist in acute abdomen management ?

    José Carlos Menegoci

    1999-12-01

    Full Text Available Os autores relatam o caso de uma paciente com 35 anos de idade, submetida à colecistectomia videolaparoscópica há 1 ano e que apresentou quadro sugestivo de salpingite aguda com abscesso. Durante a laparotomia notou-se um abscesso que era limitado anteriormente pelo peritônio parietal e músculo reto anterior direito do abdome, e posteriormente pelo corno uterino e pelo ligamento redondo à direita. Neste abscesso havia estrutura a seguir identificada como cálculo biliar. São discutidos os aspectos relacionados à patogenia, tratamento e prevenção desta complicação que vem sendo relatada com freqüência em virtude do maior uso da cirurgia laparoscópica.The authors report a case of a thirty-five-year-old patient, submitted to videolaparoscopic cholecystectomy one year ago, who appearently had acute salpingitis with abscess. During the laparotomy an abscess was observed, anteriorly limited by parietal peritoneum and the abdominal right anterior rectus muscle, and posteriorly by the horn of the uterus and by the right round ligament. In this abscess there was a structure later identified as gallstone. The aspects related to the pathogenesis, treatment and prevention, which have been reported frequently due to the increasing number of laparoscopic surgeries, are discussed.

  11. GISTs múltiplos em neurofibromatose tipo 1: diagnóstico incidental em paciente com abdome agudo Multiple GISTs in neurofibromatosis type 1: incidental diagnosis in a patient with acute abdomen

    Tomaz de Jesus Maria Grezzana-Filho

    2009-03-01

    Full Text Available INTRODUÇÃO: Tem sido descrito na literatura incidência aumentada de tumores estromais gastrointestinais (GISTs em portadores de neurofibromatose tipo 1. Estes tumores tipicamente ocorrem no intestino delgado e, frequentemente, são múltiplos. RELATO DO CASO: Diagnóstico incidental de GIST em um paciente portador de neurofibromatose tipo 1 com abdome agudo. No trans-operatório foi identificada apendicite retrocecal perfurada e massa neoplásica no jejuno proximal. A referida lesão ocupava aproximadamente 70% da circunferência do órgão e não apresentava invasão de estruturas adjacentes. Além disso, observaram-se dezenas de pequenos nódulos disseminados por toda a extensão do jejuno e íleo. O anatomopatológico revelou neoplasia compatível com GIST, com grau moderado de atipias, baixo índice mitótico (BACKGROUND: The literature described an increased incidence of gastrointestinal stromal tumors (GISTs in patients with neurofibromatosis type 1. These tumors typically occur in the small intestine, and frequently are multiple. Often the behavior of the tumor in this association is more favorable than in sporadic cases. CASE REPORT: Incidental diagnosis of GIST was done in a patient with neurofibromatosis type 1 during treatment for acute abdomen. Trans-operatively was identified a retrocecal perforated appendicitis and a neoplastic mass in the proximal jejunum. The lesion occupied approximately 70% of the circumference of the organ and had no invasion of adjacent structures. Moreover, there were dozens of small nodules scattered throughout the length of the jejunum and ileum. The pathology revealed malignancy consistent with GIST, with moderate degree of atypia, low mitotic index (<5 / 50 and absence of necrosis. In immunohistochemical analysis, the neoplastic cells were positive for CD-34 and CD-117 (c-KIT, and negative for desmin. After surgery, the use of Imatinib chemotherapy was indicated. After a follow-up period of 12 months

  12. Abdomen X-Ray (Radiography)

    ... News Physician Resources Professions Site Index A-Z X-ray (Radiography) - Abdomen Abdominal x-ray uses a very ... of an abdominal x-ray? What is abdominal x-ray? An x-ray (radiograph) is a noninvasive medical ...

  13. Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique.

    Kyriazanos, Ioannis D; Manatakis, Dimitrios K; Stamos, Nikolaos; Stoidis, Christos

    2015-01-01

    Wound dehiscence is a serious postoperative complication, with an incidence of 0.5-3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of "intentional open abdomen" was described and both clinical entities share common pathophysiological and clinical pathways ("postoperative open abdominal wall"). Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as "frozen abdomen," where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the "Coliseum technique" for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of "malignant" frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair. PMID:26064759

  14. MR imaging of the abdomen in pregnancy

    Sonography is still the method of choice for imaging diseases in pregnant women. The changed physiognomy of the women increases the known limitations of sonography while the advantages of MRI (large field of view, excellent soft-tissue contrast, sensitive diagnosis of edema) are not affected. The available sequences allow the differentiation of various pathologies. Most of these can frequently be visualized without intravenous administration of contrast material. Although the significance of techniques like DWI and ASL has not yet been explored, initial descriptions are promising and MR imaging in pregnancy will be increasingly important in the future. Therefore, knowledge of the most frequent diseases in pregnancy and their image appearance is relevant to radiologists. The advantages of MRI in comparison to sonography and its important role in imaging pathologies of the acute abdomen in pregnancy are illustrated and discussed. (orig.)

  15. [MR imaging of the abdomen in pregnancy].

    Klasen, J; Antoch, G; Blondin, D

    2011-06-01

    Sonography is still the method of choice for imaging diseases in pregnant women. The changed physiognomy of the women increases the known limitations of sonography while the advantages of MRI (large field of view, excellent soft-tissue contrast, sensitive diagnosis of edema) are not affected. The available sequences allow the differentiation of various pathologies. Most of these can frequently be visualized without intravenous administration of contrast material. Although the significance of techniques like DWI and ASL has not yet been explored, initial descriptions are promising and MR imaging in pregnancy will be increasingly important in the future. Therefore, knowledge of the most frequent diseases in pregnancy and their image appearance is relevant to radiologists. The advantages of MRI in comparison to sonography and its important role in imaging pathologies of the acute abdomen in pregnancy are illustrated and discussed. PMID:21487979

  16. 49 CFR 572.186 - Abdomen assembly.

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Abdomen assembly. 572.186 Section 572.186... Dummy, 50th Percentile Adult Male § 572.186 Abdomen assembly. (a) The abdomen assembly (175-5000) is part of the dummy assembly shown in drawing 175-0000 including load sensors specified in §...

  17. Electrical burns of the abdomen

    Rakesh Kumar Srivastava

    2013-01-01

    Full Text Available A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

  18. MRI of the fetal abdomen; MRT des fetalen Abdomens

    Hoermann, M.; Brugger, P.C.; Witzani, L.; Prayer, D. [Medizinische Universitaet Wien (Austria). Universitaetsklinik fuer Radiodiagnostik

    2006-02-15

    Magnetic resonance imaging (MRI) is an important diagnostic component for central nervous system and thoracic diseases during fetal development. Although ultrasound remains the method of choice for observing the fetus during pregnancy, fetal MRI is being increasingly used as an additional technique for the accurate diagnosis of abdominal diseases. Recent publications confirm the value of MRI in the diagnosis of fetal gastrointestinal tract and urogenital system diseases. The following report provides an overview of MRI-examination techniques for the most frequent diseases of the abdomen. (orig.) [German] Die MRT ist ein wichtiger Bestandteil zur Diagnostik des zentralen Nervensystems und thorakaler Erkrankungen in der fetalen Entwicklung. Wenngleich der Ultraschall die Methode der Wahl zur Ueberwachung des Feten in der Schwangerschaft bleibt, bekommt die fetale MRT als zusaetzliche Untersuchungstechnik zur akkuraten Diagnostik abdomineller Erkrankungen immer groessere Bedeutung. Die neueren Publikationen bestaetigen v. a. den Stellenwert der MRT in der Diagnose von Erkrankungen des fetalen Gastrointestinaltrakts und des Urogenitalsystems. Im Folgenden soll ein Ueberblick ueber die MR-Untersuchungstechnik der haeufigsten Erkrankungen des Abdomens gegeben werden. (orig.)

  19. MRI of the fetal abdomen

    Magnetic resonance imaging (MRI) is an important diagnostic component for central nervous system and thoracic diseases during fetal development. Although ultrasound remains the method of choice for observing the fetus during pregnancy, fetal MRI is being increasingly used as an additional technique for the accurate diagnosis of abdominal diseases. Recent publications confirm the value of MRI in the diagnosis of fetal gastrointestinal tract and urogenital system diseases. The following report provides an overview of MRI-examination techniques for the most frequent diseases of the abdomen. (orig.)

  20. Hemograma e proteinograma plasmático de eqüinos hígidos e de eqüinos acometidos por abdômem agudo, antes e após laparotomia Hemogram and plasma proteins of healthy horses and horses with acute abdomen before and after laparotomy

    J.J. Fagliari

    2002-12-01

    Full Text Available Foram examinados 20 eqüinos adultos, 10 sadios e 10 acometidos por abdômen agudo, submetidos à laparotomia. O exame clínico e a colheita de amostras de sangue foram realizados antes da laparotomia e diariamente, a partir da cirurgia, até o 10º dia após a intervenção. Constatou-se elevação da temperatura retal, das freqüências cardíaca e respiratória, do número de hemácias e de leucócitos, do volume globular e dos valores das proteínas plasmáticas após a cirurgia, em ambos os grupos, porém com valores mais elevados nos animais enfermos, especialmente do número de neutrófilos. O proteinograma plasmático dos eqüinos com abdômen agudo mostrou que houve elevação significativa nas concentrações de proteínas na fase aguda com maiores valores ao redor de 48 horas após a cirurgia. Os resultados indicaram que o padrão de elevação e decréscimo dessas proteínas pode ser útil na definição do prognóstico do quadro clínico de abdômen agudo e da recuperação cirúrgica dos eqüinos.Hemogram and plasma protein concentrations of healthy horses and horses affected with acute abdomen before and after laparotomy were determined to investigate if these determinations can be of help on the diagnosis and prognosis of the post-operative intercurrence. The body temperature, respiratory and heart rates, red blood cell, leukocyte and neutrophil counts, packed cell volume, and plasma protein concentrations increased after laparotomy, mainly in sick horses. Acute phase protein concentrations were higher in the horses affected with acute abdomen than in the healthy horses with the highest values detected at about 48 hours after surgery. The results suggest that determining the level of these proteins can be useful for the diagnosis and prognosis of post-operative recovery after laparotomy in healthy horses and in horses affected with acute abdomen.

  1. How to deal with an open abdomen?

    De Waele, Jan; Kaplan, Mark; Sugrue, Michael; Sibaja, Pablo; Bjorck, Martin

    2015-01-01

    Appropriate open abdomen treatment is one of the key elements in the management of patients who require decompressive laparotomy or in whom the abdomen is left open prophylactically. Apart from fluid control and protection from external injury, fluid evacuation and facilitation of early closure are now the goals of open abdomen treatment. Abdominal negative pressure therapy has emerged as the most appropriate method to reach these goals. Especially when combined with strategies that allow pro...

  2. MR imaging of the abdomen in pregnancy; MR-Diagnostik des Abdomens in der Schwangerschaft

    Klasen, J.; Antoch, G.; Blondin, D. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2011-06-15

    Sonography is still the method of choice for imaging diseases in pregnant women. The changed physiognomy of the women increases the known limitations of sonography while the advantages of MRI (large field of view, excellent soft-tissue contrast, sensitive diagnosis of edema) are not affected. The available sequences allow the differentiation of various pathologies. Most of these can frequently be visualized without intravenous administration of contrast material. Although the significance of techniques like DWI and ASL has not yet been explored, initial descriptions are promising and MR imaging in pregnancy will be increasingly important in the future. Therefore, knowledge of the most frequent diseases in pregnancy and their image appearance is relevant to radiologists. The advantages of MRI in comparison to sonography and its important role in imaging pathologies of the acute abdomen in pregnancy are illustrated and discussed. (orig.)

  3. Leucograma e teores plasmáticos de proteínas de fase aguda de eqüinos portadores de abdômen agudo e submetidos à laparotomia Leukogram and plasma acute phase protein concentrations in horses with acute abdomen submitted to treatment by laparotomy

    J.J. Fagliari

    2008-04-01

    Full Text Available Foram examinados 20 eqüinos adultos portadores de abdômen agudo e submetidos à laparotomia. Dez recuperaram-se sem intercorrência pós-operatória (G1 e 10 foram a óbito sete a 10 dias após a cirurgia, com sinais de choque séptico (G2. Avaliaram-se temperatura retal, freqüências cardíaca e respiratória, tempo de preenchimento capilar e teores plasmáticos das proteínas de fase aguda - fibrinogênio, ceruloplasmina, proteína C-reativa, antitripsina, haptoglobina e glicoproteína ácida -, antes e até sete dias após a laparotomia. As leucometrias às 72h e no sétimo dia pós-operatório dos eqüinos que foram a óbito foram, respectivamente, 34,6% e 57,1%, mais altas que a dos animais curados. Os maiores valores de proteína de fase aguda ocorreram no sétimo dia após a cirurgia; os percentuais de elevação de fibrinogênio, antitripsina, glicoproteina ácida, proteína C-reativa, ceruloplasmina e haptoglobina de eqüinos do G2 em relação ao G1 foram 46,8%, 67,9%, 91,9%, 112,2%, 126,9% e 186,2%, respectivamente.Twenty adult horses with acute abdomen were examined and submitted to treatment by laparotomy; ten had no postoperative complication (group 1, and ten showed septic shock symptom and died from seven to ten days after surgery (group 2. Body temperature, heart and respiratory rates, filling capillary time, and plasma acute phase protein concentrations - fibrinogen, ceruloplasmin, C-reactive protein, antitrypsin, haptoglobin, and acid glycoprotein - were evaluated before laparotomy and until seven days after surgery. White blood cell counts at 72h and seven days after surgery in group 2 animals were, respectively, 34.6% and 57.1%, and were higher than those measured in group 1 horses. The highest values of acute phase proteins occurred on the seventh day after surgery. The increase percentages of fibrinogen, antitrypsin, acid glycoprotein, C-reactive protein, ceruloplasmin, and haptoglobin plasma concentrations in group 2

  4. 肠脂肪酸结合蛋白在急腹症患者中鉴别急性肠缺血的价值%The value of serum intestinal fatty acid binding protein measurement in discriminating intestinal ischemia in patients with acute abdomen

    石卉; 吴本俨; 刘文徽; 苏斌斌; 李婷婷

    2012-01-01

    目的 评估肠脂肪酸结合蛋白( I-FABP)在急腹症患者中鉴别急性肠缺血的价值.方法 2009年11月至2011年8月解放军总医院151例住院急腹症患者及17例健康对照者纳入本研究,测定其血清I-FABP水平,根据ROC曲线计算I-FABP诊断急性肠缺血的临界值、敏感性、特异性、阳性似然比、阴性似然比、阳性预测值、阴性预测值,评估其诊断及鉴别诊断价值.结果 151例急腹症患者中急性肠缺血24例,非肠缺血127例.肠缺血组的I-FABP水平[(109.67 ±48.82)μg/L]明显高于非肠缺血组[(36.78±11.25) μg/L]和健康对照组[(8.33±6.25) μg/L],P值均<0.01.I-FABP的诊断临界值为87.52 μg/L,I-FABP诊断急性肠缺血的敏感度为0.762,阴性预测值为0.963,阳性似然比3.05,阴性似然比0.24.结论 血清I-FABP用于鉴别急腹症中急性肠缺血患者具有临床诊断价值.%Objective To assess the differential diagnostic value of serum intestinal fatty acid binding protein (I-FABP) in distinguishing intestinal ischemia patients from acute abdomen patients.Methods A total of 151 patients with acute abdomen and 17 healthy controls from the PLA General Hospital were enrolled from November,2009 to August,2011. Serum I-FABP levels were measured by ELISA.According to the ROC curve,the cut-off value,sensitivity,specificity,positive likelihood ratio (PLR),negative likelihood ratio ( NLR),positive predietive value (PPV) and negative predictive value (NPV) were calculated. Results Of the 151 acute abdomen patients,there were 24 intestinal ischemia patients and 127 without intestinal ischemia.Serum I-FABP level in intestinal ischemia group [( 109.67 ±48.82) μg/L]was significantly higher than those in patients without intestinal ischemia [(36.78 ± 11.25) μg/L]and healthy controls[(8.33 ±6.25) μg/L]( all P values <0.01 ).The serum I-FABP cut-off value for the diagnosis of intestinal ischemia was 87.52 μg/L.Serum I-FABP was efficient in terms of

  5. 血浆PTX3检测在预测急腹症并发全身炎症反应综合征患者预后中的临床意义%Clinical Significance of Plasma PTX3 Detection in Predicting the Prognosis of Patients with Acute Abdomen Comeplicated with Systemic Inflammatory Response Syndrom e

    朱世纯; 李倩; 张文丽; 蒙国光; 李广洲

    2014-01-01

    To observe the dynamic changes in serum cytokines levels of PTX3 and investigate the clinical significance of plasma PTX3 detection in predicting the prognosis of patients with acute abdomen complicated with systemic inflammatory response syndrome(SIRS).Method:107 patients with acute abdomen complicated with systemic inflammatory response syndrome were selected,the peripheral venous blood were collected on the day of admission,and 1,5 days after admission respectively.The levels of pentraxin 3(PTX3)were detected by enzyme-linked immunosorbent assay,selected 60 healthy persons as control group,and compared with their results.Result:The levels of PTX3 in 107 patients with acute abdomen complicated with systemic inflammatory response syndrome at each monitoring point were significantly higher than those in the control group,and the levels of PTX3 in the complication group at each monitoring point were significantly higher than those in the no complication group,the differences were statistically significant(P<0.05). Conclusion:In acute abdomen patients combined with SIRS,the levels of PTX3 are increased.PTX3 elevated levels and systemic inflammatory response syndrome is closely related to the severity and postoperative complications.%目的:观察急腹症并发全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)患者血浆正五聚素(pentraxin 3,PTX3)水平的动态变化,探讨PTX3在预测急腹症并发全身炎症反应综合征患者预后中的临床意义。方法:选取107例符合SIRS诊断的急腹症患者,分别于入院当日(0 d)及入院后1、5 d清晨采集空腹外周静脉血,用酶联免疫吸附法(ELISA)检测PTX3的血浆浓度,并设60例健康体检者为对照组予以比较。结果:107例急腹症并发全身炎症反应综合征患者的各监测点的PTX3水平均明显高于对照组,且并发症组患者血浆各监测点的PTX3水平均明显高于无并发症组,差

  6. Utilidad de la anamnesis y de las técnicas inmunológicas en el diagnóstico de la anisakidosis en pacientes con abdomen agudo Usefulness of anamnesis and inmunological techniques in the diagnosis of anisakidosis in patients with acute abdomen

    A. del Rey-Moreno

    2008-03-01

    Full Text Available Introducción: Anisakis simplex puede producir síntomas digestivos y alérgicos. En este trabajo se evalúan los antecedentes epidemiológicos y los resultados inmunológicos para diferenciar entre pacientes con anisakidosis y aquellos con otras patologías digestivas que cursan con dolor abdominal. Pacientes y método: estudio de cohortes realizado con 134 pacientes: 52 fueron diagnosticados de anisakidosis por los hallazgos quirúrgicos y anatomopatológicos y/o seroconversión específica frente a A. simplex (grupo A y en 82 pacientes la anisakidosis fue excluida como diagnóstico (grupo NA: no-anisakidosis. Se han evaluado el antecedente de ingesta de pescado crudo, la prueba cutánea en prick (PC y el inmunoblot IgE como elementos de diagnóstico. Resultados: los pacientes de los grupos A y NA mostraron resultados diferentes respecto a la de ingesta de pescado crudo (p Introduction: Anisakis simplex can be a cause of digestive symptoms. Our aim was to evaluate the epidemiological antecedents and immunological data available for a differentiation between patients with anisakidosis and those with other acute abdominal problems. Patients and methods: this is a prospective cohort study involving 134 patients with acute abdominal problems: 52 patients were diagnosed with anisakidosis by means of surgical and pathological findings and/or specific IgE seroconversion against Anisakis simplex (group A, and in 82 patients anisakidosis had been ruled out (group NA: non-anisakidosis. We evaluated the antecedent of raw fish ingestion, the skin prick test, and IgE immunoblotting as diagnostic tools. Results: patients in groups A and NA differ in terms of prior raw fish ingestion (p < 0.0001 and positive SPT (p < 0.0001, with their respective negative predictive values (NPV being 98.39% (95%CI: 90.17-99.92 and 95.56% (95%CI: 83.64-99.23. Regarding immunoblotting, in 86.2% of patients in group A a band of 60 kDa was detected, which was also detected in 19

  7. Linfangioma cístico do mesentério: uma rara apresentação de abdômen agudo Mesenteric cystic lymphangioma: an uncommon presentation of an acute abdomen

    Florentino de Araújo Cardoso Filho; Fábio Machado Landim; Fernanda Braga Perdigão

    2000-01-01

    Mesenteric cyst is a rare intra abdominal pathology. The incidence ranges from 1/100,000 to 1/250,000 hospital admissions. The authors present a case of a female patient, 20 years old, with abdominal pain for four months which three days had an acute onset of abdominal pain, and ultrasound revealed a cyst of mesentery within a dense fluid. The patient had been submitted to a laparotomy, and resection of the cyst. We emphasized the clinical symptoms, diagnostic evaluation and the therapeutic o...

  8. Linfangioma cístico do mesentério: uma rara apresentação de abdômen agudo Mesenteric cystic lymphangioma: an uncommon presentation of an acute abdomen

    Florentino de Araújo Cardoso Filho

    2000-04-01

    Full Text Available Mesenteric cyst is a rare intra abdominal pathology. The incidence ranges from 1/100,000 to 1/250,000 hospital admissions. The authors present a case of a female patient, 20 years old, with abdominal pain for four months which three days had an acute onset of abdominal pain, and ultrasound revealed a cyst of mesentery within a dense fluid. The patient had been submitted to a laparotomy, and resection of the cyst. We emphasized the clinical symptoms, diagnostic evaluation and the therapeutic of this condition.

  9. Metformin induced acute pancreatitis

    Alsubaie, Sadeem; Almalki, Mussa H.

    2013-01-01

    Acute pancreatitis frequently presents with abdomen pain but may presents with various skin manifestations as rash and rarely, pancreatic panniculitis. Metformin, one of the most effective and valuable oral hypoglycemic agents in the biguanide class was linked to acute pancreatitis in few cases. Here, we report a case of metformin induce acute pancreatitis in young healthy man with normal renal function.

  10. Analysis on 29 Cases of Acute Abdomen Disease of Ectopic Pregnancy in Adolescent Females%少女异位妊娠急腹症29例分析

    王树楼; 王微

    2012-01-01

    Objective To accumulate treatment experiences for emergency room doctors through analyzing the clinical data of adolescent ectopic pregnancy patients. Methods Retrospective analysis on the clinical data of 29 adolescent ectopic pregnancy patients were done. Results All of the 29 patients received sur-geries( by abdominal or laparoscopic surgery ), proved to be rapture of ectopic pregnancy, and were cured and discharged. Conclusion Early diagnosis, early treatment and selection of optimal surgery plan are the keys to provide clinical efficacy to acute abdominal disease of ectopic pregnancy.%目的 分析异位妊娠少女患者的临床资料,以积累可供急诊科医师参考的诊治经验.方法 对在我科就诊的29例少女异位妊娠的临床资料进行回顾性分析.结果 29例患者均经手术治疗(经腹或经腹腔镜),术后均证实为异位妊娠破裂,全部康复出院.结论 少女异位妊娠急腹症的早期诊断、早期治疗及最佳治疗方案是提供临床疗效的关键.

  11. Nutrition Support in the Open Abdomen.

    Moore, Scott M; Burlew, Clay Cothren

    2016-02-01

    Early provision of enteral nutrition (EN) in critically ill and injured patients has become standard practice in surgical intensive care units (ICUs) due to its proven role in reducing septic complications. Increasingly, intensivists are confronted with patients with an open abdomen due to the use of damage control surgery and the recognition of the abdominal compartment syndrome; the role and timing of EN in these challenging patients continue to be debated. Patients with an open abdomen are often among the sickest in the ICU and hence could benefit from early nutrition support. However, the exposed abdominal viscera can understandably create anxiety regarding the initiation of EN; there is theoretic concern over exacerbation of bowel distention with resultant inability to close the abdomen and an increased aspiration risk due to paralytic ileus. Recent studies have investigated the utility of EN in the patient with an open abdomen, addressing these clinical concerns. The goal of this clinical review is to provide guidance to physicians caring for these complex patients. PMID:26673199

  12. Roentgenological observation in the disease of biliary tract by plain film study of abdomen

    Kim Byung Soo [Busan National University College of Medicine, Busan (Korea, Republic of)

    1979-06-15

    , the gallbladder shadow was found only at the acute stage, for the reason that, in the two cases of the showing gallbladder shadow, the gall bladder shadow could not be shown on the plain film taken after remission of the clinical symptoms. 8. Consequently, the author concluded that the radiographic findings of showing gallbladder shadow and abnormal meteorism in plain films of abdomen could be considered as a key point to diagnose the cholecystography in patients of acute abdomen.

  13. Roentgenological observation in the disease of biliary tract by plain film study of abdomen

    , the gallbladder shadow was found only at the acute stage, for the reason that, in the two cases of the showing gallbladder shadow, the gall bladder shadow could not be shown on the plain film taken after remission of the clinical symptoms. 8. Consequently, the author concluded that the radiographic findings of showing gallbladder shadow and abnormal meteorism in plain films of abdomen could be considered as a key point to diagnose the cholecystography in patients of acute abdomen.

  14. Adult midgut malrotation presented with acute bowel obstruction and ischemia

    Akile Zengin

    2016-01-01

    Conclusion: Malrotation should be considered in differential diagnosis in patients presented with acute abdomen and intestinal ischemia. Surgical intervention should be prompt to limit morbidity and mortality.

  15. Multislice-CT of the abdomen

    Zech, Christoph Johannes; Reiser, Maximilian F. (eds.) [Univ. Hospitals Munich, Grosshadern (Germany). Dept. of Clinical Radiology; Baron, Richard [Chicago Univ., IL (United States). Dept. of Radiology; Bartolozzi, Carlo [Pisa Univ. (Italy). Dept. of Oncology; Pisa Univ. (Italy). Dept. of Transplants and Advanced Technology

    2012-07-01

    This book provides a lucid summary of modern multislice CT imaging of the abdomen, with a focus on the essential imaging findings. After a concise technical introduction, the most important abdominal diseases are described and illustrated with high-quality images. Sections are devoted to the liver and biliary system, the pancreas and spleen, the kidneys and urogenital system, and the bowel and peritoneal cavity. Throughout, key differential diagnostic features are highlighted. The editorial team is composed of internationally renowned radiologists from Europe and the United States, and all chapters have been written by recognized experts in the topic under consideration. Multislice CT of the Abdomen will serve as an excellent reference for radiologists participating in further professional training and will prove an ideal source of information for all who wish to deepen their personal knowledge of the subject.

  16. Trauma imaging in the thorax and abdomen

    This book thoroughly covers the radiologic diagnosis of traumatic injuries of the thorax and abdomen with special consideration given to the physical principles governing blunt, blast, and penetrating trauma and to the pathophysiology which they cause. The clinical experience forming the major data base for this book is drawn from the Ramban Medical Center in Haifa, Israel, the major trauma center for the Middle East wars

  17. Severe Acute Pancreatitis in Pregnancy

    Bahiyah Abdullah

    2015-01-01

    Full Text Available This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes.

  18. Perforated jejunal diverticulitis as a rare cause of acute abdomen

    Jejunal diverticula is rare and in most cases without any symptoms. They become clinically relevant when complications, such as diverticulitis, malabsorption caused by bacterial overgrowth, intestinal hemorrhage, or obstruction, occur. In this case report a case of perforated jejunal diverticulitis is presented and the problems in finding the correct diagnosis are discussed. (orig.)

  19. [Acute abdomen caused by spontaneous perforation of the colon].

    Balotta, F; Ghidotti, G; Pecchia, G; Santoro, A

    The literature on simple ulcer of the colon is reviewed. Three successfully treated cases of spontaneous perforation of the colon due to ulcer of the sigmoid, and single and multiple ulceration of the caecum are described, with particular reference to their aetiopathogenesis. The view that simple ulcer is caused by mechanical and circulatory factors, with or without inflammation, is expressed. Surgical management of this lesion must take the patient's age and local and general condition into account. These parameters will determine the type of operation employed, ranging from simple colorrhaphy to variously extensive resection of the perforated segment. PMID:7019756

  20. Perforated jejunal diverticulitis as a rare cause of acute abdomen

    Peters, R.; Grust, A.; Fuerst, G. [Department of Radiology, Heinrich-Heine-University, Duesseldorf (Germany); Gerharz, C.D. [Department of Pathology, Heinrich-Heine-University, Duesseldorf (Germany); Dumon, C. [Department of Surgery, Heinrich-Heine-University, Duesseldorf (Germany)

    1999-09-01

    Jejunal diverticula is rare and in most cases without any symptoms. They become clinically relevant when complications, such as diverticulitis, malabsorption caused by bacterial overgrowth, intestinal hemorrhage, or obstruction, occur. In this case report a case of perforated jejunal diverticulitis is presented and the problems in finding the correct diagnosis are discussed. (orig.) With 3 figs., 13 refs.

  1. Acute Abdomen in Interstitial Ectopic Pregnancy, An Emergency Laparoscopic Treatment

    Picardo, E; M. Mitidieri; Salvagno, F; E.M. Canuto; Benedetto, C.; G.L. Marchino; Minniti, E.

    2014-01-01

    The present case report demonstrates a laparoscopic approach to treat interstitial cornual pregnancy in emergency. Interstitial ectopic pregnancy develops in the uterine portion of the fallopian tube which accounts for 2–4% of all ectopic pregnancies and has the potential to cause life-threatening hemorrhage at rupture. The mortality rate for a woman diagnosed with such a pregnancy is 2–2.5%. Diagnosis of interstitial pregnancy is made by ultrasound. In this case a 32 year-old woman, Gravida ...

  2. Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

    Toshihiro Kitai

    2014-01-01

    Full Text Available Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts.

  3. Spontaneous Uterine Perforation due to Pyometra Presenting as Acute Abdomen

    Loabat Geranpayeh; Mohsen Fadaei-Araghi; Behnam Shakiba

    2006-01-01

    Spontaneous perforation of the uterus is rare, its incidence being about 0.01% − 0.05%. We report a rare case of diffuse peritonitis caused by spontaneously perforated pyometra. A 63-year-old woman with severe abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy, about 900 mL of pus was found in the peritoneal cavity. There were no abnormal findings in the alimentary tract, li...

  4. Spontaneous uterine perforation of pyometra presenting as acute abdomen.

    Kitai, Toshihiro; Okuno, Kentaro; Ugaki, Hiromi; Komoto, Yoshiko; Fujimi, Satoshi; Takemura, Masahiko

    2014-01-01

    Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts. PMID:25057420

  5. Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

    Toshihiro Kitai; Kentaro Okuno; Hiromi Ugaki; Yoshiko Komoto; Satoshi Fujimi; Masahiko Takemura

    2014-01-01

    Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized ...

  6. Spontaneous Uterine Perforation Due to Pyometra Presenting as Acute Abdomen

    Sahoo, Sarada Prasanna; Dora, Arun Kumar; Harika, M.; Kumar, K. Ramesh

    2011-01-01

    Spontaneous perforation of uterus is rare, its incidence being about 0.01%-0.5%. We report a rare case of diffuse peritonitis and pneumoperitoneum caused by spontaneously perforated pyometra. A 50-year postmenopausal lady with abdominal pain was admitted to our hospital. Laparotomy was performed because of the suspicion of gastrointestinal perforation with generalized peritonitis. At laparotomy about 1,500 ml of pus present in peritoneal cavity and whole of alimentary tract and gallbladder we...

  7. Multidetector computed tomography angiography of the abdomen

    Multidetector computed tomography (MDCT) angiography has provided excellent opportunities for advancement of computed tomography (CT) technology and clinical applications. It has a wide range of applications in the abdomen including vascular pathologies either occlusive or aneurysmal; enables the radiologist to produce vascular mapping that clearly show tumor invasion of vasculature and the relationship of vessels to mass lesions. MDCTA can be used in preoperative planning for hepatic resection, preoperative evaluation and planning for liver transplantation. MDCTA can also provide extremely valuable information in the evaluation of ischemic bowel disease, active Crohn disease, the extent and location of collateral vessels in cirrhosis

  8. Accidental foreign bodies in pediatric abdomens: A pictorial essay

    Foreign bodies in pediatric abdomens are caused by accidental ingestion or trauma. The purpose of this article is to review the various findings of accidental foreign bodies in pediatric abdomens. Abdominal radiography, fluoroscopic examination, gastrointestinal contrast studies and CT may be useful in evaluating the location and type of foreign body, and for evaluating complications such as bowel perforation and obstruction

  9. Accidental foreign bodies in pediatric abdomens: A pictorial essay

    Park, Chan Ho; Kim, Young Tong [Soonchunhyang Univ. Cheonan Hospital/Soonchunhyang Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-08-15

    Foreign bodies in pediatric abdomens are caused by accidental ingestion or trauma. The purpose of this article is to review the various findings of accidental foreign bodies in pediatric abdomens. Abdominal radiography, fluoroscopic examination, gastrointestinal contrast studies and CT may be useful in evaluating the location and type of foreign body, and for evaluating complications such as bowel perforation and obstruction.

  10. Does dragonfly's abdomen flexion help with fast turning maneuvers?

    Liu, Geng; Li, Chengyu; Dong, Haibo; Flow Simulation Research Group Team

    2013-11-01

    Dragonflies are able to achieve fast turning maneuvers during take-off flights. Both asymmetric wing flapping and abdomen flexion have been observed during the fast turning. It's widely thought that the asymmetric wing beats are responsible of producing the aerodynamic moment needed for the body rotation. However, the dynamic effect of the abdomen flexion is not clear yet. In this study, an integrated experimental and computational approach is used to study the underlying dynamic effect of dragonfly abdomen flexion. It's found that dragonfly abdomen tended to bend towards the same side as the body reorienting to. Quantitative analysis have shown that during take-off turning maneuver the abdomen flexion can modulate the arm of force by changing the position of the center of mass relative to the thorax. As a result, roll and yaw moments produced by the wing flapping can be enhanced. This work is supported by NSF CBET-1313217. This work is supported by NSF CBET-1313217.

  11. Simultaneous acute appendicitis and ectopic pregnancy

    Ankouz Amal; Ousadden Abdelmalek; Majdoub Karim; Chouaib Ali; Maazaz Khalid; Taleb Khalid

    2009-01-01

    The acute abdomen in pregnancy is a surgical emergency. Ectopic pregnancy and appendicitis are two causes of acute abdomen in pregnancy. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case presented here underlies the pathogenesis of the simultaneous existence of these two conditions in a patient.

  12. Soporte nutricional en pacientes con abdomen abierto Nutricional support in patients with open abdomen

    J. O. Velázquez G.

    2007-04-01

    Full Text Available Objetivos: El soporte nutricional es fundamental en los pacientes con trauma severo para disminuir los efectos de la respuesta inflamatoria sistémica y el hipermetabolismo. Se diseñó un protocolo para evaluar la tolerancia y eficacia y del soporte nutricional, así como la evolución clínica en los pacientes post-operados con abdomen abierto. Pacientes y métodos: Se realizó un estudio descriptivo, prospectivo de pacientes intervenidos quirúrgicamente a quienes se les dejó el abdomen abierto con bolsa de Bogotá y recibieron soporte nutricional. Fueron excluidos del estudio aquellos pacientes que permanecieron menos de 4 días con el abdomen abierto. Un grupo recibió nutrición parenteral total (NPT con mezclas tres en uno, otro grupo recibió nutrición enteral a través de yeyunostomía con aguja y catéter y un tercer grupo recibió soporte nutricional mixto. Ambiente: Servicio de Cirugía I del Hospital Universitario Ángel Larralde. IVSS Valencia (Venezuela. Período del estudio entre mayo del 2002 a mayo del 2005. Resultados: Ingresaron 24 pacientes al estudio, 46% recibió soporte nutricional mixto (enteral y parenteral, 33% exclusivamente NPT y 31% exclusivamente nutrición enteral. 75% evolucionaron favorablemente egresando al domicilio en buenas condiciones generales, 25% fallecieron debido a falla múltiple de órganos por sepsis severa. En relación al soporte nutricional, 66% de los pacientes no presentaron complicaciones, de los que recibieron nutrición parenteral 21% presentaron hiperglicemia y de los que recibieron nutrición enteral 13% presentaron diarrea. En cuanto a la eficacia de la nutrición enteral 69% de los pacientes alcanzaron el 80% de la meta calórica estimada entre el 4º y 5º día del inicio de la administración de la fórmula. Conclusión: El cuidado integral de los pacientes con abdomen abierto, sumado a un esquema de soporte nutricional que se ajuste las condiciones de cada paciente puede ayudar a

  13. Psoriasis May Raise Risk for Aneurysms in Abdomen

    ... nlm.nih.gov/medlineplus/news/fullstory_158314.html Psoriasis May Raise Risk for Aneurysms in Abdomen: Study ... 14, 2016 THURSDAY, April 14, 2016 (HealthDay News) -- Psoriasis patients may face a higher risk of an ...

  14. Parenteral nutrition including polyamine under experimental irradiation of the abdomen

    White rats-males were used in experiments. Irradiation dose of abdomen area is 13.5 Gy (1400 R). Parenteral nutrition using aminoacid preparation of polyamine affects favourably during radiation damage resulted from local irradiation of abdomen area. This was manifested in weakening of gastroenteric syndrom, reduction of 3.5 day death of animals and increase of their 30 day survival rate, intensification of recovery processes in small intestine, decrease of cell devastation in bone marrow

  15. Acute pancreatitis complicated with splenic rupture: A case report

    Hernani, Bruno L; Silva, Pedro C; Nishio, Ricardo T; Mateus, Henrique C; Assef, José C; De Campos, Tercio

    2015-01-01

    Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography (CT) of the abdomen, the pa...

  16. Whole-abdomen radiotherapy for non-Hodgkin's lymphoma using twice-daily fractionation

    Purpose: To report the tolerability and efficacy of twice-daily whole-abdomen irradiation (WAI) for non-Hodgkin's lymphoma (NHL). Methods and Materials: Of 123 patients treated for NHL with WAI, 37% received previous chemotherapy, 28% received WAI as part of comprehensive lymphatic irradiation (CLI), and 32% received WAI for palliation. The median dose to the whole abdomen was 25.0 Gy, followed by a median tumor boost of 9.8 Gy in 58 patients. Fractionation was 1.0 Gy once daily (54%) or 0.8 Gy twice daily (46%). Blood counts were measured weekly. Results: At a median follow-up of 4.3 years, local control was 72% and overall survival was 55% at 5 years. Median time of WAI was 42 days for once-daily treatment and 32 days for twice-daily treatment. Patients receiving twice-daily WAI did not have a significantly higher rate of acute side effects (e.g., nausea, diarrhea, platelet or red blood cell toxicity). Overall, acute thrombocytopenia was the most frequent side effect of treatment; 24 of 96 patients (25%) with available hematologic data had Grade 3+ toxicity. There was no acute Grade 3 gastrointestinal toxicity and no late small bowel obstruction. Multiple regression indicated that patients with four or less involved sites and disease size ≤6 cm had improved local control and overall survival. Conclusions: Twice-daily WAI using 0.8 Gy/fraction does not appear to have any greater toxicity compared with once-daily treatment using 1 Gy/fraction. Small doses per fraction (0.8-1 Gy/fx) are effective, tolerated well in the acute setting, and associated with a low rate of late toxicity

  17. Imaging diagnosis of acute appendicitis

    The nontraumatic acute abdomen is one of the most common presentation to the emergency room, with appendicitis being one of the most common causes of the acute abdomen. Up to 30 % of patients suspected of having acute appendicitis will present with atypical signs and symptoms. There are many conditions that imitate acute appendicitis. The percentage of unnecessary appendectomies that result from a clinical false-positive diagnosis of appendicitis. The use of computed tomography (CT) before planned surgery has decreased the negative appendicectomy rate for patients with suspected acute appendicitis. Recognition of the typical and atypical CT signs of appendicitis is important to optimize the diagnosis yield of the examination. Visualization of an appendix with normal characteristics is the most important finding to exclude appendicitis. (author)

  18. Diffusion-weighted magnetic resonance imaging of the abdomen; Diffusionsgewichtete Magnetresonanztomographie des Abdomens

    Schmid-Tannwald, C.; Reiser, M.F.; Zech, C.J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2011-03-15

    Diffusion-weighted magnetic resonance imaging (DW-MRI) provides qualitative and quantitative information of tissue cellularity and the integrity of cellular membranes. Since DW-MRI can be performed without ionizing radiation exposure and contrast media application, DW-MRI is a particularly attractive tool for patients with allergies for gadolinium-based contrast agents or renal failure. Recent technical developments have made DW-MRI a robust and feasible technique for abdominal imaging. DW-MRI provides information on the detection and characterization of focal liver lesions and can also visualize treatment effects and early changes in chronic liver disease. In addition DW-MRI is a promising tool for the detection of inflammatory changes in patients with Crohn's disease. (orig.) [German] Die diffusionsgewichtete (DW-)MRT ermoeglicht die Erfassung qualitativer und quantitativer Informationen bzgl. der Gewebezellularitaet und Membranintegritaet. Die DW-MRT ist insbesondere bei Patienten mit einer Allergie gegen gadoliniumhaltige Kontrastmittel oder eingeschraenkter Nierenfunktion attraktiv, da ihr Einsatz nicht mit Strahlenexposition oder Kontrastmittelgabe verbunden ist. Durch technische Weiterentwicklungen ist die robuste Anwendung der DW-MRI in der Bildgebung des Abdomens seit einiger Zeit moeglich geworden. In der Leberdiagnostik lassen sich Zusatzinformationen zur Detektion und Charakterisierung von Leberlaesionen gewinnen, aber auch Therapieerfolge dokumentieren und fruehe chronische Leberveraenderungen visualisieren. Neben ihrer Rolle bei hepatologischen und onkologischen Fragestellungen erscheint der Einsatz der DW-MRT zudem bei entzuendlichen Fragestellungen wie dem Morbus Crohn sehr viel versprechend. (orig.)

  19. Acute oesophageal necrosis syndrome

    Garas, George; Wou, Constance; Sawyer, Joseph; Amygdalos, Iakovos; Gould, Stuart

    2011-01-01

    An 89-year-old woman with a known hiatus hernia presented to the accident and emergency department with acute onset epigastric pain. CT of the thorax and abdomen revealed a large hiatus hernia with mesentero-axial volvulus but no evidence of strangulation. A large aneurysmal aortic arch and descending aorta were visible with associated mural thrombus. As the pain was worsening, following discussion with the patient, the decision to operate was taken. The hiatus hernia was successfully reduced...

  20. Acute pancreatitis complicating severe dengue

    Vishakha Jain; O P Gupta; Tarun Rao; Siddharth Rao

    2014-01-01

    Dengue is an arthropod borne viral infection endemic in tropical and subtropical continent. Severe dengue is life threatening. Various atypical presentations of dengue have been documented. But we present a rare and fatal complication of severe dengue in form of acute pancreatitis. A 27-year-old male had presented with severe dengue in decompensated shock and with pain in abdomen due to pancreatitis. The pathogenesis of acute pancreatitis in dengue is not clearly understood, but various mecha...

  1. Magnetic Sensing through the Abdomen of the Honey bee.

    Liang, Chao-Hung; Chuang, Cheng-Long; Jiang, Joe-Air; Yang, En-Cheng

    2016-01-01

    Honey bees have the ability to detect the Earth's magnetic field, and the suspected magnetoreceptors are the iron granules in the abdomens of the bees. To identify the sensing route of honey bee magnetoreception, we conducted a classical conditioning experiment in which the responses of the proboscis extension reflex (PER) were monitored. Honey bees were successfully trained to associate the magnetic stimulus with a sucrose reward after two days of training. When the neural connection of the ventral nerve cord (VNC) between the abdomen and the thorax was cut, the honey bees no longer associated the magnetic stimulus with the sucrose reward but still responded to an olfactory PER task. The neural responses elicited in response to the change of magnetic field were also recorded at the VNC. Our results suggest that the honey bee is a new model animal for the investigation of magnetite-based magnetoreception. PMID:27005398

  2. Radiological diagnostics of abdomen and thorax. Image interpretation considering anatomical landmarks and clinical symptoms; Radiologische Diagnostik Abdomen und Thorax. Bildinterpretation unter Beruecksichtigung anatomischer Landmarken und klinischer Symptome

    Krombach, Gabriele A. [Universitaetsklinikum Giessen (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Mahnken, Andreas H. (ed.) [Universitaetsklinikum Marburg (Germany). Diagnostische und Interventionelle Radiologie

    2015-07-01

    The book on radiological diagnostics of abdomen and thorax - image interpretation considering anatomical landmarks and clinical symptoms - includes three chapters: (1) imaging of different parts of the body: thorax and abdomen. (II) Thorax: head and neck; mediastinum; heard and pericardium; large vessels; lungs and pleura; mamma. (III) Abdomen: liver; gall bladder and biliary tract; pancreas; gastrointestinal tract; spleen and lymphatic system; adrenal glands; kidneys and urinary tract; female pelvis; male pelvis.

  3. Open abdomen in trauma patients: a double-edged sword

    Huang, Yu-Hua; Li, You-sheng

    2016-01-01

    The use of open abdomen (OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19th century. Since the 1980s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula (EAF). As a result, OA should not be ove...

  4. Follicular Dendritic Cell Sarcoma of the Abdomen: the Imaging Findings

    Kang, Tae Wook; Lee, Soon Jin; Song, Hye Jong [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-04-15

    Follicular dendritic cell sarcoma is a rare neoplasm that originates from follicular dendritic cells in lymphoid follicles. This disease usually involves the lymph nodes, and especially the head and neck area. Rarely, extranodal sites may be affected, including tonsil, the oral cavity, liver, spleen and the gastrointestinal tract. We report here on the imaging findings of follicular dendritic cell sarcoma of the abdomen that involved the retroperitoneal lymph nodes and colon. It shows as a well-defined, enhancing homogenous mass with internal necrosis and regional lymphadenopathy.

  5. Hernia interna de Quain como causa de abdomen agudo

    M. García-Oria; A. Muñoz de la Fuente; J.M. Peraza Casajús; I. Bodega Quiroga; A. Martínez Pozuelo; A Serrano Muñoz

    2012-01-01

    Presentamos el caso de una paciente de 47 años de edad que consulta en urgencias por un cuadro de 8 horas de evolución, de dolor abdominal continuo y difuso, acompañado de vómitos alimentarios al inicio y biliosos después. La paciente presenta estabilidad hemodinámica permaneciendo afebril. El hemiabdomen inferior presenta signos de irritación peritoneal. En los análisis destaca la presencia de neutrofilia y leucocitosis, la radiología simple de abdomen es compatible con suboclusión de intest...

  6. Small Cell Carcinoma of the Lung Presented as Acute Pancreatitis. Case Report and Review of the Literature

    Abdulzahra Hussain; Shamsi El-Hasani; Ali Adnan

    2012-01-01

    Context Small cell carcinoma of the lung is an aggressive cancer with gloomy prognosis. Links to acute pancreatitis is extremely rare. Case report We are reporting a 53-year-old patient who was admitted because of acute pancreatitis. She had no history of gallstones, alcohol abuse, medications or any other predisposition for acute pancreatitis. Further investigations of blood, CT of chest abdomen and neck and ultrasound scan of abdomen, bone marrow and neck lymph node biopsies confirmed advan...

  7. Radiological observation of acute pancreatitis

    The radiologic study of the pancreas oriented in the upper retroperitoneal space is difficult because the specific density of this viscus is the same as that of its surrounding tissue. so that it cannot be visualized directly. Furthermore, it is one of the few viscera in the abdomen which cannot be outlined by a contrast medium. In the abdomen, the diagnosis of acute pancreatitis is very important since the present treatment of this disease is conservative, which emergency laparatomy is indicated in most other abdominal crisaes. However, the diagnosis of acute pancreatitis cannot be made by roentgen studies alone, yet such studies can at times confirm an uncertain clinical diagnosis when evaluated with clinical findings and can occasionally alert the unsuspecting clinician to the possible presence of this disease. Because a radiologic examination plays such an important role in the differential diagnosis of the acute abdomen and at present augmenting interest for pancreatic disease, we present this discussion in order to focus attention on the radiologic features of acute pancreatitis.1. From Nov. 1968 to June 1978, roentgenologic studies of 275 patients diagnosed as acute pancreatitis were reviewed. 2. In this series, the important findings on the chest roentgenograms of 275 cases were as follows. 1) Fifty-five cases (20.0%) of these represented pleural effusion. 2) Platelike atelectasis at the lung bases was noted in 44 cases (16.0%). 3) There was elevation of the diaphragm in 33 cases (12.0%). 3. The significant findings on the simple abdomen of 247 cases were as follows. 1) The presence of a sentinel loop occurred in 168 cases (68.0%). 2) Colon 'cut-off' sign was noted in 106 cases (42.9%). 3) Obliteration of psoas shadows in 8 cases (3.2%). 4) Gastrocolic separation in 4 cases (1.6%). 4. One hundred and seventy-five barium meal studies of the stomach and duodenum were available for review.

  8. A RARE CASE OF ILEAL CARCINOID PRESENTING WITH ACUT E INTESTINAL OBSTRUCTION

    Abinash

    2013-04-01

    Full Text Available A 55 year old male presented to casualty with featur es of acute intestinal obstruction - Patient was treated one year back for subacute inte stinal obstruction which was suspected to be ileo-caecal tuberculosis treated with Cat II ATT. - On examination abdomen uniform distention, tenderne ss present all over the abdomen. - Bowel sounds were sluggish - Per rectal examination shows empty rectum - Clinical diagnosis is – acute intestinal obstructio n.

  9. Imaging findings of Castleman disease of the abdomen and pelvis

    Objective: The purpose of this work was to analysis the most suggestive imaging findings of Castleman disease in the abdomen and pelvis and to improve the recognition of this rare disease. Methods: Ten patients with pathologically proved Castleman disease in the abdomen (n=9) and pelvis (n=1) were included in this study. Patients were 18-56 yeas old (mean=40); 7 were men and 3 women. Imaging findings (CT and MRI, n=4; only CT, n=4; only MRI, n=2) were retrospectively reviewed and correlated with clinical and pathologic findings. Results: The lesions were divided into localized (n=9) and disseminated (n=1) group. The pathologic subtypes of all 9 cases of localized disease were hyaline vascular type. Imaging findings showed a single large mass in six and a single dominant mass with small satellite nodules in three. On plain CT images, the lesions manifested as homogeneous soft masses, which is isoattenuating to muscle. After intravenous injection of contrast media, most of the masses enhanced sharply (5/7) with the attenuation similar to large arteries at arterial phase and delay scans. On MR imaging, the lesions also were homogenous and had isointense or slightly low signal intensity compared with that of muscle on T1 weighted images and high signal intensity on T2 weighted images, and showed contrast enhancement in a similar pattern to contrast enhanced CT. After intravenous injection of contrast media, areas of central lower radial attenuation in the mass were noted in 4 cases of large masses ( > 5 cm) and proved to be fibrotic component pathologically. The pathologic subtypes of 1 cases of disseminated disease was plasma cell type. Imaging findings showed several well-defined nodules lied in the retroperitoneal zone that enhanced sharply with the attenuation similar to large arteries after intravenous injection of contrast media. Conclusion: Imaging findings of Castleman disease in the abdomen and pelvis are closely associated with its pathology. The most

  10. Open abdomen in trauma patients: a double-edged sword.

    Huang, Yu-Hua; Li, You-Sheng

    2016-01-01

    The use of open abdomen (OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19(th) century. Since the 1980s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula (EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management. The temporary abdominal closure (TAC) technique after abbreviated laparotomy was used to improve wound healing and facilitate final fascial closure of OA. Negative pressure therapy (NPT) is the most commonly used TAC method. PMID:27042329

  11. ACUTE APENDICITIS – GUIDELINES OF DIAGNOSIS AND TREATMENT ON CLINICAL EVIDENCE (II)

    E. Maloman; N. Gladun; Ungureanu, S.; C. Lepadatu

    2006-01-01

    Acute appendicitis is the most frequent cause of acute abdomen. In this paper we present the treatment according to our experience in acute apendicitis. We made a exposure of the surgical methods and the approach techniques. We also performed a review of the literature.

  12. Anatomical study of superficial fascia and localized fat deposits of abdomen

    Pramod Kumar

    2011-01-01

    Full Text Available Background: The development of liposuction and abdominoplasty has renewed interest in the anatomy of the localized fat deposits (LFD areas of the abdomen. This study aims at ascertaining the gross anatomy of superficial fascia and the localized fat deposits of abdomen. Materials and Methods: Eight adult cadavers (four males and four females were dissected. Attachments, number of layers of fascia and colour, shape and maximum size of the fat lobules in loin, and upper and lower abdomen were noted. Thickness of deep membranous layer of superficial fascia of upper abdomen and lower abdomen were measured by metal casing electronic digital calipers, with resolution being 10 μm. The independent sample t-test, ANOVA for comparison and Pearson coefficient for correlation were used. Results: Superficial fascia of the abdomen was multilayered in the midline and number of layers reduced laterally. The shape, size, color, and arrangement of fat lobules were different in different locations. The thickness of the fascia of the lower abdomen in males (mean 528.336 ± SE38.48 was significantly (P < 0.041 more than that in females. (Mean 390.822 ± SE36.24. Pearson correlation between thickness of the membranous layer of the upper and lower abdomen revealed moderately positive correlation (r=0.718; P<0.045. Conclusions: The LFD in the central region of the abdomen corresponds to the area of multilayered fascia with smaller fat lobules. The relatively thinner supporting fascia of the lower abdomen in females may be responsible for excessive bulges of the lower abdomen. The fat lobule anatomy at different sites under study was different.

  13. MR imaging of upper abdomen following cholecystectomy: normal and abnormal findings

    Haakansson, K. [Kalmar Hospital, (Sweden). Dept. of Radiology; Leander, P.; Ekberg, O. [Malmoe Univ. Hospital (Sweden). Dept. of Radiology; Haakansson, H.O. [Kalmar Hospital, (Sweden). Dept. of Surgery

    2001-03-01

    To describe the normal MR appearance after cholecystectomy and the findings in patients with postoperative complications using fast pulse sequences in abdominal MR imaging. Material and methods: In a prospective study of 119 patients, 64 were examined with MR after cholecystectomy. In total, 56 patients with uncomplicated cholecystectomy were examined with MR 1-5 days (mean 1.6 days) after cholecystectomy. Nine patients had an abdominal postoperative complication and 8 of these were examined with MR after the complication commenced 1-12 days after the cholecystectomy. Results: Oedema in the gallbladder fossa was the only finding in 39 patients (61%), all with uneventful recovery. Small fluid collections in an area consistent with the gallbladder fossa were seen in 9/64 (14%) patients, of which 3 had surgical complications: 1 bleeding and 2 bile duct leakage. Twenty-two (34%) patients had small locally situated fluid collections adjacent to the liver, 14 were uneventful and 8 showed postoperative surgical complications. Seven patients had fluid in the rest of the abdomen of which 5 had surgical complications; 4 due to bile duct leakage and 1 acute pancreatitis. One patient had a postoperative bleeding not seen on MR images. Conclusion: MR is very sensitive in detecting fluid collections. Early MR findings following cholecystectomy are normally only subtle changes, mainly in the gallbladder fossa. Fluid collections diagnosed elsewhere than in the gallbladder fossa usually indicate a surgical complication and a surgical complication is unlikely if MR fails to show a fluid collection.

  14. Episode of Familial Mediterranean Fever-Related Peritonitis in the Second Trimester of Pregnancy Followed by Acute Cholecystitis: Dilemmas and Pitfalls

    Kosmidis, Christophoros; Anthimidis, Georgios; Varsamis, Nikolaos; Makedou, Fotini; Georgakoudi, Eleni; Efthimiadis, Christophoros

    2016-01-01

    Patient: Female, 33 Final Diagnosis: Acute cholecystitis after Familial Mediterranean Fever-related peritonitis Symptoms: Acute abdomen • fever Medication: Colchicine Clinical Procedure: Laparoscopic cholecystectomy and adhesiolysis in the second trimester of pregnancy Specialty: Surgery Objective: Rare co-existance of disease or pathology Background: Differential diagnosis of acute abdomen in pregnant patients is one of the greatest challenges for the clinician. Occurrence of Familial Medite...

  15. Diagnostic evaluation of acute pancreatitis in two patients with hypertriglyceridemia

    Yoshifumi Okura; Kozo Hayashi; Tetsuji Shingu; Goro Kajiyama; Yoshiyuki Nakashima; Keijiro Saku

    2004-01-01

    We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipidemia.Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels. The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis. Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist, exhibiting a relief of abdominal symptoms. As in the present cases with acute abdomen following the ingestion of fatty food, the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen, when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.

  16. Consolidation whole abdomen irradiation following adjuvant carboplatin-paclitaxel based chemotherapy for advanced uterine epithelial cancer: feasibility, toxicity and outcomes

    To evaluate feasibility and preliminary outcomes associated with sequential whole abdomen irradiation (WAI) as consolidative treatment following comprehensive surgery and systemic chemotherapy for advanced endometrial cancer. We conducted a retrospective analysis of patients treated at our institution from 2000 to 2011. Inclusion criteria were stage III-IV endometrial cancer patients with histological proof of one or more sites of extra-uterine abdomen-confined disease, treated with WAI as part of multimodal therapy. Endpoints were feasibility, acute toxicity, late effects, recurrence-free survival (RFS) and overall survival (OS). Twenty patients were identified. Chemotherapy consisted of 3 to 6 cycles of a platinum-paclitaxel regimen in 18 patients. WAI was delivered using conventional technique to a median total dose of 27.5 Gy. No grade 4 toxicities occurred during chemotherapy or radiotherapy. No radiation dose reduction was necessary. Three patients developed small bowel obstruction, all in the context of recurrent intraperitoneal disease. Kaplan-Meier estimates and 95% confidence intervals for RFS and OS at one year were 63% (38–80%) and 83% (56-94%) and at 3 years 57% (33-76%) and 62% (34-81%), respectively. On univariate Cox analysis, stage IVB and serous papillary (SP) histology were found to be statistically significantly (at the p = 0.05 level) associated with worse RFS and OS. The peritoneal cavity was the most frequent site of initial failure. Consolidative WAI following chemotherapy is feasible and can be performed without interruption with manageable acute and late toxicity. Patients with endometrioid adenocarcinoma, especially stage FIGO III, had favorable outcomes possibly meriting prospective evaluation of the addition of WAI following chemotherapy in selected patients. Patients with SP do poorly and do not routinely benefit from this approach

  17. Evaluation of amylase and lipase levels in blunt trauma abdomen patients

    Subodh Kumar

    2012-01-01

    Full Text Available Background: There are studies to prove the role of amylase and lipase estimation as a screening diagnostic tool to detect diseases apart from acute pancreatitis. However, there is sparse literature on the role of serum and urine amylase, lipase levels, etc to help predict the specific intra-abdominal injury after blunt trauma abdomen (BTA. Aim: To elucidate the significance of elevation in the levels of amylase and lipase in serum and urine samples as reliable parameters for accurate diagnosis and management of blunt trauma to the abdomen. Materials and Methods: A prospective analysis was done on the trauma patients admitted in Jai Prakash Narayan Apex Trauma Center, AIIMS, with blunt abdomen trauma injuries over a period of six months. Blood and urine samples were collected on days 1, 3, and 5 of admission for the estimation of amylase and lipase, liver function tests, serum bicarbonates, urine routine microscopy for red blood cells, and complete hemogram. Clinical details such as time elapsed from injury to admission, type of injury, trauma score, and hypotension were noted. Patients were divided into groups according to the single or multiple organs injured and according to their hospital outcome (dead/discharged. Wilcoxon′s Rank sum or Kruskal-Wallis tests were used to compare median values in two/three groups. Data analysis was performed using STATA 11.0 statistical software. Results: A total of 55 patients with median age 26 (range, 6-80 years, were enrolled in the study. Of these, 80% were males. Surgery was required for 20% of the patients. Out of 55 patients, 42 had isolated single organ injury [liver or spleen or gastrointestinal tract (GIT or kidney]. Patients with pancreatic injury were excluded. In patients who suffered liver injuries, urine lipase levels on day 1, urine lipase/amylase ratio along with aspartate aminotransferase (AST, alanine aminotransferase (ALT, and alkaline phosphatase (ALP on days 1, 3, and 5, were found to

  18. Abdomen and spinal cord segmentation with augmented active shape models.

    Xu, Zhoubing; Conrad, Benjamin N; Baucom, Rebeccah B; Smith, Seth A; Poulose, Benjamin K; Landman, Bennett A

    2016-07-01

    Active shape models (ASMs) have been widely used for extracting human anatomies in medical images given their capability for shape regularization of topology preservation. However, sensitivity to model initialization and local correspondence search often undermines their performances, especially around highly variable contexts in computed-tomography (CT) and magnetic resonance (MR) images. In this study, we propose an augmented ASM (AASM) by integrating the multiatlas label fusion (MALF) and level set (LS) techniques into the traditional ASM framework. Using AASM, landmark updates are optimized globally via a region-based LS evolution applied on the probability map generated from MALF. This augmentation effectively extends the searching range of correspondent landmarks while reducing sensitivity to the image contexts and improves the segmentation robustness. We propose the AASM framework as a two-dimensional segmentation technique targeting structures with one axis of regularity. We apply AASM approach to abdomen CT and spinal cord (SC) MR segmentation challenges. On 20 CT scans, the AASM segmentation of the whole abdominal wall enables the subcutaneous/visceral fat measurement, with high correlation to the measurement derived from manual segmentation. On 28 3T MR scans, AASM yields better performances than other state-of-the-art approaches in segmenting white/gray matter in SC. PMID:27610400

  19. Endoluminal contrast for abdomen and pelvis magnetic resonance imaging.

    Gupta, Mohit K; Khatri, Gaurav; Bailey, April; Pinho, Daniella F; Costa, Daniel; Pedrosa, Ivan

    2016-07-01

    Magnetic resonance (MR) imaging of the abdomen and pelvis can be limited for assessment of different conditions when imaging inadequately distended hollow organs. Endoluminal contrast agents may provide improved anatomic definition and detection of subtle pathology in such scenarios. The available routes of administration for endoluminal contrast agents include oral, endorectal, endovaginal, intravesicular, and through non-physiologic accesses. Appropriate use of endoluminal contrast agents requires a thorough understanding of the clinical indications, available contrast agents, patient preparation, and interaction of the contrast agent with the desired MR imaging protocol. For example, biphasic oral enteric contrast agents are preferred in MR enterography as their signal properties on T1- and T2-weighted imaging allow for evaluation of both intraluminal and bowel wall pathology. In specific situations such as with MR enterography, MR defecography, and accurate local staging of certain pelvic tumors, the use of an endoluminal contrast agent is imperative in providing adequate diagnostic imaging. In other clinical scenarios, the use of an endoluminal contrast agent may serve as an indispensable problem-solving tool. PMID:26907710

  20. Hernia interna de Quain como causa de abdomen agudo

    M. García-Oria

    2012-12-01

    Full Text Available Presentamos el caso de una paciente de 47 años de edad que consulta en urgencias por un cuadro de 8 horas de evolución, de dolor abdominal continuo y difuso, acompañado de vómitos alimentarios al inicio y biliosos después. La paciente presenta estabilidad hemodinámica permaneciendo afebril. El hemiabdomen inferior presenta signos de irritación peritoneal. En los análisis destaca la presencia de neutrofilia y leucocitosis, la radiología simple de abdomen es compatible con suboclusión de intestino delgado, y la TAC de urgencia sugiere la posibilidad de torsión intestinal. La cirugía urgente realizada aprecia una hernia interna de un segmento de ileon de unos 25cm, a través de un orificio patológico en el lado derecho del ligamento ancho del útero. Se realiza resección del asa herniada que sufre necrosis isquémica y se cierra el orificio herniario para evitar la recidiva. El día 11 tras el ingreso, es dada de alta sin complicaciones.

  1. A Case of Hypopharyngeal Squamous Cell Carcinoma with Peritonead and Liver Metastasis Presenting Acute Abdomen

    Hashem Sharifian

    2009-01-01

    Full Text Available "nIntroduction: Squamous cell carcinoma (SCC of the head and neck is usually confined to local and regional sites but occasionally patients may present with rare manifestation of distant metastasis. We reported a case of hypopharyngeal SCC with liver and peritoneal metastasis. "nClinical picture: A 50-year-old female with advanced hypopharyngeal SCC was treated in this center by laryngoesophagectomy and gastric pull up. "nOne year later she presented with signs of bowel obstruction. CT scan showed an 11×15 centimeter mass with a large necrotic center in the peritoneal cavity which caused bowel obstruction. "n Some other necrotic masses were seen in the liver too. After surgery, histopathologic examination shows these masses are metastatic SCC. Abdominal fluid showed malignant cells. "nConclusion: These rare and aggressive presentations of SCC of the head and neck remind us that they may show atypical manifestations and may need more aggressive search of the distant disease in at least some subgroups of the head and neck carcinoma. "n"n  

  2. Torsion of cystic ovary: an unusual cause of acute abdomen in midtrimester pregnancy

    Poornima C

    2014-08-01

    Full Text Available Torsion of ovary is an infrequent cause of surgical emergency in pregnancy. Most frequently ovarian torsion occurs in first trimester, occasionally in second and rarely in the third trimester. Diagnosis of ovarian torsion is challenging due to non-specific clinical features. We report here a case of dermoid cyst causing ovarian torsion in second trimester and imaging modalities for its diagnosis and management. A case of 19 year old primi at 24 weeks of gestational age came with complaints of pain in right iliac fossa for 2 days. USG done showed non vascular heterogeneous hyper echoic lesion in right adnexa, suggestive of torsion of right ovary with viable intrauterine fetus. She underwent emergency laparotomy, during which we removed necrotic and gangrenous right ovary and fallopian tube. Ovarian torsion is an infrequent cause of abdominal pain in pregnancy. Though it occurs most frequently in first trimester, it may occur in second trimester also. USG is an accurate tool in diagnosing torsion. Early surgical management is associated with favorable maternal and fetal outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1134-1137

  3. A case of intensive care unit-acquired weakness after emergency surgery for acute abdomen

    Tominaga, Tetsuro; Nonaka, Takashi; Takeshita, Hiroaki; Honda, Yuichiro; Nagura, Hiroki; Shiraishi, Toshio; Kunizaki, Masaki; Sumida, Yorihisa; Hidaka, Shigekazu; Sawai,Terumitsu; Nagayasu, Takeshi

    2016-01-01

    Introduction Surgeons often perform surgery for patients who are critically ill. Intensive care unit (ICU)-acquired weakness (ICUAW) is a condition in which systemic and prolonged muscle weakness occurs and causes worse short-term and long-term outcomes. Presentation of case A 60-year-old woman with sudden nausea and vomiting presented to our hospital and developed shock. Abdominal CT showed thickness of the descending colon and ascites. She was diagnosed with sepsis due to descending colon c...

  4. A case of intensive care unit-acquired weakness after emergency surgery for acute abdomen

    Tetsuro Tominaga; Takashi Nonaka; Hiroaki Takeshita; Yuichiro Honda; Hiroki Nagura; Toshio Shiraishi; Masaki Kunizaki; Yorihisa Sumida; Shigekazu Hidaka; Terumitsu Sawai; Takeshi Nagayasu

    2016-01-01

    Introduction: Surgeons often perform surgery for patients who are critically ill. Intensive care unit (ICU)-acquired weakness (ICUAW) is a condition in which systemic and prolonged muscle weakness occurs and causes worse short-term and long-term outcomes. Presentation of case: A 60-year-old woman with sudden nausea and vomiting presented to our hospital and developed shock. Abdominal CT showed thickness of the descending colon and ascites. She was diagnosed with sepsis due to descending co...

  5. Acute and overuse injuries of the abdomen and groin in athletes.

    Atkins, Justin M; Taylor, Jonathan C; Kane, Shawn F

    2010-01-01

    Abdominal and groin injuries are common problems encountered by athletes across a wide variety of sports. They range from benign but annoying, such as exercise-related transient abdominal pain (ETAP), to the activity-limiting and possibly career-ending condition of athletic hernia. This article covers ETAP, rectus abdominus injuries, osteitis pubis, athletic hernia, and abdominal/groin hernias to provide an update on the current pathophysiology and treatment of common abdominal and pelvic conditions in the athlete. PMID:20220355

  6. Acute Abdomen Secondary to Incarcerated Umbilical Hernia after Treatment of Massive Cirrhotic Ascites

    Hiang Keat Tan; Pik Eu Chang

    2013-01-01

    Umbilical herniation is common in patients with liver cirrhosis and ascites. Rarely, they suffer from incarceration and strangulation of the umbilical hernia after treatment of ascites. We report 3 cases of umbilical hernia incarceration following removal of massive ascites with different treatment modalities. Physicians managing this group of patients should be aware of this rare and potentially fatal complication.

  7. Acute Abdomen Secondary to Incarcerated Umbilical Hernia after Treatment of Massive Cirrhotic Ascites

    Hiang Keat Tan

    2013-01-01

    Full Text Available Umbilical herniation is common in patients with liver cirrhosis and ascites. Rarely, they suffer from incarceration and strangulation of the umbilical hernia after treatment of ascites. We report 3 cases of umbilical hernia incarceration following removal of massive ascites with different treatment modalities. Physicians managing this group of patients should be aware of this rare and potentially fatal complication.

  8. Intussusception as an acute abdomen caused by non Hodgkin’s lymphoma: A rare case

    Tandon, Mrinal; Shah, Yunus; Gedam, B. S; Saxena, Divish; Bansode, Prasad

    2015-01-01

    In children, non-Hodgkin’s lymphoma has been found to be the lead point in intussusception involving the terminal ileum. We present here a case of ileal primary non-Hodgkin’s lymphoma which presented as intussusception, highlighting the  presentation of this patient, with a brief review of the literature.

  9. The changes of amylase and trypsin activities in rat after abdomen gamma irradiation

    The changes of amylase and trypsin activities in rat following local abdomen gamma irradiation were studied. The results showed that within a certain dose range, the activities of pancreatic enzymes decreased with the increase of doses and reached half of the normal value five days after local and fractional radiation with 30Gy on the abdomen, and maintained at the level below normal for a long time. The complete recovery of pancreatic enzyme activities occurred 120 days after local abdomen exposure. The mechanism of the decrease and recovery of pancreatic enzyme activity after exposure to radiation is briefly discussed

  10. Acute Pancreatitis Complicating Acute Hepatitis E Virus Infection: A Case Report and Review

    Hemanta Kumar Nayak

    2013-01-01

    Full Text Available Acute pancreatitis complicating fulminant viral hepatitis has been well recognized; however, acute pancreatitis occurring in nonfulminant hepatitis is very rare. The case presented describes moderate pancreatitis in a young male, manifesting during the course of nonfulminant acute hepatitis E infection. The diagnosis of acute viral hepatitis E was confirmed by serology and reverse transcriptase polymerase chain reaction (RT-PCR to demonstrate Hepatitis E virus (HEV RNA in both stool and serum. Patients with acute viral hepatitis presenting with severe abdominal pain should have a diagnosis of acute pancreatitis suspected and appropriate investigations including serum amylase, lipase, biliary ultrasonography and/or contrast-enhanced computed tomography of the abdomen should be undertaken. The identification of this unusual complication of Hepatitis E is important; however, the prognosis for patients with Acute Pancreatitis Complicating Acute Hepatitis E Virus Infection is good, and uncomplicated recovery with conservative treatment is expected.

  11. The Reversal of Stoma Following Open Abdomen Management.

    Yetişir, Fahri; Şarer, AkgünEbru; Acar, H Zafer; Çiftciler, Erdinç

    2016-06-01

    Bowel stoma formation is very often required during open abdomen (OA) management; we aim to report our stoma reversal series following OA management retrospectively. A retrospective analysis of 31 patients who underwent the reversal of the stoma created during OA management between January 2008 and September 2014 was performed. Twenty-eight of these 31 patients were included in this study. The stoma-related complications are more common after OA management during waiting time interval for reversal. At this time interval, patients with jejunostomy had more stoma-related complications than patients with ileostomy (p = 0.008) and colostomy. (p = 0.001). Waiting time interval was shorter for reversal of jejunostomy than reversal of ileostomy (p = 0.014) and colostomy (p = 0.001). Operation time for jejunostomy (p = 0.016) and colostomy reversal (p = 0.001) were significantly longer than the ileostomy reversal. There was no difference between early and late reversal of stoma regarding morbidity and mortality. The stoma-related complications are more common following OA management during waiting time interval for stoma reversal. The reversal time is more critical for this kind of patients especially with life-threatening complicated jejunostomy. For loop stoma created during OA management, the reversal may be performed after average 50 days without increasing morbidity and mortality. The reversal of end stoma created during OA management has high morbidity. If it is possible, loop stoma should be preferred during OA management. PMID:27358511

  12. Gross anatomy of superficial fascia and future localised fat deposit areas of the abdomen in foetus

    Pramod Kumar; Arvind Kumar Pandey; Brijesh Kumar; K S Aithal; Antony Sylvan Dsouza

    2013-01-01

    Background: The development and popularity of body contouring procedures such as liposuction and abdominoplasty has renewed interest in the anatomy of the superficial fascia and subcutaneous fat deposits of the abdomen. The study of anatomy of fascia and fetal adipose tissue was proposed as it may be of value in understanding the possible programing of prevention of obesity. Objectives: The present study was undertaken to understand the gross anatomy of superficial fascia of abdomen and to st...

  13. Computed Tomographic Study of Superficial Fascia of the Abdomen: Implication to Localized Fat Deposits (LFD) Areas

    Pandey AK; Kumar P; Radhakrishnan P; Kumar S; Kotian SR; D'Souza A; D'Souza AS

    2015-01-01

    Background: Superficial fascia of the abdomen, being a supportive structure plays a vital role in abdominal localized fat deposits (LFDs) as well as in surgical treatment of obesity. Interest in the anatomy of the superficial fascia is increasing with increasing popularity of surgical procedures for abdominal obesity. The study aims at computed tomographic evaluation and classification of the superficial fascia of abdomen & comparing with the earlier published cadaveric study. Materials and m...

  14. A case of functional non communicating rudimentary horn of unicornuate uterus presenting as persistent lump abdomen

    Sana Amrin

    2016-02-01

    Full Text Available Unicornuate uterus with a functional non communicating rudimentary horn is a rare congenital mullerian duct anomaly. It presents with various complaints like dysmenorrhoea, hematometra, endometriosis, lump in abdomen, infertility and even ectopic pregnancy. Here we present such a case which had undergone exploratory laparotomy in the past for lump in abdomen and now presented to us with persistence of lump even after surgery. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 530-531

  15. Delayed primary closure in open abdomen with stoma using dynamic closure system

    Suarez-Grau, Juan Manuel; Guadalajara Jurado, Juan Francisco; Gómez Menchero, Julio; Bellido Luque, Juan Antonio

    2015-01-01

    Background The situation of abdominal sepsis secondary to colonic perforation sometimes forces treat the patient with multiple interventions in the open abdomen (OA) context. Correct management of OA is important to restore the patient’s clinical situation and to avoid further complications of the abdominal wall. Delayed primary closure of the abdomen using a dynamic and progressive traction is a relatively new technique for treating the OA. Case presentation We report the case of a 50 year o...

  16. Repair of radiation ulcus of the lower abdomen with groin flap

    Yoshimura, Y.; Harashina, T.; Tajima, S. (Keio Univ., Tokyo (Japan). School of Medicine); Suzuki, S.

    1980-08-01

    Two patients with radiation ulcers of the lower abdomen which had occurred after radiotherapy for cancer of the cervix uteri and was repaired with groin flap were reported. Effects of flaps in plastic and reconstructive surgery were also referred to. Besides defects in the lower abdomen, defects in the vulva, the perineum, and the upper region of the femur were probably reconstructed effectively with groin flaps.

  17. Repair of radiation ulcus of the lower abdomen with groin flap

    Two patients with radiation ulcus of the lower abdomen which had occurred after radiotherapy for cancer of the cervix uteri and was repaired with groin flap were reported. Effects of flaps in plastic and reconstructive surgery were also referred to. Besides defects in the lower abdomen, defects in the vulva, the perineum, and the upper region of the femur were probably reconstructed effectively with groin flaps. (Tsunoda, M.)

  18. Acute appendicitis complicated by mass formation occurring simultaneously with serologically proven dengue fever: a case report

    Senanayake, Manouri P; Samarasinghe, Malik

    2014-01-01

    Introduction Acute abdomen and acute appendicitis are unusual clinical presentations that occur in dengue infection–caused illness. Lymphoid hyperplasia and mesenteric adenitis are possible explanations, although vasculitis in the pathology of dengue infection has not been reported. Authors of previous case reports have described mimicking of acute appendicitis discovered upon surgical treatment. Dengue virus has not been proven to cause acute appendicitis. Case presentation We report a case ...

  19. Utilization of alteplase in trauma victim with an open abdomen

    Martin, Sharolyn L; Tellez, M Geno

    2011-01-01

    Trauma victims with multisystem injuries are at risk for the development of deep vein thrombosis and pulmonary embolus (PE). The use of thrombolytic therapy remains very controversial and not well-documented in both the postsurgical and trauma subset of patients. Major trauma, surgery or head injury have been noted as absolute contraindications to thrombolysis in acute myocardial infarction. The decision to utilize thrombolytic therapy cannot be algorithmic; it must be based on the assessment...

  20. Dosimetric assessments multi-slice CT of the chest and abdomen in pediatrics; Evaluaciones dosimetricas en TC multicorte de torax y abdomen en pediatria

    Giner Sala, M.; Roch Gonzalez, M.; Rodriguez Martin, G.; Garcia Castanon, P.; Espana Lopez, M. L.

    2013-07-01

    The objective of this study is the dosimetry evaluation in pediatric MSCT of thorax and abdomen, and the estimation of effective dose in the different ranges of age taking into account the new ICRP recommendations, by variations that may be involved in explorations that affect breast. (Author)

  1. Analgesia en el paciente con abdomen agudo: ¿persiste el peligro? Analgesia in patients with acute abdomen: does danger persist?

    Juan Camilo Correa Gallego; Edward Alexander Blandón Castaño

    2006-01-01

    INTRODUCCIÓN: el dolor abdominal es un motivo de consulta frecuente. Dado que se presenta como el síntoma principal en diversas enfermedades y que existe la posibilidad de que se generen complicaciones si el diagnóstico no se establece oportunamente, ha habido renuencia a brindar analgesia en forma temprana en estos casos. Los cambios en el ejercicio médico actual permiten preguntarse si está aún justificada la conducta de mantener a estos pacientes sin analgesia. MATERIALES Y MÉTODOS: se rea...

  2. Acute intermittent porphyria and pregnancy: an obstetric challenge

    Pragati Meena

    2016-02-01

    Full Text Available Acute intermittent porphyria is a rare autosomal dominant disease caused by a mutation in the gene coding for the porphobillinogen deaminase enzymes in heam biosynthesis. The disease manifests as acute attacks of neuropsychiatric dysfunction and neurovisceral manifestations presenting as acute abdomen. In pregnancy, 54% patient has exacerbation of attacks in the form of seizures and acute abdomen occurs due to hormonal changes. Prevalence of acute intermittent porphyria is 1-2/200000 in general. Here we report a case of 36 year old women, G4P1L2A2 presenting at 10+4 weeks of gestation requesting pregnancy termination. Patient was diagnosed as case of acute intermittent porphyria with porphyic polyneuropathy 6 months back. At that time her main symptoms were acute pain abdomen with numbness and weakness in all four limbs. Her urinary porphobillinogen and 5 ALA raised. Her CECT of brain and nerve conduction studies were normal. Since then she is on Tablet Gabapentin 300 mg H.S. She underwent successful pregnancy termination by suction and evacuation under spinal anesthesia and she refused for copper-T insertion. Only safe drugs were used for procedure and she was discharged with advice of barrier contraception. [Int J Reprod Contracept Obstet Gynecol 2016; 5(2.000: 542-544

  3. Dose to organs at risk in the upper abdomen in patients treated with extended fields by helical tomotherapy: a dosimetric and clinical preliminary study

    The aim of this work was to determine the technical feasibility and safety of extended-field radiotherapy (EF), performed by Helical TomoTherapy, in patients with positive pelvic and/or para-aortic nodes. Dosimetric data were collected and acute and sub-acute toxicities of the upper abdominal organs at risk (OAR) were evaluated. Twenty-nine patients suitable for EF irradiation for local disease and/or nodal disease in the pelvic or para-aortic area were treated. The prescription dose was 50.4/54 Gy (1.7-1.8 Gy/fraction) for prophylactic lymph nodes (N-) and 60–70.5 Gy (2–2.35 Gy/fraction) for clinically evident gross disease (N+). Modulation factor (MF), pitch and field width (FW) were chosen to optimize dose distribution and treatment duration. Dose values of PTVs and OAR were analysed. The length of the treatment field, the N + and N- volumes, and treatment duration were reported. To evaluate the safety of treatment, haematological, hepatic, renal and pancreatic functions were assessed before, during and after treatment. The median follow-up time was 17.6 months (range: 6–22 months). The treatment was well tolerated and all patients but one completed treatment without interruption. Four of the 29 patients experienced G3 haematological acute toxicity (13.8%), but no patient experienced sub-acute grade G3 toxicity. Ten patients experienced G1 and three G2 acute gastrointestinal toxicity (nausea). No sub-acute gastrointestinal or renal toxicity was observed. Only one (3.7%) patient had a persistent slight increase of pancreatic enzymes and two (7.4%) patients a slight increase of hepatic enzymes six months after radiotherapy (G1 toxicity). With our treatment design and dose regimen, we found that EF treatment by TomoTherapy could be safely and effectively delivered with minimal acute and sub-acute toxicities in the upper abdomen area

  4. Surgical treatment of acute pancreatitis

    Klose, K.J.; Neher, M.; Kuhn, F.P.; Kuemmerle, F.; Thelen, M.

    1983-03-31

    The diagnosis of acute pancreatitis is based on anamnestic, clinical and chemical data. Ultrasound and computed tomography permit direct visualisation of the pancreas and establish the diagnosis. In cases of haemorrhagic-necrotising pancreatitis they demonstrate the extent of morphological changes and permit exclusion of other causes of an acute abdomen. The imaging methods support indications for operation in cases of subtotal or total parenchymatous necrosis and in pancreatic abscesses. Conservative expectant approaches in patients with severe clinical course and slight morphological changes as well as in agreement of clinical and morphological findings are facilitated. Complete demonstration of parenchymatous and peripancreatic necroses furnishes useful additional information for total extirpation. Gallstone disease can be demonstrated or excluded preoperatively. Since introduction of ultrasound and computed tomography for the diagnosis of acute pancreatitis a marked diminution of early surgical intervention and delayed operation has been achieved.

  5. Diagnostic evaluation of acute pancreatitis in two patients with hypertriglyceridemia

    Okura, Yoshifumi; Hayashi, Kozo; Shingu, Tetsuji; Kajiyama, Goro; Nakashima, Yoshiyuki; Saku, Keijiro

    2004-01-01

    We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type V hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels. The imaging examination of ultrasonography could not detect significant findings of a...

  6. Acute amebic appendicitis: Report of a rare case

    Singh Naorem

    2010-10-01

    Full Text Available Acute appendicitis of amebic origin is considered a rare cause of acute appendicitis. We report a case of amebic appendicitis presenting with fever, severe pain in the right lower quadrant of the abdomen and rebound tenderness. Lab investigations revealed neutrophilic leukocytosis. The patient underwent appendectomy. Histopathological examination revealed numerous Entameba histolytica trophozoites in the mucosa of the appendix. Acute appendicitis of amebic origin does not appear frequently. Appendicular amebiasis can give the clinical features of acute appendicitis and should be treated accordingly.

  7. Improving abdomen tumor low-dose CT images using a fast dictionary learning based processing

    In abdomen computed tomography (CT), repeated radiation exposures are often inevitable for cancer patients who receive surgery or radiotherapy guided by CT images. Low-dose scans should thus be considered in order to avoid the harm of accumulative x-ray radiation. This work is aimed at improving abdomen tumor CT images from low-dose scans by using a fast dictionary learning (DL) based processing. Stemming from sparse representation theory, the proposed patch-based DL approach allows effective suppression of both mottled noise and streak artifacts. The experiments carried out on clinical data show that the proposed method brings encouraging improvements in abdomen low-dose CT images with tumors. (paper)

  8. MUTUAL INFORMATION BASED 3D NON-RIGID REGISTRATION OF CT/MR ABDOMEN IMAGES

    2001-01-01

    A mutual information based 3D non-rigid registration approach was proposed for the registration of deformable CT/MR body abdomen images. The Parzen Windows Density Estimation (PWDE) method is adopted to calculate the mutual information between the two modals of CT and MRI abdomen images. By maximizing MI between the CT and MR volume images, the overlapping part of them reaches the biggest, which means that the two body images of CT and MR matches best to each other. Visible Human Project (VHP) Male abdomen CT and MRI Data are used as experimental data sets. The experimental results indicate that this approach of non-rigid 3D registration of CT/MR body abdominal images can be achieved effectively and automatically, without any prior processing procedures such as segmentation and feature extraction, but has a main drawback of very long computation time. Key words: medical image registration; multi-modality; mutual information; non-rigid; Parzen window density estimation

  9. Contrast-enhanced 3D MR angiography in the chest, abdomen and lower extremities

    Contrast-enhanced 3D MR angiography permits comprehensive assessment of the arterial system in the chest, abdomen und lower extremities. The method combines intravenous bolus application of a non-nephrotoxic, paramagnetic, extracellular contrast agent with the acquisition of a fast 3D data set. High contrast between the vascular lumen and surrounding tissues, inherent three-dimensionality and the ability to collect image data in the chest and abdomen under apnea conditions all contribute to excellent image quality. Contrast-enhanced 3D MRA is being employed in many centers throughout the world for the evaluation of various arterial pathologies. This review provides a technical overview and critically discusses the clinical applications in the chest, abdomen and lower extremities based upon the available literature and several clinical examples. (orig.)

  10. Das Akute Abdomen beim Kleintier aus chirurgischer Sicht : Eine retrospektive Studie von 2000- 2005

    Günther, Charlotte Stefanie

    2011-01-01

    Das Akute Abdomen bezeichnet einen akut bedrohlichen Zustand mit starken (progredienten) Bauchschmerzen, der wegen der Tendenz zur raschen Verschlimmerung der unverzüglichen Abklärung bedarf. Bei der Diagnosestellung ist neben dem klinischen Bild die Bildgebung von größter Bedeutung. Das Röntgen und der Ultraschall zählen hier zu den wichtigsten Verfahren. Nach Kenntnis der Autorin ist diese Studie die erste in der veterinärmedizinischen Literatur, die die Gesamtheit aller akuten Abdomen ...

  11. Stability of the volume of air trapped on the abdomen of the water spider Argyroneta aquatica

    Neumann, Dietrich; Woermann, Dietrich

    2013-01-01

    The water spider Argyroneta aquatica lives under water, diving to various depths from time to time. At rest, it breathes air trapped within its diving bell with a hydrophilic surface. Outside their diving bell water spiders trap air on their abdomen under a layer of hydrophobic hair. Is the structure of the layer of hair trapping a volume of air on the abdomen of the water spider Argyroneta aquatica under water related to its observed diving depth (of the order of decimetre)? A positive answe...

  12. Fetus-in-fetu presenting as acute intestinal obstruction

    Singh Sunita; Rattan Kamal; Navtej; Gil Meenu; Mathur S; Sen Rajeev

    2010-01-01

    Fetus-in-fetu is a rare condition in which a fetiform calcified mass is often present in the abdomen of its host; a newborn or infant. We present the case of a three-month-old male baby with acute intestinal obstruction and abdominal mass. X-ray abdomen and ultrasonogram revealed a cystic mass with calcification. On laparotomy, a well encapsulated retroperitoneal mass causing high intestinal obstruction was identified. Total excision of the mass was done. Diagnosis of fetus-in-fetu was confir...

  13. Fetus-in-fetu presenting as acute intestinal obstruction

    Singh Sunita

    2010-01-01

    Full Text Available Fetus-in-fetu is a rare condition in which a fetiform calcified mass is often present in the abdomen of its host; a newborn or infant. We present the case of a three-month-old male baby with acute intestinal obstruction and abdominal mass. X-ray abdomen and ultrasonogram revealed a cystic mass with calcification. On laparotomy, a well encapsulated retroperitoneal mass causing high intestinal obstruction was identified. Total excision of the mass was done. Diagnosis of fetus-in-fetu was confirmed on histopathology. Postoperative recovery was uneventful.

  14. Radiodiagnosis programs for the recognition of acute surgical diseases of the abdominal organs, retroperitoneal space and complications thereof

    Program for complex use of X-ray and ultrasonic diagnostic methods, X-ray computerized tomography was worked out in diseases of the abdominal organs, retroperitoneal space. Creation of such program was necessary due to acute surgical intervention in diseases of these organs (1750 patients with clinical picture of acute abdomen, 1350 patients with acute diseases of abdomen cavity organs). Obtaining of momentary information for diagnosis is required in most of cases. Schemes are suggested for complex usage of these diagnostic methods in different pathology, clinical symptoms, severity in patient state, technical possibilities of medical establishments

  15. Multislice CT of the abdomen. Current indications and future trends

    Multislice CT systems allow the simultaneous acquisition of multiple slices per gantry rotation. In combination with faster gantry rotation times of 0.5 seconds, the abdominal structures can be displayed in higher spatial and temporal resolution. In MS-CT of the liver it is possible to scan the entire organ with an optimal slice thickness of 2 - 3 mm within a defined perfusion phase in less than 10 seconds. This results in an improved detection and characterization of focal liver lesions. A high-quality, 3-dimensional reconstruction of the hepatic arterial and portalvenous system is obtained with the same data set. The diagnostic use of the simultaneously acquired perfusion data will lead to a better characterization of focal liver lesions in the future. The diagnostics of the pancreas also profits from MS-CT, especially for the detection of small tumors and the evaluation of resectability of a pancreatic carcinoma. All abdominal structures can be displayed in a coronal view without loss of image quality because of the almost isotropic voxels obtained. This proves to be beneficial for the preoperative diagnostics of renal cell carcinomas, especially if the tumor extension into adjacent organs (e.g., liver or spleen) in the longitudinal direction has to be evaluated. The multiplanar display and the sophisticated 3-dimensional reconstruction tools have a substantial value for the abdominal CT angiography. It proves to have a major diagnostic impact on acute abdominal aortic and visceral arterial diseases because even large distances in the z-direction can be covered with high spatial resolution. (orig.)

  16. Adenomyomatous hyperplasia of the ampulla of Vater presenting as acute pancreatitis

    Rafiullah,; Tanimu, Sabo

    2014-01-01

    We report an interesting and rare case of a man with adenomyomatous hyperplasia of the ampulla of Vater presenting as acute pancreatitis, which to our knowledge, is only the second reported case in the English literature. The patient presented with an acute onset of abdominal pain, nausea and vomiting, without fever, chills or rigours. CT of the abdomen revealed changes of acute pancreatitis with a peripancreatic adenopathy, and abdominal ultrasound revealed a slightly hyperechoic and oedemat...

  17. Acute appendicitis in a 14-year-old boy with familial Mediterranean fever

    Yoshihiko Sakurai; Takaaki Murata; Hirohisa Hirata; Takeshi Morita

    2015-01-01

    Familial Mediterranean fever (FMF) is one manifestation of a heritable periodic fever syndrome that is characterized by recurrent attacks of febrile polyserositis, most frequently peritonitis. An FMF abdominal attack is often misdiagnosed as acute appendicitis, a more common cause of an acute abdomen. We report a 14-year-old boy with FMF who developed acute appendicitis during his follow-up. The patient had a several-year history of abdominal pain episodes, and was initially admitted for an a...

  18. Dosimetric assessments multi-slice CT of the chest and abdomen in pediatrics

    The objective of this study is the dosimetry evaluation in pediatric MSCT of thorax and abdomen, and the estimation of effective dose in the different ranges of age taking into account the new ICRP recommendations, by variations that may be involved in explorations that affect breast. (Author)

  19. Analysis of Acoustic Access to the Prostate Through the Abdomen and Perineum for Extracorporeal Ablation

    Hall, Timothy L.; Hempel, Christopher R.; Sabb, Brian J.; Roberts, William W.

    2010-03-01

    As part of the development of a noninvasive treatment for BPH using histotripsy, this study aimed to measure acoustic access for extracorporeal ablation of the prostate. Both transabdominal and transperineal approaches were considered. The objective was to measure the size and shape of a transducer aperture that could target the prostate without obstruction. CT images obtained from 17 subjects >56 years of age were used to create 3D reconstructions of the lower abdomen and pelvis. Target locations on the urethra at the base, mid, and apex in the prostate were marked along with a transrectal imaging probe. Evenly space rays spanning were traced from each target location towards the perineum and separately towards the abdomen with the maximum x-ray density encountered along each path recorded. The overall free aperture through the perineum was found to be a triangular shaped region bounded by the lower bones of the pelvis and the transrectal probe varying significantly in size between subjects. The free aperture through the abdomen was wedge shaped limited by the pubis also with great subject to subject variability. Average unblocked fractions of an f/1 transducer to target base, veru, and apex through the perineum were 77.0%, 94.4%, and 99.6%, respectively. Averages targeting through the abdomen were 86.1%, 52.3%, and 11.0%. Acoustic access to the prostate for through the perineum was judged to be feasible.

  20. Outcome of Negative-Pressure Wound Therapy for Open Abdomen Treatment After Nontraumatic Lower Gastrointestinal Surgery

    Bertelsen, Claus Anders; Fabricius, Rasmus; Kleif, Jakob;

    2014-01-01

    Few studies have focused on the risk factors for failure to achieve fascial closure after use of negative-pressure wound therapy (NPWT) in an open abdomen (OA). We aimed at analyzing possible risk factors for failure of fascial closure and the risk of fistulas after nontrauma lower gastrointestinal...

  1. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

    Michael J Forster; Jacob A Akoh

    2008-01-01

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

  2. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.

    Forster, Michael-J; Akoh, Jacob-A

    2008-03-21

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen. PMID:18350613

  3. Diagnosis of acute appendicitis with MSCT

    Objective: To analyze the CT appearance of acute appendicitis and investigate diagnostic value of MSCT on acute appendicitis. Methods: The type and CT appearance of 15 cases with acute appendicitis proved by surgery and histopathology or clinic was analyzed retrospectively. Multi-stages scanning was carried out on the whole abdomen with 16 row CT. Post processing techniques including MPR, CPR and MIP were performed to observe the lesions. Results: There were 3 acute suppurative appendicitis, 12 acute gangrene and perforative appendicitis and appendiceal abscess. Complication occurred in 10 cases with gangrene and perforative appendix or appendix molten. The complication included 4 pelvic abscess, 3 intra-abdminal abscess, 1 combined pelvic and intra-abdominal abscess, 4 conglutination bowel obstruction, 1 ureteritis stegnosis and 1 abdominal wall fistulae. The exact ratio of CT diagnosis on acute suppurative appendicitis and appendiceal abscess reached 93.3% preoperatively. It is difficult to distinguish between acute suppurative appendicitis and acute gangrenous appendicitis without perforation. Conclusion: The MSCT appearance of acute appendicitis was marked and of important value on diagnosis of acute appendicitis. (authors)

  4. Acute Salpingitis in a Nonsexually Active Adolescent.

    Fein, Daniel M; Sellinger, Catherine; Fagan, Michele J

    2015-12-01

    Acute salpingitis is an uncommon cause of an acute surgical abdomen, especially in an adolescent who is not sexually active. The following is a case of a 12-year-old girl who denied sexual activity, had a remote history of an appendectomy, and a recent diagnosis of a large, right-sided ovarian cyst, who presented with acute abdominal pain, urinary symptoms, and fever. The patient was ill-appearing and progressed to uncompensated septic shock in the emergency department despite aggressive fluid resuscitation and empiric antibiotics. She ultimately underwent an exploratory laparotomy and was diagnosed with acute bilateral salpingitis. This case highlights the diagnostic dilemmas facing those caring for an adolescent girl with abdominal pain and presents an extremely rare etiology for abdominal pain in a nonsexually active adolescent. PMID:26626893

  5. Diagnosis of acute appendicitis using ultrasonography

    It is well known that acute appendicitis is the most common cause of emergency operation of the abdomen. The mortality rate of acute appendicitis has considerably declined during the past decades, but the diagnostic accuracy is still 70 to 82%, and moreover 54 to 65% in the young women. Various radiologic examinations have been proposed to improve diagnostic accuracy. Scout films of the abdomen and barium examinations have all proved to be of some value but are not generally employed. The purpose of this study was to improve the diagnostic accuracy and to make early diagnosis of acute appendicitis using ultrasonography. High resolution real time ultrasonography was performed in 39 patients with clinically suspected acute appendicitis at the department of Radiology, St. Mary's Hospital, Catholic University Medical College from May to July 1987. Ultrasonographic findings, operative findings and results of clinical follow-up of acute appendicitis were analyzed and correlated. The results were as follows: 1. Ultrasonographic finding of acute appendicitis was visualization of appendix with thickened wall and distended lumen. In the acute appendicitis the thickness of wall was 4.5 ± 2.02mm (2 to 10mm) and even in 84.6%. The diameter of distended lumen was 6.58 ± 2.33mm (3 to 10mm). 2. Anechoic area over the appendix was thought to be a sign of periappendiceal abscess. 3. Although no echolucency was demonstrated around the appendix, perforation of appendix should be suspected when thickening of the appendiceal wall was asymmetrical and eccentric without luminal distension. 4. Ultrasonography had an 88.9% sensitivity, an 89.5% specificity and an 89.2% accuracy. 5. Ultrasonography is felt to be very accurate and effective method in the diagnosis of acute appendicitis

  6. Ultrasonographic diagnosis of acute appendicitis

    Acute appendicitis is the most common surgical disease of acute abdomen, But the diagnosis of acute appendicitis is often difficult, and not in frequently, operation for appendicitis is performed only to find a normal appendix. Various radiological examinations have been proposed to improve diagnostic accuracy of appendicitis. The purpose of this study was to improve the diagnostic accuracy of appendicitis, and to decline negative exploration. High resolution real time ultrasonographical examination using graded compression was performed in 57 consecutive patients who were clinically suspected of appendicitis. Autors analysed ultrasonographical, surgical, and clinical follow up findings. The results were are follows: 1. Ultrasonographical finding of acute appendicitis was visualization of appendix as a tubular structure with one bline end, or target phenomenon. 2. Hypoechoic area over the appendix was thought to be a sign of periappendiceal abscess. 3. The sensitivity of US diagnosis of acute appendicitis in this study was 92.8% with a specificity of 93.1%. The overall accuracy was 93.0%. 4. In control group of 50 individuals, the abnormal appendix was not visualized. 5. In cases of clinically suspected appendicitis, the US evaluation with graded compression technique is very accurate and effective examination.

  7. Small Cell Carcinoma of the Lung Presented as Acute Pancreatitis. Case Report and Review of the Literature

    Abdulzahra Hussain

    2012-11-01

    Full Text Available Context Small cell carcinoma of the lung is an aggressive cancer with gloomy prognosis. Links to acute pancreatitis is extremely rare. Case report We are reporting a 53-year-old patient who was admitted because of acute pancreatitis. She had no history of gallstones, alcohol abuse, medications or any other predisposition for acute pancreatitis. Further investigations of blood, CT of chest abdomen and neck and ultrasound scan of abdomen, bone marrow and neck lymph node biopsies confirmed advanced small cell carcinoma of the lung with hypercalcemia, which was the only definite cause of acute pancreatitis. The patient made good recovery from pancreatitis after controlling the hypercalcemia. She was referred to respiratory team for further management of lung cancer. Conclusion Acute pancreatitis due to hypercalcemia of advanced small cell carcinoma of the lung is an extremely rare condition. Acute pancreatitis due to hypercalcemia should be thoroughly investigated to exclude serious pathology as in our case.

  8. The abdomen, thigh, and arm as sites for subcutaneous sodium heparin injections.

    Fahs, P S; Kinney, M R

    1991-01-01

    The purpose of this study was to evaluate three subcutaneous injection sites for low-dose heparin therapy (5,000 units). One hundred and one subjects were randomly placed in one of three groups. Group A received injections in the abdomen, Group B, in the thigh, and Group C in the arm. Each subject received three injections at the one site. Activated partial thromboplastin time (APTT) was measured prior to initiation of heparin and again four hours after the first injection. Bruising was measured at 48, 60, and 72 hours postinjection. There were no statistically significant differences among groups for either changes in APTT or bruising at 60 and 72 hours postinjection. Thus the clinical practice of utilizing the abdomen as the only or preferred site for subcutaneous heparin injections was not supported. PMID:1857645

  9. Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

    Desoil, M.; Gillis, P.; Gossuin, Y.; Pankhurst, Q. A.; Hautot, D.

    2005-01-01

    The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe3O4) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin.

  10. Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

    The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe3O4) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin

  11. Definitive identification of magnetite nanoparticles in the abdomen of the honeybee Apis mellifera

    Desoil, M [Biological Physics Department, University of Mons-Hainaut (Belgium); Gillis, P [Biological Physics Department, University of Mons-Hainaut (Belgium); Gossuin, Y [Biological Physics Department, University of Mons-Hainaut (Belgium); Pankhurst, Q A [London Centre for Nanotechnology, University College London, London WC1E 7HN (United Kingdom); Hautot, D [London Centre for Nanotechnology, University College London, London WC1E 7HN (United Kingdom); Institute for Science and Technology in Medicine, Keele University, Thornburrow Drive, Hartshill, Stoke-en-Trent, ST4 7QB (United Kingdom)

    2005-01-01

    The biogenic magnetic properties of the honeybee Apis mellifera were investigated with a view to understanding the bee's physiological response to magnetic fields. The magnetisations of bee abdomens on one hand, and heads and thoraxes on the other hand, were measured separately as functions of temperature and field. Both the antiferromagnetic responses of the ferrihydrite cores of the iron storage protein ferritin, and the ferrimagnetic responses of nanoscale magnetite (Fe{sub 3}O{sub 4}) particles, were observed. Relatively large magnetite particles (ca. 30 nm or more), capable of retaining a remanent magnetisation at room temperature, were found in the abdomens, but were absent in the heads and thoraxes. In both samples, more than 98% of the iron atoms were due to ferritin.

  12. Nutrición enteral temprana, en pacientes con abdomen abierto

    Mario Sánchez-Arias

    2006-03-01

    Full Text Available Objetivo: Observar la factibilidad de la nutrición enteral en el paciente crítico quirúrgico con abdomen abierto y valorar su avance y posibles complicaciones. Método: Estudio observacional descriptivo de los pacientes que ingresaron a la Unidad de Cuidado Intermedio Quirúrgico de la Sección de Cirugía del Hospital Dr. R.A. Calderón Guardia, con abdomen abierto, de junio de 2003 a noviembre de 2004, y en quienes se colocó una sonda de nutrición en yeyuno. Resultados: Se observaron 15 pacientes, con una edad promedio de 46 años, con abdomen abierto y acceso nasoyeyunal el 80% y yeyunal directo el 20%, a los cuales se les inició nutrición enteral temprana (36 hrs con una fórmula polimérica, a razón de 23cc/hr, que se avanzó a razón de 6.6cc/día, por un promedio de 9 días, alcanzando un 80% de ellos el 80% de sus requerimientos estimados, en 4.6, días. No hubo mortalidad en la serie, aunque sí intolerancia al régimen (33.3%, principalmente por persistencia de fístula; tales pacientes se pasaron a nutrición parenteral. Conclusiones: La nutrición enteral puede usarse en pacientes con abdomen abierto, si se les procura un acceso yeyunal y se les proporciona en volúmenes y aumentos discretos, de acuerdo con la condición del intestino.Ojective: To observe enteral nutrition feasibility in patients with "open abdomen" their evolution and complications. Methods: This is an observational study of patients with "open abdomen" who were admitted to the Intermediate Care Unit of the Surgical Service at the Calderón Guardia Hospital between june 2003 to November 2004, with a yeyunal access for nutrition. Results: Fifteen patients were studied with an average age of 36 years, all of them with open abdomen and jejunal access, who got early enteral nutrition (36 hrs with a polymeric formula, starting at 23 cc/hrs and were then advanced 6.6cc/ daly for 9 days, reaching 80% of the patients, 80% of threir requirements in 4.6 days. There

  13. Blunt liver injury with intact ribs under impacts on the abdomen: a biomechanical investigation.

    Yu Shao

    Full Text Available Abdominal trauma accounts for nearly 20% of all severe traffic injuries and can often result from intentional physical violence, from which blunt liver injury is regarded as the most common result and is associated with a high mortality rate. Liver injury may be caused by a direct impact with a certain velocity and energy on the abdomen, which may result in a lacerated liver by penetration of fractured ribs. However, liver ruptures without rib cage fractures were found in autopsies in a series of cases. All the victims sustained punches on the abdomen by fist. Many studies have been dedicated to determining the mechanism underlying hepatic injury following abdominal trauma, but most have been empirical. The actual process and biomechanism of liver injury induced by blunt impact on the abdomen, especially with intact ribs remained, are still inexhaustive. In order to investigate this, finite element methods and numerical simulation technology were used. A finite element human torso model was developed from high resolution CT data. The model consists of geometrically-detailed liver and rib cage models and simplified models of soft tissues, thoracic and abdominal organs. Then, the torso model was used in simulations in which the right hypochondrium was punched by a fist from the frontal, lateral, and rear directions, and in each direction with several impact velocities. Overall, the results showed that liver rupture was primarily caused by a direct strike of the ribs induced by blunt impact to the abdomen. Among three impact directions, a lateral impact was most likely to cause liver injury with a minimum punch speed of 5 m/s (the momentum was about 2.447 kg.m/s. Liver injuries could occur in isolation and were not accompanied by rib fractures due to different material characteristics and injury tolerance.

  14. Nutrición enteral temprana, en pacientes con abdomen abierto

    Mario Sánchez-Arias

    2006-03-01

    Full Text Available Objetivo: Observar la factibilidad de la nutrición enteral en el paciente crítico quirúrgico con abdomen abierto y valorar su avance y posibles complicaciones. Método: Estudio observacional descriptivo de los pacientes que ingresaron a la Unidad de Cuidado Intermedio Quirúrgico de la Sección de Cirugía del Hospital Dr. R.A. Calderón Guardia, con abdomen abierto, de junio de 2003 a noviembre de 2004, y en quienes se colocó una sonda de nutrición en yeyuno. Resultados: Se observaron 15 pacientes, con una edad promedio de 46 años, con abdomen abierto y acceso nasoyeyunal el 80% y yeyunal directo el 20%, a los cuales se les inició nutrición enteral temprana (36 hrs con una fórmula polimérica, a razón de 23cc/hr, que se avanzó a razón de 6.6cc/día, por un promedio de 9 días, alcanzando un 80% de ellos el 80% de sus requerimientos estimados, en 4.6, días. No hubo mortalidad en la serie, aunque sí intolerancia al régimen (33.3%, principalmente por persistencia de fístula; tales pacientes se pasaron a nutrición parenteral. Conclusiones: La nutrición enteral puede usarse en pacientes con abdomen abierto, si se les procura un acceso yeyunal y se les proporciona en volúmenes y aumentos discretos, de acuerdo con la condición del intestino.

  15. Estimation of breast dose and cancer risk in chest and abdomen CT procedures

    The use of CT in medical diagnosis delivers radiation doses to patents that are higher than those from other radiological procedures. Lack of optimized protocols be an additional source of increased dose in developing countries. The aims of this study are first, to measure patient doses during CT chest and abdomen procedures, second, to estimate the radiation dose to the breast, and third to quantify the radiation risks during the procedures. Patient doses from two common CT examinations were obtained from four hospitals in Khartoum.The patient doses were estimated using measurement of CT dose indexes (CTDI), exposure-related parameters, and the IMPACT spreadsheet based on NRPB conversion factors. A large variation of mean organ doses among hospitals was observed for similar CT examinations. These variations largely originated from different CT scanning protocols used in different hospitals and scanner type. The largest range was found for CT of the chest, for which the dose varied from 2.3 to 47 (average 24.7) mSv and for abdomen CT, it was 1.6 to 18.8 (average 10.2) mSv. Radiation dose to the breast ranged from 1.6 to 32.9 mSv for the chest and 1.1 to 13.2 mSv for the abdomen. The radiation risk per procedure was high. The obtained values were mostly higher than the values of organ doses reported from the other studies. It was concluded that current clinical chest and abdomen protocols result in variable radiation doses to the breast. The magnitude of exposure may have implications for imaging strategies.(Author)

  16. Use of chorioamniotic membrane instead of bogota bag in open abdomen: How I Do It?

    Tekin, Sakir; Tekin, Ahmet; Küçükkartallar, Tevfik; ÇAKIR, Murat; Kartal, Adil

    2008-01-01

    It is one of the most important problems for general surgeons to decide which operation should be undertaken on patients with intra-abdominal infection, especially those with concomitant abdominal hypertension. Recentlly, closure techniques using prosthetic meshes in order to retain abdominal tension and to control sepsis have become very popular for patients with abdominal sepsis and hypertension. We used chorioamniotic membrane instead of plastic material to cover the open abdomen. We concl...

  17. Delayed rupture of thoracic aorta aneurysm following a kick to the abdomen.

    Oliva, Antonio; De Giorgio, Fabio; Partemi, Sara; Pascali, Vincenzo L; Carbone, Arnaldo

    2009-03-01

    Several theories have been proposed to explain the Blunt Traumatic Aortic Rupture (BTAR) because different mechanical forces act on the aorta, at anatomically susceptible sites, including shearing, torsion and stretching, but the origin, transduction and relative importance of these forces remain uncertain. We report a case of a 74-year-old man injured by a kick to the abdomen. After 2 days he felt chest pain paroxysm and weakness in his left leg. The patient was admitted to an emergency care department where he experienced sudden and severe hemodynamic deterioration, dying rapidly. The autopsy, performed 3 days later, showed haemorragic infarction of hypogastric subcutaneous tissues and revealed an extended dissecting aneurysm of the thoracic aorta with following haemopericardium. In our case we considered that a low energy compression to the abdomen, in presence of underlying atherosclerosis, caused aortic dissection rather than rupture and then the 48h time span after the traumatic event and the cardiac tamponade was enough to complete the aortic retrograde dissection. We finally emphasise the importance of the careful surveillance of any trauma close to the abdomen in view of initially unpredictable, as well as eventful injuries. The finding of early signs of neointima formation in thoracoabdominal portions of aortic dissection strongly supported our interpretation. The forensic interest of this case is correlated to the voluntary character of the inflicted injury. The culprit was thus charged with manslaughter. PMID:18849182

  18. MREIT conductivity imaging of the postmortem canine abdomen using CoReHA

    Magnetic resonance electrical impedance tomography (MREIT) is a new bio-imaging modality providing cross-sectional conductivity images from measurements of internal magnetic flux densities produced by externally injected currents. Recent experimental results of postmortem and in vivo imaging of the canine brain demonstrated its feasibility by showing conductivity images with meaningful contrast among different brain tissues. MREIT image reconstructions involve a series of data processing steps such as k-space data handling, phase unwrapping, image segmentation, meshing, modelling, finite element computation, denoising and so on. To facilitate experimental studies, we need a software tool that automates these data processing steps. In this paper, we summarize such an MREIT software package called CoReHA (conductivity reconstructor using harmonic algorithms). Performing imaging experiments of the postmortem canine abdomen, we demonstrate how CoReHA can be utilized in MREIT. The abdomen with a relatively large field of view and various organs imposes new technical challenges when it is chosen as an imaging domain. Summarizing a few improvements in the experimental MREIT technique, we report our first conductivity images of the postmortem canine abdomen. Illustrating reconstructed conductivity images, we discuss how they discern different organs including the kidney, spleen, stomach and small intestine. We elaborate, as an example, that conductivity images of the kidney show clear contrast among cortex, internal medulla, renal pelvis and urethra. We end this paper with a brief discussion on future work using different animal models

  19. Dose estimation in CT exams of the abdomen based on values of DLP

    One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo4:Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

  20. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  1. Abdomen - swollen

    ... of a serious medical problem) Gas in the intestines from eating foods that are high in fiber (such as fruits and vegetables) Irritable bowel syndrome Lactose intolerance Ovarian cyst Partial bowel blockage Pregnancy ...

  2. The abdomen

    An interesting survey conducted by Merrill and his co-workers from the Royal Hallamshire Hospital in Sheffield deals with performing barium enemas after biopsy. Their results confirm that superficial biopsies do not lead to complication, but deep biopsies may. Two interesting articles describing pneumatosis have been selected. One is about patients with Chrohn's disease, the other by Yamaguchi, who showed a relationship between pneumatosis and trichloroethylene exposure. An article dealing with the natural history of minute hepatocellular carcinomas is included. It is interesting to see what happens to a disease when little or no treatment is used. It is probably the most important type of study when one wants to compare the effectiveness of treatment. Usually it is not possible to obtain an adequate series of patients who have been followed but not treated. Magnetic resonance imaging of the liver is included, claiming tissue-specific characterization for cavernous hemangiomas. Ultrasound assessment in diffuse parenchymal disease is discussed, demonstrating the usefulness as well as limitation of ultrasound in these entities

  3. Body vectoring technique with Radiesse® for tightening of the abdomen, thighs, and brachial zone

    Cogorno Wasylkowski V

    2015-05-01

    Full Text Available Valeria Cogorno Wasylkowski Médico Estético Cosmetic Medicine, Clinic Novosalud, Madrid, Spain Background: The objective of this study was to investigate the efficacy, safety, and subject satisfaction of the calcium hydroxylapatite-based dermal filler Radiesse® in a novel body vectoring technique to correct skin flaccidity in the thighs, abdomen, and brachial zones.Methods: Female subjects with self-evaluated flaccidity scores ≥3 on a 6-point scale (0, no flaccidity; 5, very severe flaccidity in the zones of interest were included. Radiesse was injected according to predesigned vector maps (3 mL per thigh, 1.5 mL per hemiabdomen or brachial zone. Clinical assessments (skin density and thickness were made by an independent reviewer at an exact position before and 5 weeks after treatment using a cutometer and an ultrascan. Subjects rated skin flaccidity before and 5 weeks after treatment on the 6-point scale and performed a pinch test to self-assess changes in skin thickness. All adverse events were recorded.Results: Twenty females (aged 28–67 years were enrolled, contributing 36 treatment zones. Across all zones, 78% of flaccidity measurements improved after treatment. Improvements in skin flaccidity were most common in the thighs (82% of cases. An improvement in skin density versus baseline was observed in the majority across all zones, most frequently in the abdomen (88% of cases. Skin thickness in each zone also improved versus baseline for the majority, most frequently in the thighs (88% of cases. Mean self-assessed flaccidity scores at baseline were 3.6 (thighs, 3.7 (abdomen, and 3.8 (brachial zone, and 2.6, 2.7, and 3.0, respectively, posttreatment. All subjects reported a positive pinch test. In total, 47.0% of subjects had bruising after treatment, which resolved within a week. No serious adverse events were reported.Conclusion: Using this novel technique, Radiesse had notable results on skin flaccidity, density and thickness in

  4. Microvascular blood flow response in the intestinal wall and the omentum during negative wound pressure therapy of the open abdomen

    Hlebowicz, Joanna; Hansson, Johan; Lindstedt, Sandra

    2011-01-01

    Purpose Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) compared with other wound therapy techniques. However, the method has occasionally been associated with increased development of intestinal fistulae. The present study measures microvascular blood flow in the intestinal wall and the omentum before and during NPWT. Methods Six pigs underwent midline incision and application of NPWT to the open abdomen. The microvascular blood flow in...

  5. Open abdomen procedure in managing abdominal compartment syndrome in a child with severe fungal peritonitis and sepsis after gastric perforation

    Wei Lai

    2016-04-01

    Full Text Available Abdominal compartment syndrome with increased abdominal pressure resulted in multi-organ dysfunctions can be lethal in children. The open abdomen procedure intentionally leaves the abdominal cavity open in patients with severe abdominal sepsis and abdominal compartment syndrome by temporarily relieving the abdominal pressure. We reported our experience of open abdomen procedure in successfully treating a 4-year old boy with abdominal compartment syndrome caused by severe fungal peritonitis and sepsis after gastric perforation.

  6. Recurrent Acute Pancreatitis and Wirsungocele. A Case Report and Review of Literature

    Rajesh Gupta

    2008-07-01

    Full Text Available Context The association of Santorinicele with pancreas divisum has been well described. There is an increased risk of recurrent acute pancreatitis in patients with pancreas divisum who also have Santorinicele. Focal saccular dilation of the terminal part of the main pancreatic duct has been described as an incidental finding and termed, ‘Wirsungocele’. Case report We report a case of a 39-yearold male who had recurrent episodes of acute pancreatitis. Laboratory tests, US of the abdomen and CECT of the abdomen confirmed acute pancreatitis. MRCP showed focal saccular dilation of the terminal part of the main pancreatic duct suggestive of Wirsungocele. An ERCP confirmed MRCP findings. An endoscopic pancreatic sphincterotomy was performed and a 5 Fr single pigtail pancreatic stent was placed. The pancreatic stent was removed after 4 weeks. At the 12-week follow-up, the patient was asymptomatic. Conclusion This case report describes the association of Wirsungocele with recurrent acute pancreatitis.

  7. MR imaging in clinically suspected acute cholecystitis: a comparison with ultrasonography

    Haakansson, K. [Kalmar Hospital (Sweden). Dept. of Radiology; Leander, P.; Ekberg, O. [Malmoe Univ. Hospital (Sweden). Dept. of Radiology; Haakansson, H.O. [Kalmar Hospital (Sweden). Dept. of Surgery

    2000-07-01

    Purpose: The diagnostic value of fast pulse sequences in MR imaging was compared with US in patients with clinically suspected acute cholecystitis. Material and Methods: In a prospective study of 94 patients, 35 were examined with both MR and US within 24 h. Results: MR diagnoses were acute cholecystitis in 23, gallbladder and common bile duct stones in 3, other pathologic conditions of the abdomen in 7 and normal in 2 patients. US diagnoses were acute cholecystitis in 17, gallbladder stones in 8, other pathologic conditions of the abdomen in 2, normal in 5 and non-conclusive in 3 patients. Conclusion: MR has a higher sensitivity than US for diagnosing acute cholecystitis and, with increased accessibility (may be the first imaging method)

  8. Issues in Management of Acute Appendicitis in Pregnancy

    Sivalingam Nalliah; Lionel Wijesuriya; Subramani Venugopal

    2011-01-01

    Acute appendicitis is an infrequent yet the commonestsurgical emergency in pregnancy occurring in about1:1500 pregnancies. The classical abdominal pain in theright lower quadrant of the abdomen is the only reliableclinical sign. Delay in diagnosis is attributed to presenceof symptoms commonly seen in pregnancy like nauseaand vomiting and difficulty in localizing abdominal paindue to displacement of the appendix with advancinggestation. Perforated appendix and generalizedperitonitis impacts ad...

  9. Hematocolpos as a Result of Delayed Treatment of Acute Straddle Injury in an Adolescent Girl

    Hae Jin Hwang; Hyun Wook Lim; Young Shin Han; Jeong In Choi; Min Jeong Kim

    2016-01-01

    Accidental genital trauma is most commonly caused by straddle-type injuries and is usually treatable by nonoperative management, and most of the injuries have a good prognosis. When the bleeding occurred due to straddle injury in adolescent girl, experienced gynecological examination and treatment were very important. We experienced a case of straddle injury to the posterior fourchette that caused acute hematocolpos due to delayed adequate treatment with hypotension and acute abdomen in an ad...

  10. Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

    Eze, Kenneth C.; Salami, Taofeek A; James U Kpolugbo

    2014-01-01

    Background: To highlight the problems of diagnosis and management of acute abdomen in patients with lassa fever. And to also highlight the need for high index of suspicion of lassa fever in patients presenting with acute abdominal pain in order to avoid surgical intervention with unfavourable prognosis and nosocomial transmission of infections, especially in Lassa fever-endemic regions. Materials and Methods: A review of experiences of the authors in the management of lassa fever over a 4-yea...

  11. CLINICAL STUDY AND MANAGEMENT OF BLUNT INJURY ABDOMEN PERTAINING TO SOLID ORGANS

    Katta Srinivasa

    2015-09-01

    Full Text Available Blunt Abdominal trauma is one of the most common causes among injuries caused mainly due to road traffic accidents. 1 The rapid increase in number of motor vehicles and its aftermath has caused rapid increase in number of victims to blunt abdominal trauma. Motor vehicle accidents account for 75 to 80% of blunt abdominal trauma. 2 Blunt injury of abdomen is also a result of fall from height, assault with blunt objects, industrial mishaps, sport injuries, bomb blast and fall from riding bicycle. 2 In view of increasing number of vehicles and consequently road traffic accidents, this topic is chosen to study the cases of blunt abdominal trauma with reference to the patients presenting at Govt. General Hospital, attached to Guntur Medical College, Guntur. OBJECTIVES: The objectives of the study are: 1. To evaluate the impact of blunt abdominal trauma on solid viscera. 2. To evaluate etiology and various modes of presentation. 3. To evaluate various available investigations for the detection of solid organ injuries. 4. To evaluate various modalities of treatment available with aim to reduce the mortality and morbidity. 5. To evaluate common complications of solid organ injury in blunt trauma abdomen. MATERIALS AND METHODS: Patients admitted in Government General Hospital, Guntur, from November 2012 to October 2014 and studied 50 cases. This is a prospective study conducted over 2 years. RESULTS: Male patients were commonly affected (80%, Peak age group being 21 – 30 years (48%. The commonest mode of injury was road traffic accident (58%. The common organ injured was spleen (54% followed by liver. 70% of the patients were treated by surgery, 30% conservatively. The mortality in this study was 14%. CONCLUSIONS : Blunt injury abdomen forms considerable load and health care system, most common age group is youngsters in road traffic accidents , so efforts should be made to formulate and execute road traffic regulations. Well established trauma care

  12. Appendicular mass complicating acute appendicitis in a patient with dengue fever.

    Low, Y N; Cheong, B M K

    2016-04-01

    Abdominal pain with dengue fever can be a diagnostic challenge. Typically, pain is localised to the epigastric region or associated with hepatomegaly. Patients can also present with acute abdomen. We report a case of a girl with dengue fever and right iliac fossa pain. The diagnosis of acute appendicitis was made only after four days of admission. An appendicular mass and a perforated appendix was noted during appendectomy. The patient recovered subsequently. Features suggestive of acute appendicitis are persistent right iliac fossa pain, localised peritonism, persistent fever and leucocytosis. Repeated clinical assessment is important to avoid missing a concurrent diagnosis like acute appendicitis. PMID:27326951

  13. Right Hydronephrosis as a Complication of Acute Appendicitis

    Okur, Selahattin Koray; Koca, Yavuz Savaş; Yıldız, İhsan; Barut, İbrahim

    2016-01-01

    Introduction. Acute appendicitis is the most common cause of acute abdomen, but atypical appendicitis may lead to delayed diagnosis and related complications. In this report, we present a very rare case of acute appendicitis causing right hydronephrosis. Case Report. A 54-year-old male patient who had been receiving antibiotic therapy due to the diagnosis of urinary tract infection for the last one week but had no clinical improvement was admitted to the emergency service. Abdominal computed tomography (CT) showed right hydronephrosis and a pelvic abscess. After appendectomy and abscess drainage had been performed, hydronephrosis was completely recovered. Discussion. The use of appendicitis scoring systems, abdominal ultrasonography (USG), abdominal CT, and diagnostic laparoscopy can be useful for the diagnostic process in patients presenting with acute abdomen. In our patient, we considered that the surgical treatment was delayed since the symptoms of acute appendicitis were suppressed by the antibiotic therapy that was being administered due to the complaints including symptoms of urinary tract infections. Conclusion. Atypical appendicitis may cause a delay in the diagnosis of acute appendicitis and thus may lead to serious complications such as right hydronephrosis, prolonged hospital stay, increased morbidity and mortality, and increased antibiotic resistance. PMID:27069699

  14. Right Hydronephrosis as a Complication of Acute Appendicitis.

    Okur, Selahattin Koray; Koca, Yavuz Savaş; Yıldız, İhsan; Barut, İbrahim

    2016-01-01

    Introduction. Acute appendicitis is the most common cause of acute abdomen, but atypical appendicitis may lead to delayed diagnosis and related complications. In this report, we present a very rare case of acute appendicitis causing right hydronephrosis. Case Report. A 54-year-old male patient who had been receiving antibiotic therapy due to the diagnosis of urinary tract infection for the last one week but had no clinical improvement was admitted to the emergency service. Abdominal computed tomography (CT) showed right hydronephrosis and a pelvic abscess. After appendectomy and abscess drainage had been performed, hydronephrosis was completely recovered. Discussion. The use of appendicitis scoring systems, abdominal ultrasonography (USG), abdominal CT, and diagnostic laparoscopy can be useful for the diagnostic process in patients presenting with acute abdomen. In our patient, we considered that the surgical treatment was delayed since the symptoms of acute appendicitis were suppressed by the antibiotic therapy that was being administered due to the complaints including symptoms of urinary tract infections. Conclusion. Atypical appendicitis may cause a delay in the diagnosis of acute appendicitis and thus may lead to serious complications such as right hydronephrosis, prolonged hospital stay, increased morbidity and mortality, and increased antibiotic resistance. PMID:27069699

  15. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  16. Effective dose conversion coefficients for X-ray radiographs of the chest and the abdomen

    Lima, F.R.A. [Centro regional de Ciencias Nucleares, CRCN/CNEN, Rua Conego Barata, 999, Tamarineira, Recife, PE (Brazil); Kramer, R.; Vieira, J.W.; Khoury, H.J. [Departamento de Energia Nuclear, DEN/UFPE, Cidade Universitaria, Recife, PE (Brazil)]. E-mail: falima@cnen.gov.br

    2004-07-01

    The recently developed MAX (Male Adult voXel) and the FAXht (Female Adult voXel) head and trunk phantoms have been used to calculate organ and tissue equivalent dose conversion coefficients for X-ray radiographs of the chest and the abdomen as a function of source and field parameters, like voltage, filtration, field size, focus-to-skin distance, etc. Based on the equivalent doses to twenty three organs and tissues at risk, the effective dose has been determined and compared with corresponding data for others phantoms. The influence of different radiation transport codes, different tissue compositions and different human anatomies have been investigated separately. (Author)

  17. Superparamagnetic particles as gastrointestinal contrast agent in magnetic resonance imaging of lower abdomen

    Negative gastrointestinal contrast enhancement can be achieved by oral administration of superparamagnetic particles. Their feasibility for the MR imaging of the female pelvis and lower abdomen was evaluated in studies on 32 follow-up patients with treated gynaecologic cancer. All the applied doses (0.2-1.0 mg particles/ml given in a volume of 600-800 ml) of contrast medium decreased the intraluminal signal. However, there was unpredictable individual variation in segmental distribution, and in some cases only a limited contrast effect was obtained. Image distortion was detected when the applied particle concentration exceeded 0.5 mg/ml, especially of the sagittal sections. (orig.)

  18. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Ghodratollah Maddah; Hossein Shabahang; Abbas Abdollahi; Vahid Zehi; Mohsen Abdollahi

    2014-01-01

    The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag). The study population comprised of 11 (57.9%) male and 8 (42.1%) female with an av...

  19. Effective dose evaluation for chest and abdomen X-ray tests

    The radiation doses resulting from diagnostic X-ray examinations are routinely measured in terms of entrance skin exposure (ESE). In this study, for the purpose of radiation protection, the radiation doses received from chest and abdomen X-ray tests were evaluated in terms of equivalent dose and effective dose. The dose calculations were conducted by using the MCNP Monte Carlo code and an adult hermaphrodite mathematical phantom. The effects of both operating high voltage and projection geometry on the effective dose were investigated. The absolute values of the effective doses may be provided from the national average ESE. (authors)

  20. Use of chorioamniotic membrane instead of bogota bag in open abdomen: how i do it?

    Tekin, Sakir; Tekin, Ahmet; Kucukkartallar, Tevfik; Cakir, Murat; Kartal, Adil

    2008-02-01

    It is one of the most important problems for general surgeons to decide which operation should be undertaken on patients with intra-abdominal infection, especially those with concomitant abdominal hypertension. Recently, closure techniques using prosthetic meshes in order to retain abdominal tension and to control sepsis have become very popular for patients with abdominal sepsis and hypertension. We used chorioamniotic membrane instead of plastic material to cover the open abdomen. We conclude that human chorioamniotic membrane prepared under sterile conditions may be an alternative to conventional plastic bags in daily practice, for preventing serosal erosion and fistulas in patients undergoing open abdominal surgery. PMID:18205280

  1. Use of chorioamniotic membrane instead of bogota bag in open abdomen:How I Do It?

    Sakir Tekin; Ahmet Tekin; Tevfik Kücükkartallar; Murat Cakir; Adil Kartal

    2008-01-01

    It is one of the most important problems for general surgeons to decide which operation should be undertaken on patients with intra-abdominal infection,especially those with concomitant abdominal hypertension.Recentlly,closure techniques using prosthetic meshes in order to retain abdominal tension and to control sepsis have become very popular for patients with abdominal sepsis and hypertension.We used chorioamniotic membrane instead of plastic material to cover the open abdomen.We conclude that human chorioamniotic membrane prepared under sterile conditions may be an alternative to conventional plastic bags in daily practice,for preventing serosal erosion and fistulas in patients undergoing open abdominal surgery.

  2. Sarcoma de Ewing extraesquelético que semeja abdomen agudo

    Gilberto Guzmán Valdivia-Gómez; María Teresa Soto-Guerrero; María Isabel Cedillo-de la Cruz

    2010-01-01

    Introducción: El sarcoma de Ewing extraóseo es un tumor raro de origen neuroectodérmico que se ha presentado principalmente en las partes blandas de las extremidades y del tórax; histológicamente es similar al sarcoma de Ewing en el tejido óseo. Caso clínico: Paciente con abdomen agudo y leucocitosis, en quien por imagen (ultrasonido y tomografía axial computarizada) se diagnosticó enfermedad diverticular complicada del colon, por lo que fue intervenido quirúrgicamente, encontrando lesión loc...

  3. Dengue Fever Presenting as Acute Pancreatitis

    Prasad Seetharam; Gabriel Rodrigues

    2010-01-01

    A 56-year-old non-alcoholic male was admitted with complaints of severe abdominal pain and was diagnosed with acute pancreatitis after blood investigations and a computed tomography scan of the abdomen. He developed a high-grade fever on the third day of admission, and serology tested positive for dengue. Treatment for dengue was instituted, leading to a good response and complete resolution of pancreatitis. The patient has been doing well and has had no recurrence of pancreatitis at the end ...

  4. Acute appendicitis in a premature baby

    Beluffi, Giampiero; Alberici, Elisa [Department of Radiodiagnosis, Section of Paediatric Radiology, IRCCS Policlinico S. Matteo, Piazzale Golgi 2, 27100 Pavia PV (Italy)

    2002-07-01

    A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

  5. Gastrointestinal stromal tumor: acute liquefaction necrosis

    Stromal tumors, together with leiomyomas and schwannomas, constitute the sol-called mesenchymal tumors of the intestinal wall. Stromal tumors are histologically differentiated from other mesenchymal tumors in that they are derived from the interstitial cell of Cajal. These tumors can be encountered at any point throughout the entire digestive tract, by usually develop in stomach or small bowel. the clinical presentation in anemia secondary to gastrointestinal bleeding. Acute abdomen due to perforation or necrosis is rare. We present a case of jejunal stromal tumors with massive liquefaction necrosis, a circumstance that resulted in the peculiar radiological features observed. (Author) 9 refs,

  6. Acute appendicitis in a premature baby

    A case of acute appendicitis in a premature baby in whom diagnosis was suggested on plain films of the abdomen is presented. In this baby air in a hollow viscus suspected of being an enlarged appendix was the clue to diagnosis. The diagnostic dilemma of this rare and life-threatening condition in premature babies and newborns is underlined. The relevance of different imaging modalities and of different findings in this age group is discussed. Awareness of this rare condition and possible differential diagnosis in newborns and premature babies is stressed. (orig.)

  7. Approach, management and prediction of prognosis in the acute abdomen syndrome in dogs. Study of prognosis predictors in 28 cases

    Ribeiro, Ana Margarida de Bastos

    2013-01-01

    RESUMO - ABORDAGEM, MANEIO E PREVISÃO DE PROGNÓSTICO NA SÍNDROME DE ABDÓMEN AGUDO EM CÃES. ESTUDO DE PREVISORES DE PROGNÓSTICO EM 28 CASOS - A síndrome de abdómen agudo é caracterizada por dor abdominal de início repentino, normalmente associada a sinais clínicos gerais tais como vómito, diarreia, alterações de postura e equilíbrio, anorexia, letargia e choque. O sucesso na resolução desta síndrome resulta de uma abordagem proactiva ao maneio médico, incluindo estabilização rápida...

  8. Abdomen disease diagnosis in CT images using flexiscale curvelet transform and improved genetic algorithm.

    Sethi, Gaurav; Saini, B S

    2015-12-01

    This paper presents an abdomen disease diagnostic system based on the flexi-scale curvelet transform, which uses different optimal scales for extracting features from computed tomography (CT) images. To optimize the scale of the flexi-scale curvelet transform, we propose an improved genetic algorithm. The conventional genetic algorithm assumes that fit parents will likely produce the healthiest offspring that leads to the least fit parents accumulating at the bottom of the population, reducing the fitness of subsequent populations and delaying the optimal solution search. In our improved genetic algorithm, combining the chromosomes of a low-fitness and a high-fitness individual increases the probability of producing high-fitness offspring. Thereby, all of the least fit parent chromosomes are combined with high fit parent to produce offspring for the next population. In this way, the leftover weak chromosomes cannot damage the fitness of subsequent populations. To further facilitate the search for the optimal solution, our improved genetic algorithm adopts modified elitism. The proposed method was applied to 120 CT abdominal images; 30 images each of normal subjects, cysts, tumors and stones. The features extracted by the flexi-scale curvelet transform were more discriminative than conventional methods, demonstrating the potential of our method as a diagnostic tool for abdomen diseases. PMID:26499377

  9. Anatomic atlas for computed tomography in the mesaticephalic dog: caudal abdomen and pelvis

    The purpose of this study was to produce a comprehensive anatomic atlas of CT anatomy of the dog for use by veterinary radiologists, clinicians, and surgeons. Whole-body CT images of two mature beagle dogs were made with the dogs supported in sternal recumbency and using a slice thickness of 13 mm. At the end of the CT session, each dog was euthanized, and while carefully maintaining the same position, the body was frozen. The body was then sectioned at 13-mm intervals, with the cuts matched as closely as possible to the CT slices. The frozen sections were cleaned, photographed, and radiographed using xeroradiography. Each CT image was studied and compared with its corresponding xeroradiograph and anatomic section to assist in the accurate identification of specific structures. Clinically relevant anatomic structures were identified and labeled in the three corresponding photographs (CT image, xeroradiograph, and anatomic section). In previous papers, the head and neck, and the thorax and cranial abdomen of the mesaticephalic (beagle) dog were presented. In this paper, the caudal part of the abdomen and pelvis of the bitch and male dog are presented

  10. Evaluation of polypropylene mesh coated with biological hydrogels for temporary closure of open abdomen.

    Deng, Youming; Ren, Jianan; Chen, Guopu; Li, Guanwei; Guo, Kun; Hu, Qiongyuan; Wu, Xiuwen; Wang, Gefei; Gu, Guosheng; Li, Jieshou

    2016-08-01

    Polypropylene mesh, as a temporary abdominal closure device, may cause mechanical intestine injury and inflammatory response. Chitosan/gelatin hydrogel has excellent biocompatibility, soft and elastic properties. This work is to assess the effects of the chitosan/gelatin hydrogel coated polypropylene mesh on open abdomen wounds. Histological analysis and detection of healing-related factors were conducted to evaluate the inflammation and wound healing process. After 1-day implantation in a murine model of open abdomen, the coated polypropylene mesh, compared with simple polypropylene mesh, demonstrated well protection of the intestine serosa. After 14-day implantation, it reduced the inflammation response by down-regulating the cytokines interleukin-6 and tumor necrosis factor-α, and up-regulating the anti-inflammatory factor interleukin-10. Meanwhile, the composite stimulated granulation tissue growth, and promoted matrix deposition and angiogenesis after 7 and 14 days. In conclusion, the modified temporary abdominal closure composite could significantly protect the intestines from mechanical damage and accelerate wound healing. PMID:27114442

  11. Syringocystadenoma papilliferum in the right lower abdomen: a case report and review of literature

    Xu D

    2013-03-01

    Full Text Available Dong Xu,1,2 Tienan Bi,3,2 Huanrong Lan,3,2 Wenjie Yu,1 Wenmin Wang,1 Feilin Cao,1,2 Ketao Jin1,2 1Department of Surgical Oncology, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang, People’s Republic of China; 2Laboratory of Translational Oncology, Public Research Platform, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang, People’s Republic of China; 3Department of Gastrointestinal Surgery, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang, People’s Republic of China Abstract: Syringocystadenoma papilliferum (SCAP is an uncommon benign adnexal tumor of the skin. It is frequently seen in association with other benign adnexal lesions, such as nevus sebaceous, apocrine nevus, tubular apocrine adenoma, apocrine hidrocystoma, apocrine cystadenoma, and clear cell syringoma. The unusual reported locations of SCAP include the head and neck, the buttock, the vulva, the scrotum, the pinna, the eyelid, the outer ear canal, the forehead, the back, the scalp, the thigh, the nipple, the axilla, and the postoperative scar. The occurrence of SCAP in the right lower abdomen is distinctly uncommon. Herein, we report an unusual case of a 41-year-old man with SCAP occurring in the right lower abdomen that did not develop malignancy, despite a long disease course and an absence of medical treatment. The clinical and histopathologic features and the differential diagnosis of SCAP are also discussed. Keywords: adnexal, skin tumor, benign

  12. Acute gastro-duodenal ulceration - lesions without a niche

    Between 1974 and 1978 we saw nine patients with acute gastro-duodenal ulcers. Morphologically these were characterised by their unusual extent without deep penetration, by sharp bizarre contours, and with symmetrical findings in the gastric antrum. Spasm and submucous inflammatory reactions may obscure the niche of an antral ulcer and lead to stenosis and rigidity; in the differential diagnosis an infiltrating carcinoma must be excluded. This is possible by double contrast demonstration of the ulcer en face. The clinical picture is one of sudden, severe upper abdominal pain with features of an acute abdomen, often with a previous history of stress or of gastic distension with vomiting. (orig.)

  13. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  14. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  15. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  16. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  17. Pharmacokinetics and metabolic effects of growth hormone injected subcutaneously in growth hormone deficient patients: thich versus abdomen

    Laursen, Torben; Jørgensen, Jens Otto Lunde; Christiansen, Jens Sandahl

    1994-01-01

    Abstract OBJECTIVE: The absorption of insulin following subcutaneous (s.c.) injection is faster in the abdomen than the thigh. We therefore studied the effect of changing the site of injection on the absorption and metabolic effects of human growth hormone. DESIGN AND MEASUREMENTS: In a cross...... the s.c. tissue (mm) was higher on the abdominal site (9.35 +/- 1.38 (thigh), and 22.61 +/- 2.19 (abdomen), P < 0.001). Mean (+/- SEM) integrated levels (area under the curves (AUC) divided by time) of GH (mU/l) were identical: 5.54 +/- 0.70 (thigh) versus 5.48 +/- 0.64 (abdomen) (P = 0.91). AUC (m...

  18. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  19. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  20. CLINICAL STUDY OF SIGMOID VOLVULUS IN ACUTE INTESTINAL OBSTRUCTION CASES : 3 YEARS E XPERIENCE

    Rambabu

    2015-09-01

    Full Text Available Sigmoid volvulus is abnormal rotation of sigmoid colon along it’s mesenteric axis which may results in effects ranging from partial to complete obstruction of bowel to vascular compromise, culminating in gangrene of bowel. Sigmoid volvulus is responsible for about 4 - 24% of all acute intestinal obstruction. Retrospectiv ely for last 3 years all cases of acute intestinal obstruction admitted to surgery were reviewed and study of sigmoid volvulus cases done. We analysed 247 cases of acute intestinal obstruction retrospectively over a period of 3 years . 50 cases are due to s igmoid volvulus. Most of cases are around 41 - 60 years. Most of cases present with pain abdomen , abdominal distention , constipation. Diagnosis is made by plain x - ray abdomen. Most cases treated with Derotation , resection and anastomosis. Out of 50 cases 6 d eaths occurred.

  1. Acute pelvic inflammatory disease: pictorial essay focused on computed tomography and magnetic resonance imaging findings

    Febronio, Eduardo Miguel; Rosas, George de Queiroz; D' Ippolito, Giuseppe, E-mail: giuseppe_dr@uol.com.br [Department of Imaging Diagnosis, Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPMUnifesp), Sao Paulo, SP (Brazil)

    2012-11-15

    The present study was aimed at describing key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain derived from pelvic inflammatory disease. Two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed between January 2010 and December 2011 in patients with proven pelvic inflammatory disease leading to presentation of acute abdomen. Main findings included presence of intracavitary fluid collections, anomalous enhancement of the pelvic excavation and densification of adnexal fat planes. Pelvic inflammatory disease is one of the leading causes of abdominal pain in women of childbearing age and it has been increasingly been diagnosed by means of computed tomography and magnetic resonance imaging supplementing the role of ultrasonography. It is crucial that radiologists become familiar with the main sectional imaging findings in the diagnosis of this common cause of acute abdomen (author)

  2. Acute pelvic inflammatory disease: pictorial essay focused on computed tomography and magnetic resonance imaging findings

    The present study was aimed at describing key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain derived from pelvic inflammatory disease. Two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed between January 2010 and December 2011 in patients with proven pelvic inflammatory disease leading to presentation of acute abdomen. Main findings included presence of intracavitary fluid collections, anomalous enhancement of the pelvic excavation and densification of adnexal fat planes. Pelvic inflammatory disease is one of the leading causes of abdominal pain in women of childbearing age and it has been increasingly been diagnosed by means of computed tomography and magnetic resonance imaging supplementing the role of ultrasonography. It is crucial that radiologists become familiar with the main sectional imaging findings in the diagnosis of this common cause of acute abdomen (author)

  3. Ultrasonographic findings of acute appendicitis

    For the evaluation of acute appendicitis, many diagnostic methods, such as physical examination, laboratory findings, plain abdomen and barium enema have been widely used. But the overall accuracy was ranged from 50% to 84% and negative appendectomy rate was reported between 5% and 35%. In these days, high resolution ultrasonography is well known to be a good imaging modality in evaluation of acute appendicitis and its complications. Using high resolution ultrasonography, 138 patients with right lower quadrant abdominal pain were examined for 16 months. The results were compared to post-operative findings and clinical follow up study. The results were as follows: 1. The sex distribution of cases were 58 males and 80 females, and most common in the third decade (33.3%). 2. The positive ultrasonographic findings were in 69 cases (50%), those were simple appendicitis without complication in 46 cases (66.7%), acute appendicitis with periappendicitis in 9 cases (13.0%), acute appendicitis with abscess in 6 cases (8.7%), acute appendicitis with appendicolith in 4 cases (5.8%) and perforated appendicitis in 4 cases (16%). 3. The ultrasonographic findings of normal appendix were in 69 cases (50%), those were nonvisualization of appendix in 62 cases (91.3%) and visualization of normal appendix with single thin echogenic wall in 6 cases (8.7%). 4. In the 50 cases of control group, the visualization of normal appendix on ultrasonography were in 8 cases (16%). 5. The overall accuracy was 95.7% with 97.1% of sensitivity and 94.4% of specificity

  4. Función del diafragma durante la colocación de cargas sobre el abdomen en sujetos normales

    Sergio G. Monteiro; Fernando A. Pessolano; Adrián A. Suárez; Eduardo L. De Vito

    2012-01-01

    Los efectos de las cargas en el abdomen con el objeto de producir entrenamiento del diafragma, no han sido suficientemente evaluados. Estudiamos la función del diafragma durante la colocación de cargas sobre el abdomen y con cambios en el patrón respiratorio. Se estudiaron 6 voluntarios normales. Se obtuvo flujo en la boca, presión gástrica (Pga), presión esofágica (Pes), movimiento torácico (TX) y abdominal (AB), presión inspiratoria máxima (PImax) y presión transdiafragmática media (Pdi) y ...

  5. Torsión de epiplon como causa de abdomen agudo: a propósito de dos casos

    Capitan-Morales, Luis-Cristobal; Naranjo Capitán, M.; Pacheco García, José Manuel; Araji, O.; Nogales Muñoz, Angel Luis; Galnares Jiménez, A.; Balongo Garcia, R.; Ortega Beviá, J.M.; Cantillana Martínez, J.

    1993-01-01

    La torsión de epiplón mayor, con el consiguiente infarto epiploico que origina, es una rara causa de abdomen agudo. Su diagnóstico preoperatorio es sumamente difícil, ya que habitualmente se piensa en otras causas más frecuentes de abdomen agudo, llegándose al diagnóstico de certeza en el acto operatorio. Presentamos 2 casos de torsión aguda de epiplón mayor atendidos en el servicio de urgencias de nuestro centro, uno de ellos asociado a hernia inguinal incarcerada y el Otro a enteritis r...

  6. ROD PENETRATES MAN: ARM TO THORACO-ABDOMEN – SURVI VES

    Sitaram

    2013-03-01

    Full Text Available ABSTRACT : Penetrating chest and abdominal injuries are potenti al life threatening due to the associated haemorrhagic shock and visceral injury 1 ,2. Through and through penetrating injury with poly trauma is rarely encountered 8. We report a case presenting with situ projecting heavy iron- metallic rod in a through and through pe netrating into left arm and thoraco- abdomen in a road traffic accident. Management was difficult due to inability to positio n in supine, rapidly progressive haemorrhagic shock and hypoxia due to haemo pneumotho rax. Two operative tables were used with adequate intervening space to accommodate the pr ojecting rod during intubation in supine position. Delayed development of thrombosis in brach ial artery after removal of iron rod, which was removed and brachial artery was repaired. Intens ive monitoring and resuscitation resulted in uneventful outcome.

  7. Accumulation of melanin in the peritoneum causes black abdomens in broilers.

    Wang, J; Wang, Y; Luo, C; Qu, H; Shu, D

    2014-03-01

    A suspected case of localized visceral hyperpigmentation was described for a breed of broiler in China. Using optical microscopy, the accumulation of pigments in the abdominal skin and visceral peritoneum was observed. Electron microscopy was used to further study the ultrastructure of the pigmented peritoneum, and pigment granules resembling melanosomes at different stages were found, and melanocytes were present in this tissue. Infrared spectroscopy was used to analyze the physical-chemical properties of pigments extracted from these broilers. Using synthetic melanin as a reference and the melanin from the peritoneum of Silkie fowls as a control, the pigments in the peritonea of these broilers were found to be melanin, and it had a chemical structure similar to that of melanin from the Silkie fowl peritoneum. In this way, the black abdomens of these broilers were found to have been caused by accumulation of melanin produced by melanocytes in visceral peritonea. PMID:24604870

  8. RANKL-Expressing Ectopic Extramammary Paget's Disease on the Lower Abdomen

    Hagiwara-Takita, Akiko; Fujimura, Taku; Kakizaki, Aya; Aiba, Setsuya

    2016-01-01

    Ectopic extramammary Paget's disease (EMPD) is a rare variant of EMPD that develops in nonapocrine regions. Since reports about ectopic EMPD are limited, little is known about the biological and immunological background of ectopic EMPD. In this report, we present a case of ectopic EMPD on the lower abdomen that expressed RANKL but lacked the expression of MMP7. As we previously reported, Paget's cells express RANKL and MMP7, release soluble RANKL in the tumor microenvironment, and stimulate tumor-associated macrophages to produce tumor-loading factors in conventional EMPD. In our present case, both CCL5-expressing cells and MMP25-bearing cells were lacking, whereas substantial numbers of CCL5-expressing cells and MMP25-bearing cells were found in conventional EMPD. Our case suggested that the lack of MMP7 on Paget's cells might be one of the possible explanations for the biology of ectopic EMPD. PMID:27462221

  9. Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen.

    Stulz, P; Pfeiffer, K M

    1982-03-01

    Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar. PMID:7065874

  10. Utility of screening computed tomography of chest, abdomen and pelvis in patients after heart transplantation

    Introduction: Malignancy is a late cause of mortality in heart transplant recipients. It is unknown if screening computed tomography scan would lead to early detection of such malignancies or serious vascular anomalies post heart transplantation. Methods: This is a single center observational study of patients undergoing surveillance computed tomography of chest, abdomen and pelvis atleast 5 years after transplantation. Abnormal findings, included pulmonary nodules, lymphadenopathy and intra-thoracic and intra-abdominal masses and vascular anomalies such as abdominal aortic aneurysm. The clinical follow up of each of these major abnormal findings is summarized. Results: A total of 63 patients underwent computed tomography scan of chest, abdomen and pelvis at least 5 years after transplantation. Of these, 54 (86%) were male and 9 (14%) were female. Mean age was 52 ± 9.2 years. Computed tomography revealed 1 lung cancer (squamous cell) only. Non specific pulmonary nodules were seen in 6 patients (9.5%). The most common incidental finding was abdominal aortic aneurysms (N = 6 (9.5%)), which necessitated follow up computed tomography (N = 5) or surgery (N = 1). Mean time to detection of abdominal aortic aneurysms from transplantation was 14.6 ± 4.2 years. Mean age at the time of detection of abdominal aortic aneurysms was 74.5 ± 3.2 years. Conclusion: Screening computed tomography scan in patients 5 years from transplantation revealed only one malignancy but lead to increased detection of abdominal aortic aneurysms. Thus the utility is low in terms of detection of malignancy. Based on this study we do not recommend routine computed tomography post heart transplantation.

  11. Ferric ammonium citrate as a positive bowel contrast agent for MR imaging of the upper abdomen

    Purpose: To evaluate the safety and diagnostic efficacy of two different doses of ferric ammonium citrate as a paramagnetic oral contrast agent for MR imaging of the upper abdomen. Material and methods: Ninety-nine adult patients referred for MR imaging for a known or suspected upper abdominal pathology were included in this randomized multicenter double-blind clinical trial. Imaging was performed with spin-echo (T1- and T2-weighted) and gradient-echo (T1-weighted) techniques before and after administration of either 1200 mg or 2400 mg of ferric ammonium citrate dissolved in 600 ml of water. Safety analysis included monitoring of vital signs, assessment of adverse events, and laboratory testing. Efficacy with regard to organ distension, contrast distribution, bowel enhancement and delineation of adjacent structures was graded qualitatively. Results: No serious adverse events were reported for either of the two concentrations. A total of 31 minor side effects were noted, of which significantly more occurred in the higher dose group (p<0.01). The diagnostic confidence in defining or excluding disease was graded as better after contrast administration for 48% of all images. Marked or moderate enhancement of the upper gastrointestinal tract was achieved at both doses in 69.5% of cases with no evident difference between the two doses. The higher dose tended to show better results in terms of the contrast assessment parameters. Conclusion: Ferric ammonium citrate is a safe and effective oral contrast agent for MR imaging of the upper abdomen at two different dose levels. The higher dose showed a tendency toward better imaging results while the lower dose caused significantly fewer side effects. Therefore, the 1200 mg dose can be recommended in view of the risk-to-benefit ratio. (orig.)

  12. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  13. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  14. An overview of systems for CT- and MRI-guided percutaneous needle placement in the thorax and abdomen

    Arnolli, Maarten M.; Hanumara, Nevan C.; Franken, Michel; Brouwer, Dannis M.; Broeders, Ivo A.M.J.

    2014-01-01

    Minimally invasive biopsies, drainages and therapies in the soft tissue organs of the thorax and abdomen are typically performed through a needle, which is inserted percutaneously to reach the target area. The conventional workflow for needle placement employs an iterative freehand technique. This a

  15. Attainment of dosimetric pediatrics grandeur to computed tomography examinations of the abdomen; Obtencao das grandezas dosimetricas em exames de tomografia computadorizada pediatricas do abdomen

    Jormada, Tiago S., E-mail: tsj@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil). Curso de pos-graduacao em Ciencias e Tecnologia das Radiacoes, Minerais e Materiais; Silva, Teogenes A., E-mail: silvata@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-10-01

    Currently, 10% of all computerized tomography exams (CT) are made in pediatric patients. In developed countries, the practice of obtaining the dosimetric quantities (weighted index dose C{sub w}, index air kerma volumetric C{sub vol} product kerma-length P{sub KL},{sub CT}) and effective dose (E) in pediatric CT scans is common. In Brazil, data like these are practically nonexistent. The goal of this work is to obtain the dosimetric quantities and the dose effective in pediatric CT scans, and study its application in the optimization process. The study took place in a thermographs' Toshiba Asteion Single-Slice and a GE Brightsped's multi-slice where measurements were made with type pencil ionization chamber and a trunk's phantom of PMMA with diameter of 16 cm. In single-slice CT scanner, the results obtained for the C{sub vol}, P{sub KL},{sub CT} and E were 18.73 mGy, 15.61 mGy and 6.87 mSv mGy.cm 343.51, respectively, whereas in multi-slice CT scanner the results were 18.81 mGy, 20.07 mGy, 441.64 mGy.cm and 8,83 mSv. There was no significant difference between the values of C{sub w} obtained already in the values of the Cvol, P{sub KL},{sub CT} and E dose the differences between the results were quite significant. Comparing the C{sub w} and P{sub KL},{sub CT} and with the values recommended by UCRP 87 (25 mGy for C{sub vol} and 360 mGy.cm for P{sub KL},{sub CT} in pediatric CT scans of the abdomen), the two scanners were below reference levels for C{sub w} and not require an start on process of optimization. (author)

  16. The CT frequencies of various non-traumatic acute abdominal emergencies in hemodialysis, peritoneal dialysis patients and the general population

    Purpose: To investigate the frequency of non-traumatic acute abdominal emergencies in end-stage renal disease (ESRD) (peritoneal dialysis (PD) and haemodialysis (HD)) patients and in the general population as diagnosed by computed tomography (CT) imaging. Methods: The abdominal CT findings of ESRD patients with non-traumatic acute abdominal pain during the years 2001–2010 have been retrospectively evaluated. Thirty-three HD (14 females, 19 males, mean age: 62 ± 10.5) and 22 PD patients (12 females, 10 males, mean age: 59 ± 9.4) with acute abdominal pathology based on their CT scans have been included into the study. In addition, 127 individuals (68 females, 59 males, mean age: 40.7 ± 12.8) with normal renal functions who presented with non-traumatic acute abdominal pain diagnosed with an acute abdominal pathology based on their CT scans have been prospectively evaluated during the years 2009–2010. Results: While the most frequent etiology in PD patients was peritonitis (45.4%), acute pancreatitis (13.6%) and perforation (18.1), and in HD patients it was nonocclusive mesenteric ischemia (18.1%) and spontaneous intraabdominal bleeding (21.2%). The basic causes of acute abdomen in the general population were ureteral stone (34.6%) and appendicitis (18.1%). Conclusions: The causes of acute abdominal pain in ESRD patients is significantly different when compared to the general population. And within this special patient population the etiology of acute abdomen differs depending on the renal replacement therapy modality they are receiving. Thus, the causes of acute abdomen in PD patients are mostly peritonitis, acute pancreatitis, and perforation, while being mostly nonocclusive mesenteric ischemia and spontaneous intraabdominal bleeding in patients receiving HD therapy.

  17. Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

    The aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds. We reviewed the records of 267 patients who underwent prostate brachytherapy with loose 125I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration. A total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration. We showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90

  18. Pulmonary embolism with acute pancreatitis: A case report and literature review

    Qing Zhang; Qing-Xia Zhang; Xiao-Ping Tan; Wei-Zheng Wang; Chang-Hua He; Li Xu; Xiao-Xia Huang

    2012-01-01

    Acute pancreatitis is an inflammatory disease characterized by local tissue injury which can trigger a systemic inflammatory response. So vascular complications of pancreatitis are a major cause of morbidity and mortality. Pulmonary embolism in acute pancreatitis has been reported to be very rare. We reported a case of pulmonary embolism with acute pancreatitis. A 38-year-old woman broke out upper abdomen pain without definite inducement. She had no nausea and vomiting, fever, dyspnea, cough and expectoration, chest pain. The patient had been diagnosed with acute pancreatitis in local hospital. The patient was treated with antibiotics and proton pump inhibitors, and the abdomen pain was alleviated slightly. But the patient came forth cough and expectoration with a little blood, progressive dyspnea. A computed tomographic scan of the abdomen revealed pancreatitis. Subsequent computer tomography angiography of chest revealed pulmonary embolism (both down pulmonary arteries, left pulmonary artery and branch of right pulmonary artery). Dyspnea of the patient got well with thrombolytic treatment and anti-coagulation therapy. Pulmonary embolism is a rare but potentially lethal complication of pancreatitis. Familiarity with this complication will aid in its early diagnosis, therapy and prevent pulmonary embolism, a rare but catastrophic phenomenon.

  19. Study of dosimetric quantities and image quality in pediatric examinations of chest and abdomen computed tomography

    This work had the objective to achieve the knowledge of the dosimetric quantities related to chest and abdomen computed tomography (CT) examinations of pediatric patients, in Belo Horizonte city. The reason of this work is based on the fact that the probability of health detriment in children, which it may be caused by radiation, is higher than in adults. Besides, although in many countries the knowledge and control of patient doses is a normal procedure, this safety culture does not exist in Brazil. Another objective of this work was to compare the dosimetric quantity values with the Diagnostic Reference Levels (DRLs); when it was needed, an optimization process was applied and the quality of the diagnostic image obtained with the optimized technical parameters was analyzed. This study was carried out in five hospitals, where the weighted air kerma index (Cw), the volumetric air kerma index (Cvol), the air kerma - length product (PKL,CT), the Effective Dose (E) and the Normalized Effective Dose (En) were determined; three methods were adopted for measurements: the ionization chamber inside a chest pediatric phantom, radiochromic films and the CT-EXPO software. The optimization process was applied to a single hospital through variations in the current (mA) and voltage (kV) of the x-ray tube for the protocols used for abdomen CT examinations. The analysis of the quality of the diagnostic image was done by Normal Distribution and ROC analysis; spatial resolution analysis was used through MTF determination and the noise level was judged in terms quantitative and qualitative. Results of the dosimetric quantities showed that they significantly differed between single-slice and multi-slice tomography units, but their values were always below the recommended DRLs. The optimized values of the dosimetric quantities obtained after the optimization process showed that it was possible to reduce the radiation exposure of pediatric patient without losing the image quality

  20. The diagnostic value of barium enema in acute appendicitis

    Acute appendicitis is the most common acute surgical condition of the abdomen. When the clinical presentation is atypical, barium enema has proven to be safe and useful in confirming the diagnosis and reducing the negative surgical exploration. However, the performance of barium enema in acute appendicitis has known contraindication primarily because of fear of leakage by perforation of the inflamed appendix. This study using barium enema as a diagnostic aid in acute appendicitis with atypical clinical presentation was performed to further support the previously noted efficacy and safety of this procedure. The results were as followings: 1. In case of acute appendicitis with atypical clinical presentation, the use of barium enema as a diagnostic aid increased the accuracy of diagnosis and decreased the negative surgical exploration. In women between 11 to 50 years old age, especially, it played important role differentiating appendicitis from nonsurgical acute abdomen. 2. The results of the study were 92.31% in sensitivity, 7.69% in false positive, 6.9% in false negative, and 10.26% in negative appendectomy. 3. None of case of leakage of barium by perforation of the inflamed appendix was noted, therefore, barium enema was thought to be safe as a diagnostic aid in acute appendicitis. 4. A simple partial or non filling of appendix without other associated positive finding could not exclude appendicitis, therefore, close clinical observation was necessary. 5. The positive findings of barium enema and their sensitivity were as followings: 1. Non filling of appendix: 90% 2. Partial filling of appendix: 91.7% 3. Displacement or a local impression on terminal ileum: 100%

  1. Patient-specific dose calculations for pediatric CT of the chest, abdomen and pelvis

    Organ dose is essential for accurate estimates of patient dose from CT. To determine organ doses from a broad range of pediatric patients undergoing diagnostic chest-abdomen-pelvis CT and investigate how these relate to patient size. We used a previously validated Monte Carlo simulation model of a Philips Brilliance 64 multi-detector CT scanner (Philips Healthcare, Best, The Netherlands) to calculate organ doses for 40 pediatric patients (M:F = 21:19; range 0.6-17 years). Organ volumes and positions were determined from the images using standard segmentation techniques. Non-linear regression was performed to determine the relationship between volume CT dose index (CTDIvol)-normalized organ doses and abdominopelvic diameter. We then compared results with values obtained from independent studies. We found that CTDIvol-normalized organ dose correlated strongly with exponentially decreasing abdominopelvic diameter (R2 > 0.8 for most organs). A similar relationship was determined for effective dose when normalized by dose-length product (R2 = 0.95). Our results agreed with previous studies within 12% using similar scan parameters (e.g., bowtie filter size, beam collimation); however results varied up to 25% when compared to studies using different bowtie filters. Our study determined that organ doses can be estimated from measurements of patient size, namely body diameter, and CTDIvol prior to CT examination. This information provides an improved method for patient dose estimation. (orig.)

  2. A Review on Vacuum-assisted Closure Therapy for Septic Peritonitis Open Abdomen Management.

    Rausei, Stefano; Amico, Francesco; Frattini, Francesco; Rovera, Francesca; Boni, Luigi; Dionigi, Gianlorenzo

    2014-11-01

    This article presents a literature review undertaken to identify advantages of vacuum-assisted closure (VAC) methods compared with other temporary abdominal closure (TAC) methods for septic peritonitis open abdomen (OA) management. A literature review was conducted through the U.S. National Library of Medicine at the National Institutes of Health. OA management and septic peritonitis were the main topics considered for this purpose. Online available information from papers discussed at relevant meetings and congresses was also included for review. The search was designed following the Patient Intervention Comparison Outcome Criteria. All shortlisted articles were reviewed by two authors independently. The review resulted in 79 items. Only one randomized study was found and considered for review. A large variety of TAC methods for OA are reported in the available literature to date and are described with a heterogeneous set of names. VAC methods allow the possibility of draining and accounting for fluids collecting in the peritoneal cavity. VAC may offer a solution to fascial closure problems. VAC helps prevent peritoneal contamination. Intra-abdominal hypertension prevention is one factor undoubtedly favoring VAC methods against non-VAC ones for OA management in septic peritonitis. PMID:25433226

  3. Whole abdomen irradiation in epithelial ovarian cancer - state of the art

    Epithelial ovarian cancer (OC) as a malignancy which poses multiple challenges has led to growing attention and concern during recent years. The not very noteworthy treatment results achieved during the last three decades with contemporary chemotherapeutic schemes have led to the need for research and development of new therapeutic approaches, as well as to a resurgence of interest in radiotherapy (RT) as part of a combined modality approach and as salvage therapy for patients with small volume persistent disease after primary cytoreductive surgery and chemotherapy. This article reviews the state of the art of whole abdomen irradiation (WAI) (excluding the moving strip field technique) as part of the complex treatment of epithelial OC. The prognostic factors and risk groups of epithelial OC are discussed as indicators for WAI, giving in detail the applied treatment modalities, fractionation and total doses. Toxicity and second primary malignancies following WAI are analyzed. The clinical experience accumulated during the last decades, as adjuvant, consolidative, salvage and palliative WAI in combined treatment of epithelial OC, is presented. Current issues in the radiotherapeutic management are discussed along with ideas for future clinical research directions. (author)

  4. First identification of nanoparticles on thorax, abdomen and wings of the worker bee Apis dorsata Fabricius

    Bhattacharyya Atanu

    2016-06-01

    Full Text Available The presence of nanoparticles on the body of the honeybee Apis dorsata Fabricius, was investigated for the first time to better understand the bee’s behaviour. These have been observed by using Scanning Electron Microscopy (SEM, Transmission Electron Microscopy (TEM and confirmed by Atomic Force Microscopy (AFM. Our study clearly denotes that the Indian rock honey bee Apis dorsata possess calcium silicate and calcium phosphate nanoparticles on its body surface of 5-50 nm in diameter. In particular, the nanoparticles on the abdomen and thorax of A. dorsata have an average diameter of about 10 nanometers and they are smaller than those found on wings of the same bees which are about 20 nanometers. The nanoparticles found are different of the ones previously observed on honey bees or other insects. The origin and role of these natural nanoparticles on the body of the Indian rock bee need to be to be further investigated; more research in the subject might raise important aspects in relation to the conservation of these unique pollinators.

  5. Radiotherapy of ovarian epithelial cancer by total orthogonal field irradiation of the abdomen

    Isotopic intraperitoneal curietherapy by 32P is the simplest method for irradiating the peritoneum, but it has only limited indications. This irradiation has usually to be given by the percutaneous route, but because of the size of the region to be irradiated it raises delicate problems poorly resolved by the traditional methods applied. For this reason, a particular method is suggested including, among other characteristics: 4 orthogonal fields; 2 sessions daily, irradiating one part of the abdomen in the morning and the other part in the afternoon; spreading of the doses in confirmity with current specifications; and modulation of the total dose as a function of the maximum size of the tumoral remnants. Abdominal radiotherapy is currently the method of choice in cases where lesions are in their early stages, in so far as chemotherapy, much more restrictive for the patient, has not yet demonstrated its long-term efficacy. A controlled clinical study is necessary in order to determine the most effective method

  6. Improved regression models for ventilation estimation based on chest and abdomen movements

    Non-invasive estimation of minute ventilation is important for quantifying the intensity of physical activity of individuals. In this paper, several improved regression models are presented, based on the measurement of chest and abdomen movements from sensor belts worn by subjects (n = 50) engaged in 14 types of physical activity. Five linear models involving a combination of 11 features were developed, and the effects of different model training approaches and window sizes for computing the features were investigated. The performance of the models was evaluated using experimental data collected during the physical activity protocol. The predicted minute ventilation was compared to the criterion ventilation measured using a bidirectional digital volume transducer housed in a respiratory gas exchange system. The results indicate that the inclusion of breathing frequency and the use of percentile points instead of interdecile ranges over a 60 s window size reduced error by about 43%, when applied to the classical two-degrees-of-freedom model. The mean percentage error of the minute ventilation estimated for all the activities was below 7.5%, verifying reasonably good performance of the models and the applicability of the wearable sensing system for minute ventilation estimation during physical activity. (paper)

  7. Patient-specific dose calculations for pediatric CT of the chest, abdomen and pelvis

    Kost, Susan D.; Carver, Diana E.; Stabin, Michael G. [Vanderbilt University, Physics and Astronomy Department, Nashville, TN (United States); Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN (United States); Fraser, Nicholas D.; Pickens, David R.; Price, Ronald R.; Hernanz-Schulman, Marta [Vanderbilt University Medical Center, Department of Radiology and Radiological Sciences, Nashville, TN (United States)

    2015-11-15

    Organ dose is essential for accurate estimates of patient dose from CT. To determine organ doses from a broad range of pediatric patients undergoing diagnostic chest-abdomen-pelvis CT and investigate how these relate to patient size. We used a previously validated Monte Carlo simulation model of a Philips Brilliance 64 multi-detector CT scanner (Philips Healthcare, Best, The Netherlands) to calculate organ doses for 40 pediatric patients (M:F = 21:19; range 0.6-17 years). Organ volumes and positions were determined from the images using standard segmentation techniques. Non-linear regression was performed to determine the relationship between volume CT dose index (CTDI{sub vol})-normalized organ doses and abdominopelvic diameter. We then compared results with values obtained from independent studies. We found that CTDI{sub vol}-normalized organ dose correlated strongly with exponentially decreasing abdominopelvic diameter (R{sup 2} > 0.8 for most organs). A similar relationship was determined for effective dose when normalized by dose-length product (R{sup 2} = 0.95). Our results agreed with previous studies within 12% using similar scan parameters (e.g., bowtie filter size, beam collimation); however results varied up to 25% when compared to studies using different bowtie filters. Our study determined that organ doses can be estimated from measurements of patient size, namely body diameter, and CTDI{sub vol} prior to CT examination. This information provides an improved method for patient dose estimation. (orig.)

  8. Studying the Physiology of Tadpoles through their Naturally Transparent Abdomen Walls

    Naitoh, T.; Yamashita, M.; Wassersug, R.

    Because their development is external and they grow rapidly, anurans (frogs and toads) have been important model species in studies of how spaceflight affects vertebrate development. However the long term effects of spaceflight on post embryonic stages have barely been studied in these, or for that matter, any other vertebrate species. Tadpoles of certain species have naturally transparent skin covering a large portion of their ventral abdomen wall. Consequently viscera and visceral movements can be observed through this window without any invasive treatment to the animals. Respiration rate (as measured by buccal floor movements), heart rate, and gut motility are all indices of physiological state that can be observed in unconstrained larvae of these particular anuran species. We are using changes in these physiological variables to study the responses of tadpoles to changes in their external environment. Our study of the physiological responses of these tadpoles to microgravity has been selected as a candidate spaceflight experiment (to be housed in the Canadian Aquatic Research Facility). Ground-based studies with these same larvae are currently underway. Those experiments make use of stepwise changes in temperature as a stimulus to document the effect of temperature on intestinal motility in tadpoles. The scope of our studies on gravitational physiology and key issues in post- embryonic development of anurans are the focus of our presentation. This research is a prelude to raising a vertebrate through a complete life cycle in the space environment.

  9. Advantages and disadvantages of using non-coplanar techniques in radiotherapy of the abdomen formed 3D; Ventajas e inconvenientes del uso de tecnicas con coplanares en radiaoterpia 3D conformada de abdomen

    Urena Llinares, A.; Castro Ramirez, I.; Iborra Oquendo, M. A; Quinones Rodriguez, L. A.; Angulo Pain, E.

    2011-07-01

    3D Radiotherapy locations abdomen, especially in pancreas and stomach cancers is often extremely difficult if we are to meet the dose constraints to organs at risk due to proximity and many of these (liver, kidneys, intestines, lungs, bone. ..). Of these, the most critical are the kidneys, which also present values of tolerance, in most cases difficult to meet. This is done in our hospital are using non-coplanar techniques performing well both as coating PTV dose to both kidneys.

  10. Acute Portomesenteric Venous Thrombosis following Laparoscopic Small Bowel Resection and Ventral Hernia Repair

    Bhradeev Sivasambu

    2015-01-01

    Full Text Available Acute portomesenteric venous thrombosis is a rare but life-threatening complication of laparoscopic surgery that has been described in literature. Prompt diagnosis and early initiation of treatment are vital to prevent life-threatening complications such as mesenteric ischemia and infarction. A 51-year-old lady had laparoscopic small bowel resection and primary anastomosis with ventral hernia repair 4 weeks earlier for partial small bowel obstruction. Her postoperative period was uneventful and she was discharged home. Four weeks after surgery she developed watery diarrhea and generalized abdominal pain for four-day duration. A computed tomography of the abdomen revealed portomesenteric venous thrombosis although a computed tomography of abdomen before surgery 4 weeks back did not show any portomesenteric venous thrombosis. We are reporting a case of acute portomesenteric venous thrombosis as a complication of laparoscopic surgery.

  11. Acute peritoneal dialysis in a Jehovah's Witness post laparotomy.

    Appalsawmy, Usha Devi; Akbani, Habib

    2016-01-01

    A 56-year-old man who was a Jehovah's Witness with an advanced directive against autologous procedures developed acute kidney injury needing renal replacement therapy while he was intubated and ventilated on the intensive care unit. He was being treated for hyperosmolar hyperglycaemic state. He also had a healing laparotomy wound, having undergone a splenectomy less than a month ago following a road traffic accident. His hyperkalaemia and metabolic acidosis were refractory to medical treatment. As he became oligoanuric, decision was taken to carry out acute peritoneal dialysis (PD) by inserting a Tenckhoff catheter in his abdomen using peritoneoscopic technique. The patient was started on automated PD without any complications. His urine output gradually improved, and his renal function eventually recovered. On discharge from hospital, his renal function was within normal range, and he had no abdominal complications from the acute PD. PMID:27581233

  12. Case report of ruptured non-communicating right rudimentary horn pregnancy: an acute emergency.

    Hassan, Che Hasnura Che; Karim, Abdul Kadir Abdul; Ismail, Nor Azlin Mohamed; Omar, Mohd Hashim

    2011-01-01

    Ruptured pregnancy in the rudimentary horn of women who have had a vaginal delivery is rare and unpredictable. However, when undiagnosed, this condition could lead to maternal morbidity and mortality. We report a pregnancy at 19 weeks gestation presented with acute abdomen and hypovolemic shock. She was initially thought to have an intrauterine pregnancy with the provisional diagnosis of a ruptured uterus. Intraoperatively, a ruptured non-communicating right rudimentary horn with ex utero pregnancy was discovered. PMID:22250483

  13. Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

    Forster, Michael J.; Akoh, Jacob A.

    2008-01-01

    Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed th...

  14. CLINICAL STUDY ON ACUTE PANCREATITIS

    Suhaib Rehaman

    2015-07-01

    Full Text Available INTRODUCTION : Early diagnosis and severity evaluation on patients with acute pancreatitis are very important due to its potential morbidity and mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Sev eral clinical, laboratory and radiologic factors and many scoring systems have been proposed for outcome prediction. AIMS AND OBJECTIVES: To study the symptomatology, clinical presentation and management in pancreatitis . To study the severity of acute panc reatitis according to Glasgow Scale . METHODS: Present study includes consecutive 38 patients hospitalized in CSI Holdsworth Memorial Hospital over the period of 2 years. All patients were thoroughly investigated and were stratified according to the Glasgow criteria. Data was collected on complications, investigations and interventions undertaken, outcome, duration of stay in hospital and ICU. STATISTICAL ANALYSIS USED: Descriptive, Chi square tests, Crosstabs (Contingency coefficient analysis . RESULTS : Mean age of presentation in our study was 43.1 years. There was a male predominance accounting for 68.4% compared to 31.6% females. Alcohol was the main etiological factor in about 50% of the patients. Sensitivity to S. amylase was about 100%. Accuracy of USG abdomen in diagnosing pancreatitis was about 88.5%. Ascitis was the commonest complication seen in 13.2%. Mean duration of hospital stay was 6.2 days. The patient were stratified according to Glasgow scoring system into mild (0 - 3 and severe (>3 panc reatitis. In our study 32 people were graded with mild pancreatitis, all improved and in 6 people who were graded with severe pancreatitis, 83.3 % improved and 2.6% expired because of complications. Test statistics showed Contingency coefficient 0.355 and P 0.019 (NS. CONCLUSION : Glasgow scoring system remains a valid predicting system for the outcome in patients with acute pancreatitis. It is simple easy to apply with

  15. Respiratory-Gated MRgHIFU in Upper Abdomen Using an MR-Compatible In-Bore Digital Camera

    Vincent Auboiroux; Lorena Petrusca; Magalie Viallon; Arnaud Muller; Sylvain Terraz; Romain Breguet; Xavier Montet; Becker, Christoph D; Rares Salomir

    2014-01-01

    Objective. To demonstrate the technical feasibility and the potential interest of using a digital optical camera inside the MR magnet bore for monitoring the breathing cycle and subsequently gating the PRFS MR thermometry, MR-ARFI measurement, and MRgHIFU sonication in the upper abdomen. Materials and Methods. A digital camera was reengineered to remove its magnetic parts and was further equipped with a 7 m long USB cable. The system was electromagnetically shielded and operated inside the bo...

  16. Negative Pressure Wound Therapy for the Treatment of the Open Abdomen and Incidence of Enteral Fistulas: A Retrospective Bicentre Analysis

    Sven Richter; Stefan Dold; Johannes P. Doberauer; Peter Mai; Jochen Schuld

    2013-01-01

    Introduction. The open abdomen (OA) is often associated with complications. It has been hypothesized that negative pressure wound therapy (NPWT) in the treatment of OA may provoke enteral fistulas. Therefore, we analyzed patients with OA and NPWT with special regard to the occurrence of intestinal fistulas. Methods. The present study included all consecutive patients with OA treated with NWPT from April 2010 to August 2011 in two hospitals. Patients' demographics, indications for OA, risk fac...

  17. Aromatherapy Massage on the Abdomen for Alleviating Menstrual Pain in High School Girls: A Preliminary Controlled Clinical Study

    Myung-Haeng Hur; Myeong Soo Lee; Ka-Yeon Seong; Mi-Kyoung Lee

    2012-01-01

    This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment) group ( = 3 2 ) and the acetaminophen (control) group ( = 2 3 ). Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain wa...

  18. Acute pancreatitis

    ... page: //medlineplus.gov/ency/article/000287.htm Acute pancreatitis To use the sharing features on this page, ... fatty foods after the attack has improved. Outlook (Prognosis) Most cases go away in a week. However, ...

  19. Acute Pericarditis

    ... Sugar Control Helps Fight Diabetic Eye Disease Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... cancer, or heart surgery, the fluid is blood. Causes Acute pericarditis usually results from infection or other ...

  20. Acute pancreatitis complicated with splenic rupture: A case report

    Bruno; L; Hernani; Pedro; C; Silva; Ricardo; T; Nishio; Henrique; C; Mateus; José; C; Assef; Tercio; De; Campos

    2015-01-01

    Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography(CT) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventytwo hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.

  1. Attainment of dosimetric pediatrics grandeur to computed tomography examinations of the abdomen

    Currently, 10% of all computerized tomography exams (CT) are made in pediatric patients. In developed countries, the practice of obtaining the dosimetric quantities (weighted index dose Cw, index air kerma volumetric Cvol product kerma-length PKL,CT) and effective dose (E) in pediatric CT scans is common. In Brazil, data like these are practically nonexistent. The goal of this work is to obtain the dosimetric quantities and the dose effective in pediatric CT scans, and study its application in the optimization process. The study took place in a thermographs' Toshiba Asteion Single-Slice and a GE Brightsped's multi-slice where measurements were made with type pencil ionization chamber and a trunk's phantom of PMMA with diameter of 16 cm. In single-slice CT scanner, the results obtained for the Cvol, PKL,CT and E were 18.73 mGy, 15.61 mGy and 6.87 mSv mGy.cm 343.51, respectively, whereas in multi-slice CT scanner the results were 18.81 mGy, 20.07 mGy, 441.64 mGy.cm and 8,83 mSv. There was no significant difference between the values of Cw obtained already in the values of the Cvol, PKL,CT and E dose the differences between the results were quite significant. Comparing the Cw and PKL,CT and with the values recommended by UCRP 87 (25 mGy for Cvol and 360 mGy.cm for PKL,CT in pediatric CT scans of the abdomen), the two scanners were below reference levels for Cw and not require an start on process of optimization. (author)

  2. Whole-abdomen radiation therapy in ovarian carcinoma: Its role as a salvage therapeutic modality

    A significant proportion of patients with epithelial ovarian carcinoma eventually fail after initial responses to chemotherapy. Further treatment with chemotherapy consisting of either the same combination or second-line regimens has been ineffective in producing durable responses. Thus, between June 1983 and June 1987, thirty patients with epithelial ovarian carcinoma who failed one or more chemotherapeutic regimens were treated with whole-abdominopelvic-cavity radiation therapy. Prior to the radiation the amount of residual disease after debulking was noted to be microscopic in 16 patients and macroscopic in 14 patients. Radiation was delivered with an open-field technique that extended from the domes of the diaphragm to the obturator foramina. Doses of 2500 cGy were planned to the whole abdomen, with a boost of another 2500 cGy to the pelvic and or paraaortic nodes when indicated. Higher doses were delivered to the areas of gross disease in the pelvis. Only 2 patients were unable to complete the planned therapy. Another 26% of the patients required interruption of the therapy secondary to hematologic toxicity but eventually completed the treatment. With an overall median follow-up of 14 months, 56% of the patients remain alive. Two-year actuarial survival and recurrence-free survival rates are 47 and 32%, respectively. The survival and recurrence-free survival rates for the group with microscopic residual disease--61 and 33%, respectively--are better than those for the patients with macroscopic residual disease--36 and 18%. The abdominopelvic cavity was the first site of failure in all but one of the 17 patients who have failed. In spite of the higher doses, pelvic failure alone or as a component occurred in 54% of the patients. Small bowel obstruction necessitating surgical intervention as a complication of therapy was seen in 13% of the patients

  3. Comparison of exposure dose by using AEC mode of abdomen AP study in radiography

    Kim, Ki Won [Dept. of Radiology, Gang-dong Kyung Hee Medical Center, Seoul (Korea, Republic of); Kwon, Yong Rak; Seo, Seong Won [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Kwon, Kyung Tae [Dept. of Radiology, Dongnam Health University, Suwon (Korea, Republic of); Oh, Joo Young; Son, Soon Yong [Asan Medical Center, Seoul (Korea, Republic of); Min, Jung Whan [Dept. of Radiology, Shingu University, Sungnam (Korea, Republic of)

    2015-09-15

    We evaluated the effectiveness of TL (Time Limit) method by comparing with NTL (Non-time limit) method when it is used for examinations for abdomen Anterior Posterior (AP) in this paper. The evaluation was conducted based on the comparison of dose, and of signal to noise ratio (SNR) and contrast to ratio (CNR) on both methods. The experiments were conducted with XGEO GC 80 (Samsung, Korea), Unfors ThinX RAD (Unfors, Sweden) and Rando Phantom (Alderson research laboratories, USA) and shielding material with the size of 5.5 × 9 × 0.1 cm{sup 3}. It was set to activate only two upper ionization chambers in automatic exposure control (AEC) mode and the tube-voltage was set to 80kVp. When the exposure time was limited, it is limited to 51 msec. The images both by NTL AEC method and TL AEC method were acquired when with and without attachment of shielding material on the upper ionization chambers. The images were evaluated by SNR and CNR which are the image evaluation methods using ‘Image J’. The NTL AEC method showed increases in dose as much as 130.7% at maximum and 80% at minimum than other methods. The TL AEC method showed decreases in mAs and exposure dose than the NTL AEC method as much as 43.8% and 44.4% respectively. There were no significant differences in SNR or CNR for the experiments (p≥0.05). Therefore, it is suggested that the TLAEC mode is more effective when examining patients who have high BMI index or a patient with a metallic substance in the body after surgery.

  4. Tremulatory and abdomen vibration signals enable communication through air in the stink bug Euschistus heros.

    Andreja Kavčič

    Full Text Available Communication by substrate-borne mechanical signals is widespread among animals but remains one of their least understood communication channels. Past studies of vibrational communication in insects have been oriented predominantly to communication during mating, showing that species- and sex-specific vibrational signals enable recognition and localization of potential mates on continuous solid substrates. No special attention has been paid to vibrational signals with less obvious specificity as well as to the possibility of vibrational communication across substrates that are not in physical contact. We aimed to reinvestigate emission of the aforementioned vibrational signals transmitted through a plant in the stink bug Euschistus heros (Pentatomidae: Pentatominae and to check whether individuals are able to communicate across adjecent, physically separated substrates. We used laser vibrometry for registration of substrate-borne vibrational signals on a bean plant. Using two bean plants separated for 3 to 7 cm between two most adjacent leaves, we investigated the possibility of transmission of these signals through air. Our study showed that males and females of E. heros communicate using tremulatory, percussion and buzzing signals in addition to the previously described signals produced by vibrations of the abdomen. Contrary to the latter, the first three signal types did not differ between sexes or between pentatomid species. Experiments with two physically separated plants showed significant searching behaviour and localization of vibrational signals of an E. heros male or a female, in response to abdominal vibration produced signals of a pair duetting on the neighbouring plant, in comparison to control where no animals were on the neighbouring plant. We also confirmed that transmission through air causes amplitude and frequency decay of vibrational signals, which suggests high-amplitude, low-frequency tremulatory signals of these stink bugs

  5. Prehospital advanced trauma life support for critical penetrating wounds to the thorax and abdomen.

    Pons, P T; Honigman, B; Moore, E E; Rosen, P; Antuna, B; Dernocoeur, J

    1985-09-01

    The role of advanced trauma life support (ATLS) in the prehospital care of the critically injured is highly controversial. This study analyzes the efficacy of ATLS in the management of critical penetrating wounds of the thorax and abdomen. In the 2 1/2-year period ending July 1984, 203 consecutive patients underwent emergency laparotomy or thoracotomy for gunshot and stab wounds. All patients were treated in the field by advanced paramedics (EMT-P). For gunshot wounds the mean time (+/- S.E.M.) responding to the scene was 4.5 (+/- 0.29) minutes, on the scene 10.1 (+/- 0.41) minutes, and returning to the hospital 6.4 (+/- 0.32) minutes. For stab wounds the mean time responding to the scene was 4.8 (+/- 0.21) minutes, on the scene 9.5 (+/- 0.37) minutes, and returning to the hospital 5.7 (+ 0.30) minutes. The number of intravenous lines started averaged 1.8 per patient. Eighty-one patients had PASG applied and 28 patients underwent endotracheal intubation (21 orally, seven nasally). Thirty-three patients had no obtainable blood pressure, of whom six survived (18%). One hundred sixty (94%) of the remaining 170 patients who had any initial blood pressure survived. One hundred nine (55%) patients had an increase in BP greater than or equal to 10 mm Hg (average, 35.6 mm Hg), 64 (32%) had no significant change, and 25 (13%) had a fall greater than or equal to 10 mm Hg (average, 24.2 mm Hg) from the field to the emergency department. Twenty (80%) of the 25 patients with a fall in blood pressure survived.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4032506

  6. Acute dyspnea

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  7. Bronchitis (acute)

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  8. Acute intermittent porphyria caused by novel mutation in HMBS gene, misdiagnosed as cholecystitis

    Alfadhel M

    2014-11-01

    Full Text Available Majid Alfadhel,1,3 Neam Saleh,2 Helal Alenazi,2 Henry Baffoe-Bonnie21Division of Genetics, Department of Pediatrics, 2Division of General Medicine, Department of Medicine, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia; 3College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaBackground: Acute intermittent porphyria (AIP is an autosomal dominant neurovisceral inherited disorder due to a defect in the heme biosynthesis pathway. Misdiagnosis of the porphyrias is not uncommon.Case report: We present a case of a 26-year-old female with suspected acute cholecystitis, mental status changes, and seizures. Biochemical and molecular investigations confirmed the diagnosis of AIP by findings of elevated urinary porphobilinogen, 5-aminolevulinic acid, and total porphyrins. DNA molecular testing showed a novel heterozygous mutation (c. 760delC p.L254X in the exon11 of the HMBS gene. To the best of our knowledge, this is the first report of a misdiagnosis of AIP presenting with acute cholecystitis.Conclusion: Clinicians are alerted to consider the possibility of AIP in an adult presenting with an acute abdomen, features of cholecystitis, and neuropsychiatric manifestations.Keywords: porphyria, cholecystitis, acute abdomen, acute intermittent porphyria, HMBS gene, hydroxymethylbilane synthase

  9. Endocardite infecciosa com apresentação inicial de abdome agudo Endocarditis infecciosa con presentación inicial de abdomen agudo Infective endocarditis with initial presentation of acute abdomen

    Humberto F. G. Freitas; Paulo R Chizzola; Flavio C Pinha; Luiz G Velloso

    2010-01-01

    Paciente de 35 anos de idade foi atendido em Serviço de Emergência com seis horas de dor em fossa ilíaca direita e febre. Feita hipótese diagnóstica de apendicite aguda e realizada laparotomia exploradora. com apendicectomia. O paciente retornou ao hospital três dias após alta hospitalar. prostrado. febril. com alteração de fala. diminuição de nível de consciência e com hemiparesia completa à esquerda. CT scan de crânio e punção de líquor normal. RMN de encéfalo revelou aspectos compatíveis c...

  10. Acute glomerulonephritis in dengue hemorrhagic fever: A rare case report

    K R Meena

    2013-01-01

    Full Text Available An 11-year-old male child presented with fever, bodyache, swelling over the whole body, and oliguria. He had hypertension. Urine microscopy showed hematuria and glomerular casts. Renal functions were deranged and had low complement C3 level. Chest X-ray showed plural effusion and ultrasonography abdomen showed mild ascitis. The immunoglobulin (IgM and IgG enzyme-linked immunosorbent essay for dengue virus were positive. Diagnosis of dengue hemorrhagic fever with acute glomerulonephritis was made. He was managed with maintenance fluid, antihypertensive medicine and supportive care. He recovered gradually and was discharged 12 days after admission.

  11. Experiencia en el cuidado de enfermería: herida de abdomen abierto en el adulto Experiência no cuidado de enfermagem: ferida de abdômen aberto em adultos Nursing care experience: open abdomen wound in adults

    Ricardo Alfonso Castro Becerra

    2011-12-01

    Full Text Available Objetivo: estructurar un protocolo de cuidados de enfermería para la persona adulta con herida de abdomen abierto, en una empresa social del Estado de la ciudad de Bogotá. Método: estudio descriptivo transversal, cuya muestra se constituye por cuatro personas con herida de abdomen abierto y el aporte de la experiencia del enfermero profesional de la institución. La información se recolecta a partir de una guía de observación, del registro fotográfico de la evolución de cuatro personas adultas con herida de abdomen abierto y de una entrevista semiestructurada realizada al profesional de enfermería de la Clínica de Heridas tomada como referencia, la cual sirve como guía y en la que se recomienda profundizar en investigaciones posteriores. Resultados: se estructura un protocolo de cuidados de enfermería, integrado por doce flujogramas agrupados y distribuidos en cuatro lineamientos básicos. Conclusiones: el protocolo es el resultado de la descripción y análisis de los procedimientos realizados por personal de enfermería que cuenta con una amplia experiencia en el manejo de personas con herida de abdomen abierto, confrontados a la luz de la literatura. Sin embargo, se requiere continuar la estructuración del mismo, teniendo en cuenta no solo la parte fisiológica del proceso de cicatrización, sino también las dimensiones psicosociales que intervienen en el cuidado de las personas adultas con herida abierta de abdomen.Objetivo: criar um protocolo de cuidados de enfermagem para adultos com feridas de abdômen abertas numa empresa social do Estado, na cidade de Bogotá. Método: estudo descritivo transversal, cuja amostra foi constituída por quatro (4 pessoas com feridas de abdômen abertas, e o aporte da experiência do enfermeiro profissional da instituição. A informação é arrecadada de um guia de observação, do registro fotográfico da evolução de quatro adultos com feridas de abdômen abertas e de uma entrevista semies

  12. Pressure transduction and fluid evacuation during conventional negative pressure wound therapy of the open abdomen and NPWT using a protective disc over the intestines

    Lindstedt Sandra; Malmsjö Malin; Hansson Johan; Hlebowicz Joanna; Ingemansson Richard

    2012-01-01

    Abstract Background Negative pressure wound therapy (NPWT) has gained acceptance among surgeons, for the treatment of open abdomen, since very high closure rates have been reported with this method, compared to other kinds of wound management for the open abdomen. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective di...

  13. Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

    Kenneth C Eze

    2014-01-01

    Full Text Available Background: To highlight the problems of diagnosis and management of acute abdomen in patients with lassa fever. And to also highlight the need for high index of suspicion of lassa fever in patients presenting with acute abdominal pain in order to avoid surgical intervention with unfavourable prognosis and nosocomial transmission of infections, especially in Lassa fever-endemic regions. Materials and Methods: A review of experiences of the authors in the management of lassa fever over a 4-year period (2004-2008. Literature on lassa fever, available in the internet and other local sources, was studied in November 2010 and reviewed. Results: Normal plain chest radiographic picture can change rapidly due to pulmonary oedema, pulmonary haemorrhage and acute respiratory distress syndrome. Plain abdominal radiograph may show dilated bowels with signs of paralytic ileus or dynamic intestinal obstruction due to bowel wall haemorrhage or inflamed and enlarged Peyer′s patches. Ultrasound may show free intra-peritoneal fluid due to peritonitis and intra-peritoneal haemorrhage. Bleeding into the gall bladder wall may erroneously suggest infective cholecystitis. Pericardial effusion with or without pericarditis causing abdominal pain may be seen using echocardiography. High index of suspicion, antibody testing for lassa fever and viral isolation in a reference laboratory are critical for accurate diagnosis. Conclusion: Patients from lassa fever-endemic regions may present with features that suggest acute abdomen. Radiological studies may show findings that suggest acute abdomen but these should be interpreted in the light of the general clinical condition of the patient. It is necessary to know that acute abdominal pain and vomiting in lassa fever-endemic areas could be caused by lassa fever, which is a medical condition. Surgical option should be undertaken with restraint as it increases the morbidity, may worsen the prognosis and increase the risk of

  14. Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

    Eze, Kenneth C.; Salami, Taofeek A.; Kpolugbo, James U.

    2014-01-01

    Background: To highlight the problems of diagnosis and management of acute abdomen in patients with lassa fever. And to also highlight the need for high index of suspicion of lassa fever in patients presenting with acute abdominal pain in order to avoid surgical intervention with unfavourable prognosis and nosocomial transmission of infections, especially in Lassa fever-endemic regions. Materials and Methods: A review of experiences of the authors in the management of lassa fever over a 4-year period (2004-2008). Literature on lassa fever, available in the internet and other local sources, was studied in November 2010 and reviewed. Results: Normal plain chest radiographic picture can change rapidly due to pulmonary oedema, pulmonary haemorrhage and acute respiratory distress syndrome. Plain abdominal radiograph may show dilated bowels with signs of paralytic ileus or dynamic intestinal obstruction due to bowel wall haemorrhage or inflamed and enlarged Peyer's patches. Ultrasound may show free intra-peritoneal fluid due to peritonitis and intra-peritoneal haemorrhage. Bleeding into the gall bladder wall may erroneously suggest infective cholecystitis. Pericardial effusion with or without pericarditis causing abdominal pain may be seen using echocardiography. High index of suspicion, antibody testing for lassa fever and viral isolation in a reference laboratory are critical for accurate diagnosis. Conclusion: Patients from lassa fever-endemic regions may present with features that suggest acute abdomen. Radiological studies may show findings that suggest acute abdomen but these should be interpreted in the light of the general clinical condition of the patient. It is necessary to know that acute abdominal pain and vomiting in lassa fever-endemic areas could be caused by lassa fever, which is a medical condition. Surgical option should be undertaken with restraint as it increases the morbidity, may worsen the prognosis and increase the risk of nosocomial transmission

  15. Acute myelogenous leukemia (AML) - children

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  16. Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

    Yu Chen

    2014-01-01

    Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

  17. Pressure transduction and fluid evacuation during conventional negative pressure wound therapy of the open abdomen and NPWT using a protective disc over the intestines

    Lindstedt Sandra

    2012-03-01

    Full Text Available Abstract Background Negative pressure wound therapy (NPWT has gained acceptance among surgeons, for the treatment of open abdomen, since very high closure rates have been reported with this method, compared to other kinds of wound management for the open abdomen. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective disc placed between the intestines and the vacuum source prevents the induction of ischemia. In this study we compare pressure transduction and fluid evacuation of the open abdomen with conventional NPWT and NPWT with a protective disc. Methods Six pigs underwent midline incision and the application of conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source. The pressure transduction was measured centrally beneath the dressing, and at the anterior abdominal wall, before and after the application of topical negative pressures of -50, -70 and -120 mmHg. The drainage of fluid from the abdomen was measured, with and without the protective disc. Results Abdominal drainage was significantly better (p Conclusions The drainage of the open abdomen was significantly more effective when using NWPT with the protective disc than with conventional NWPT. This is believed to be due to the more even and effective pressure transduction in the open abdomen using a protective disc in combination with NPWT.

  18. The use of computer tomography of the abdomen in differentiating post-transplant complications in patients with renal grafts using a study of clinical cases

    The aim of the study was to describe the diagnostic efficiency of computer tomography in the differentiation of urgent complications after renal transplants. The most common situation which needs to be explained using imaging diagnostics is acute abdominal pain in patients with renal grafts shortly after the operation (within a few weeks) in conditions of emergency. Most of the examinations were performed without contrast enhancement to avoid possible nephrotoxicity of the contrast media following the transplantology rule. The difference in the efficiency of the two methods with or without i.v. infusion contrast is emphasized. Thirty-two CT's of 22 patients with complications after renal transplants were analyzed by comparing their clinical data. The images were compared with regard to size, parenchymal density, and homogeneity of the renal graft. Furthermore, contrast enhancement homogeneity with preservation of the cortical-medullar differentiation, width of the excretory system and the ureter, and presence of circumgraft fluid collection with a designation of its density and periorbital specify (lymphocele, abscess, or hematoma) were also considered. When possible, the lumen of the renal vessels and the state of vessel anastomosis were recorded (CT angiography and some good-quality contrast examination). Also, other pathologies in the examined region were considered as a potential cause of the acute pain (e.g. multiplanar reconstruction was performed to obtain proper images of the lumbal spine). CT of the abdomen explained clinical problems in 21 of the 22 patients (95%). Most examinations showed that the fluid collections were lymphocele, mainly small and without compression of adjoining structures, which are considered normal after transplants. Large fluid collections requiring decompression were found in 6 patients (including 2 hematoma and 1 with abscess). Causes unrelated to renal graft were found in 4 cases. Computer tomography, although it is not included

  19. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Ghodratollah Maddah

    2014-05-01

    Full Text Available The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag. The study population comprised of 11 (57.9% male and 8 (42.1% female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9% patients, subjective judgment that the fascia closure is too tight in 6 (31.6% patient's damage control surgery in one patient (5.3% and development of abdominal compartment surgery in one patient (5.3%. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4% patients, post operative intestinal fistula in 4 (21.1% patients, post traumatic intra abdominal bleeding in 3 (15.8% patients and intestinal obstructions in 3 (15.8% patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0% patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1 early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3% late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54 months. Currently 10 patients (52.6% are alive at a follow up of 45 (range 1

  20. The optimization of acoustic fields for ablative therapies of tumours in the upper abdomen

    Gélat, P.; ter Haar, G.; Saffari, N.

    2012-12-01

    High intensity focused ultrasound (HIFU) enables highly localized, non-invasive tissue ablation and its efficacy has been demonstrated in the treatment of a range of cancers, including those of the kidney, prostate and breast. HIFU offers the ability to treat deep-seated tumours locally, and potentially bears fewer side effects than more invasive treatment modalities such as resection, chemotherapy and ionizing radiation. There remains however a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to ablate tissue at the required foci whilst minimizing the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. This sometimes results in overheating of bone and overlying tissue during treatment, leading to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy is deposited. Previously, a boundary element approach based on a Generalized Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data (Gélat et al 2011 Phys. Med. Biol. 56 5553-81). The present paper describes the reformulation of the boundary element equations as a least-squares minimization problem with nonlinear constraints. The methodology has subsequently been tested at an excitation frequency of 1 MHz on a spherical multi-element array in the presence of ribs. A single array-rib geometry was investigated on which a 50% reduction in the maximum acoustic pressure magnitude on the surface of the ribs was achieved with only a 4% reduction in the peak focal pressure compared to the spherical focusing case. This method was then compared with a binarized apodization approach

  1. Towards the optimisation of acoustic fields for ablative therapies of tumours in the upper abdomen

    Gélat, P.; ter Haar, G.; Saffari, N.

    2013-08-01

    The efficacy of high intensity focused ultrasound (HIFU) for the non-invasive treatment of cancer has been demonstrated for a range of different cancers including those of the liver, kidney, prostate and breast. As a non-invasive focused therapy, HIFU offers considerable advantages over other techniques such as chemotherapy and surgical resection, in terms of its non-invasiveness and low risk of harmful side effects. There is, however, a number of significant challenges which currently hinder its widespread clinical application. One of these challenges is the need to transmit sufficient energy through the ribcage to induce tissue necrosis at the required foci whilst minimising the formation of side lobes and sparing healthy tissue. Ribs both absorb and reflect ultrasound strongly. As such, a common side effect of focusing ultrasound in regions located behind the rib cage is the overheating of bone and surrounding tissue, which can lead to skin burns. Successful treatment of a patient with tumours in the upper abdomen therefore requires a thorough understanding of the way acoustic and thermal energy are deposited. This is likely to rely on a treatment planning procedure in which optimal source velocity distributions are obtained so as to maximise a dose quantity at the treatment sites, whilst ensuring that this quantity does not exceed a specified threshold at other field locations, particularly on the surface of the ribs. Previously, a boundary element approach based on a Generalised Minimal Residual (GMRES) implementation of the Burton-Miller formulation was developed to predict the field of a multi-element HIFU array scattered by human ribs, the topology of which was obtained from CT scan data [1]. This work describes the reformulation of the boundary element equations as a least-squares minimisation problem with non-linear constraints. The methodology was subsequently tested at an excitation frequency of 100 kHz on a spherical multi-element array in the presence

  2. Temporary abdominal closure in the critically ill patients with an open abdomen.

    Maddah, Ghodratollah; Shabahang, Hossein; Abdollahi, Abbas; Zehi, Vahid; Abdollahi, Mohsen

    2014-01-01

    The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags (Bogotá bag). The study population comprised of 11 (57.9%) male and 8 (42.1%) female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 (57.9%) patients, subjective judgment that the fascia closure is too tight in 6 (31.6%) patient's damage control surgery in one patient (5.3%) and development of abdominal compartment surgery in one patient (5.3%). Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 (47.4%) patients, post operative intestinal fistula in 4 (21.1%) patients, post traumatic intra abdominal bleeding in 3 (15.8%) patients and intestinal obstructions in 3 (15.8%) patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one (10.0%) patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 (%21.1) early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 (26.3%) late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 (range 2-54) months. Currently 10 patients (52.6%) are alive at a follow up of 45 (range 1

  3. Optimization of recommendations for abdomen computerized tomography based on reconstruction filters, voltage and tube current

    The use of computed tomography has increased significantly over the past decades. In Brazil the use increased more than twofold from 2008 to 2014, in the meantime the abdomen procedures have tripled. The high frequency of this procedure combined by the increasing collective radiation dose in medical exposures, has resulted development tools to maximize the benefit in CT images. This work aimed to establish protocols optimized in abdominal CT through acquisitions parameters and reconstructions techniques based on filters kernels. A sample of patients undergoing abdominal CT in a diagnostic center of Rio de Janeiro was assessed. Had been collected patients information and acquisitions parameters. The phantoms CT image acquisitions were performed by using different voltage values by adjusting the tube current (mAs) to obtain the same value from CTDIvol patients with normal BMI. Afterwards, the CTDIvol values were reduced by 30%, 50% and 60%. All images were reconstructed with low-contrast filters (A) and standard filters (B). The CTDIvol values for patients with normal BMI were 7% higher than in patients with underweight BMI and 30%, 50% and 60% lower than the overweight, obese I and III patients, respectively. The evaluations of image quality showed that variation of the current (mA) and the reconstruction filters did not affect the Hounsfield values. When the contrast-to-noise ratio (CNR) was normalized to CTDIvol, the protocols acquired with 60% reduction of CTDIvol with 140 kV and 80 kV showed CNR 6% lower than the routine. Modifications of the acquisition parameters did not affect spatial resolution, but the post-processing with B filters reduced the spatial frequency by 16%. With reduced the dose of 30%, lesions in the spleen had the CNR higher than 10% routine protocols with 140 kV acquired and post-processed to filter A. The image post-processing with a filter A with a 80kV voltage provided CNR values equal to the routine for the liver lesions with a 30

  4. Use of a furosemide drip does not improve earlier primary fascial closure in the open abdomen

    Leland H Webb

    2012-01-01

    Full Text Available Background: The furosemide drip (FD, in addition to improving volume overload respiratory failure, has been used to decrease fluid in attempts to decrease intra-abdominal and abdominal wall volumes to facilitate fascial closure. The purpose of this study is to evaluate the FD and the associated rate of primary fascial closure following trauma damage control laparotomy (DCL. Materials and Methods: From January 2004 to September 2008, a retrospective review from a single institution Trauma Registry of the American College of Surgeons dataset was performed. All DCLs greater than 24 h who had a length of stay for 3 or more days were identified. The study group (FD+ and control group (FD- were compared. Demographic data including age, sex, probability of survival, red blood cell transfusions, initial lactate, and mortality were collected. Primary outcomes included primary fascial closure and primary fascial closure within 7 days. Secondary outcomes included total ventilator days and LOS. Results: A total of 139 patients met inclusion criteria: 25 FD+ and 114 FD-. The 25 FD+ patients received the drug at a median 4 days post DCL. Demographic differences between the groups were not significantly different, except that initial lactate was higher for FD- (1.7 vs 4.0; P=0.03. No differences were noted between groups regarding successful primary fascial closure (FD+ 68.4% vs FD- 64.0%; P=0.669, or closure within 7 days (FD+13.2% vs FD- 28.0%; P=0.066 of original DCL. FD+ patients suffered more open abdomen days (4 [2-7] vs 2 [1-4]; P=0.001. FD+ did not demonstrate an association with primary fascial closure [Odds ratio (OR 1.5, 95% confidence interval (CI 0.260-8.307; P=0.663]. FD+ patients had more ventilator days and longer Intensive Care Unit (ICU/hospital LOS (P<0.01. Conclusion: FD use may remove excess volume; however, forced diuresis with an FD is not associated with an increased rate of primary closure after DCL. Further studies are warranted to

  5. Carcinoma de células escamosas con invasión múltiple en abdomen en una oveja Rasa Aragonesa (Scaly cells carcinoma with multiple invasion in abdomen in a Rasa Aragonesa Sheep)

    Loste, A; Fernández, A.; Ortín, A; García de Jalón, J.A.; Borobia, M.; Marteles, D.

    2009-01-01

    ResumenUna oveja de raza Rasa Aragonesa, procedente de una explotación de laprovincia de Zaragoza, fue remitida a la Facultad de Veterinaria,presentando un historial de descarga vaginal sanguinolenta, oscura ymaloliente, por lo que se sospechó de un proceso de metritis y seadministró oxitocina para favorecer la eliminación de la secreción. Otros síntomas encontrados tras la exploración fueron caquexia, palidez de mucosas y debilidad. A la palpación del abdomen se detectaron varios nódulos, de...

  6. Acute pancreatitis induced by methimazole therapy.

    Abraham, Albin; Raghavan, Pooja; Patel, Rajshree; Rajan, Dhyan; Singh, Jaspreet; Mustacchia, Paul

    2012-05-01

    Among the causative factors for acute pancreatitis, adverse drug reactions are considered to be rare. The diagnosis of drug-induced pancreatitis (DIP) is challenging to establish, and is often underestimated because of the difficulties in determining the causative agent and the need for a retrospective re-evaluation of the suspected agent. We present the case of an 80-year-old woman who presented with complaints of abdominal pain. Her medications included methimazole (MMI) which she had been on for the past 3 months. Computed tomography of her abdomen showed peripancreatic fat stranding with trace amount of surrounding fluid, along with amylase and lipase levels suggestive of acute pancreatitis. In the absence of classical risk factors for acute pancreatitis, a diagnosis of DIP secondary to MMI use was made. Withdrawal of the drug from her medication regimen was accompanied by relief of symptoms and resolution of clinical evidence of pancreatitis. The aim of this paper is to report only the fourth case of MMI-induced pancreatitis in the published literature, and to illustrate the significance of an appropriate and timely diagnosis of DIP. PMID:22679409

  7. Dose reduction and image quality in MDCT of the upper abdomen. Potential of an adaptive post-processing filter

    Purpose: To evaluate the effects of a 2D non-linear adaptive post-processing filter (2D-NLAF) on image quality in dose-reduced multi-detector CT (MDCT) of the upper abdomen. Materials and Methods: MDCT of the upper abdomen was simulated on a 64-slice scanner using a multi-modal anthropomorphic phantom (CIRS, Norfolk, USA). While keeping the collimation (64 x 0.6 mm) and pitch (p = 1) unchanged, the tube current (100 - 500 mAs) and tube potential (80 - 140 kVp) were varied to perform MDCT as high dose (CTDI > 20), middle dose (CTDI 10-20) and low dose (CTDI < 10) level protocols. Four independent blinded radiologists evaluated axial images with a thickness of 7 and 3 mm with respect to the presentation of ''mesenteric low contrast lesions'', ''liver veins'', ''liver cysts'', ''renal cysts'' and ''big vessels''. The subjective image quality of original data and post-processed images using a 2D-NLAF (SharpViewCT, Linkoeping, Sweden) was graded on a 5-point scale (from ''1'' not visible to ''5'' excellent) and statistically analyzed. The effective dose (E) was estimated using commercial software (CT-EXPO). Results: For all protocol groups, 2D-NLAF led to a significant improvement in subjective image quality for all examined lesions (p < 0.01), particularly at the protocols of middle dose (E: 5 - 8 mSv) and low dose level (E: 1-5 mSv). A maximum effect was seen in middle dose protocols for ''low contrast lesions'' (score ''3.3'' with filter versus ''2.5'' without) and ''liver veins'' (''4.5'' versus ''3.9''). Conclusion: The phantom study indicates a potential dose reduction of up to 50% in MDCT of the upper abdomen by use of a 2D-NLAF, which should be further examined in clinical trails. (orig.)

  8. The gap gene giant of Rhodnius prolixus is maternally expressed and required for proper head and abdomen formation.

    Lavore, Andrés; Pagola, Lucía; Esponda-Behrens, Natalia; Rivera-Pomar, Rolando

    2012-01-01

    The segmentation process in insects depends on a hierarchical cascade of gene activity. The first effectors downstream of the maternal activation are the gap genes, which divide the embryo in broad fields. We discovered a sequence corresponding to the leucine-zipper domain of the orthologue of the gene giant (Rp-gt) in traces from the genome of Rhodnius prolixus, a hemipteran with intermediate germ-band development. We cloned the Rp-gt gene from a normalized cDNA library and characterized its expression and function. Bioinformatic analysis of 12.5 kbp of genomic sequence containing the Rp-gt transcriptional unit shows a cluster of bona fide regulatory binding sites, which is similar in location and structure to the predicted posterior expression domain of the Drosophila orthologue. Rp-gt is expressed in ovaries and maternally supplied in the early embryo. The maternal contribution forms a gradient of scattered patches of mRNA in the preblastoderm embryo. Zygotic Rp-gt is expressed in two domains that after germ band extension are restricted to the head and the posterior growth zone. Parental RNAi shows that Rp-gt is required for proper head and abdomen formation. The head lacks mandibulary and maxillary appendages and shows reduced clypeus-labrum, while the abdomen lacks anterior segments. We conclude that Rp-gt is a gap gene on the head and abdomen and, in addition, has a function in patterning the anterior head capsule suggesting that the function of gt in hemipterans is more similar to dipterans than expected. PMID:21763688

  9. Radiographic image quality and dose at thorax, abdomen and skull of patients at HC-FMB-UNESP

    Alvarez, Matheus; Giacomini, Guilherme; Bacchim Neto, Fernando A.; Alves, Allan F.F.; Velo, Alexandre F.; Miranda, Jose R.A., E-mail: matheus@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (IBB/UNESP), Botucatu, SP (Brazil). Inst. de Biociencias. Dept. de Fisica e Biofisica; Pina, Diana R. de, E-mail: drpina@fmb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (FMB/UNESP), Botucatu, SP (Brazil). Inst. de Biociencias. Dept. de Doencas Tropicais e Diagnostico por Imagem

    2013-11-01

    ICRP 103 specifies reference dose levels to be used during radiographic exams. Usually, the radiographer qualitative determines the best radiographic technique (kV and mAs) in order to obtain better image quality with the lowest dose. The objective of this study was to evaluate the doses used in examination of the chest, abdomen and skull in patients of different physical sizes, and infer about the amount of dose required to maintain acceptable radiological contrast in patients of different physical sizes. Techniques used by experienced radiographers of HC-FMB-UNESP for examinations of the chest (PA), abdomen (AP) and skull (AP) for patients of different thickness (small, medium and thick body) were obtained. Dose measurements were performed referring to all kV/mAs combinations. PMMA phantoms were placed below the ionization chamber. The Signal Difference Noise Ratio (SDNR) of the images of the phantoms were calculated from an area of contrast and a region of normal tissue. The Figure of Merit (FoM) was calculated for each of the exam modality. Measured FoM decreased according to the thickness of the chest and abdomen, indicating the need to increase the dose level to maintain the same level of image contrast. Patients thicker usually end up getting more than twice the dose of lean patients. Required image quality levels for correct diagnosis should be obtained using dose levels as low as reasonably practicable examination. These factors highlight the need for a program of quality assurance and effective dose studies in actual service. (author)

  10. Abdomen agudo quirúrgico en el adulto mayor. Hospital Vladimir Ilich Lenin. Enero 2005 a enero 2008

    Pavel Sánchez Reynaldo; Yasmín Rodríguez Pascual; Rafael Vázquez Fernández; Celia Yamila Cordero Monferrer

    2010-01-01

    Aborda un estudio descriptivo prospectivo en 388 adultos mayores operados de abdomen agudo en el Hospital Vladimir Ilich Lenin, enero 2005 a enero 2008, a fin de caracterizar el comportamiento de las afecciones que provocan esta entidad intraabdominal. La tercera edad y el sexo masculino resultaron los más afectados. El factor de riesgo quirúrgico más asociado fue la hipertensión arterial. El diagnóstico preoperatorio más frecuente fue la oclusión intestinal mecánica. No se indicaron adecuada...

  11. Función del diafragma durante la colocación de cargas sobre el abdomen en sujetos normales

    Sergio G. Monteiro

    2012-04-01

    Full Text Available Los efectos de las cargas en el abdomen con el objeto de producir entrenamiento del diafragma, no han sido suficientemente evaluados. Estudiamos la función del diafragma durante la colocación de cargas sobre el abdomen y con cambios en el patrón respiratorio. Se estudiaron 6 voluntarios normales. Se obtuvo flujo en la boca, presión gástrica (Pga, presión esofágica (Pes, movimiento torácico (TX y abdominal (AB, presión inspiratoria máxima (PImax y presión transdiafragmática media (Pdi y máxima (Pdimax. Se calculó la relación Pdi/Pdimax y el índice tensión-tiempo del diafragma (TTdi. Etapas: patrón normal (PN, patrón abdominal (PA y carga de 1, 2, 4 y 6 kg con PN y PA. El PA fue facilitado por las cargas sobre el abdomen. Solo con 6 kg (PN y PA la Pga a capacidad residual funcional aumentó significativamente (p 0.001. La Pdi siguió a las variaciones de la Pga y aumentó con todos los PA (p < 0.001. Con PA y carga el índice TTdi alcanzó un valor de 0.05 ± 0.02 (p < 0.001. Las cargas no aumentaron este índice más de lo que hizo el PA solo. Nuestros hallazgos sugieren que las cargas sobre el abdomen aumentan la propiocepción relacionada con los movimientos respiratorios y descenso del diafragma. Las cargas producen cambios leves en la mecánica del diafragma (en sujetos normales, 1/3 de la carga necesaria para desarrollar fatiga. En sujetos normales estos cambios parecen ser insuficientes para producir entrenamiento de los músculos respiratorios.

  12. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

    Leonor Montoya; Ericka Rodríguez; Grace Zúñiga; Gaby Yamamoto; Elsa González

    2014-01-01

    El objetivo del estudio fue describir las características en la presentación y el manejo del abdomen agudo (AA) en pacientes con el virus de la inmunodeficiencia humana (VIH). Se revisaron las historias clínicas de 97 pacientes portadores del VIH que cursaron con un cuadro de AA y que fueron atendidos en el período 2006-2011 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró que el 1,6% de los pacientes inmunosuprimidos ingresó a sala de operaciones. La apendicectomía fue el ...

  13. In vitro dose measurements in a human cadaver with abdomen/pelvis CT scans

    Zhang, Da; Padole, Atul; Li, Xinhua; Singh, Sarabjeet; Khawaja, Ranish Deedar Ali; Lira, Diego; Shi, Jim Q.; Otrakji, Alexi; Kalra, Mannudeep K.; Liu, Bob, E-mail: bliu7@mgh.harvard.edu [Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Liu, Tianyu; Xu, X. George [Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, New York 12180 (United States)

    2014-09-15

    Purpose: To present a study of radiation dose measurements with a human cadaver scanned on a clinical CT scanner. Methods: Multiple point dose measurements were obtained with high-accuracy Thimble ionization chambers placed inside the stomach, liver, paravertebral gutter, ascending colon, left kidney, and urinary bladder of a human cadaver (183 cm in height and 67.5 kg in weight) whose abdomen/pelvis region was scanned repeatedly with a multidetector row CT. The flat energy response and precision of the dosimeters were verified, and the slight differences in each dosimeter's response were evaluated and corrected to attain high accuracy. In addition, skin doses were measured for radiosensitive organs outside the scanned region with OSL dosimeters: the right eye, thyroid, both nipples, and the right testicle. Three scan protocols were used, which shared most scan parameters but had different kVp and mA settings: 120-kVp automA, 120-kVp 300 mA, and 100-kVp 300 mA. For each protocol three repeated scans were performed. Results: The tube starting angle (TSA) was found to randomly vary around two major conditions, which caused large fluctuations in the repeated point dose measurements: for the 120-kVp 300 mA protocol this angle changed from approximately 110° to 290°, and caused 8% − 25% difference in the point dose measured at the stomach, liver, colon, and urinary bladder. When the fluctuations of the TSA were small (within 5°), the maximum coefficient of variance was approximately 3.3%. The soft tissue absorbed doses averaged from four locations near the center of the scanned region were 27.2 ± 3.3 and 16.5 ± 2.7 mGy for the 120 and 100-kVp fixed-mA scans, respectively. These values were consistent with the corresponding size specific dose estimates within 4%. The comparison of the per-100-mAs tissue doses from the three protocols revealed that: (1) dose levels at nonsuperficial locations in the TCM scans could not be accurately deduced by simply scaling

  14. Open field whole abdomen irradiation of ovarian and endometrial carcinomas - early clinical tolerance

    Whole abdomen irradiation (WAI) is broadly applied as a part of the complex treatment of ovarian and high risk endometrial carcinomas prone to development and dissemination in the abdominal cavity. The aim of the present study is to evaluate the early clinical tolerance of WAI open field technique in ovarian and endometrial tumors. During the period 1993 - 2007 56 patients received open field WAI treatment in the Radiotherapy department, The clinical material included 20 patients with ovarian carcinomas, 26 - with endometrial cancer, 6 - with lymphomas and 4 - with other localizations of malignant tumors. The median age of the patients from the more numerous groups was 44 years for these with ovarian tumors and 56 - for these with endometrial tumors, all of them having a Karnofsky index of 100. The patients with endometrial tumors were in the Hi clinical stage, while earlier clinical stages were predominant (80%) for the patients with ovarian tumors. The serous-papillary histological types were prevalent in the ovarian tumors - 6 (30%), and the adenocarcinomas prevailed in the endometrial cancer - 18 (69%). The distribution of the patients with ovarian tumors according to the differentiation grade was: G1:G2:G3 -50%:22%:28%, and of those with endometrial tumors - 21%:67%:12%. WAI was delivered to all patients using tele gamma therapeutic equipment. The planned target volume (PTV) included the peritoneal cavity and the retroperitoneum from the diaphragm domes to the pelvis bottom. The irradiation was achieved via 2 opposite fields with daily doses of 1.0 - 1-5 Gy and total dose of 20 - 30 Gy. Lead protection of kidneys was included after total dose 16-18 Gy, and liver protection was applied after total dose 16-20 Gy.The patients with endometrial and ovarian tumors were given pelvic boost and/or boost in para aortal lymphatic chains and the rest of the patients - in the residual formations. The early clinical tolerance was evaluated using the scale of CTCAE v.3NCI

  15. Computerized tomography in normal abdomen: retrospective study of renal hila angles

    To obtain mean angulation values for renal hila in relation to the horizontal plane traced over the right and left spinal erector muscles, considering the center of the lumbar vertebral spine as a parameter for measuring the renal hila angles. The authors have analyzed 250 abdominal computed tomography studies of both male and female healthy individuals (128 men with mean age 52.45 ± 17.42 years, and 122 women with mean age 54.39 ± 18.27 years), corresponding to 500 renal hila evaluated. The mean angulation of each hilum in relation to the horizontal plane was obtained taking acute angles into consideration. The comparative study have not found any statistically significant difference in acute angles of renal hila between male and female individuals. The statistical analysis demonstrated limits of 40.40 deg and 44.54 deg for mean right hilum angulation and 39.91 deg and 43.23 deg for mean left hilum angulation, with a confidence interval of 95% . Renal hila present similar angulation independently of sex. Higher angulation values correspond to hyper-rotation or excessive rotation, and lower angulation values, to incomplete or reverse rotation. (author)

  16. Acute liver failure caused by concurrent autoimmune hepatitis and hepatitis B in a 16-year old girl

    Pawłowska, Małgorzata; Halota, Waldemar

    2010-01-01

    A 16 year-old girl was admitted to hospital because of fatigue and somnolence, nausea, epistaxis and jaundice. Physical examination revealed jaundice, an enlarged liver and tenderness of upper right abdomen. Laboratory tests revealed an increased level of acute liver failure, bilirubin, bile acids, GGTP and a decreased prothrombin ratio, with elevated gamma-globulin and IgG levels, and the presence of anti-mitochondrial M2 antibodies and HBV infection markers. The patient was diagnosed with l...

  17. Use of CO2 as an angiographic contrast material in the diagnosis of acute hepatic hemorrhage a case report

    Selective abdominal arteriography with an iodinated contrast material is the method of choice for detecting the site of bleeding in patients with acute gastrointestinal hemorrhage in whom the results of endoscopic examination were negative CO2, has been used successfully as a contrast material for arteriography of abdomen and lower limbs. We present the case of a patient in whom suspected gastrointestinal bleeding was detected more rapidly and reliably with co2 than with an iodinated contrast material. (Author) 18 Refs

  18. Porcine survival model to simulate acute upper gastrointestinal bleedings.

    Prosst, Ruediger L; Schurr, Marc O; Schostek, Sebastian; Krautwald, Martina; Gottwald, Thomas

    2016-06-01

    The existing animal models used for the simulation of acute gastrointestinal bleedings are usually non-survival models. We developed and evaluated a new porcine model (domestic pig, German Landrace) in which the animal remains alive and survives the artificial bleeding without any cardiovascular impairment. This consists of a bleeding catheter which is implanted into the stomach, then subcutaneously tunnelled from the abdomen to the neck where it is exteriorized and fixed with sutures. Using the injection of porcine blood, controllable and reproducible acute upper gastrointestinal bleeding can be simulated while maintaining normal gastrointestinal motility and physiology. Depending on the volume of blood applied through the gastric catheter, the bleeding intensity can be varied from traces of blood to a massive haemorrhage. This porcine model could be valuable, e.g. for testing the efficacy of new bleeding diagnostics in large animals before human use. PMID:26306615

  19. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA: Design and rationale

    Bossuyt Patrick MM

    2007-08-01

    Full Text Available Abstract Background The acute abdomen is a frequent entity at the Emergency Department (ED, which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US, computed tomography (CT and even diagnostic laparoscopy. However, no evidence-based guidelines exist in current literature. The actual diagnostic work-up of a patient with acute abdominal pain presenting to the ED varies greatly between hospitals and physicians. The OPTIMA study was designed to provide the evidence base for constructing an optimal diagnostic imaging guideline for patients with acute abdominal pain at the ED. Methods/design Thousand consecutive patients with abdominal pain > 2 hours and Discussion This study aims to provide the evidence base for the development of a diagnostic algorithm that can act as a guideline for ED physicians to evaluate patients with acute abdominal pain.

  20. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    Liao, S; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle.

  1. Ct enterography/ct abdomen and pelvis using neutral oral contrast. a new combination of natural products

    Our purpose was to assess the performance of a new combination of neutral oral contrast for CT abdomen and CT Enterography in comparison with commercially available neutral oral contrast VoLumen. Seventy three consecutive patients were given sorbitol/CMC (Carboxy Methyl Cellulose) solution or VoLumen as oral contrast agent for abdominal computed tomography (CT) scan. 23 patients were male and 37 females. Age range was between 16 and 67 years. Since the use of CT scan for abdominal pathologies, there was need to separate bowel loops to localize the pathology. Three types of oral contrast can be used in CT-Scan abdomen; Positive, Neutral and negative. The above used contrasts are Neutral contrast these refers to agents that have an attenuation value similar to that of water (0-30 H).Our results show this new combination of Cc and Sorbitol to be equally good as VoLumen, for luminal distension and mural details, in duodenum and jejunum. While better than VoLumen for Ileal distension. (author)

  2. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle

  3. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  4. Effective dose evaluation of head and abdomen CT exams in adult patients at the Instituto de Radiologia of Faculdade de Medicina of University of Sao Paulo, SP, Brazil; Estimativa de dose efetiva em exames de tomografia de cranio e abdomen em pacientes adultos do Instituto de Radiologia da Faculdade de Medicina da USP (INRAD/FM/USP)

    Nersissian, Denise Y.; Scolastici, Eric F.; Doro, Renato B.; Furquim, Tania A.C., E-mail: yanikian@if.usp.br, E-mail: ericfs@if.usp.br, E-mail: rbdoro@if.usp.br, E-mail: tfurquim@if.usp.br [Universidade de Sao Paulo (IF/USP), SP (Brazil). Instituto de Fisica. Departamento de Fisica Nuclear. Laboratorio de Dosimetria

    2013-11-01

    This paper presents an estimate of the effective dose from CTDI{sub vol} for exams of skull and abdomen in adult patients. Thereafter, measurements were taken of CTDI using an ionization chamber type pencil (Radcal Corportation, model 10 x 5 - 3CT) and cylindrical phantom of PMMA equivalent to regions of the skull (diameter = 16 cm) and abdomen (diameter = 32 cm). The results of effective dose for abdomen varied between 7,3 and 12,1 mSv and for skull between 1,4 and 5,0 mSv. Comparing with the literature data, for abdomen exams between 5 and 7 mSV and skull exams between 1 and 2 mSv, it is shown that it is possible to optimize these protocols, aiming to reduce the doses to patients.

  5. Acute Gastric Volvulus Secondary to Malrotation of Gut in a Child with Cerebral Palsy

    Kanchan Kayastha

    2011-08-01

    Full Text Available Acute gastric volvulus secondary to malrotation of gut is a rare surgical emergency. We report a case of an eight years old cerebral palsy (CP child who presented to us with sudden upper abdominal distension and non productive retching. X-ray abdomen revealed a huge gas shadow on left side of abdomen with paucity of distal gas shadows. On exploration organoaxial gastric volvulus with gastric ischemia, secondary to malrotation of gut, was found. Volvulus derotated and Ladd’s procedure was done. Gastropexy and fundoplication was not done due to gastric ischemia. Early diagnosis and surgical management can save the patient from fatal complications of gastric perforation due to gastric ischemia.

  6. Acute gallbladder torsion - a continued pre-operative diagnostic dilemma

    Desrochers Randal

    2011-04-01

    Full Text Available Abstract Acute gallbladder volvulus continues to remain a relatively uncommon process, manifesting itself usually during exploration for an acute surgical abdomen with a presumptive diagnosis of acute cholecystitis. The pathophysiology is that of mechanical organo-axial torsion along the gallbladder's longitudinal axis involving the cystic duct and cystic artery, and with a pre-requisite of local mesenteric redundancy. The demographic tendency is septua- and octo-genarians of the female sex, and its overall incidence is increasing, this being attributed to increasing life expectancy. We discuss two cases of elderly, fragile women presenting to the emergency department complaining of sudden onset right upper quadrant abdominal pain. Their subsequent evaluation suggested acute cholecystitis. Ultimately both were taken to the operating room where the correct diagnosis of gallbladder torsion was made. Pre-operative diagnosis continues to be a major challenge with only 4 cases reported in the literature diagnosed with pre-operative imaging; the remainder were found intra-operatively. Consequently, a delay in diagnosis can have devastating patient outcomes. Herein we propose a necessary high index of suspicion for gallbladder volvulus in the outlined patient demographic with symptoms and signs mimicking acute cholecystitis.

  7. Usefulness of computed tomography in patients with right inferior abdominal quadrant pain: acute appendicitis and its alternative diagnosis

    Purpose: To review the tomography findings of the acute appendicitis, their complications and alternative diagnosis. To value the use of helicoidal computed tomography (HCT) in the diagnosis of acute appendicitis and in the study of patients with right inferior abdominal quadrant (RIQ) pain and acute abdomen, for diagnosis and eventual complications, in order to decide treatment. Materials and method: For five months, the populations included in this retrospectively study were all patients delivered for presenting with RIQ pain for a HCT exam. These exams were made with oral and intravenous contrasts, when there were not contraindications. The HCT results were correlated with clinical follow up, surgery and histopathologic exams. Results: Over a total of 100 patients studied, 53 presented tomographic diagnosis of appendicitis, 22 of which presented perforation signs; 27 showed an alternative diagnosis (ovaries follicles, ureteral litiasis, tiphlitis, diverticulitis, colitis, salpingitis), 18 patients did not present tomographic findings to support the clinical symptoms and 2 presented indeterminated results. These data represented a sensibility of 100%, specificity of 95,7%, positive predictive value (PPV) of 96,2% and negative predictive value (NPV) of 100% for the tomography diagnosis of acute appendicitis and a sensibility of 100%, specificity of 81,8%, PPV of 95,1% and NPV of 100% for the tomography diagnosis of the different etiology in patient with right inferior acute abdomen. Conclusion: HCT is extremely useful in the study of patients with acute abdomen with origin in the RIQ, not only to make a diagnosis, but also to evaluate the complications, so as to decide proper treatment. (authors)

  8. Acute intermittent porphyria in the puerperium

    Sparić Radmila

    2010-01-01

    Full Text Available Introduction. Acute intermittent porphyria emerges as a result of partial defect of porphobilinogen deaminase and is manifested by repeated episodes of somatic, psychiatric and neurological disorders. The disease is conducted via the autosomaldominant gene of variable penetration, so most of the carriers never experience seizures. Timely making of diagnosis, screening of blood relatives of the patient and education of patients on avoidance of provoking factors are the key to adequate treatment. Case Outline. A 23-year-old patient having born the third child was hospitalized due to pains in the abdomen and convulsive seizures nine days after the vaginal delivery. At admittance, she suffered a generalized convulsive seizure of clonic-tonic type. The patient immediately underwent a complete clinical, laboratory, bacteriological and ultrasound examination. Bearing in mind the fact that the patient had several convulsive seizures even after the given neurological therapy, haem-arginate was introduced into therapy during four days. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The patient was treated by a team of doctors, in the intensive care ward, with the use of medicaments, which are allowed in the case of acute porphyria. Sixteen days after the admittance, with clean neurological status and gynaecological and ultra-sound findings, she was released for ambulatory treatment. Conclusion. The presented case exhibits the gravity of making a diagnosis of acute intermittent porphyria in puerperium and the necessity of multi-disciplinary approach in treating this disease. Acute intermittent porphyria should be considered in cases of ambiguous abdominal pain, as well as in patients having abdominal pains followed by neuro-psychiatric disorders.

  9. Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis?

    To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 v. 6.2 h), hospital admission rates or post-test therapeutic interventions. Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients. (author)

  10. Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis?

    Worster, A. [Hamilton Health Sciences Corp., Div. of Emergency Medicine, Hamilton, Ontario (Canada); Haines, T. [McMaster Univ., Health Sciences Centre, Faculty of Health Sciences, Hamilton, Ontario (Canada)

    2002-06-01

    To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 v. 6.2 h), hospital admission rates or post-test therapeutic interventions. Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients. (author)

  11. Dosimetric comparison of helical tomothearpy and linac-based IMRT in whole abdomen radiotherapy

    Kang, Young-nam; Kim, Dae-Hyun; Jang, Hong Seok; Song, Jin Ho; Choi, Byung Ock; Cho, Seok Goo; Jung, Ji-Young; Kay, Chul Seung

    2012-10-01

    Recent advances in radiotherapy techniques have allowed a significant improvement in the therapeutic ratio of whole abdominal irradiation (WAI) through linear-accelerator (Linac) based intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT). IMRT has been shown to reduce the dose to organs at risk (OAR) while adequately treating the tumor volume. HT operates by adjusting 51 beam directions, couch speed, pitch and shapes of a binary multileaf collimator (MLC), with the purpose of clinically increasing the befit to the patient. We incorporated helical tomotherapy as a new modality for WAI for the treatment of non-Hodgkin's lymphoma patients whose disease involved the intestine and the mesenteric lymph nodes. Excellent tumor coverage with effective sparing of normal organ sparings, and homogeneous dose distribution could be achieved. This study dosimetrically compared HT and linac-based IMRT by using several indices, including the conformity index (CI) and the homogeneity index (HI) for the planning target volume (PTV), as well as the, max dose and the mean dose and the quality index (QI) for five organs at risk (OARs). The HI and the CI were used to compare the quality of target coverage while the QI was used compare the dosimetric performans for OAR systems. The target coverages between the two systems were similar, but the most QIs were lower than 1, what means that HT is batter at sparing OARs than IMRT. Tomotherapy enabled excellent target coverage, effective sparing of normal tissues, and homogeneous dose distribution without severe acute toxicity.

  12. Exoskeleton Morphology of Three Species of Preponini, with Discussion of Morphological Similarities among Neotropical Charaxinae (Lepidoptera: Nymphalidae)-III. Abdomen and Genitalia.

    Bonfantti, Dayana; Casagrande, Mirna Martins; Mielke, Olaf Hermann Hendrik

    2015-06-01

    The present paper is the final part of a study of the external morphology of Preponini, which compares the abdomen and genitalia of Archaeoprepona demophon demophon (Linnaeus, 1758), Archaeoprepona licomedes licomedes (Cramer, 1777) and Prepona pylene pylene Hewitson, [1854], through descriptions and illustrations. The results are compared with three other species, Prepona claudina annetta (Gray, 1832), Memphis moruus stheno Hübner, [1819] and Zaretis itys itylus (Westwood, 1850). The abdomen is commonly the most informative tagma for butterflies. In Charaxinae, this tagma supports diagnoses of both genera and species, besides providing a solid morphological base for recent molecular findings for Preponini. PMID:26003986

  13. Gastric pH and motility in a porcine model of acute lung injury using a wireless motility capsule

    Rauch, Stefan; Muellenbach, Ralf M.; Johannes, Amélie; Zollhöfer, Bernd; Roewer, Norbert

    2011-01-01

    Summary Background Evaluation of gastric pH and motility in a porcine model of acute lung injury using a novel, wireless motility capsule. Material/Methods A motility capsule was applied into the stomach of 7 Pietrain pigs with acute lung injury induced by high volume saline lavage. Wireless transmission of pH, pressure and temperature data was performed by a recorder attached to the animal’s abdomen. Gastric motility was evaluated using pH and pressure values, and capsule location was confir...

  14. First clinical results of ultrafast, gadolinium-enhanced dual-phase 3D MR-angiography in the abdomen

    To assess the utility of breath-hold abdominal ultrafast three-dimensional (3D) gadolinium-enhanced dual-phase magnetic resonance angiography (MRA). Material and methods: 125 patients with various abdominal pathologies were imaged using a breath-hold ultrafast gadolinium-enhanced dual-phase 3D-MRA technique. Results: 119 (95%) of 125 MRA's were of good or excellent quality. The sensitivity in the detection of renal artery stenoses as well as stenoses of the celiac trunk and the superior mesenteric artery was 100%. Accessory renal arteries (n=9) and replaced hepatic arteries (n=4) were reliably detected by MRA. In 24 (71%) of 34 cases MR-angiographic delineation of the spleno-portal system and hepatic veins was superior compared to conventional angiography. Conclusion: Breath-hold gadolinium-enhanced dual-phase 3D-MRA has the potential to replace conventional angiography in the abdomen. (orig.)

  15. Transplantation of an eight-organ multivisceral graft in a patient with frozen abdomen after complicated Crohn's disease

    Andreas Pascher; Jochen Klupp; Sven Kohler; Jan M Langrehr; Peter Neuhaus

    2006-01-01

    To report an extended multivisceral transplantation (MVTx) including right kidney and ascending colon in a patient with complicated Crohn's disease (CD).A 36-year old female suffering from short bowel syndrome and frozen abdomen due to fistulizing CD after multiple abdominal operations underwent MVTx of eight organs including stomach, pancreatoduodenal complex, liver, intestine, ascending colon, right kidney,right adrenal gland, and greater omentum in November 2003. Immunosuppression consisted of alemtuzumab,tacrolimus and steroids. The patient was off parenteral nutrition by postoperative wk 3. She experienced one episode of pneumonia. The patient recovered completely and discharged 2.5 mo and was doing well 30 mo after MVTx. This is one of the very rare cases in which a complete mulitivisceral graft of eight abdominal organs was transplanted orthotopically.

  16. [Acute myocarditis].

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  17. A P ROSPECTIVE STUDY ON PENETRATING INJURIES TO THE ABDOMEN IN S.V.R.R.G.G HOSPITAL, TIRUPATI

    Sobha Rani

    2015-09-01

    Full Text Available INTRODUCTION: Penetrating trauma to abdomen is an important cause of surgical emergencies as young productive adults are involved. Patients with penetrating abdominal wound presenting with shock, peritonitis or evisceration are usually subjected to early laparotomy alth ough a very few studies have been done to validate the criteria. AIMS & OBJECTIVES: To study the etiology, extent of organ involvement in the penetrating injury and organs most commonly involved. To assess patient, for surgical intervention and avoid negat ive laparotomy. To assess morbidity rate, due to different organs involved. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS: STUDY DESIGN: Prospective Clinical Study. STUDY AREA: Sri Venkateswara Medical College Tiru pathi. SOURCE OF DATA: The material for the present study is collected from the patients who present to the Out Patient Department of Surgery, Sri Venkateswara Medical College with swelling in the scrotal region fulfilling the inclusion criteria. METHODS: In a prospective study of 44 consecutive patients with penetrating wounds to anterior abdomen flank or lower chest, various clinical and radiological criteria were evaluated for their accuracy in predicting the presence of significant abdominal organ injur y. All the patients with peritoneal penetration, signs of generalized peritonitis, hemodynamic instability underwent exploratory laparotomy. RESULTS: Overall 30 patients (68% had significant abdominal injury requiring repair. The criteria for significant organ injury were shock on admission, generalized peritonitis, evisceration of omentum and or bowel. Mere penetration of peritoneal cavity is a poor indicator of organ injury. Extra luminal air or free peritoneal fluid on X - ray is unreliable to predict the organ injury or to add to the management in the presence of other signs. INTERPRETATION AND CONCLUSION: Signs of hemodynamic instability generalized peritonitis are

  18. A new instrument for the measurement of rib cage and abdomen circumference variation in respiration at rest and during exercise.

    Lafortuna, C L; Passerini, L

    1995-01-01

    A simple and inexpensive new extensometer for measuring changes in chest wall circumference during human respiratory movements is presented. The instrument detects the delay between ultrasound emission and reception at opposite ends of two rubber tubes encircling the rib cage and abdomen. Assuming a two degree of freedom model of the chest wall and employing an isovolume procedure for determination of volume-motion coefficients, extensometer estimation of tidal volume (VT) from changes of rib cage and abdomen circumference was compared with spirometer measurements at rest and during exercise on a cycle ergometer (55-155 W) in six subjects and, in four of them, on a treadmill (4-12 km.h-1). In three subjects hypercapnic hyperpnoea at rest was also studied. The slopes of the linear relationship between extensometer and spirometer VT (litres) averaged 0.9967 (SD 0.0117) (r2 = 0.995-0.998; n = 90-143) for cycle ergometer exercise, 1.0072 (SD 0.0078) (r2 = 0.991-0.998; n = 75-93) for treadmill exercise and 0.9942 (SD 0.0188) (r2 = 0.997-0.998; n = 18-25) for hypercapnic hyperpnoea. In all instances the slope of the regression line was consistent with the model of the identity line (slope = 1). The changes in end-expiratory lung volume between respiration at rest and during exercise were determined by the extensometers, and were nearly identical (98.4% on average) to those measured with the spirometer (r2 = 0.945; n = 24). It is concluded that determination of chest wall circumference with this new instrument is suitable for quantitative measurement of ventilation and lung volume variations in humans under most physiological conditions. PMID:7588698

  19. Neoplastic and other pathologic effects of fractionated fast neutrons or photons on the thorax and anterior abdomen of beagles

    Thirty-nine adult male beagle dogs received either fast-neutron or photon irradiation to the right hemithorax and right rostral abdomen. Twenty-four dogs (six per group) received fast neutrons (15 MeV) to total doses of 1000, 1500, 2250, or 3375 cGy in four fractions per week for six weeks. Fifteen dogs received 3000, 4500, or 6750 cGy of photons in an identical fractionation pattern. One photon-irradiated dog and 13 neutron-irradiated dogs died or were euthanatized because of hepatic and gastrointestinal disturbances 47 to 708 days after irradiation; 20 dogs died of other causes. These 34 dogs were necropsied and have been studied microscopically; the remaining five dogs are still alive seven years after irradiation. Neutron-induced lesions included hemorrhage, necrosis, fibrosis, and atrophy of the heart, liver, pancreas, pylorus, duodenum, and kidney. All lesions were associated with degenerative and occlusive vascular changes including coronary arteriosclerosis. The relative biological effectiveness (RBE) of fast neutrons, assessed by clinical signs and by gross and microscopic pathology, is between 3 and 4.5 for pancreas, ∼4.5 for heart, pylorus, duodenum, and kidney, and greater than 6.75 for liver. Ten malignancies and two benign tumors developed in the irradiated field of six of 12 neutron-exposed dogs that survived over one year after irradiation. Two malignancies and one benign tumor arose in three of 12 photon-exposed dogs surviving over one year postirradiation. Only one neoplasm developed in the same field in 11 nonirradiated controls or in 62 dogs irradiated at sites other than the thorax or abdomen. The neutron RBE for neoplasia is approximately 6.75. 85 refs., 8 figs., 3 tabs

  20. RECURRENT SEASONAL ACUTE PSYCHOSIS

    Agarwal, Vivek

    1999-01-01

    Acute psychoses have been reported to occur more frequently in summer. This is a report of seasonal recurrence of acute psychosis in a patient. This case report emphasizes towards the biological etiology of acute psychoses.

  1. Acute cerebellar ataxia

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  2. Comparison of helical computed tomography and ultrasonography in diagnosis of acute appendicitis

    The objective of study is to compare the diagnostic accuracy of helical computed tomography and ultrasonography in acute appendicitis using histopathology as gold standard. Thirty cases of clinically suspected acute appendicitis were included in the study selected on non probability convenience sampling technique. Computed tomography and graded compression ultrasonography of right lower quadrant of abdomen were conducted and results compared with histopathological findings. Amongst 30 patients who underwent computed tomography and graded compression ultrasonography examinations of right lower quadrant for diagnosis of acute appendicitis, on computed tomography 19 were diagnosed with acute appendicitis, 10 were diagnosed as not having the disease and 01 patient diagnosed as not having appendicitis on computed tomography did not improve clinically, was operated upon and histopathology proved it as acute appendicitis. While on graded compression ultrasonography 15 were diagnosed with acute appendicitis, 11 were diagnosed as not having the disease and 04 patients diagnosed as not having appendicitis on ultrasonography, did not improve clinically, were operated upon and histopathology proved it as acute appendicitis. This showed that CT scan has sensitivity of 95%, specificity 100%, positive predictive value 100%, negative predictive value 90.91% and overall accuracy of 96.67% while ultrasonography has sensitivity of 78.9%, specificity 100%, positive predictive value 100%, negative predictive value 73.33% and overall accuracy of 86.67%. We concluded that Helical computed tomography is highly accurate in diagnosing acute appendicitis as compared to ultrasonography and it helps to reduce negative appendectomy rate. (author)

  3. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Seval İzdeş; Neriman Defne Altıntaş; Gülin Karaaslan; Recep Uygun; Abdulkadir But

    2011-01-01

    Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to dis...

  4. The role and difficulties of the use of routine screening abdomen ultrasound for the detection of a liver metastasis in postoperative breast cancer patients

    To evaluate the role and difficulties of the use of routine abdomen ultrasound (US) in postoperative breast cancer patients. We reviewed the clinical records of 2460 patients who received breast cancer surgeries and underwent routine follow-up abdomen US for more than five years. We evaluated the number and clinical conditions of patients with a liver metastasis. We also evaluated the cut-off point of the breast cancer stage where a metastasis was likely to occur using the chi-squared test and receiver operator characteristic (ROC) analysis. A metastasis developed in 238 patients (9.7%), and the liver was the third most common organ site. However, just 24 (0.98%) patients presented only with a liver metastasis. Among these 24 patients, a metastasis was detected in 17 patients with the use of routine abdomen US. The cut-off point for a metastasis was Stage 3A. The use of routine screening abdomen ultrasound for the detection of a liver metastasis in postoperative breast cancer patients is not recommended. However, US can be used selectively in patients with clinical symptom or that present with a high stage equal or greater than Stage 3A

  5. CLINICAL STUDY OF ACUTE PANCREATITIS AND ITS COMPLICATIONS

    Raj Siddharth

    2016-03-01

    Full Text Available BACKGROUND More than a century after its comprehensive description, acute pancreatitis remains a common disorder with devastating consequences. The presentation of wide spectrum of symptoms gives the clinician a heart breaking exercise to bring back the patient from the clutches of the disease process. Pancreatitis by itself is a disease which is unique, protean and extrudes into the diagnostic arena. It cannot be too strongly emphasized that the primary treatment of acute pancreatitis is conservative only, but it is the Pandora’s box of manifestation with its inherent complications from surgery comes into play as diagnostic, prognostic and therapeutic endeavour. To study age and sex incidence of acute pancreatitis, to study and analyse the etiopathological factors associated with acute pancreatitis, especially alcohol aetiology in our study. To analyse the prognosis of acute pancreatitis using CT scan abdomen. To analyse the complications, to analyse the role of surgery in acute pancreatitis. METHODS This study was carried out on patients admitted in the General Surgery Department, MGM Hospital, from December 2013 to June 2015. RESULTS The incidence of acute pancreatitis was found to be in a younger age group in our study. Serum amylase and lipase both (80% sensitivity should be used for diagnosis wherever possible. Ideally, all cases should be stratified during the first 48 hours according to one of the scoring systems (Balthazar’s. Scoring systems help to identify patients who are more likely to have a severe attack and they should be referred to higher centres if adequate facilities are not available.

  6. Acute colitis: differential diagnosis using multidetector CT

    Aim: To investigate the utility of multidetector CT (MDCT) in helping to establish the underlying cause of acute colitis. Methods and materials: All patients who had acute colitis with a well-identified cause and underwent abdomen 64-MDCT were included in the study. MDCT images were retrospectively analysed in a blinded fashion and the CT findings were correlated with the eventual aetiological diagnosis. Results: The study population included 105 patients. Acute colitis was related to inflammatory bowel disease in 43 cases. MDCT was used to identify six relevant signs of inflammatory colitis: the “comb” sign (p < 0.001), enlarged lymph nodes (p < 0.001), abscess (p = 0.026), fibro-fatty infiltration (p = 0.007), small bowel involvement (p < 0.001), and the absence of an “empty colon” sign (p = 0.045). Multivariate logistic regression analysis identified three independent signs of inflammatory colitis: the “comb” sign, small bowel involvement, and enlarged lymph nodes. Acute colitis was related to bacterial infection in 35 cases. Five signs were significantly associated with infectious colitis: continuous distribution (p = 0.020), an “empty colon” sign (p = 0.002), absence of fat stranding (p = 0.013), and absence of a “comb” sign (p = 0.010) and absence of enlarged lymph nodes (p = 0.035). Multivariate analysis identified three independent signs: the “empty colon” sign and absence of fat stranding and of a “comb” sign. The remaining causes were ischaemic colitis (n = 21) and drug-related colitis (n = 6). MDCT examination provided five relevant signs of ischaemic colitis: fat stranding (p = 0.002), discontinuous distribution (p < 0.001), and absence of enlarged lymph node (p < 0.001), a “comb” sign (p = 0.006) and small bowel involvement (p = 0.037). Conclusions: MDCT provides certain suggestive signs that may be helpful in distinguishing the underlying aetiological cause of acute colitis

  7. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    Justin L, Regner, E-mail: Justin.Regner@BSWHealth.org; Angela, Lomas [Department of Surgery, Baylor Scott and White Health and Texas A& M Health Science Center College of Medicine, Temple, TX (United States)

    2016-03-25

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.

  8. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet

  9. Progress in research into the mechanism of Radix salviae miltiorrhizae in treatment of acute pancreatitis

    Xi-Ping Zhang; Zhi-Jun Li; Da-Ren Liu

    2006-01-01

    BACKGROUND: Acute pancreatitis (AP) is a common acute abdomen with high mortality, multiple complications and complicated causes. There is no effective therapy for AP. Radix salviae miltiorrhizae (Danshen), a traditional herbal medicine, has a low price and a wide range of clinical applications. It is effective to promote blood lfow, eliminate stagnancy, and relieve pain. It is also found to be effective in treating AP. We reviewed the progress in research into the mechanism of Radix salviae miltiorrhizae in treatment of AP. DATA SOURCES: An english-language literature search was conducted using MEDLINE (1988-2005) on Radix salviae miltiorrhizae (Danshen) and acute pancreatitis. RESULTS:The mechanisms of Danshen in the treatment of AP include improvement of microcirculatory disturbances;elimination of oxygen free radicals; modulation of the metabolism of lipid inlfammatory mediator;and blocking of calcium inlfow and prevention of calcium overload. CONCLUSION:Danshen can effectively reduce the mortality and complications of AP.

  10. Study of dosimetric quantities and image quality in pediatric examinations of chest and abdomen computed tomography; Estudo das grandezas dosimetricas e da qualidade da imagem em exames pediatricos de torax e abdomen por tomografia computadorizada

    Jornada, Tiago da Silva

    2013-08-01

    This work had the objective to achieve the knowledge of the dosimetric quantities related to chest and abdomen computed tomography (CT) examinations of pediatric patients, in Belo Horizonte city. The reason of this work is based on the fact that the probability of health detriment in children, which it may be caused by radiation, is higher than in adults. Besides, although in many countries the knowledge and control of patient doses is a normal procedure, this safety culture does not exist in Brazil. Another objective of this work was to compare the dosimetric quantity values with the Diagnostic Reference Levels (DRLs); when it was needed, an optimization process was applied and the quality of the diagnostic image obtained with the optimized technical parameters was analyzed. This study was carried out in five hospitals, where the weighted air kerma index (Cw), the volumetric air kerma index (Cvol), the air kerma - length product (PKL,CT), the Effective Dose (E) and the Normalized Effective Dose (En) were determined; three methods were adopted for measurements: the ionization chamber inside a chest pediatric phantom, radiochromic films and the CT-EXPO software. The optimization process was applied to a single hospital through variations in the current (mA) and voltage (kV) of the x-ray tube for the protocols used for abdomen CT examinations. The analysis of the quality of the diagnostic image was done by Normal Distribution and ROC analysis; spatial resolution analysis was used through MTF determination and the noise level was judged in terms quantitative and qualitative. Results of the dosimetric quantities showed that they significantly differed between single-slice and multi-slice tomography units, but their values were always below the recommended DRLs. The optimized values of the dosimetric quantities obtained after the optimization process showed that it was possible to reduce the radiation exposure of pediatric patient without losing the image quality

  11. Feasibilities of combination of hyperbaric oxygenation, ultraviolet blood irradiation, hemisorption in treating patients with sepsis as a complication of acute inflammatory diseases of abdomen

    Consideration is given to correlation of efficiency of results of treating patients with sepsis during traditional intensive therapy and during complex treatment, including hemosorption, hyperbaric oxygenation, ultraviolet blood irradiation, based on studying clinical picture, biochemical and immunological indices. Increase of treatment efficiency when using mentioned therapeutic measures, particularly their different combinations, is shown. 69 refs

  12. GE Light speed 16 CT扫描技术在急腹症中的应用%Application of GE Light Speed 16 CT in Acute Abdomen

    龙腾河

    2009-01-01

    目的:探讨GE Light speed 16 CT扫描技术在急腹症中的应用.方法:系统总结各类急腹症所使用的GELight speed 16 CT技术参数.结果:根据急腹症的病因和部位,选择合适的技术参数扫描可以快速、准确地诊断急腹症.结论:根据急腹症的个性应用GE Light speed 16 CT进行扫描,不但能快速提供急腹症影像资料和影像诊断,而且能够提高急腹症诊断的准确率.

  13. Cálculo biliar "perdido": um novo problema para o ginecologista na abordagem do abdome agudo? "Lost" gallstone: a new problem for the gynecologist in acute abdomen management ?

    José Carlos Menegoci; Edson Alcoléa Filho; Álvaro Augusto Germano Gutierres

    1999-01-01

    Os autores relatam o caso de uma paciente com 35 anos de idade, submetida à colecistectomia videolaparoscópica há 1 ano e que apresentou quadro sugestivo de salpingite aguda com abscesso. Durante a laparotomia notou-se um abscesso que era limitado anteriormente pelo peritônio parietal e músculo reto anterior direito do abdome, e posteriormente pelo corno uterino e pelo ligamento redondo à direita. Neste abscesso havia estrutura a seguir identificada como cálculo biliar. São discutidos os aspe...

  14. Malrotación intestinal en adultos: causa infrecuente de abdomen agudo oclusivo Intestinal malrotation in adults: infrecuent cause of acute oclusive syndrome

    Josefina Etchevers; Mariano Palermo; María Gabriela Salvatore; Francisco Tarsitano; Vicente Villafañe

    2008-01-01

    El 90 % de los casos de obstrucción por malrotación intestinal ocurre en niños menores de 1 año de edad, siendo altamente infrecuente en adultos. Un paciente de sexo masculino, de 31 años de edad, con antecedente de episodios de dolor abdominal, vómitos y constipación que alternaban con períodos de normalidad desde la niñez es admitido en el hospital por sintomatología similar, la que no cede. Luego de estudios radiológicos y de laboratorio se decide su intervención quirúrgica con el diagnóst...

  15. Laparoscopia no abdome agudo inflamatório de difícil diagnóstico Laparoscopy in inflamatory acute abdomen of difficult diagnosis

    Antonio Carlos Valezi; Jorge Mali Junior; Rodrigo Gomes de Oliveira; Mario Liberatti; Antonio César Marson; Edivaldo Macedo de Brito

    2003-01-01

    OBJETIVOS: O objetivo deste estudo foi analisar a eficácia do método laparoscópico em casos de abdome agudo inflamatório de difícil avaliação, quanto à acurácia, sensibilidade, especificidade e valores preditivos positivo e negativo. MÉTODO: Foram examinados, prospectivamente, 29 doentes com suspeita clínica de abdome agudo inflamatório, que após exames clínico e complementares não esclarecedores, foram submetidos à laparoscopia diagnóstica e/ou terapêutica. RESULTADOS: A precisão diagnóstica...

  16. Diverticulite do intestino delgado, uma causa incomum de abdome agudo inflamatório = Diverticulitis of the small bowel, an unusual cause of inflamatory acute abdomen

    Leão, Ari Ben-Hur Stefani

    2012-01-01

    Conclusões: A localização da doença diverticular no intestino delgado é pouco comum, e sua apresentação com complicações como perfuração, obstrução e hemorragia a tornam de grande importância clínica, pela dificuldade de se estabelecer o diagnóstico diferencial com outras moléstias abdominais.

  17. Diverticulite do intestino delgado, uma causa incomum de abdome agudo inflamatório = Diverticulitis of the small bowel, an unusual cause of inflamatory acute abdomen

    Leão, Ari Ben-Hur Stefani

    2012-01-01

    Objetivos: Descrever a apresentação clínica, o diagnóstico diferencial e o tratamento de um caso de diverticulite do intestino delgado. Descrição do caso: Um homem de 58 anos de idade apresentou quadro clínico de dor e distensão abdominal, com exames de imagem demonstrando espessamento de alça de intestino delgado. Foi realizado exame videolaparoscópico do abdome e diagnosticada diverticulite do intestino delgado, a qual recebeu tratamento cirúrgico. O paciente teve boa evolução no pós ope...

  18. Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar When and why use unenhanced computed tomography in patients with acute abdomen

    Edison de Oliveira Freire Filho; Paulo Eduardo Marinho de Jesus; Giuseppe D'Ippolito; Jacob Szejnfeld

    2006-01-01

    A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discut...

  19. Malrotación intestinal en adultos: causa infrecuente de abdomen agudo oclusivo Intestinal malrotation in adults: infrecuent cause of acute oclusive syndrome

    Josefina Etchevers

    2008-12-01

    Full Text Available El 90 % de los casos de obstrucción por malrotación intestinal ocurre en niños menores de 1 año de edad, siendo altamente infrecuente en adultos. Un paciente de sexo masculino, de 31 años de edad, con antecedente de episodios de dolor abdominal, vómitos y constipación que alternaban con períodos de normalidad desde la niñez es admitido en el hospital por sintomatología similar, la que no cede. Luego de estudios radiológicos y de laboratorio se decide su intervención quirúrgica con el diagnóstico de obstrucción intestinal. El diagnóstico intraoperatorio realizado fue de malrotación intestinal tipo I, practicándose la operación de Ladd. La evolución del paciente es favorable. La infrecuente presentación de esta patología en adultos es lo que motiva la presentación del caso.The 90 % of the bowel obstruction caused by intestinal malrotation occurred in children younger than 1 year, this type of obstruction is very uncommon in adults. This is a male of 31 years old, with history of abdominal pain, vomits and constipation since he was a child. These symptoms were sporadical, he didn't need any surgical treatment. Recently he was admitted in our institution presenting similar symptoms, without remission of them. After imaging and laboratory studies, was performed a surgery, and the intraoperatoty diagnosis was intestinal malrotation type I. The surgical treatment was the Ladd Operation. The postsurgery evolution was good. Discharged 4 days after the surgery. The aim of this article is to present a rare case of intestinal obstruction in adults caused for an intestinal malrotation.

  20. Laparoscopia no abdome agudo não traumático: estudo retrospectivo Laparoscopy in nontraumatic acute abdomen: retrospective study

    Marcos Bettini Pitombo; José Luiz Guarino; Lizardo Augusto de Lima Martins; Cid Araújo Pitombo; Alexandra Mello Schmidt

    1999-01-01

    Os autores analisaram, retrospectivamente, 117 pacientes portadores de abdome agudo não-traumático, submetidos à laparoscopia diagnóstica e/ou terapêutica, na Casa de Saúde Santa Martha, em Niterói. A precisão diagnóstica do exame laparoscópico foi de 96,6%. Com relação à terapêutica, 74,4% dos pacientes foram tratados por laparoscopia, 21,4% por laparotomia e 4,3% foram tratados clinicamente. A precocidade na realização da laparoscopia relacionou-se à maior taxa de sucesso com o tratamento l...

  1. Abdome agudo perfurativo por corpo estranho em paciente com situs inversus totalis Perfurative acute abdomen due to foreign body in patient with situs inversus totalis

    André Vitorio Câmara Oliveira; Carlos Eduardo Costa Maranhão; Clístenes Dejane Sobral Coelho; Sabine de Lucena Martins Ferreira; Bruno Nogueira Bezerra Tavares; Larissa Cavalcanti Barros

    2008-01-01

    INTRODUÇÃO: Situs inversus totalis é descoberta importante para a conduta clínica cirúrgica. Corpo estranho no intestino grosso pode ocorrer devido a ingestão ou introdução anal. A perfuração intestinal é acompanhada de elevada morbidade e constitui-se em desafio aos cirurgiões. RELATO DO CASO: Paciente, masculino, 28 anos, deficiente mental, com dor e distensão abdominal há sete dias, anorexia há dois, parada de eliminação de gases e fezes, sem vômitos. Ao exame apresentava dispnéia leve, de...

  2. The Comparison of Apotel plus Low Dose of Morphine and Full Dose of Morphine in Pain Relief in Patients with Acute Renal Colic

    Morteza-Bagi, Hamid Reza; Amjadi, Mohsen; Mirzaii-Sousefidi, Reyhaneh

    2015-01-01

    Background Renal colic is an acute flank pain which may radiate to the groin, lower abdomen, or external genitalia due to the passage of a urinary stones. Pain management is the most important task in emergency wards when a patient with renal colic attends. This study aims to compare intravenous acetaminophen plus a low dose of morphine with a full dose of morphine in renal colic. Methods In present randomized clinical trial, 100 patients with confirmed renal colic were recruited from the Eme...

  3. Non-Hodgkin lymphoma as a cause of acute intestinal obstruction/perforation in patients with adenocarcinoma of the sigmoidcolon: a case report

    Marcelo Pandolfi Basso; Adriana Borgonovi Christiano; Letícia Vieira Guerrer; Francisco De Assis Gonçalves-Filho; João Gomes Netinho

    2011-01-01

    Report of a rare case of an 83-year-old patient with lymphoma of the terminal ileum causing obstructive/perforated acute abdomen synchronous with sigmoid colon adenocarcinoma and review of literature data about small bowel malignancies, particularly lymphomas. It seems to correspond to a rare disease (2% of all bowel cancers), more prevalent in elderly and immunocompromised patients, whose symptoms are vague and early diagnosis is difficult, often making it impossible to establish the correct...

  4. Evaluation of the Appendix Base Location in Acute Appendicitis Using Sonography and its Clinical Significance

    The purpose of this study is to investigate the location of appendiceal base using sonography in acute appendicitis and the usefulness of the appendiceal base marking in deciding the incision site of appendectomy. We performed appendix sonography in 813 patients and 381 patients were diagnosed as acute appendicitis. During sonography, we marked the base of the appendix on the skin of the patients' abdomen. After appendiceal base marking, we measured the distance from McBurney's point to the appendiceal base. The marking was used as the guide for incision site for appendectomy by the surgeon. Among 381 patients, we excluded 78 patients due to non visualization of the cecoappendiceal junction (n = 6), pregnancy appendicitis (n = 2), false positive appendicitis (n = 3) and no reply from the surgeon (n = 67). So we investigated 303 patients prospectively. After operation, we asked the surgeon whether the appendiceal base marking was helpful for appendectomy or not. The base of the appendix at McBurney's point were 31%, lying within 2 cm from McBurney's point were 20%, within 5 cm were 28%, more than 5 cm were 21%. For the usefulness of appendiceal base marking, 95% showed good correlation with marking and surgical incision, and 5% revealed poor correlation. The base of the appendix was located in diverse areas of the abdomen, although most frequent in the McBurney's point and within 2 cm from the McBurney's point. Appendiceal base marking on the skin of the abdomen after diagnosis of acute appendicitis could be an useful method to guide the surgeon for decision of surgical incision site

  5. Evaluation of the Appendix Base Location in Acute Appendicitis Using Sonography and its Clinical Significance

    Lee, Kwan Seop; Kim, Min Jeong; Ko, Eun Young; Hong, Myung Sun; Jeon, Eui Yong; Hwang, Hee Sung; Lee, In Jae; Yang, Ik; Lee, Eil Seong; Lee, Bong Hwa [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2005-12-15

    The purpose of this study is to investigate the location of appendiceal base using sonography in acute appendicitis and the usefulness of the appendiceal base marking in deciding the incision site of appendectomy. We performed appendix sonography in 813 patients and 381 patients were diagnosed as acute appendicitis. During sonography, we marked the base of the appendix on the skin of the patients' abdomen. After appendiceal base marking, we measured the distance from McBurney's point to the appendiceal base. The marking was used as the guide for incision site for appendectomy by the surgeon. Among 381 patients, we excluded 78 patients due to non visualization of the cecoappendiceal junction (n = 6), pregnancy appendicitis (n = 2), false positive appendicitis (n = 3) and no reply from the surgeon (n = 67). So we investigated 303 patients prospectively. After operation, we asked the surgeon whether the appendiceal base marking was helpful for appendectomy or not. The base of the appendix at McBurney's point were 31%, lying within 2 cm from McBurney's point were 20%, within 5 cm were 28%, more than 5 cm were 21%. For the usefulness of appendiceal base marking, 95% showed good correlation with marking and surgical incision, and 5% revealed poor correlation. The base of the appendix was located in diverse areas of the abdomen, although most frequent in the McBurney's point and within 2 cm from the McBurney's point. Appendiceal base marking on the skin of the abdomen after diagnosis of acute appendicitis could be an useful method to guide the surgeon for decision of surgical incision site

  6. Diagnosis and Treatment of Mucinous Appendiceal Neoplasm Presented as Acute Appendicitis

    Kehagias, Ioannis; Markopoulos, Georgios; Papandreou, Thanasis; Kraniotis, Pantelis

    2016-01-01

    Appendiceal mucocele is a rare cause of acute abdomen. Mucinous appendiceal neoplasms represent 0.2–0.7% of all appendix specimens. The aim of this study is to report a case of a mucinous appendiceal neoplasm presented as acute appendicitis, discussing the clinical and surgical approach in the emergency setting. A 72-year-old female patient was admitted to the emergency department with a clinical examination indicative of acute abdomen. The patient underwent abdominal computed tomography scan which revealed a cystic lesion in the right iliac fossa measuring 8.3 × 5.2 × 4.1 cm, with calcified walls, and a mean density indicative of high protein content. The patient was taken to the operating room and a right hemicolectomy was performed. The postoperative course was unremarkable. The histopathological examination revealed a low-grade mucinous appendiceal neoplasm with negative regional lymph nodes. Ultrasound and CT are useful in diagnosing appendiceal mucocele and synchronous cancers in the emergency setting. The initial operation should include appendectomy and resection of the appendicular mesenteric fat along with any fluid collection for cytologic examination. During urgent appendectomy it is important to consider every mucocele as malignant in order to avoid iatrogenic perforation causing pseudomyxoma peritonei. Although laparotomy is recommended, the laparoscopic approach is not contraindicated. PMID:27066284

  7. Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

    Clivio Alessandro

    2010-11-01

    Full Text Available Abstract Purpose A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA and fixed field intensity modulated therapy (IMRT for Whole Abdomen Radiotherapy (WAR after ovarian cancer. Methods and Materials Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV_WAR and 45 Gy to the pelvis and pelvic nodes (PTV_Pelvis with Simultaneous Integrated Boost (SIB technique. Plans were investigated for 6 MV (RA6, IMRT6 and 15 MV (RA15, IMRT15 photons. Objectives were: for both PTVs V90% > 95%, for PTV_Pelvis: Dmax Results IMRT and RapidArc resulted comparable for target coverage. For PTV_WAR, V90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV_Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U5-95% = D5%-D95%/Dmean. U5-95% for PTV_WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15, 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15; for PTV_Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6, 2841 ± 318 (IMRT15, 538 ± 29 (RA6, 635 ± 139 (RA15; the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15 and 4.8 ± 0.2 (RA6 and RA15. GAIIMRT6 = 97.3 ± 2.6%, GAIIMRT15 = 94.4 ± 2.1%, GAIRA6 = 98.7 ± 1.0% and GAIRA15 = 95.7 ± 3.7%. Conclusion RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT.

  8. Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

    A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA) and fixed field intensity modulated therapy (IMRT) for Whole Abdomen Radiotherapy (WAR) after ovarian cancer. Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV-WAR) and 45 Gy to the pelvis and pelvic nodes (PTV-Pelvis) with Simultaneous Integrated Boost (SIB) technique. Plans were investigated for 6 MV (RA6, IMRT6) and 15 MV (RA15, IMRT15) photons. Objectives were: for both PTVs V90% > 95%, for PTV-Pelvis: Dmax < 105%; for organs at risk, maximal sparing was required. The MU and delivery time measured treatment efficiency. Pre-treatment Quality assurance was scored with Gamma Agreement Index (GAI) with 3% and 3 mm thresholds. IMRT and RapidArc resulted comparable for target coverage. For PTV-WAR, V90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV-Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U5-95% = D5%-D95%/Dmean). U5-95% for PTV-WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15), 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15); for PTV-Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6), 2841 ± 318 (IMRT15), 538 ± 29 (RA6), 635 ± 139 (RA15); the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15) and 4.8 ± 0.2 (RA6 and RA15). GAIIMRT6 = 97.3 ± 2.6%, GAIIMRT15 = 94.4 ± 2.1%, GAIRA6 = 98.7 ± 1.0% and GAIRA15 = 95.7 ± 3.7%. RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT

  9. Acute pancreatitis

    A prospective study was performed on the relationship of CT findings to the clinical course of 148 patients with acute pancreatitis. The type of pancreatic inflammation seen on CT was classified into six categories based on an overall assessment of size, contour and density of the gland, and peripancreatic abnormalities. The majority (94%) of patients in whom CT showed mild pancreatic changes (grades A, B and C) had two or less positive clinical indicaters of severe pancreatitis (Ranson's signs). In contrast, 92% of patients in whom CT showed more severe changes of pancreatitis (grades D, E or F) had three or more positive signs. The nine patients who died with pancreatitis-related complications were in grades D, E or F. We wish to draw attention to a CT appearance which we have called 'fat islets' (low density intrapancreatic or peripancreatic areas, the contents of which approach fat in attenuation values); there was a strong correlation between this appearance and subsequent infection. (author). 24 refs.; 7 figs.; 4 tabs

  10. [Ultrasonography in acute pelvic pain].

    Kupesić, Sanja; Aksamija, Alenka; Vucić, Niksa; Tripalo, Ana; Kurjak, Asim

    2002-01-01

    Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more

  11. [Acute pancreatitis caused by varicella-zoster virus after liver transplantation].

    Coelho, J C; Wiederkehr, J C; Campos, A C; Zeni Neto, C; Oliva, V

    1994-02-01

    Twenty-six days after liver transplantation for primary biliary cirrhosis, a 52 year-old patient was rehospitalized for viral infection. The clinical features were fatigue, anorexia and vomiting. On physical examination, vesicular skin lesions involving the left 8 th intercostal space were suggestive of herpes-zoster infection. The following day the patient was extremely tired and dyspnoeic. The abdomen was distended with moderate abdominal epigastric pain. The clinical picture worsened rapidly and the patient died a few hours later. Autopsy revealed acute haemorrhagic necrosis of the pancreas due to herpes-zoster virus. PMID:8207103

  12. Typhoid Fever Presenting With Acute Renal Failure And Hepatitis Simultaneously - A Rare Presentation

    Rajput R.

    2016-05-01

    Full Text Available Typhoid fever is an important health problem worldwide but its incidence is more in developing countries. Hepatic involvement is common, but both hepatic and renal involvement is rare in typhoid fever. We report a case of typhoid fever presenting with hepatitis and acute renal failure. A 17 year old male presenting with fever and pain abdomen was found to have raised blood urea, creatinine, liver enzymes and bilirubin. Widal and typhidot (IgM,IgG test were positive. His symptoms subsided and deranged parameters resolved with treatment of typhoid fever.

  13. Extravasation of contrast medium into brain parenchyma and CSF space after CT or DSA of the chest or abdomen

    Analysis of clinical and CT findings in patients with signs of disruption of the blood-brain or blood-CSF barrier after i.v. or i.a. administration of non-ionic contrast media. Methods: 1. Retrospective analysis of 8 patients with clinical and CT findings of disruption of the blood-brain or blood-CSF barrier after i.v. or i.a. administration of non-ionic contrast media (200-450 ml). 2. Prospective analysis of 30 intensive care patients with sepsis and suspected abscess, who underwent CT of the chest and abdomen with 240 ml of a non-ionic contrast medium followed by cranial CT to rule out septic lesions. Results: The retrospective analysis proved that disruption of the blood-brain barrier may occur in elderly patients with risk factors after injection of higher amounts of contrast media. In the prospective study, equivalent CT phenomena were observed in 3 of 30 patients with sepsis. Conclusions: Hypoxemic and toxics damage to the blood-brain barrier as well as higher amounts of contrast media may result in extravasation of contrast medium into the CSF space, which can be demonstrated by CT. For differential diagnosis, the clinical symptoms and CT patterns of a disruption of the blood-brain or blood-CSF barrier should be known. (orig.)

  14. Respiratory-Gated MRgHIFU in Upper Abdomen Using an MR-Compatible In-Bore Digital Camera

    Vincent Auboiroux

    2014-01-01

    Full Text Available Objective. To demonstrate the technical feasibility and the potential interest of using a digital optical camera inside the MR magnet bore for monitoring the breathing cycle and subsequently gating the PRFS MR thermometry, MR-ARFI measurement, and MRgHIFU sonication in the upper abdomen. Materials and Methods. A digital camera was reengineered to remove its magnetic parts and was further equipped with a 7 m long USB cable. The system was electromagnetically shielded and operated inside the bore of a closed 3T clinical scanner. Suitable triggers were generated based on real-time motion analysis of the images produced by the camera (resolution 640×480 pixels, 30 fps. Respiratory-gated MR-ARFI prepared MRgHIFU ablation was performed in the kidney and liver of two sheep in vivo, under general anaesthesia and ventilator-driven forced breathing. Results. The optical device demonstrated very good MR compatibility. The current setup permitted the acquisition of motion artefact-free and high resolution MR 2D ARFI and multiplanar interleaved PRFS thermometry (average SNR 30 in liver and 56 in kidney. Microscopic histology indicated precise focal lesions with sharply delineated margins following the respiratory-gated HIFU sonications. Conclusion. The proof-of-concept for respiratory motion management in MRgHIFU using an in-bore digital camera has been validated in vivo.

  15. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    Veneziani, G. R.; Matsushima, L. C.; Campos, L. L. [Instituto de Pesquisas Energeticas e Nucleares, Gerencia de Metrologia das Radiacoes / CNEN, Av. Lineu Prestes 2242, Cidade Universitaria, 05508-000 Sao Paulo (Brazil); Filho, A. M., E-mail: venezianigr@gmail.com [Centro Universitario de Rio Petro - UNIRP, Rodovia Br 153 (Transbrasiliana), Km. 69 Sao Jose do Rio Preto, Sao Paulo (Brazil)

    2014-08-15

    The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

  16. Negative Pressure Wound Therapy for the Treatment of the Open Abdomen and Incidence of Enteral Fistulas: A Retrospective Bicentre Analysis

    Sven Richter

    2013-01-01

    Full Text Available Introduction. The open abdomen (OA is often associated with complications. It has been hypothesized that negative pressure wound therapy (NPWT in the treatment of OA may provoke enteral fistulas. Therefore, we analyzed patients with OA and NPWT with special regard to the occurrence of intestinal fistulas. Methods. The present study included all consecutive patients with OA treated with NWPT from April 2010 to August 2011 in two hospitals. Patients’ demographics, indications for OA, risk factors, complications, outcome and incidence of fistulas before, during and after NPWT were recorded. Results. Of 81 patients with OA, 26 had pre-existing fistulas and 55 were free from a fistula at the beginning of NPWT. Nine of the 55 patients developed fistulas during ( or after NPWT (. Seventy-five patients received ABThera therapy, 6 patients other temporary abdominal closure devices. Only diverticulitis seemed to be a significant predisposing factor for fistulas. Mortality was slightly lower for patients without fistulas. Conclusion. The present study revealed no correlation between occurrence of fistulas before, during, and after NWPT, with diverticulitis being the only risk factor. Fistula formation during NPWT was comparable to reports from literature. Prospective studies are mandatory to clarify the impact of NPWT on fistula formation.

  17. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

  18. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

    Leonor Montoya

    2014-07-01

    Full Text Available El objetivo del estudio fue describir las características en la presentación y el manejo del abdomen agudo (AA en pacientes con el virus de la inmunodeficiencia humana (VIH. Se revisaron las historias clínicas de 97 pacientes portadores del VIH que cursaron con un cuadro de AA y que fueron atendidos en el período 2006-2011 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró que el 1,6% de los pacientes inmunosuprimidos ingresó a sala de operaciones. La apendicectomía fue el procedimiento quirúrgico más frecuentemente (33,3%. La morbilidad fue de 28,1%, y la mortalidad posoperatoria de 9,4%. La infección por Mycobacterium tuberculosis fue la causa más común de dolor abdominal agudo con el 26,8%. Los datos sugieren que una pronta decisión quirúrgica frente a un cuadro compatible con AA en pacientes con VIH podría evitar una importante morbimortalidad.

  19. [Removal of weremit from the abdomen. Interpretation and efficacy of an ancient Egyptian prescription by the newest scientific results].

    Katona, Júlia; Győry, Hedvig; Blázovics, Anna

    2015-12-13

    Significant percentage of today's knowledge of ancient Egyptian medicine has been acquired from papyri left behind from various periods of Egyptian history. The longest and the most comprehensive is the Ebers papyrus, kept at the University Museum of Leipzig, which was written more than one thousand years before Hippocrates (c. 460-377 BC). One of the riddles among the prescriptions of the Ebers papyrus Eb20 has been used in order to remove the so called "wemyt" weremit from the abdomen with the help of a drink, which consists of "jnnk", Conyza dioscoridis in milk or sweet beer. The authors assume that the disease could be an infection of Schistosoma haematobium and/or Schistosoma mansoni. Nowadays the tea of Conyza dioscoridis is widely used as an important part of traditional medicine against rheumatism, intestinal distention and cramps, as well as an antiperspirant, and with external use for wound healing. The authors' intent is to interpret the efficacy of the above-mentioned ancient prescription with the help of modern medical and pharmaceutical knowledge. PMID:26639646

  20. Contrast-enhanced 3D MR angiography of the chest and abdomen with breath-holding using phase reordering

    This report presents the feasibility of phase-reordered contrast-enhanced three-dimensional MR angiography in 32 consecutive patients with vascular abnormalities in the chest and abdomen. To suppress motion artifacts due to respiratory corruption, a phase-reordering technique was introduced so that the low frequency components of the phase data were obtained first during the imaging period. Image quality and degree of motion suppression were assessed by four radiologists independently without information on breath-holding time. Abnormalities were detected in 30 cases (93.8%), and their extent was correctly assessed in 28 cases (87.5%). More confident assessment was possible in abnormalities of the pulmonary vessels and thoracic aorta than in those of the abdominal aorta and portal venous system. With phase reordering, more than 20 seconds of breath-holding ensured image quality sufficient to correctly assess the vascular abnormalities. While this technique is easy and requires only single breath-holding, it can provide excellent MRA without slice-to-slice spatial misregistration. (author)

  1. Aromatherapy Massage on the Abdomen for Alleviating Menstrual Pain in High School Girls: A Preliminary Controlled Clinical Study

    Myung-Haeng Hur

    2012-01-01

    Full Text Available This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment group (=32 and the acetaminophen (control group (=23. Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain was assessed using a visual analogue scale at baseline and twenty-four hours afterward. The reduction of menstrual pain was significantly higher in the aromatherapy group than in the acetaminophen group. Using multiple regression, aromatherapy massage was found to be more highly associated with reduction in the level of menstrual pain than acetaminophen. These finding suggest that aromatherapy massage may be an effective treatment for menstrual pain in high school girls. However, it could not be verified whether the positive effects derived from the aromatherapy, the massage, or both. Further rigorous studies should be conducted using more objective measures.

  2. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

    Leonor Montoya

    2014-09-01

    Full Text Available El objetivo del estudio fue describir las características en la presentación y el manejo del abdomen agudo (AA en pacientes con el virus de la inmunodeficiencia humana (VIH. Se revisaron las historias clínicas de 97 pacientes portadores del VIH que cursaron con un cuadro de AA y que fueron atendidos en el período 2006-2011 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró que el 1,6% de los pacientes inmunosuprimidos ingresó a sala de operaciones. La apendicectomía fue el procedimiento quirúrgico más frecuentemente (33,3%. La morbilidad fue de 28,1%, y la mortalidad posoperatoria de 9,4%. La infección por Mycobacterium tuberculosis fue la causa más común de dolor abdominal agudo con el 26,8%. Los datos sugieren que una pronta decisión quirúrgica frente a un cuadro compatible con AA en pacientes con VIH podría evitar una importante morbimortalidad.

  3. Abdomen agudo quirúrgico en el adulto mayor. Hospital Vladimir Ilich Lenin. Enero 2005 a enero 2008

    Pavel Sánchez Reynaldo

    2010-01-01

    Full Text Available Aborda un estudio descriptivo prospectivo en 388 adultos mayores operados de abdomen agudo en el Hospital Vladimir Ilich Lenin, enero 2005 a enero 2008, a fin de caracterizar el comportamiento de las afecciones que provocan esta entidad intraabdominal. La tercera edad y el sexo masculino resultaron los más afectados. El factor de riesgo quirúrgico más asociado fue la hipertensión arterial. El diagnóstico preoperatorio más frecuente fue la oclusión intestinal mecánica. No se indicaron adecuadamente las investigaciones diagnósticas imprescindibles. Predominó el tiempo de evolución preoperatoria de 24 a 48 horas. El tiempo quirúrgico superior a 2 horas fue el más frecuente. Las complicaciones mediatas y el íleo paralítico predominaron. Fue más frecuente la estadía hospitalaria de 4 a 6 días. La letalidad fue de 15,72% y la causa de muerte predominante fue el shock séptico.

  4. Acute chylous peritonitis due to acute pancreatitis

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of “chyle” occurs rapidly, the patient may present with signs of peritonitis. Preoperative...

  5. Issues in Management of Acute Appendicitis in Pregnancy

    Sivalingam Nalliah

    2011-06-01

    Full Text Available Acute appendicitis is an infrequent yet the commonestsurgical emergency in pregnancy occurring in about1:1500 pregnancies. The classical abdominal pain in theright lower quadrant of the abdomen is the only reliableclinical sign. Delay in diagnosis is attributed to presenceof symptoms commonly seen in pregnancy like nauseaand vomiting and difficulty in localizing abdominal paindue to displacement of the appendix with advancinggestation. Perforated appendix and generalizedperitonitis impacts adversely on pregnancy contributingto increases in miscarriage, pre-term delivery, fetalloss and even maternal mortality. Imaging studieslike abdominal ultrasonogram, helical computerizedtomography and magnetic imaging have been utilizedto complement clinical suspicion and decrease ‘negativeappendectomies’ but robust data on their routine use isawaited. Although the laparoscopic approach is a usefuldiagnostic and therapeutic tool in early pregnancy, itsuse as the primary approach for appendicectomy inpregnancy requires further evaluation as increases inthe incidence of fetal loss of 5.6% has been reportedcompared to 3.1% in open access surgery.

  6. Monte carlo simulation of pregnant female phantoms and dose assessment of fetus and pregnant female from diagnostics x-ray at abdomen examination

    Mathematical phantoms of representing the adult female at 0,3,6 and 9 months of gestation were constructed, and organ doses and effective doses were calculated in standard irradiation environment and abdomen X-ray examination. Phantoms were based on the data set of ORNL and MCNP4B, a general-purposed Monte Carlo code was used for dose calculation. Firstly, organ doses and effective doses of pregnant female and fetus for 0.4 and 0.8MeV broad parallel beam incident from AP and PA direction were calculated. Then, the same calculations were performed in abdomen AP X-ray examination. As gestation period went by, effective doses of pregnant woman decreased because major organs were shielded by expanded uterus. Fetus of 9 month is lower than that of 6 month because of shielding effect of placement for AP irradiation

  7. Differential gene expression in abdomens of the malaria vector mosquito, Anopheles gambiae, after sugar feeding, blood feeding and Plasmodium berghei infection

    Romans Patricia A; Kern Marcia K; Hillenmeyer Maureen E; Lobo Neil F; Dana Ali N; Collins Frank H

    2006-01-01

    Abstract Background Large scale sequencing of cDNA libraries can provide profiles of genes expressed in an organism under defined biological and environmental circumstances. We have analyzed sequences of 4541 Expressed Sequence Tags (ESTs) from 3 different cDNA libraries created from abdomens from Plasmodium infection-susceptible adult female Anopheles gambiae. These libraries were made from sugar fed (S), rat blood fed (RB), and P. berghei-infected (IRB) mosquitoes at 30 hours after the bloo...

  8. Comparison of the Effectiveness of the Treatment Using Standard Methods and Negative Pressure Wound Therapy (NPWT in Patients Treated with Open Abdomen Technique

    Szmyt Krzysztof

    2015-03-01

    Full Text Available Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg.

  9. Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines

    Hlebowicz Joanna; Hansson Johan; Malmsjö Malin; Lindstedt Sandra; Ingemansson Richard

    2011-01-01

    Abstract Background Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) than with other wound management techniques. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective disc placed between the intestines and the vacuum source prevents the induction of ischemia. In th...

  10. Evaluation of Absorbed Dose of Critical Organ in Rando Phantom under Head, Abdomen and Pelvis Spiral CT Scan by Thermo Luminescent Dosimetery - TLD

    Gholamhosein Haddadi; Simin Mehdizadeh; Mohammad Bagher Haddadi; Mohammad Hasan Meshkibaf

    2011-01-01

    Background & Objectives: Computed tomography (CT) represents 11% of all diagnostic radiology procedures but it contributes to almost 67% of the total effective dose to the human population. In head and neck CT which consist of 1/3 of total CT scans, other critical organs such as lenses and thyroid are in the radiation field. Also in the abdomen and pelvis scan, irradiation of ovaries is unavoidable. Because of high sensitivity of these organs, the probability of abnormality and cancer in thes...

  11. Dose estimation in CT exams of the abdomen based on values of DLP; Estimativa da dose em exames de tomografia de abdome com base nos valores de DLP

    Kikuti, C.F.; Medeiros, R.B.; Salvadori, P.S.; Costa, D.M.C; D' lppolito, G., E-mail: kikuticf@gmail.com, E-mail: rbitelli2011@gmail.com [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Coordenadoria de Fisica e Higiene das Radiacoes. Departamento de Diagnostico por Imagem

    2013-10-01

    One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo{sub 4}:Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

  12. Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report

    L.F.F. Botelho

    2010-06-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, the patient developed a nosocomial pneumonia and cefepime was initiated. On the fourth day of cephalosporin treatment, he presented with a maculopapular, pruritic eruption affecting the face, neck, abdomen and limbs. One day later he developed disseminated pustular lesions and his temperature was 37°C. Laboratory analysis evidenced leukocytosis and skin biopsy showed subcorneal pustule, edema in the papillary dermis, perivascular inflammatory infiltrate consisting of neutrophils, leukocytoclasia and red cell extravasation in the epidermis. Cefepime was suspended and within 4 days the non-follicular pustules cleared following a desquamation. AGEP is a disease attributed to a variety of causes, but in 90% of the cases it is due to an adverse drug reaction. Antibiotics are implicated in 80% of these cases, mostly penicillins and macrolides. There are few cases associated with cephalosporins. It is very important to consider AGEP in cases of acute pustular rashes and drugs should be investigated as causative agents.

  13. Acute pancreatitis with saw palmetto use: a case report

    Amankona Raymond

    2011-08-01

    Full Text Available Abstract Introduction Saw palmetto is a phytotherapeutic agent commercially marketed for the treatment of benign prostatic hyperplasia. Evidence suggests that saw palmetto is a safe product, and mild gastrointestinal adverse effects have been reported with its use. We report a case of acute pancreatitis, possibly secondary to the use of saw palmetto. Case presentation A 61-year-old Caucasian man with a history of benign prostatic hyperplasia and gastroesophageal reflux disease developed epigastric pain associated with nausea 36 hours prior to presentation. He denied drinking alcohol prior to the development of his symptoms. His home medications included saw palmetto, lansoprazole and multivitamins. Laboratory results revealed elevated lipase and amylase levels. An abdominal ultrasound demonstrated a nondilated common bile duct, without choledocholithiasis. Computed tomography of his abdomen showed the pancreatic tail with peripancreatic inflammatory changes, consistent with acute pancreatitis. Our patient's condition improved with intravenous fluids and pain management. On the fourth day of hospitalization his pancreatic enzymes were within normal limits: he was discharged home and advised to avoid taking saw palmetto. Conclusion It is our opinion that a relationship between saw palmetto and the onset of acute pancreatitis is plausible, and prescribers and users of saw palmetto should be alert to the possibility of such adverse reactions.

  14. Scrotal Swelling as a Complication of Hydrochlorothiazide Induced Acute Pancreatitis

    Ivan Nikiforov

    2015-01-01

    Full Text Available Background. Scrotal swelling is a rare complication of acute pancreatitis with few reported cases in the literature. In this case report, we present a 59-year-old male with hydrochlorothiazide induced pancreatitis who developed scrotal swelling. Case Presentation. A 59-year-old male presented to the emergency department with sharp epigastric abdominal pain that radiated to the back and chest. On physical examination, he had abdominal tenderness and distention with hypoactive bowel sounds. Computed tomography (CT scan of the abdomen showed acute pancreatitis. The patient’s condition deteriorated and he was admitted to the intensive care unit (ICU. After he improved and was transferred out of the ICU, the patient developed swelling of the scrotum and penis. Ultrasound (US of the scrotum showed large hydrocele bilaterally with no varicoceles or testicular masses. Good blood flow was observed for both testicles. The swelling diminished over the next eight days with the addition of Lasix and the patient was discharged home in stable condition. Conclusion. Scrotal swelling is a rare complication of acute pancreatitis. It usually resolves spontaneously with conservative medical management such as diuretics and elevation of the legs.

  15. Acute mesenteric ischemia: experience in a tertiary care hospital

    Acute mesenteric ischemia is an abdominal catastrophe. This has been described as a complex of diseases rather than a single clinical entity. The incidence in United States is 1 in 1000 hospital admissions. The objective of this descriptive study was to determine the clinical presentations and out come after surgery of patients with acute mesenteric ischemia. It was conducted at Dubai Hospital, Dubai, United Arab Emirates. Methods: All patients having per operative or histopathological diagnosis of acute mesenteric ischemia from 2002 to 2006 were included. There were 16 patients in all. Their mean age was 51 years, 12 were male and 4 were female. Abdominal pain was present in 16 patients, vomiting in 12 and anorexia in 9 patients. Abdominal tenderness was present in 16 patients, abdominal distension and rebound tenderness in 12 patients. Five patients had hypertension, 4 had myocardial infarction and 4 had diabetes mellitus as risk factors. X-Ray abdomen was done in 13 patients, Ultrasound in 9 and CT Scan in one patient. Resection of bowel was done in 14 patients. Post operatively 5 patients developed pneumonia, 3 had wound dehiscence, 3 had sepsis, and 3 had Lower GI bleeding. Five patients were expired after surgery in the hospital. Four patients were lost to follow up. We should have a high index of suspicion for mesenteric ischemia in patients with unexplained abdominal pain. Early diagnosis and prompt surgical intervention improves the outcome. (author)

  16. Akut abdomen som følge af torkveret adnexa uteri hos en tiårig pige

    Steinthorsdottir, Kristin Julia; Folmer, Lars; Bisgaard, Thue

    2014-01-01

    A ten-year-old girl presented with four days of lower abdominal pain. A diagnostic laparoscopy on the suspicion of acute appendicitis revealed left-sided adnexal torsion. The cyanotic ovary was detorsed and recovered. At three-month follow-up there were no clinical or ultrasonic signs of pathology...

  17. Milttorsion kan være årsag til akut abdomen hos børn

    Helvind, Neel Maria; Gögenur, Ismail; Stadeager, Morten

    2013-01-01

    A six-year-old boy was admitted with symptoms consistent with acute appendicitis. Immediately before placement of the first trocar, a large abdominal mass was observed which on imaging was identified as a torsioned spleen. Due to suboptimal reperfusion and risk of reperfusion-mediated morbidity a...

  18. Are contrast media required for (68)Ga-DOTATOC PET/CT in patients with neuroendocrine tumours of the abdomen?

    Mayerhoefer, Marius E.; Magnaldi, Silvia; Weber, Michael; Trattnig, Siegfried [Medical University of Vienna, Vienna General Hospital, Department of Radiology, PET/CT Center, Vienna (Austria); Schuetz, Matthias; Karanikas, Georgios [Medical University of Vienna, Vienna General Hospital, Department of Nuclear Medicine, PET/CT Center, Vienna (Austria)

    2012-04-15

    To determine the value of intravenous contrast medium in (68)Ga-DOTA-Phe(1)-Tyr(3)-octreotide - (68)Ga-DOTATOC - PET/CT for the detection of abdominal neuroendocrine tumours (NET). In fifty-five patients with known or suspected NETs of the abdomen PET/CT was performed on a 64-row multi-detector hybrid system. For PET, 150 MBq of (68)Ga-DOTATOC were injected intravenously. Full-dose unenhanced, and arterial- and venous-phase contrast-enhanced CT images were obtained. Unenhanced and contrast-enhanced PET/CT images were evaluated separately for the presence of NETs on a per-region basis, by two separate teams with different experience levels. On unenhanced PET/CT, sensitivity and specificity ranged from 89.3% (junior team) to 92% (senior team), and 99.1% (junior team) to 99.2% (senior team), respectively. On contrast-enhanced PET/CT, sensitivity and specificity ranged from 92.3% (junior team) to 98.5% (senior team), and 99.4% (junior team) to 99.5% (senior team), respectively. These increases in sensitivity and specificity, due to the use of contrast-enhanced images, were statistically significant (P < 0.05). Intravenous contrast medium only moderately, aleit significantly, improves the sensitivity of (68)Ga-DOTATOC PET/CT for the detection of abdominal NETs, and hardly affects specificity. Thus, while contrast enhancement is justified to achieve maximum sensitivity, unenhanced images may be sufficient for routine PET/CT in NET patients. (orig.)

  19. Acute arterial occlusion - kidney

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  20. Acute Pancreatitis in Children

    ... a feeding tube or an IV to prevent malnutrition and improve healing. Does my child have to ... intestines. Can my child die from acute pancreatitis? Death from acute pancreatitis is quite rare in children– ...

  1. Pulmonary Thromboembolism Complicating Acute Pancreatitis With Pancreatic Ascites: A Series of 4 cases

    Ruchir Patel

    2016-05-01

    Full Text Available Acute pancreatitis is an inflammatory disease often associated with local and systemic complications. Portosplenic and splanchnic vascular complications of acute pancreatitis are common, but extrasplanchnic vessel thrombosis is less commonly seen. Among them, pulmonary thromboembolism is a very rare complication to be encountered with. We report four cases of acute pulmonary thromboembolism in patients with acute pancreatitis superimposed on chronic pancreatitis. All the patients had abdominal pain on presentation and distention of abdomen during the course. Dyspnea was present in all the patients. All patients were found to have pancreatic ascites, whose association with pulmonary thromboembolism is reported only in two patients till date upto our knowledge. Two of them had deep vein thrombosis and rest two had no venous thrombosis. All of them were managed conservatively using subcutaneous heparin, intravenous fluids and analgesics. We provide the causative mechanism for occurrence of pulmonary thromboembolism in acute on chronic pancreatitis. We have also hypothesized pancreatic ascites as the possible cause for pulmonary thromboembolism and provide explanation for it. We conclude that pulmonary thromboembolism in acute pancreatitis has good prognosis if diagnosed timely. Whenever patient with pancreatic ascites presents with dyspnea, pulmonary thromboembolism must be ruled out.

  2. Diagnosing and Treating Acute Bronchitis

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis It is important to get your questions about ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  3. Acute mastoiditis in children

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren;

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute ot...

  4. Recurrent acute renal failure

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  5. CT -- Abdomen and Pelvis

    ... few hours beforehand. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce ... have any allergies. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications ( ...

  6. Critique of Sew it Up! A Western Trauma Association Multi-Institutional Study of Enteric Injury Management in the Postinjury Open Abdomen

    Nuri Abdurraheim

    2013-03-01

    Full Text Available Background: Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen.Methods: Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development.Results: During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77% sustaining blunt trauma (66% with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41. Injury patterns included 81 (40% small bowel, 37 (18% colonic, and 86 (42% combined injuries. Enteric injuries were managed with immediate repair (58, immediate anastomosis (15, delayed anastomosis (96, stoma (10, and a combination (22; three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17% abscesses, 15 (7% leaks, and 11 (5% enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%. There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour

  7. MRT of the abdomen in combination with enteroclysis in Crohn disease with oral and intravenous Gd-DTPA; MRT des Abdomens in Kombination mit der Enteroklyse bei Morbus Crohn unter Verwendung von oralem und intravenoesem Gd-DTPA

    Rieber, A.; Wruk, D.; Nuessle, K.; Aschoff, A.J.; Brambs, H.J.; Tomczak, R. [Abt. Roentgendiagnostik, Radiologische Klinik der Univ. Ulm (Germany); Reinshagen, M.; Adler, G. [Abt. fuer Innere Medizin 1 (Gastrenterologie) der Univ. Ulm (Germany)

    1998-01-01

    60 patients between 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The length of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel contrast is optimal. The main prerequisite is a large filling volume of the small bowel to reach a homogeneous contrast and a good distension of the small bowel lumen. (orig./AJ) [Deutsch] 60 Patienten im Alter von 17-72 Jahren wurden untersucht. Zunaechst wurde eine Enteroklyse in konventioneller Technik durchgefuehrt, wobei der Methylzellulose in einer Mischung von 1:10 positives orales MR-Kontrastmittel (Magnevist enteral) zugesetzt wurde. Nach Abschluss der Enteroklyse erfolgte die MRT unter Verwendung T1- und T2-gewichteter Sequenzen (Flash 2D vor und nach i.v. Gd-DTPA bzw. TSE) in Atemanhaltetechnik in koronarer und axialer Schnittffuehrung. Die in der Enteroklyse nachweisbaren Schleimhautveraenderungen und Stenosenlaenge entsprachen einer nachweisbaren Darmwandverdickung bzw. Stenose in der MRT. Mit der MRT konnten bei 28 Patienten Zusatzbefunde wie Fisteln, Abszesse oder Hydronephrosen diagnostiziert werden, oder die Stenose war wegen der ueberlagerungsfreien Darstellung in der MRT besser beurteilbar als mittels Enteroklyse. Mit der MRT kann

  8. Laparoscopic Cholecystectomy for Severe Acute Cholecystitis in a Patient with Situs Inversus Totalis and Posterior Cystic Artery

    Theodoros E. Pavlidis

    2008-01-01

    Full Text Available Situs inversus totalis is an inherited condition characterized by a mirror-image transposition of thoracic and abdominal organs. It often coexists with other anatomical variations. Transposition of the organs imposes special demands on the diagnostic and surgical skills of the surgeon. We report a case of a 34-year-old female patient presented with left upper quadrant pain, signs of acute abdomen, and unknown situs inversus totalis. Severe acute cholecystitis was diagnosed, and an uneventful laparoscopic cholecystectomy was performed. A posterior cystic artery was identified and ligated. Laparoscopic cholecystectomy is feasible in patients with severe acute calculus cholecystitis and situs inversus totalis; however, the surgeon should be alert of possible anatomic variations.

  9. Management Of Acute Migraine

    Mehndiratta M

    2002-01-01

    Full Text Available Pharmacotherapy for migraine involves treatment for the acute attack as well as using long-term prophylaxis in order to reduce the frequency and severity of the attacks. Based on severity, there are a number of drugs available to treat the acute attacks. For mild to moderate attacks, analgesics, NSAIDs and Ergotamine are effective but severe attacks may need Dihydroergotamine (DHE or a triptan. Sumatriptan and the second generation triptans have revolutionized the acute treatment of migraine. Early and appropriate treatment holds the key to successful therapy of the acute attack. This article discusses the various acute treatment options available.

  10. Beta Lactamase Producing Clostridium perfringens Bacteremia in an Elderly Man with Acute Pancreatitis

    Rashmi Mishra

    2016-01-01

    Full Text Available Clostridium perfringens bacteremia is associated with adverse outcomes. Known risk factors include chronic kidney disease, malignancy, diabetes mellitus, and gastrointestinal disease. We present a 74-year-old man admitted with confusion, vomiting, and abdominal pain. Exam revealed tachycardia, hypotension, lethargy, distended abdomen, and cold extremities. He required intubation and aggressive resuscitation for septic shock. Laboratory data showed leukocytosis, metabolic acidosis, acute kidney injury, and elevated lipase. CT scan of abdomen revealed acute pancreatitis and small bowel ileus. He was started on vancomycin and piperacillin-tazobactam. Initial blood cultures were positive for C. perfringens on day five. Metronidazole and clindamycin were added to the regimen. Repeat CT (day 7 revealed pancreatic necrosis. The patient developed profound circulatory shock requiring multiple vasopressors, renal failure requiring dialysis, and bacteremia with vancomycin-resistant enterococci. Hemodynamic instability precluded surgical intervention and he succumbed to multiorgan failure. Interestingly, our isolate was beta lactamase producing. We review the epidemiology, risk factors, presentation, and management of C. perfringens bacteremia. This case indicates a need for high clinical suspicion for clostridial sepsis and that extended spectrum beta lactam antibiotic coverage may be inadequate and should be supplemented with use of clindamycin or metronidazole if culture is positive, until sensitivities are known.

  11. Acute loss of consciousness.

    Tristán, Bekinschtein; Gleichgerrcht, Ezequiel; Manes, Facundo

    2015-01-01

    Acute loss of consciousness poses a fascinating scenario for theoretical and clinical research. This chapter introduces a simple yet powerful framework to investigate altered states of consciousness. We then explore the different disorders of consciousness that result from acute brain injury, and techniques used in the acute phase to predict clinical outcome in different patient populations in light of models of acute loss of consciousness. We further delve into post-traumatic amnesia as a model for predicting cognitive sequels following acute loss of consciousness. We approach the study of acute loss of consciousness from a theoretical and clinical perspective to conclude that clinicians in acute care centers must incorporate new measurements and techniques besides the classic coma scales in order to assess their patients with loss of consciousness. PMID:25702218

  12. Binge Eating Leading to Acute Gastric Dilatation, Ischemic Necrosis and Rupture –A Case Report

    Khare, Manish Kumar; Mishra, Sumanta; Marhual, Jogesh Chandra

    2016-01-01

    Acute gastric dilatation is a rarely encountered clinical scenario in our day to day practice. This is very rapidly progressing condition and can lead to ischemic necrosis and perforation/rupture of the stomach. It could be fatal if not timely intervened. We report such a case of a 17-year-old, otherwise healthy boy, who presented with pain and distension of abdomen following binge eating episode after 24 hours of prolonged fasting. On exploration, stomach was dilated with necrosis and perforation at fundus near greater curvature. He was managed with excision of all the devitalized area and primary repair with feeding jejunostomy. The case is presented due to its rarity. Acute gastric dilatation (AGD) leading to ischemic necrosis and perforation because of binge eating episode in an otherwise healthy person is an exceptional occurrence with only few cases reported in literature. The clinician should be aware of this condition for prompt and appropriate management. PMID:27134932

  13. Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier

    2007-01-01

    Acute pancreatitis (AP) is a common acute abdomen in clinic with a rapid onset and dangerous pathogenetic condition.AP can cause an injury of intestinal mucosa barrier, leading to translocation of bacteria or endotoxin through multiple routes,bacterial translocation (BT), gutorigin endotoxaemia, and secondary infection of pancreatic tissue, and then cause systemic inflammatory response syndrome (SIRS) or multiple organ dysfunction syndrome (MODS), which are important factors influencing AP's severity and mortality. Meanwhile, the injury of intestinal mucosa barrier plays a key role in AP's process. Therefore, it is clinically important to study the relationship between the injury of intestinal mucosa barrier and AP. In addition, many factors such as microcirculation disturbance, ischemical reperfusion injury, excessive release of inflammatory mediators and apoptosis may also play important roles in the damage of intestinal mucosa barrier. In this review, we summarize studies on mechanisms of AP.

  14. Multidendritic sensory neurons in the adult Drosophila abdomen: origins, dendritic morphology, and segment- and age-dependent programmed cell death

    Sugimura Kaoru

    2009-10-01

    Full Text Available Abstract Background For the establishment of functional neural circuits that support a wide range of animal behaviors, initial circuits formed in early development have to be reorganized. One way to achieve this is local remodeling of the circuitry hardwiring. To genetically investigate the underlying mechanisms of this remodeling, one model system employs a major group of Drosophila multidendritic sensory neurons - the dendritic arborization (da neurons - which exhibit dramatic dendritic pruning and subsequent growth during metamorphosis. The 15 da neurons are identified in each larval abdominal hemisegment and are classified into four categories - classes I to IV - in order of increasing size of their receptive fields and/or arbor complexity at the mature larval stage. Our knowledge regarding the anatomy and developmental basis of adult da neurons is still fragmentary. Results We identified multidendritic neurons in the adult Drosophila abdomen, visualized the dendritic arbors of the individual neurons, and traced the origins of those cells back to the larval stage. There were six da neurons in abdominal hemisegment 3 or 4 (A3/4 of the pharate adult and the adult just after eclosion, five of which were persistent larval da neurons. We quantitatively analyzed dendritic arbors of three of the six adult neurons and examined expression in the pharate adult of key transcription factors that result in the larval class-selective dendritic morphologies. The 'baseline design' of A3/4 in the adult was further modified in a segment-dependent and age-dependent manner. One of our notable findings is that a larval class I neuron, ddaE, completed dendritic remodeling in A2 to A4 and then underwent caspase-dependent cell death within 1 week after eclosion, while homologous neurons in A5 and in more posterior segments degenerated at pupal stages. Another finding is that the dendritic arbor of a class IV neuron, v'ada, was immediately reshaped during post

  15. Blunt abdominal trauma with handlebar injury: A rare cause of traumatic amputation of the appendix associated with acute appendicitis

    Amanda Jensen

    2016-04-01

    Full Text Available We describe traumatic appendicitis in a 7-year-old boy who presented after sustaining blunt abdominal trauma to his right lower abdomen secondary to bicycle handlebar injury. With diffuse abdominal pain following injury, he was admitted for observation. Computed axial tomography (CT obtained at an outside hospital demonstrated moderate stranding of the abdomen in the right lower quadrant. The CT was non-contrasted and therefore significant appendiceal distention could not be confirmed. However, there was a calcified structure in the right pelvis with trace amount of free fluid. Patient was observed with conservative management and over the course of 15 h his abdominal pain continued to intensify. With his worsening symptoms, we elected to take him for diagnostic laparoscopy. In the operating room we found an inflamed traumatically amputated appendix with the mesoappendix intact. We therefore proceeded with laparoscopic appendectomy. Pathology demonstrated acute appendicitis with fecalith. It was unclear as to whether the patient's appendicitis and perforation were secondary to fecalith obstruction, his blunt abdominal trauma or if they concurrently caused his appendicitis. Acute appendicitis is a common acute surgical condition in the pediatric population and continues to be a rare and unique cause of operative intervention in the trauma population.

  16. Ultrasound signs of acute appendicitis in children - clinical application

    Background. Acute appendicitis is a leading cause of the abdominal pain in children that need an urgent surgical treatment. Neither of individually clinical variables doesn't have a real discriminational nor predictive strength to be used as the only diagnostic test. A goal of this study is to define ultrasound criteria of the acute appendicitis by appointing of ultrasound parameters for this pathological condition, determine the relation between ultrasound signs and pathohistological finding, determine the connection of several ultrasound signs with a degree of the inflammation of the acute appendicitis. Methods. In the prospective study with an ultrasound method we examine 50 patients with clinical signs of the acute abdomen. In these patients, the sonographic diagnosis is confirmed by the surgical finding, in fact with a pathohistological diagnosis. A basic, positive sonograph finding of the acute appendicitis was the identification of tubular, noncompresive, aperistaltic bowel which demonstrates a connection with coecum and blind terminal. In our work we analysed the lasting of the symptoms until the hospital intervention in patients stratified according to the pathohistological finding. We used ultrasound equipment- Toshiba Sonolayer with convex 3.75 MHz and linear 8 MHz probes. Results. From 8 ultrasound signs of the acute appendicitis, only an anterior-posterior (AP) diameter of appendices, FAT (width of periappendicular fat tissue) and a peristaltic absence are positive ultrasound signs of the acute appendicitis. Appendicitis phlegmonosa is the most common pathohistological finding in our study (44%). Perforate gangrenous appendicitis and gangrenous appendicitis are represented in more than half of patients (30% + 22%), which suggests a long period of persisting symptoms until a hospital treatment. A statistic analysis shows a great possibility for using values of AP diameter, width of periapendicular fat tissue, just like the values of mural thickness in

  17. Acute pancreatitis in acute viral hepatitis

    2007-01-01

    AIM: To elucidate the frequency and characteristics of pancreatic involvement in the course of acute (nonfulminant) viral hepatitis.METHODS: We prospectively assessed the pancreatic involvement in patients with acute viral hepatitis who presented with severe abdomimanl pain.RESULTS: We studied 124 patients with acute viral hepatitis, of whom 24 presented with severe abdominal pain. Seven patients (5.65%) were diagnosed to have acute pancreatitis. All were young males. Five patients had pancreatitis in the first week and two in the fourth week after the onset of jaundice. The pancreatitis was mild and all had uneventful recovery from both pancreatitis and hepatitis on conservative treatment.The etiology of pancreatitis was hepatitis E virus in 4,hepatitis A virus in 2, and hepatitis B virus in 1 patient.One patient had biliary sludge along with HEV infection.The abdominal pain of remaining seventeen patients was attributed to stretching of Glisson's capsule.CONCLUSION: Acute pancreatitis occurs in 5.65% of patients with acute viral hepatitis, it is mild and recovers with conservative management.

  18. Acute chylous peritonitis due to acute pancreatitis.

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide. PMID:22563182

  19. Acute chylous peritonitis due to acute pancreatitis

    Georgios K Georgiou; Haralampos Harissis; Michalis Mitsis; Haralampos Batsis; Michalis Fatouros

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

  20. Carcinoma de células escamosas con invasión múltiple en abdomen en una oveja Rasa Aragonesa (Scaly cells carcinoma with multiple invasion in abdomen in a Rasa Aragonesa Sheep

    Loste, A.

    2009-05-01

    Full Text Available ResumenUna oveja de raza Rasa Aragonesa, procedente de una explotación de laprovincia de Zaragoza, fue remitida a la Facultad de Veterinaria,presentando un historial de descarga vaginal sanguinolenta, oscura ymaloliente, por lo que se sospechó de un proceso de metritis y seadministró oxitocina para favorecer la eliminación de la secreción. Otros síntomas encontrados tras la exploración fueron caquexia, palidez de mucosas y debilidad. A la palpación del abdomen se detectaron varios nódulos, destacando por su tamaño uno localizado en la región umbilical, que podían corresponder con abscesos.El estado de la oveja empeoró progresivamente, por lo que se decidió su sacrificio humanitario. En la necropsia de observaron múltiples nódulos distribuidos en la zona abdominal (peritoneo, hígado y bazo, y uno de enorme tamaño localizado en el cuello del útero. No se encontraron lesiones en ninguna otra localización. Se tomaron muestras para el estudio anatomopatológico, que dio como resultado un carcinoma de células escamosas. Los carcinomas de células escamosas se han descrito en ganado ovino localizados en cabeza (fosas nasales y tercer párpado, asociados normalmente a una alta exposición a radiaciones solares en zonas desprotegidas de la piel y mucosas. En la bibliografía no se ha encontrado ninguna descripción de carcinoma de células escamosas de localización abdominal en ganado ovino. Dado que no se encontró en la necropsia ningún foco primario de localización típica en esta especie, se especula con el posible origen de la neoplasia a nivel del cuello del útero.SummaryA Rasa Aragonesa sheep from a flock of Zaragoza (Spain, was sent to the Veterinary Faculty with a history of bleeding, dark and smelly vaginal discharge. Metritis was suspected and treated with oxitocina in order to eliminate the secretion. Clinical exploration reveled caquexia, mucous paleness and weakness, and also several nodules were detected by

  1. Acute appendicitis: sensitivity, specificity and diagnostic accuracy of thin-section contrast-enhanced CT findings

    To assess the sensitivity, specificity, and diagnostic accuracy of individual contrast-enhanced helical CT findings of acute appendicitis. We retrospectively reviewed the appendiceal helical CT scans, obtained after intravenous contrast administration (abdomen; 7-mm collimation, abdominopelvic junction; 5-mm collimation), of 50 patients with surgically proven acute appendicitis and 112 with alternative diagnoses. The following parameters were analysed by three radiologists: enlarged appendix (>6 mm in diameter), appendiceal wall thickening, appendiceal wall enhancement, no identification of the appendix, appendicolith(s), (appendiceal) intraluminal air, abscess, lymphadenopathy, terminal ileal wall thickening, focal cecal apical thickening, focal colonic wall thickening, and segmental colonic wall thickening. The CT findings of acute appendicitis that statistically distinguished it from alternative diagnoses were an enlarged appendix (sensitivity; 92%, specificity; 93%, diagnostic accuracy; 93%), appendiceal wall thickening (for these three parameters: 68%, 96% and 88%, respectively), periappendiceal fat stranding (90%, 79%, 82%), appendiceal wall enhancement (72%, 86%, 82%), appendicolith (16%, 100%, 74%), and focal cecal apical thickening (14%, 100%, 74%) (for each, p<0305). On thin-section contrast-enhanced helical CT, an enlarged appendix and periappendiceal fat stranding were found in 90% or more patients with acute appendicitis. Appendiceal wall thickening and enhancement were alearly demonstrated and significant findings for diagnosis. Less common but specific findings include appendicolith, focal cecal apical thickening and intramural air, can also help us establish a diagnosis of acute appendicitis

  2. Computed tomography and ultrasonography in the diagnosis of equivocal acute appendicitis. A meta-analysis

    Acute appendicitis is the most common acute surgical condition of the abdomen. Computed tomography (CT) and Ultrasonography (US) can reduce the rate of complications and unnecessary appendectomies, in addition, they can establish an alternative diagnosis. We carried out a systematic review to evaluate the evidence relating radiological imaging (US and CT scan) and early detection of acute appendicitis in patients presenting with equivocal findings, and to provide recommendations to use radiological imaging (US and CT scan) in diagnosing acute appendicitis as part of the initial clinical assessment of the patients presenting with equivocal findings to reduce complications and unnecessary appendectomies. We used the MEDLINE to search for articles published from 1966 to December 2005 that related to radiological imaging of acute appendicitis; additional articles were identified from the bibliographies of review articles. Selection criteria were used to limit the analysis to prospective studies with more than 100 patients involved in each study as a study group. Forty-five studies fulfilling our inclusion and exclusion criteria were extracted, and 13,046 patients were included. Although the CT scan was more sensitive than US in diagnosing patients with equivocal appendicitis (93.4% [95% CI 92.1-94.6] versus 83.7% [95% CI 82.3-85.0]), either diagnostic study should be used as part of the initial assessment of the patients presenting with equivocal findings. (author)

  3. Acute renal failure associated with nonfulminant acute viral hepatitis A

    Sarawgi, S.; Gupta, A. K.; Arora, D S; Jasuja, S.

    2008-01-01

    Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

  4. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan

  5. Modelo teórico práctico de atención médica al adulto mayor con abdomen agudo quirúrgico

    Rodríguez Pascual, Yazmín

    2011-01-01

    En los 100 últimos años ha transcurrido una revolución silenciosa e inusitada: la de la longevidad. Fenómeno demográfico mundial que provoca un incremento de adultos mayores, eleva la asistencia a los servicios de urgencias hospitalarios de este grupo de edad, aumenta el número de operados de esta afección, aumentan las complicaciones y muertes, es un problema de salud. La investigación tuvo como objetivo un modelo teórico práctico de atención médica al adulto mayor con abdomen ag...

  6. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    Wang, H; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan.

  7. Imaging of acute pancreatitis

    Merkle, Elmar M.; Goerich, Johannes [Department of Radiology, University Hospitals of Ulm, Steinhoevel Strasse 9, 89075 Ulm (Germany)

    2002-08-01

    Acute pancreatitis is defined as an acute inflammatory process of the pancreas with variable involvement of peripancreatic tissues or remote organ systems. This article reports the current classification, definition and terminology, epidemiology and etiology, pathogenesis and pathological findings, clinical and laboratory findings, and finally imaging findings of acute pancreatitis with emphasis on cross-sectional imaging modalities such as ultrasound, computed tomography, and magnetic resonance imaging. (orig.)

  8. Streptococcal acute pharyngitis

    2014-01-01

    Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-s...

  9. Acute generalized exanthematous pustulosis

    K.S. Dhillon

    2012-10-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare reaction pattern with a typical morphology and a short clinical course that in majority of cases is related to medication administration. It is an acute pustular eruption with unique clinical features, a rapid clinical course and a typical histopathology. Herein, we report the case of a patient with acute generalized exanthematous pustulosis for its classical presentation.

  10. Acute recurrent polyhydramnios

    Rode, Line; Bundgaard, Anne; Skibsted, Lillian;

    2007-01-01

    Acute recurrent polyhydramnios is a rare occurrence characterized by a poor fetal outcome. This is a case report describing a 34-year-old woman presenting with acute recurrent polyhydramnios. Treatment with non-steroidal anti-inflammatory drugs (NSAID) and therapeutic amniocenteses was initiated...... an enzyme-linked immunosorbent assay. As in normal pregnancies, amniotic prolactin levels decreased by 80% from highest to lowest value in this case of resolving acute recurrent polyhydramnios....

  11. Management Of Acute Migraine

    Mehndiratta M

    2002-01-01

    Pharmacotherapy for migraine involves treatment for the acute attack as well as using long-term prophylaxis in order to reduce the frequency and severity of the attacks. Based on severity, there are a number of drugs available to treat the acute attacks. For mild to moderate attacks, analgesics, NSAIDs and Ergotamine are effective but severe attacks may need Dihydroergotamine (DHE) or a triptan. Sumatriptan and the second generation triptans have revolutionized the acute treatment of migra...

  12. Atrial fibrillation (acute onset)

    Lip, Gregory Y. H.; Watson, Timothy

    2008-01-01

    Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of less than 48 hours' duration. It resolves spontaneously within 24 to 48 hours in over 50% of people. In this review we have included studies on patients with onset up to 7 days previously. Risk factors for acute atrial fibrillation include increasing age, CVD, alcohol abuse, diabetes, and lung disease.Acute atrial fibrillation increases the risk of stroke and heart failure.

  13. Improving diagnosis of acute appendicitis with atypical findings by Tc-99m HMPAO leukocyte scan

    Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800 k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation. (orig.)

  14. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  15. Mixed phenotype acute leukemia

    Ye Zixing; Wang Shujie

    2014-01-01

    Objective To highlight the current understanding of mixed phenotype acute leukemia (MPAL).Data sources We collected the relevant articles in PubMed (from 1985 to present),using the terms "mixed phenotype acute leukemia","hybrid acute leukemia","biphenotypic acute leukemia",and "mixed lineage leukemia".We also collected the relevant studies in WanFang Data base (from 2000 to present),using the terms "mixed phenotype acute leukemia" and "hybrid acute leukemia".Study selection We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version,with no limitation of research design.The duplicated articles are excluded.Results MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously.The clinical manifestations of MPAL are similar to other acute leukemias.The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 cdteria are most widely used.MPAL does not have a standard therapy regimen.Its treatment depends mostly on the patient's unique immunophenotypic and cytogenetic features,and also the experience of individual physician.The lack of effective treatment contributes to an undesirable prognosis.Conclusion Our understanding about MPAL is still limited.The diagnostic criteria have not been unified.The treatment of MPAL remains to be investigated.The prognostic factor is largely unclear yet.A better diagnostic cdteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.

  16. CT findings in acute small bowel diverticulitis; Computertomographie bei akuter Duenndarmdivertikulitis

    Ferstl, F.J.; Obert, R. [Radiologisch-Nuklearmedizinisches Zentrum (RNZ) am St. Theresienkrankenhaus Nuernberg (Germany)

    2004-02-01

    Small bowel diverticulitis is a rare cause of an acute abdomen. Originating from acquired diverticula of the jejunum, less often of the ileum, or Meckel diverticulum, the symptoms are non-specific, simulating other acute inflammatory disorders, such as appendicitis, cholecystitis or colonic diverticulitis. The diagnosis of small bowel diverticulitis is solely based on radiologic findings, with computed tomography (CT) regarded as the method of choice. In recent years, a number of case reports have described the spectrum of the CT features in acute small bowel diverticulitis and its dependence on the severity of the inflammatory process. Typical findings are an inflamed diverticulum, inflammatory mesenteric infiltration, extraluminal gas collection and mural edema of adjacent small bowel loops with resultant separation of bowel loops. An enterolith is rarely found in an inflamed diverticulum. Complications include abscesses, fistulae, small bowel obstruction and free perforation with peritonitis. Small bowel diverticulitis can be a diagnostic problem if it involves the terminal ileum or Meckel's diverticulum. For preoperative confirmation of the presumed diagnosis of small bowel diverticulitis on CT, an enteroclysis for acquired diverticula or a technetium scan for Meckel's diverticulum should be performed. We present the CT findings in three patients of acute small bowel diverticulitis, two affecting the jejunum and one a Meckel's diverticulum. (orig.) [German] Die akute Duenndarmdivertikulitis ist eine seltene Ursache eines akuten Abdomens. Ausgehend von den erworbenen Divertikeln des Jejunums, seltener des Ileums, oder von einem Meckel-Divertikel, manifestiert sich die Divertikulitis klinisch durch eine unspezifische Symptomatik, die zuerst an die haeufigeren, akutentzuendlichen Erkrankungen des Abdomens wie z. B. Appendizitis, Cholezystitis oder Kolondivertikulitis denken laesst. Die Duenndarmdivertikulitis kann praeoperativ nur durch

  17. Contrast enhancement in multidetector-row computed tomography (MDCT) of the abdomen: intraindividual comparison of contrast media containing 300 mg versus 370 mg iodine per ml

    Behrendt, F.F.; Mahnken, A.H.; Keil, S.; Das, M.; Hohl, C.; Guenther, R.W.; Muehlenbruch, G. [University Hospital RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Bauer, D. [University Hospital (RWTH), Institute of Medical Statistics, Aachen (Germany); Seidensticker, P. [Bayer Schering Pharma AG, Berlin (Germany); Jost, E. [University Hospital (RWTH), Medical Clinic IV, Aachen (Germany); Wildberger, J.E. [HELIOS Klinikum Berlin-Buch, Department of Diagnostic Radiology, Berlin (Germany)

    2008-06-15

    The purpose of this study was to intraindividually evaluate the difference in intraluminal vessel and parenchyma contrast enhancement of two different iodine concentrations in multidetector-row computed tomography (MDCT) of the abdomen. Eighty-three patients underwent baseline and follow-up MDCT-scanning (Somatom Sensation 16; Siemens, Forchheim, Germany) of the abdomen using contrast media containing 370 mg iodine/ml (protocol A; Ultravist 370, Bayer Schering Pharma, Berlin, Germany) and 300 mg iodine/ml (protocol B; Ultravist 300). The total iodine load (37 g iodine) and the iodine delivery rate (1.29 g iodine/s) were identical for both protocols. Contrast enhancement in the portal venous phase was measured in the abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney. Mean attenuation values were compared using paired t-test. Intraindividual comparison revealed no statistically significant differences of the mean attenuation values between protocols A and B for all anatomic sites: abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney (all P > 0.05). Given an injection protocol with constant total iodine load and constant iodine delivery rate, the iodine concentration of contrast media does not significantly influence abdominal contrast enhancement in the portal venous phase. (orig.)

  18. Contrast enhancement in multidetector-row computed tomography (MDCT) of the abdomen: intraindividual comparison of contrast media containing 300 mg versus 370 mg iodine per ml

    The purpose of this study was to intraindividually evaluate the difference in intraluminal vessel and parenchyma contrast enhancement of two different iodine concentrations in multidetector-row computed tomography (MDCT) of the abdomen. Eighty-three patients underwent baseline and follow-up MDCT-scanning (Somatom Sensation 16; Siemens, Forchheim, Germany) of the abdomen using contrast media containing 370 mg iodine/ml (protocol A; Ultravist 370, Bayer Schering Pharma, Berlin, Germany) and 300 mg iodine/ml (protocol B; Ultravist 300). The total iodine load (37 g iodine) and the iodine delivery rate (1.29 g iodine/s) were identical for both protocols. Contrast enhancement in the portal venous phase was measured in the abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney. Mean attenuation values were compared using paired t-test. Intraindividual comparison revealed no statistically significant differences of the mean attenuation values between protocols A and B for all anatomic sites: abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney (all P > 0.05). Given an injection protocol with constant total iodine load and constant iodine delivery rate, the iodine concentration of contrast media does not significantly influence abdominal contrast enhancement in the portal venous phase. (orig.)

  19. Acute myopericarditis masquerading as acute myocardial infarction

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  20. Leukocytosis in acute stroke

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H;

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...