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Sample records for abdomen acute

  1. Acute abdomen

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    Wig J

    1978-01-01

    Full Text Available 550 cases of acute abdomen have been analysed in detail includ-ing their clinical presentation and operative findings. Males are more frequently affected than females in a ratio of 3: 1. More than 45% of patients presented after 48 hours of onset of symptoms. Intestinal obstruction was the commonest cause of acute abdomen (47.6%. External hernia was responsible for 26% of cases of intestinal obstruction. Perforated peptic ulcer was the commonest cause of peritonitis in the present series (31.7% while incidence of biliary peritonitis was only 2.4%.. The clinical accuracy rate was 87%. The mortality in operated cases was high (10% while the over-all mortality rate was 7.5%.

  2. Pharm GKB: Acute abdomen [PharmGKB

    Lifescience Database Archive (English)

    Full Text Available Overview Alternate Names: PharmGKB Accession Id: PA165109055 External Vocabularies MeSH: Abdomen, Acute... (D000006) SnoMedCT: Acute abdomen (9209005) UMLS: C0000727 (C0000727) MedDRA: Abdominal... syndrome acute (10000096) NDFRT: Abdomen, Acute [Disease/Finding] (N0000000260) Common Searches Search Medline Plus Search CTD Pharm GKB: Acute abdomen ...

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

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    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.

  4. Scrub typhus presenting as an acute abdomen

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    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.

  5. Scrub typhus presenting as an acute abdomen

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    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...

  6. Scrub typhus presenting as an acute abdomen.

    Science.gov (United States)

    Kundavaram, Abhilash Pp; Das, Sohini; George, Varghese M

    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 investigations and surgical exploration.

  7. Acute vascular abdomen. General outlook and algorithms.

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    Miani, S; Boneschi, M; La Penna, A; Erba, M; De Monti, M; Giordanengo, F

    1999-09-01

    Acute vascular abdomen is a severe and life-threatening pathology due to arterial degeneration, leading to hemorrhage or arterial occlusion leading to ischemia. Differential diagnosis of patients with severe abdominal pain and/or shock include several vascular and traumatic diseases, the most common being rupture of abdominal aortic aneurysm (AAA), or less frequently rupture of visceral artery aneurysm. Also acute aortic dissection, iatrogenic injury and acute mesenteric ischemia may lead to acute vascular abdomen. Clinical evaluation of the haemodynamic status of the patient may be very difficult, and may require airway maintenance and ventilation with a rapid treatment of hemorrhagic shock. In the stable patient with an uncertain diagnosis, CT scan, NMR and selective angiography may be helpful in diagnosis before vascular repair. On the contrary, the unstable patient, after hemodynamic resuscitation, must be operated on expeditiously. We present our vascular algorithms, to assess timing of diagnosis and treatment of this severe acute disease.

  8. Anesthesia for the acute abdomen patient.

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    Hofmeister, Erik H

    2003-02-01

    Patients with acute abdomen often have marked physiologic and pathologic changes, making anesthesia both challenging and potentially hazardous for the patient. A thorough understanding of the pathophysiologic mechanisms of cardiovascular function under anesthesia and selection of appropriate anesthetic protocols are critical to a successful anesthetic outcome. The goal is to produce anesthesia while minimizing depression of the cardiovascular system. Monitoring and management of acid-base and cardiovascular function serve to ensure appropriate oxygen delivery to the tissues during anesthesia. Postoperative management can significantly influence patient outcome following anesthesic recovery, and must therefore be considered in the anesthetic plan. Finally, pain management in all patients is an important aspect of case management, and should not be overlooked. This article serves to educate the clinician in the above-described areas in regard to the acute abdomen patient.

  9. Surgical acute abdomen in elderly patients.

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    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.

  10. Acute abdomen caused by brucellar hepatic abscess.

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    Ibis, Cem; Sezer, Atakan; Batman, Ali K; Baydar, Serkan; Eker, Alper; Unlu, Ercument; Kuloglu, Figen; Cakir, Bilge; Coskun, Irfan

    2007-10-01

    Brucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.

  11. Gynecologycal acute abdomen in an adolescent

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    Caroline Rosa Pellicciari

    2013-03-01

    Adnexial torsion is defined as a partial or complete rotation of the adnexial vascular pedicle, causing circulatory ischemia and future necrosis. It is rare, hard to diagnosis and therefore of commonly delayed treatment. Clinical symptoms are nonspecific and similar to acute abdomen what may lead to a delay in its identification, generally performed by ultrasound examination. Treatment is surgical and may include adnexial extraction. Such uncommon diagnosis should always be remembered in adolescents patients whose abdominal pain does not resolve after conventional clinical treatment. In this study we report a demonstrative case of this important pathology.

  12. Acute Abdomen; Pre and Post-Laparotomy Diagnosis

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    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.

  13. Imaging findings of acute abdomen with intraperitoneal tuberculosis

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    Joo, Ji Seon; Kim, Mi Young; Koo, Jin Hoi; Cho, Soon Gu; Suh, Chang Hae [Inha Univ. College of Medicine, Inchon (Korea, Republic of)

    2000-12-01

    Acute abdomen caused by abdominal tuberculosis is a rare manifestation, and includes bleeding of a gastric or ileal ulcer, obstruction of the small bowel by an adhesive band, perforation of the ileum, ileocolic intussusception and fistula, and mesenteric abscesses caused by necrotic lymph nodes. The clinical and radiologic features of these complicated tuberculosis may mimic other acute abdominal diseases. Although not definitive, careful evaluation of the radiologic findings of the bowel wall, mesenteric fat infiltration, and lymph node enlargement may provide useful diagnostic clues to the presence of acute abdomen due to tuberculosis.

  14. [Pelvic actinomycosis and sub-acute abdomen].

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    Messalli, E M; Cobellis, L; Festa, B; Pecori, E; Stradella, L; Cobellis, G

    2002-12-01

    An interesting case of pelvic actinomycosis with paculiar clinical manifestation is presented. A 42 years-old patient came to our emergency service for an abdominal pelvic pain and fever. Past history showed IUD in situ for over 15 years. The patient was submitted to a ultrasonographic scan and a complete hematological screening was performed. The diagnosis was of subacute abdomen, and an exploratory laparotomy was carried out. During laparotomy an atypical reactive tissue and a suppurative cavity were found. The histological finding of tissue biopsy showed pelvic actinomycosis. On the basis of these findings the conclusion is drawn that a better prevention of pelvic actinomycosis is necessary of its diffusion in the last years due to sexual habit changes.

  15. Ascariasis presenting as acute abdomen during pregnancy and puerperium.

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    Gupta, Avantika; Rathore, Asmita Muthal; Manaktala, Usha

    2013-03-01

    Ascariasis can have various clinical presentations. We present three cases of ascariasis in pregnant or postpartum women, presenting with acute abdomen. The diagnosis of ascariasis was made clinically with the passage of ascaris worms in the vomitus or stool and was supported by ultrasonography. All three patients were treated successfully using anthelmintics. One patient underwent exploratory laparotomy.

  16. Role of Ultrasonography in Acute Abdomen

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    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

  17. Solitary mesenteric vascular anomaly presenting as acute abdomen

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    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.

  18. Guillain-Barre Syndrome Presenting as Acute Abdomen

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    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

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

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    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

  20. Sonographic diagnosis of "acute abdomen" in children and adults

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    Vauth, Christoph; Englert, Heike; Fischer, Thomas; Kulp, Werner; Greiner, Wolfgang; Willich, Stephan N.; Stroever, Brigitte; Graf von der Schulenburg, Johann-Matthias

    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 ultrasound diagnosis of the acute abdomen considering children and adults. This will be done from a medical and economic perspective. The differential diagnosis respectively the cause of the acute abdomen binds high direct treatment costs, especially in the stationary sector. Ultrasound diagnosis is a procedure that plays a big part in the differential diagnosis process and it is widely used in practise. Other research methods of diagnosing acute abdominal illness are: clinical examinations with inspection and palpation, surgical exploration and laparocopy as well as computer tomography and x-ray examination. Objectives The main objective of this HTA report is to assess what significance sonography should have within the examination strategy of the acute abdomen from the medical and economical view. Second, this HTA report will evaluate under which circumstances the ultrasonographic diagnosis of the acute abdomen, considering medical and economical quality classifications, is the alternative of choice to comparable diagnostic measures. Methods The target population this HTA report is aimed at are children and adults with acute abdomen or embedded differential diagnosis. A systematic literature search was conducted covering all relevant medical and HTA-databases. Furthermore, handsearch was conducted inside of the known data bases of HTA-institutions as well as from medical and economical journals. The following databases were searched in cooperation with DIMDI to identify relevant

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

    OpenAIRE

    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. Therefo...

  2. Protein C and S deficiency presenting as acute abdomen

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    Amit A Bharadiya

    2015-01-01

    Full Text Available Protein C and S are essential in limiting the activation of coagulation in vivo. Their deficiencies predispose the patient to thrombophilia and leads to thrombosis, often at unusual sites. Arterial thrombosis is rarely observed. We report a case of a patient with abdominal arteriovenous thrombosis leading to multiorgan infarction secondary to deficiency of protein C and protein S and presenting as acute abdomen.

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

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

    2013-04-19

    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.

  4. [Acute abdomen caused by eosinophilic enteritis: six observations].

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    Martínez-Ubieto, Fernando; Bueno-Delgado, Alvaro; Jiménez-Bernadó, Teresa; Santero Ramírez, María Pilar; Arribas-Del Amo, Dolores; Martínez-Ubieto, Javier

    2013-01-01

    Eosinophilic enteritis is a rather rare condition characterized by infiltration of the gastrointestinal tract by eosinophils; as a casue of acute abdomen it is really exceptional. The etiology is unclear and its description in the literature is sparse, but associations have been made with collagen vascular disease, inflammatory bowel disease, food allergy and parasitic infections as it was confirmed in one of our pathologic studies. From 1997 to 2011 six cases of eosinophilic enteritis that involved a small bowel segment were diagnosed. A partial resection by an irreversible necrosis was necessary in three of them; in the other three only a biopsy was necessary due to the inflammatory aspect of the affected loop causing the acute abdomen. Eosinophilic enteritis can originate acute abdomen processes where an urgent surgical treatment is necessary. The intraoperative aspect can be from a segment of small bowel with inflammatory signs up to a completely irrecoverable loop, where removing of the affected segment is the correct treatment, which can be done laparoscopically.

  5. Marfan syndrome with acute abdomen: a case report

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    Beyazit Zencirci

    2010-11-01

    Full Text Available 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 of their disease, as in the case reported.Case presentation: In a 28-year-old Turkish male, arachnodactyly, pectus excavatum, kyphoscoliosis and, according to pulmonary roentgenogram, a density increase in the left apical field were detected. In addition, according to the echocardiographic examination, Ebstein’s anomaly, mitral valve prolapse, pulmonary hypertension, and inferior deficiency of mitral, aorta, and tricuspid valves were present. The patient was planned to be operated on with the prediagnosis of acute abdomen.Conclusion: Taking into consideration the pathologies that may accompany MFS and the probable future complications, the patients must be closely monitored during anesthesia applications and required measures should be taken beforehand.Keywords: Marfan syndrome, acute abdomen

  6. MELAS syndrome presenting as an acute surgical abdomen.

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    Dindyal, S; Mistry, K; Angamuthu, N; Smith, G; Hilton, D; Arumugam, P; Mathew, J

    2014-01-01

    MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.

  7. A Rare Acute Abdomen Reason: Perforated Jejunal Diverticulitis

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    Oktay Karakose

    2014-06-01

    Full Text Available Jejunal diverticulosis is a rare case that is diagnosed incidental. Although it is generally asymptomatic, it can cause non-spesific symptoms like stomachache, nausea, diarrhoea, malabsorption, bleeding, obstruction and / or perforation. Perforated jejunal diverticulitis is a very rare acute abdomen cause. The acute complications of jejunal diverticulosis can be cause of significant morbidity and mortality especially in old patients. In this text, we report a 81 year old woman case that was operated emergently because of perforated jejunal diverticulitis and was lost in postoperation term because of multiple organ failure.

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

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    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

  9. [Acute abdomen secondary to spontaneous uterine rupture associated with pyometra].

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    Ortiz-Mendoza, Carlos Manuel

    2006-01-01

    A 71-year-old female with rheumatoid arthritis and chronic use of corticosteroids presented to the emergency room with 2 weeks of urinary symptoms, abdominal pain and a mass located in hypo-mesogastrium and both flanks. An X-ray film of the abdomen showed that bowels were displaced by the mass. Laboratory studies showed thrombocytosis (549,000/mm(3)) and leukocytosis (41,800/mm(3)). Several hours after her arrival the patient developed acute abdomen and surgery was indicated. A urinary catheter drained 2100 ml of urine and the abdominal mass was reduced in size but did not disappear. Surgery demonstrated that the urinary bladder covered the fundus and the anterior face of the uterus, where extensive necrosis and a 3-cm perforation were found; 400 ml of foul-smelling pus was drained from the uterine cavity. Due to necrosis, a hysterectomy was performed. The histopathological report indicated necrosis, atrophic cervicitis and endometritis; pus culture developed Escherichia coli and Proteus vulgaris. Despite administration of broad-spectrum antibiotics, the patient developed severe sepsis and died 11 days postoperatively. During a literature review, only one similar case was found. Acute abdomen due to uterine perforation secondary to pyometra and associated with chronic use of corticosteroids is a rare complication.

  10. Acute abdomen in a patient with paraesophageal hernia, resulting in acute compromised respiratory function

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    Mekhael, Mira Rober; El-Hussuna, Alaa

    2017-01-01

    INTRODUCTION: We present a case of acute abdomen, causing increased intra-abdominal pressure, leading to further herniation of an existing paraesophageal hernia, and consequently acute compromised respiratory function. This acute respiratory complication to a paraesophageal hernia has not previou......INTRODUCTION: We present a case of acute abdomen, causing increased intra-abdominal pressure, leading to further herniation of an existing paraesophageal hernia, and consequently acute compromised respiratory function. This acute respiratory complication to a paraesophageal hernia has...... if complicated by acute abdomen. These patients could benefit from elective hernia repair, rather than watchful waiting, as it would eliminate pulmonary symptoms and prevent similar cases. Patients monitored using watchful waiting should be informed that acute abdomen could cause acute compromised respiratory...... function. CONCLUSION: Any case of acute abdomen causing high intra-abdominal pressure could potentially cause further herniation of an existing paraesophageal hernia, resulting in acute compromised respiratory function. In patients known to have a paraesophageal hernia, similar cases should be suspected...

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

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    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...

  12. Hotel NHS and the acute abdomen - admit first, investigate later.

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    Aryal, K; Bhowmick, A; Beveridge, A J; Scott, N A

    2009-12-01

    To determine the financial consequences of a policy of admission first, followed by definitive investigation for patients with an admission diagnosis of suspected acute abdomen. Over a 1-month period, 122 patients were admitted with a suspected surgical diagnosis of acute abdomen (55 men, 67 women); age range 16-95 years (median: 56.5). Based on surgical operation required (n = 36), death after admission (n = 6, three postoperative deaths) and/or severe surgical illness (n = 17), 56 required surgical inpatient admission, while 66 did not. The patients who did not require admission spent significantly shorter time in hospital than those who required admission (median: 5 days vs. 8.5 days; p = 0.0000). Total hospital hotel and investigation cost (not including ITU or theatre costs) for all 122 patients was 330,468 pounds. Overall, 205,468 pounds was consumed by these 56 patients who required admission, while 125,000 pounds was spent on 66 patients whose clinical course did not justify admission; 92% of which was spent on hospital hotel costs and 8% on the cost of imaging and/or endoscopy. On a national basis, emergency General Surgery admissions account for 1000 Finished Consultant Episodes per 100,000 population. The findings of this study suggest that this equates to a national NHS spend of 650 million pounds each year, for the hotel costs of patients that could arguably avoid surgical admission altogether. Continuing to admit patients with a suspected acute abdomen first and then requesting definitive investigation makes neither clinical nor economic sense.

  13. [Errors and difficulties in the diagnosis and management of acute and chronic abdomen in children].

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    Sabetay, C; Singer, I; Zavate, A; Ciobanu, O; Cârstoiu, E; Stoica, A; Maloş, Anca; Farcaş, I; Kamel, J; Hams, I; Kastrati, A

    2002-01-01

    The authors are reviewing on a lot of 2844 cases between 1996 and 2000 the difficult problems of differential diagnosis between acute surgical abdomen in children and intestinal tuberculosis, abdominal tumors and inflammatory diseases such as acute osteomielitis. They are presenting 13 particular cases in which the acute abdomen diagnosis was difficult or even omitted.

  14. A rare cause of acute abdomen in adults: Parasitic infection-related acute appendicitis.

    Science.gov (United States)

    Küpeli, Aydın Hakan; Özdemir, Murat; Topuz, Sezgin; Sözütek, Alper; Paksoy, Tuğba

    2015-01-01

    Ascaris lumbricoides is a common parasitic disease all over the world, especially in less developed countries. Acute appendicitis related to parasitic infection is a rare condition. Parasitic infections should be kept in mind in patients who are admitted to the emergency department with acute abdomen, especially in endemic areas.

  15. [Acute abdomen with actinomycosis of the colon: A case report].

    Science.gov (United States)

    García-Zúñiga, Beatriz; Jiménez-Pastrana, Marco Tulio

    2016-01-01

    Actinomyces infection is a chronic inflammatory process that can sometimes, clinically and radiographically, closely mimic a malignant tumour, which may lead to giving a delayed or inappropriate treatment. Male 41 years old, with no previous history, with abdominal pain of one month onset, as well as weight loss, intermittent fever and diarrhoea. He developed acute abdomen and underwent surgery, finding a tumour in the distal ileum with necrosis and punctiform perforations. A resection was performed on the affected part of the ileum and colon, as well as an ileostomy using Hartmann's procedure. Actinomycosis is a disease that must be considered by the surgeon when faced with a clinical picture of subacute onset with intermittent fever, weight loss, abdominal pain, and even anaemia in patients with abdominal and retroperitoneal abscesses or previous history of surgery. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Acute epiploic appendagitis: A rare cause of acute abdomen and a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Afnan F Almuhanna

    2016-01-01

    Full Text Available Acute epiploic appendagitis is a relatively rare cause of lower abdominal pain that clinically mimics other acute abdomen conditions that require surgery such as acute diverticulitis or appendicitis. Here, we report a case of a 50-year-old lady who presented with an unusual lower abdominal pain. Awareness of such a clinical condition with its characteristic imaging findings is important to avoid costly hospitalization, unnecessary antibiotic courses, and the morbidity and mortality associated with surgical procedures.

  18. [Digestive bleeding and acute abdomen caused by jejunal diverticulosis. Case report].

    Science.gov (United States)

    Nari, Gustavo A; Azar, Ricardo; Feliu, Luis; Moreno, Eduardo; Bonaparte, Fernando

    2012-03-01

    We present a patient with acute abdomen and digestive bleeding caused by jejunal diverticulosis. Jejunal diverticulosis, mainly asymptomatic, when is symptomatic have a wide clinical spectrum, ranging from chronic anemic syndrome to acute abdomen. In this communication, we reviewed the clinical presentation, the pathogenesis and the treatment this infrequent pathology.

  19. Front-end specialists reduce time to a treatment plan for patients with acute abdomen

    DEFF Research Database (Denmark)

    Schultz, Helen; Backer Mogensen, Christian; Pedersen, Birthe D

    2013-01-01

    Emergency departments (EDs) are replacing acute specialised wards in Denmark. The aim was to compare time to a treatment plan for patients with acute abdomen at a surgical assessment unit (SAU) and at an ED, respectively.......Emergency departments (EDs) are replacing acute specialised wards in Denmark. The aim was to compare time to a treatment plan for patients with acute abdomen at a surgical assessment unit (SAU) and at an ED, respectively....

  20. Front-end specialists reduce time to a treatment plan for patients with acute abdomen

    DEFF Research Database (Denmark)

    Schultz, Helen; Backer Mogensen, Christian; Pedersen, Birthe D

    2013-01-01

    Emergency departments (EDs) are replacing acute specialised wards in Denmark. The aim was to compare time to a treatment plan for patients with acute abdomen at a surgical assessment unit (SAU) and at an ED, respectively.......Emergency departments (EDs) are replacing acute specialised wards in Denmark. The aim was to compare time to a treatment plan for patients with acute abdomen at a surgical assessment unit (SAU) and at an ED, respectively....

  1. Sonographic findings of ovarian hemorrhage presenting acute abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Joo Sung; Lee, Eun Ju; Kang, Hae Jin; Suh, Jung Ho [Aju University School of Medicine, Suwon (Korea, Republic of)

    2000-03-15

    To obtain the characteristic sonographic findings of ovarian hemorrhage and investigate the usefulness of ultrasonography in the diagnosis. Forty-nine cases presenting acute abdomen diagnosed as ovarian hemorrhage by ultrasonography or surgicopathological confirmation. We observed the size and margin of the ovary, size, pattern, shape, wall and internal echogenecity of the masses and the amount of hemoperitoneum. We also performed a color Doppler study to evaluate the blood flow pattern and resistive index (RI). The age of patients were between 21-41. Most symptoms occurred from days 14 to 30 of her menstrual cycle and were presented for less than 24 hours. Twenty patients had a history of intercourse shortly before the onset of the symptom. Thirty two cases involved the right ovary while the other 17 cases involved the left. All patients had a negative urine or serum hCG test except for 4 pregnant women. The size of the ovary was measured as mean 5.1 cm and marginal irregularly was noted in 36 cases. Mixed echoic solid masses were observed in 6 cases and variable echogenecity of cystic masses were seen in 43 cases. Maximal diameter of adnexal masses were measured as mean 3.95 cm. Internal echogenecity of cystic masses appeared as mainly heterogeneous (21). Twenty two cystic masses had a thick irregular wall and 17 had a thin smooth wall. Hypoechoic rim like halo surrounding was noted in 17 cystic masses. 17 cases seemed to have a small amount of hemoperitoneum, a moderate amount in 22 cases and a large amount in 9 cases. The blood flow pattern of cystic masses showed a rim (29) and spotty (8) pattern in the color Doppler study. Measured RI was 0.41 (mean). Fertile women with the complaint of acute abdominal pain, who has the laboratory data of negative hCG test, ultrasonographic findings of enlargement of ovary with irregular margin, heterogeneous echoic cystic mass, peripheral halo surrounding the mass, hemoperitoneum and low resistance index of peripheral blood

  2. Diagnostics of vascular diseases as a cause for acute abdomen; Diagnostik vaskulaerer Erkrankungen als Ursache fuer das akute Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Juchems, M.S. [Universitaetsklinikum Ulm, Klinik fuer Diagnostische und Interventionelle Radiologie, Ulm (Germany); Aschoff, A.J. [Klinikum Kempten-Oberallgaeu, Abteilung fuer Radiologie, Kempten (Germany)

    2010-03-15

    Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. (orig.) [German] Vaskulaere Pathologien sind seltene Ursachen fuer den klinischen Zustand eines akuten Abdomens. Liegt eine vaskulaere Erkrankung vor, ist jedoch aufgrund der hohen Mortalitaet eine zuegige Diagnostik von grosser Wichtigkeit. Bei den Erkrankungen der abdominellen Gefaesse sind arterielle von venoesen Ursachen zu unterscheiden. Ein Verschluss der A. mesenterica superior ist die haeufigste Ursache fuer die akute Mesenterialischaemie, daneben sind Blutungen in den abdominellen Gefaessprovinzen des arteriellen Gefaessbaums von Bedeutung. Venoese Pathologien betreffen thrombotische Verschluesse der Pfortader, der V. mesenterica und der V. cava. Die Multidetektor-CT (MDCT) ist zur Diagnostik vaskulaerer Erkrankungen des Abdominalraums praedestiniert. Mit mehrphasigen Untersuchungsprotokollen gelingt es, den arteriellen und venoesen Gefaessbaum zuverlaessig darzustellen und Erkrankungen mit hoher Sensitivitaet und Spezifitaet zu

  3. [Giant appendiceal mucocele during laparotomy for acute abdomen. Report of a case and brief review].

    Science.gov (United States)

    Caiazzo, P; Comentale, A; Rampone, B; Di Lascio, P; Morlino, A; Pastore, M; Del Vecchio, G; Tramutoli, P R

    2010-01-01

    The authors describe a case of giant appendiceal mucocele, secondary to a mucinous neoplasm of the appendix, diagnosed during laparotomy for acute abdomen. By a review of the literature they stress the rarity of this lesion, the particular onset in their case as acute complication of appendiceal neoplasm with rupture of the intestinal wall, the difficulties of diagnosis and management in emergency.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Update on the management of non-obstetric acute abdomen in pregnant patients.

    Science.gov (United States)

    Barber-Millet, Sebastián; Bueno Lledó, José; Granero Castro, Pablo; Gómez Gavara, Immaculada; Ballester Pla, Neus; García Domínguez, Rafael

    2016-05-01

    Acute abdomen is a rare entity in the pregnant patient, with an incidence of one in 500-635 patients. Its appearance requires a quick response and an early diagnosis to treat the underlying disease and prevent maternal and fetal morbidity. Imaging tests are essential, due to clinical and laboratory masking in this subgroup. Appendicitis and complicated biliary pathology are the most frequent causes of non-obstetric acute abdomen in the pregnant patient. The decision to operate, the timing, and the surgical approach are essential for a correct management of this pathology. The aim of this paper is to perform a review and update on the diagnosis and treatment of non-obstetric acute abdomen in pregnancy. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  8. Surgery for acute abdomen and MEFV mutations in patients with FMF.

    Science.gov (United States)

    Samli, Hale; Içduygu, Fadime Mutlu; Ozgöz, Asuman; Akbulut, Gökhan; Hekimler, Kuyas; Imirzalioglu, Necat

    2009-01-01

    Familial Mediterranean Fever (FMF) is an autosomal recessive disease characterized by recurrent fever, peritonitis, arthritis, pleuritis, and secondary amyloidosis. In the current study, we sought to determine the frequency of acute surgical abdominal intervention and MEFV gene mutations in FMF patients. A total of 159 patients were referred to our department with a diagnosis of FMF. Twenty-six patients (16.4%) had a history of surgical intervention. Of these, 17 (10.7%) were operated on due to appendicitis, and 9 (5.7%) were operated on due to other acute abdomen reasons. Genomic DNA was isolated from the blood samples, and in the isolated DNA samples, 12 MEFV gene mutations were studied. Mutation frequency was detected to be 80.8% in the patients with acute abdomen surgery intervention and 56.4% in the patients without acute abdomen surgical intervention. Upon mutational evaluation of these patients, we noted that the M694V (40.5%) and E148Q (21.4%) mutations occurred most frequently. The MEFV gene mutation frequency in FMF patients with acute abdomen surgical intervention was significantly higher than that in patients without such intervention. Increased mutation scanning in FMF patients will significantly decrease unnecessary surgical interventions in this patient group.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  10. Accurate diagnosis of acute abdomen in FMF and acute appendicitis patients: how can we use procalcitonin?

    Science.gov (United States)

    Kisacik, Bunyamin; Kalyoncu, Umut; Erol, M Fatih; Karadag, Omer; Yildiz, Mustafa; Akdogan, Ali; Kaptanoglu, Bugra; Hayran, Mutlu; Ureten, Kemal; Ertenli, Ihsan; Kiraz, Sedat; Calguneri, Meral

    2007-12-01

    This study was conducted to define the value of procalcitonin (PCT) levels in the differential diagnosis of abdominal familial Mediterranean fever (FMF) attacks from acute appendicitis. From October 2006 to January 2007, 28 FMF (12 males, 16 females) patients with acute abdominal attacks and 34 patients (18 males) with acute abdomen who underwent operation with the clinical diagnosis of acute appendicitis were consecutively enrolled in this study. FMF patients with concurrent infectious diseases were excluded. PCT values were measured by an immunofluorescent method using the B.R.A.H.M.S. PCT kit (B.R.A.H.M.S. Diagnostica, Berlin, Germany). Erythrocyte sedimentation rate (ESR), C-reactive proteins (CRP) and leucocyte levels were also noted. Mean disease duration in FMF patients was 9.6 +/- 8.1 years (range 2-33 years) and all were on colchicine therapy with a mean colchicine dosage of 1.2 +/- 0.4 mg/day. Among the operated patients, 5 were excluded: 3 patients had normal findings and 2 had intestinal perforation (PCT levels were 2.69 and 4.93 ng/ml, respectively) at operative and pathologic evaluation. There were no significant differences between the two groups with respect to gender and age (p was not significant (NS) for all). Acute phase reactants and PCT levels were increased in patients with FMF compared to patients with acute appendicitis (0.529[0.12 +/- 0.96] vs 0.095 [0.01-0.80] p FMF patients compared to 62% (18/29) of acute appendicitis patients (p FMF attacks from acute appendicitis, though it should not supplant more conventional investigations.

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

    DEFF Research Database (Denmark)

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  14. Rare case of an abdominal mass presenting as acute abdomen: torsion of the vermiform appendix.

    Science.gov (United States)

    Kilincaslan, Huseyin; Gedik, Ahmet Hakan; Bilici, Mustafa; Cakir, Secil

    2013-04-01

    Torsion of the vermiform appendix is a rarely observed acute abdominal emergency. The clinical manifestations are similar to acute appendicitis. It should be included in the differential diagnosis if a patient presents with intermittent abdominal pain and an acute abdominal emergency. Here, we describe a 4-year-old male patient with a mass located in the right lower abdominal quadrant, whose clinical findings were consistent with an acute abdomen. The gangrenous appendix was found in the pelvic cavity and its stump was twisted clockwise. A 1.5-cm fecalith was detected in the appendix lumen and appendectomy was performed. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    AIM: Ultrasound has a well-established role in the diagnostic assessment of acute abdominal pain where some ultrasonically easily-accessible organs account for several diagnostic possibilities. The objective of the present study was to evaluate whether surgeons without ultrasound experience could...

  16. A Clinical Skills Instruction Program: The Acute Abdomen.

    Science.gov (United States)

    Laube, Douglas W.; And Others

    1982-01-01

    An effective evaluation of the acutely ill female implies a thorough examination that integrates skills representing three learning domains. This process should include: a thorough medical history, a physical examination, good patient-physician rapport, and development of an efficacious management plan. A University of Iowa simulation approach is…

  17. A Clinical Skills Instruction Program: The Acute Abdomen.

    Science.gov (United States)

    Laube, Douglas W.; And Others

    1982-01-01

    An effective evaluation of the acutely ill female implies a thorough examination that integrates skills representing three learning domains. This process should include: a thorough medical history, a physical examination, good patient-physician rapport, and development of an efficacious management plan. A University of Iowa simulation approach is…

  18. Perforated jejunal diverticulum: a rare presentation of acute abdomen.

    Science.gov (United States)

    Kavanagh, Crystal; Kaoutzanis, Christodoulos; Spoor, Kristen; Friedman, Paul F

    2014-03-22

    Jejunal diverticulosis is a rare entity with a reported clinical incidence of 0.5%. However, symptoms relating to its presence are non-specific, which does not only delay diagnosis, but also increases the risk of serious complications approaching 15%. We report a case of perforated jejunal diverticulum presented with a 6-month history of significant weight loss and acute abdominal pain. We discuss clinical presentation in both simple and complex cases, diagnostic pitfalls and management strategies.

  19. [Clinical case--voluminous diaphragmatic hernia--surgically acute abdomen: diagnostic and therapeutical challenges].

    Science.gov (United States)

    Dumitrescu, D; Savlovschi, C; Borcan, R; Pantu, H; Serban, D; Gradinaru, S; Smarandache, G; Trotea, T; Branescu, C; Musat, L; Comandasu, M; Priboi, M; Baldir, M; Sandolache, B; Oprescu, S

    2011-01-01

    We present the case of a 58-year old male patient admitted in the surgery section of the University Emergency Hospital of Bucharest and diagnosed with acute abdomen. The minimal clinical-paraclinical investigation (i.e., thorax-pulmonary Xray, biological probes) raises questions as to the differentiated diagnosis and other associated diseases, also suggesting the existence of voluminous diaphragmatic hernia. The CT thorax-abdomen examination confirms the diaphragmatic hernia suspicion, with intra-thorax ascent of the colon up to the anterior C4 level, but does not explain the abdominal suffering; thus we suspected a biliary ileus or acute appendicitis. Medial laparotomy was imperative. Intrasurgically peritonitis was noticed located by gangrenous acute apendicitis, perforated, with coprolite, for which apendictomy and lavage-drainage pf the peritoneal cavity was performed. Post-surgical status: favourable to recovery.

  20. A CASE REPORT OF GAINT JEJUNAL DIVERTICULOSIS PRESENTING AS RECURRENT ACUTE ABDOMEN

    Directory of Open Access Journals (Sweden)

    Rambabu

    2015-09-01

    Full Text Available The diverticulum of the small bowel may be congenital or acquired. 80% of diverticula occur in the jejunum, 15% in the ileum and 5% in both . (1,2,3,4 Although it is often asymptomatic, it can lead to severe complications including perforation, haemorrhage, enterolith formation, diverticulitis, and intestinal obstruction (5,6,7,8 and occur in 10% - 30% of patients. We have a male aged 30yrs old came with h/o recurrent colicky pain abdomen and bilious vomiting since past 6 months (9,10,11 o/e he is anaemic , malnourished and dehydrated. P/abdomen – gaseous distension present , no mass palpable and no free fluid , p/r – no abnormality , plain X - ray abdomen shows multiple air fluid levels. (12 On laparotomy there are multiple giant jenjunal diverticuli with bowel distension and there is a band found attached to the middle ileum. The band is excised and the jejunum which had giant diverticula has been resected and e nd to end anastomosis is done. Jejunal diverticula are rare and mostly asymptomatic. Patients may have nonspecific symptoms, such as chronic abdominal pain and change in bowel habits. However, the morbidity and mortality rates may increase due to perforati on, obstruction, and bleeding. If acute abdomen in jejunal diverticulosis is suspected, a laparotomy and resection & anastomosis is considered and TB abdomen must be considered in the differential diagnosis

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

    Directory of Open Access Journals (Sweden)

    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.

  2. A rare cause of acute abdomen: tumor rupture of nonpalpable testis

    Science.gov (United States)

    Yıldız, Turan; İlçe, Zekeriya; Gündüz, Yasemin; Çakırsoy, Gözde Çakar

    2016-01-01

    Undescended testicle is the most common congenital anomaly among males. Testicular tumor develops in 3–5% of the boys with a complaint of undescended testicle. The clinical presentation of malignant intra-abdominal testicular tumors ranges from asymptomatic cases to acute abdomen. In this study, we present a child with testicular tumor rupture which is observed very rarely. A 16-year-old boy presented 24 hours after the sudden onset of right lower quadrant pain, nausea, vomiting and fever. On physical examination, extensive tenderness in the abdomen and abdominal guarding were found. The right testicle was not palpable. The serum white blood cell count was elevated. Ultrasonography and abdominal computerized tomography scan demonstrated a perforated, hyperdense mass with free fluid in the abdomen. The preoperative alpha fetoprotein level was found to be increased. We performed surgery with laparoscopy and a perforated right intraabdominal testicle was found in the right iliac fossa. The mass was excised. Histopathological examination revealed a yolk sac tumor. Ruptured nonpalpable testicular tumors are very rare. To our knowledge, this is the first adolescent case reported so far. Testicular tumor rupture should be considered in patients with nonpalpable testicle and acute abdomen. Laparoscopy may be performed in differential diagnosis and treatment of these patients.

  3. A rare cause of acute abdomen: tumor rupture of nonpalpable testis.

    Science.gov (United States)

    Yıldız, Turan; İlçe, Zekeriya; Gündüz, Yasemin; Çakırsoy, Gözde Çakar

    2016-09-01

    Undescended testicle is the most common congenital anomaly among males. Testicular tumor develops in 3-5% of the boys with a complaint of undescended testicle. The clinical presentation of malignant intra-abdominal testicular tumors ranges from asymptomatic cases to acute abdomen. In this study, we present a child with testicular tumor rupture which is observed very rarely. A 16-year-old boy presented 24 hours after the sudden onset of right lower quadrant pain, nausea, vomiting and fever. On physical examination, extensive tenderness in the abdomen and abdominal guarding were found. The right testicle was not palpable. The serum white blood cell count was elevated. Ultrasonography and abdominal computerized tomography scan demonstrated a perforated, hyperdense mass with free fluid in the abdomen. The preoperative alpha fetoprotein level was found to be increased. We performed surgery with laparoscopy and a perforated right intraabdominal testicle was found in the right iliac fossa. The mass was excised. Histopathological examination revealed a yolk sac tumor. Ruptured nonpalpable testicular tumors are very rare. To our knowledge, this is the first adolescent case reported so far. Testicular tumor rupture should be considered in patients with nonpalpable testicle and acute abdomen. Laparoscopy may be performed in differential diagnosis and treatment of these patients.

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

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    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.

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

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    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.

  6. Neisseria meningitidis presenting as acute abdomen and recurrent reactive pericarditis

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    Karolina Akinosoglou

    Full Text Available ABSTRACT Meningococcal meningitis is a well established potential fatal infection characterized by fever, headache, petechial rash, and vomiting in the majority of cases. However, protean manifestations including abdominal pain, sore throat, diarrhea and cough, even though rare, should not be overlooked. Similarly, although disseminated infection could potentially involve various organ-targets, secondary immune related complications including joints or pericardium should be dealt with caution, since they remain unresponsive to appropriate antibiotic regimens. We hereby report the rare case of an otherwise healthy adult female, presenting with acute abdominal pain masking Neisseria meningitidis serotype B meningitis, later complicated with recurrent reactive pericarditis despite appropriate antibiotic treatment. There follows a review of current literature.

  7. Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen

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    Tahsin Colak

    2013-01-01

    Full Text Available 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.

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

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    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.

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

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    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

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

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    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.

  11. Accessory spleen presenting as acute abdomen: A case report and operative management

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    A. Landmann

    2016-09-01

    Full Text Available Accessory spleens are found in 10–30% of patients and are asymptomatic. Rarely, torsion of an accessory spleen can cause abdominal pain and acute abdomen. We present the case of an 8-year-old girl who arrives to the emergency room with left upper quadrant abdominal pain. CT scan revealed a non-enhancing soft tissue mass and multiple small splenules. Laparoscopy revealed a torsed accessory spleen and malrotation. Accessory spleen is a common congenital anomaly that is frequently asymptomatic. Rarely, an accessory spleen may become torsed around its vascular pedicle resulting in severe abdominal pain. Treatment is surgical resection. Torsion of accessory splenic tissue is a rare cause of acute abdomen in pediatric patients.

  12. Acute Abdomen Due to Penicillium marneffei: An Indicator of HIV Infection in Manipur State.

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    Ghalige, Hemanth Sureshwara; Sahoo, Biswajeet; Sharma, Sanjeeb; Devi, Khuraijam Ranjana; Singh Th, Sudhir Chandra

    2014-09-01

    Opportunistic infection in HIV disease often present to clinicians in an atypical manner testing clinical acumen. Here, we report a case of Penicilliosis marneffei (PM) infection presenting to surgical emergency as acute abdomen with undiagnosed HIV status in advanced AIDS, chief complaints being prolonged fever and diffuse abdominal pain. Radiologic imaging showed non-specific mesenteric and retroperitoneal lymphadenopathy. Fine needle aspiration cytology (FNAC) of the lymph node was done and subjected to direct microscopy, gram staining and culture on Sabouraud's dextrose agar (SDA) which showed Penicillium marneffei. He was then treated with intravenous amphotericin. This case is reported for its rarity and unusual presentation to sensitise clinicians and microbiologists to consider PM as an aetiology in acute abdomen in high risk individuals, more so, in patients from north-east India.

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

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    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.

  14. Comparison of Different Parameters in the Diagnosis of Acute Abdomen

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    Ahmet Kocakuşlak

    2011-06-01

    Full Text Available Aim: Acute abdominal syndrome (AAS defines the failure to establish the primary diagnosis rather than being a definitive diagnosis. The fact that many patients are discharged from the hospital without surgical intervention as well as the decision regarding which patients should undergo surgery and when, all may create a dilemma for the clinician. Methods: We analyzed and recorded the data of 50 randomly chosen patients with a primary diagnosis of AAS who had been hospitalized in the emergency surgical department for follow-up. The study group was compared with a control group (50 patients who had been directly operated on for AAS without a preceding observation. The parameters used in the study were age, gender, guarding, rebound tenderness, ultrasonography, leucocytosis, and left shift of the neutrophils. Results: The mean age of the patients in the study group was statistically significantly higher than that in the control group and surgery was not necessary in 88%.Statistically significant difference was found between the two groups for guarding, rebound tenderness, ultrasonography, and gender. Logistic regression analysis revealed that rebound tenderness and ultrasonography results were more valuable than the other parameters. Rebound tenderness and ultrasonography influenced the decision for surgical intervention by 7.9- and 17.3- fold increases, respectively. Conclusion: We think that our parameters can be used as a guide by clinicians working in emergency departments to decide which patient should be operated on since only 12% of the study group had necessitated surgical intervention. (The Medical Bulletin of Haseki 2011;49: 77-83

  15. Perforated duodenal ulcer a rare cause of acute abdomen in infancy: A report of two cases

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    Kadian Yogender

    2008-01-01

    Full Text Available Duodenal ulcer perforation is very uncommon in infants and children, that is why it is not usually considered in the differential diagnosis of acute abdomen in this age group. Moreover, the diagnosis of this condition is usually overlooked because of vague and variable symptoms and low index of suspicion on the part of the treating physicians. In this brief report, we are reporting two cases of successfully managed perforated duodenal ulcer in infancy.

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

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    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)

  17. Spontaneous Perforation of Pyometra Presented as an Acute Abdomen: A Case Report

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    Saha, Pradip Kumar; Gupta, Pratiksha; Mehra, Reeti; Goel, Poonam; Huria, Anju

    2008-01-01

    Spontaneous perforation of pyometra is a rare pathologic condition that presents as diffuse peritonitis. This report describes an interesting case of spontaneous uterine perforation that mimicked gut perforation clinically and was finally diagnosed at exploratory laparotomy. Although rare, perforation of pyometra should be kept as one of the differential diagnosis in an elderly woman with an acute abdomen. A high index of suspicion is required to make a correct preoperative diagnosis, which allows early intervention, thus reducing morbidity and mortality. PMID:18324325

  18. A rare cause of acute abdomen-Spontaneous rectus sheath hematoma

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    Hock Chin Chong; Feng Yih Chai; Yew Eng Tan; Sophia Si Ling Heng; Siti Asilah Mohd Desa

    2016-01-01

    Spontaneous rectus sheath hematoma (SRSH) is a rare entity that mimics acute abdomen. Rectus sheath hematoma is the accumulation of blood in rectus sheath due to muscle or epigastric vessel injury. However, SRSH without a trauma or anticoagulation is rare. It frequently mimics acute abdomen and it may lead to misdiagnosis and unnecessary laparotomy. In this article, we described two cases of SRSH with their diagnostic and therapeutic strategy. Both of our patients in report were neither consumed antiplatelet nor coagulopathy. They both had abdominal muscle straining before their symptoms pre-sentation. We hypothesized that the SRSH may be induced by rectus muscle injury secondary to inappropriate straining or posture. To diagnose SRSH, clinical findings are important but radiologic imaging such as computed tomography, can be diagnostic. In expanding SRSH, percutaneous arterial embolization of epigastric artery is useful to secure the bleeding. If embolization is not feasible, surgical exploration hemostasis is curative. In non-expanding SRSH, it can be managed nonoperatively. SRSH is an important initial differential for acute abdomen. Radiologic imaging helps in diagnosis. Stable SRSH can be managed conservatively with good outcome.

  19. A Case of Systemic Lupus Erythematosus Presenting with an Acute Abdomen: Successful Treatment with Steroid

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    Haruka Fukatsu

    2014-01-01

    Full Text Available Abdominal pain continues to pose diagnostic challenges for emergency clinicians. A 56-year-old Japanese woman was referred to our hospital due to severe abdominal pain which presented as occasional epigastric pain five months before and intermittent abdominal pain. She had a past history of ileus twice, for both of which laparotomy was performed without an alimentary tract resection. The wall thickening with marked three-wall structure from terminal ileum to sigmoid colon was seen and bladder wall was irregularly thick and enhanced irregularly. Among the differential diagnosis of the acute abdomen, autoimmune diseases were suspected, especially lupus erythematosus and Henoch-Schönlein purpura. On the second day of admission, abdominal pain worsened. The results of examinations of antinuclear antibody, anti-double-stranded DNA antibody, ANCA, and the complements were not obtained at that time; however, we started 1-g steroid pulse treatment for three days with success. With the results obtained later, the patient was given a diagnosis of probable systemic lupus erythematosus (SLE. The present case shows that SLE can present with acute abdomen and should be included in the wide range of the differential diagnosis of acute abdomen.

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

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    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.

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

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    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 torsion of the noncommunicating rudimentary horn. The case of a patient referred for acute abdomen after distention of a noncommunicating rudimentary horn is presented herein.

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

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    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.

  3. Torsion theca lutein cyst in association with invasive mole presenting as acute abdomen: a rare case

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    Radhamani S.

    2015-08-01

    Full Text Available Gestational trophoblastic neoplasias (GTN are rare tumours that constitute less than 1% of all gynaecological malignancies. Invasive mole is a distinct subgroup of GTN, which if not diagnosed and treated early, can result in serious complications like uterine perforation and haemoperitoneum. We present a rare case of torsion theca lutein cyst in association with invasive mole of the uterus, which developed following the evacuation of a molar pregnancy with features of continued irregular vaginal bleeding, persistently high betaHcg levels along with acute abdomen. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1237-1240

  4. Ruptured Granulosa Cell Tumor of the Ovary as a Cause of Acute Abdomen in Postmenopausal Woman

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    Tufan Oge

    2012-01-01

    Full Text Available Acute abdomen with hemoperitoneum is a very rare entity in postmenopausal women due to gynecologic conditions. A 54-year-old, postmenopausal woman was brought to emergency department with severe abdominal pain. Physical examination revealed acute abdomen findings with 15 cm pelvic mass on the right adnexal region. Immediate exploratory laparotomy was performed. During laparotomy 1000 cc of bloodstained fluid, ruptured and actively bleeding large mass arising from right ovary was observed. Right salpingo-oopherectomy was performed in emergency conditions, and pathology report revealed an adult type of granulosa cell tumor. After this result, staging surgery was performed and patient was diagnosed as granulosa cell tumor stage 1 c. Cisplatin, etoposide, and bleomycin chemotherapy was given. Clinicians should be aware of granulosa cell tumors which may occur at any age and prone to rupture. Frozen section will be helpful in order to avoid incomplete surgeries especially in postmenopausal women presented with intra-abdominal bleeding.

  5. [Uncommon etiology of acute abdomen in pediatric age: the torsion of spleen].

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    Marinaccio, F; Caldarulo, E; Nobili, M; Magistro, D; Marinaccio, M

    2005-01-01

    The torsion of spleen on its vascular shank represents an uncommon problem, responsible of acute and chronic pain. The mobile spleen is fixed only through hilus vessels the gastrosplenic ligament. The incidence is unknow, greater in the male with an M:F ratio 6.1 in the first ten years of life, even if an episode of intrauterine torsion has been reported. The diagnosis can be performed with ultrasonography, angiography, scintigraphy and CT scan. There are reported two cases: male of 2.5 years female of 14 years who presented with recurrent pain to the left side, vomit diarrhoea and fever. Objectively a palpable mass was present. Ultrasonography and angio-CT scan of abdomen revealed splenomegaly, ptosis of the spleen and malrotation with signs of obstruction of the vessels. The treatment in both cases was splenectomy. The spleen appeared rotated on its shank and increased of volume, deprived of anatomical structures of fixation. The histological report confirmed the haemorrhagic infarction. The excessive mobility of the spleen, from insufficiency or absence of the ligamentous attachments is case of abdominal pain or acute abdomen, that can complicate with the infarction of the spleen. Angio-CT scan, in the cases here reported, has shown to greater sensibility in comparison to the ultrasonography. The Authors believe that the video-laparoscopic splenopexy, when the diagnosis is made of "wandering spleen" with painful repeated episodes, can be finalized, to the preservation of organ.

  6. Clinical dilemma of acute abdomen in patients with systemic lupuserythematosus: A case report

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    Ali Ghavidel

    2017-06-01

    Full Text Available Introduction: Gastrointestinal (GI symptoms and signs may be seen in approximately one third ofpatients with rheumatologic disorders as primary presentation. Some of these findings may benondiagnostic and may be clinical diagnostic challenge. GI tract involvement by systemic lupuserythematosus (SLE must be differentiated from adverse drug reactions of treatment agents.Abdominal pain, associated with nausea and vomiting, is seen in up to 30 percent of patients withSLE. The cause of abdominal pain does not differ significantly from that in patients without lupus.Special attention should be given to conditions that may accompany lupus such as lupus peritonitisand infection. Lupus peritonitis is very unusual clinical finding and it is worth reporting.Case Report: Our patient was a young female with definite rheumatologic disorders with acuteabdomen as the dominant clinical finding. Imaging findings confirmed peritoneum and smallintestine involvement. Paraclinical work-up including blood analysis confirmed SLE. She wasmanaged with prednisone and non-steroidal anti-inflammatory agents, and discharged withpartial improvement.Conclusion: This case report shows that patients with symptoms consistent with acute abdomen inSLE remind us a clinical dilemma. There have been few reports of acute abdomen in patients withSLE in the literature. And more case reports are needed.

  7. A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen.

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    Nickalls, Oliver James; Tan, Char Loo; Thian, Yee Liang

    2015-12-01

    The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author's knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before.

  8. A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen

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    Nickalls, Oliver James; Tan, Char Loo; Thian, Yee Liang

    2015-01-01

    The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author’s knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before. PMID:27200173

  9. A STUDY OF POST-SURGICAL COMPLICATIONS IN ACUTE ABDOMEN CONDITIONS

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    Bhooma Reddy Muthyala

    2016-09-01

    Full Text Available BACKGROUND The most common causes of the acute abdomen are acute appendicitis which may be perforated, typhoid ileal perforation, acute intestinal obstruction, gastroduodenal perforations, nonspecific abdominal pain, abdominal injuries, and acute cholecystitis. A summary of all the acute complications taken together will be the fact that all are associated with post-surgical complications. A sincere effort has been made to study the post-operative complications that a surgeon encounters while treating the acute abdomen cases. This study is intended to help the practising surgeons who deal with such complications. It also is intended to help the doctors who practice to identify such complications and thus refer the patients for immediate intervention. METHODS This study was conducted in the Department of General Surgery, Government Medical College, Nizamabad, Telangana. This study was done from June 2013 to May 2016. One hundred sixty patients who were admitted in the hospital after surgery for acute abdominal conditions were considered for the study. Thorough clinical examination was conducted and the complications that were encountered were noted and the complications were treated as per the need of the hour. The complications faced by the treating surgeon in each and every entity that was discussed earlier was duly noted and statistical analysis was conducted. All the statistical analysis was done using the latest SPSS software 2015 (California. RESULT In our study, the mean age of the study population was found to be 29.8 years. That means the majority of the patients who turn up in the Department of Emergency is young and generally in the third decade of life. In Acute Intestinal Obstruction and blunt abdominal injuries, significance of mortality is high (p<0.05. CONCLUSION The study was successful in proving that abdominal injuries are the main factors of causing morbidity and mortality in the younger generation. The surgical mode of

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

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    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.

  11. Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

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    Arkadopoulos Nikolaos

    2011-12-01

    Full Text Available Abstract Background Ovarian vein thrombosis (OVT is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.

  12. Inflammatory myofibroblastic tumor presenting as acute abdomen: report of one case.

    Science.gov (United States)

    Wen, Hsiu-Huei; Cheng, Kui-Lin; Hung, Yau-Kan; Chang, Pei-Yeh

    2007-01-01

    Inflammatory myofibroblastic tumor (IMT) is a very rare benign tumor composed of myofibroblastic spindle cells of uncertain etiology, which can occur at any age and affect any organ system. More and more cases of IMT in children have been described in pediatric literature in recent years. However, this tumor occurring intraabdominally in children has rarely been reported in Taiwan. Here we present a 1-year-9-month-old boy who had fever and abdominal pain only for 2 days, symptoms mimicking acute abdomen. After imaging study, a huge tumor nearly 10 cm in diameter was incidentally found over the right abdomen with unknown origin and nature. After surgical removal of the tumor, IMT was confirmed by the pathological findings. It is very difficult to make an accurate preoperative diagnosis on this tumor according to past experience, so the role of pathological diagnosis with immunohistochemical study becomes important. This case illustrates that IMT should be considered as a possible cause of intra-abdominal mass in children who have fever of unknown origin.

  13. A Rare Cause of Acute Abdomen: Perforation of Double Meckel’s Diverticulum

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    İlhan Tas

    2015-01-01

    Full Text Available Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. In this report, we aimed to represent a case of intestinal perforation, caused by double Meckel’s diverticulum, which is a very rare entity in surgical practice. The patient was a 20-year-old Caucasian man, admitted to hospital with complaints of abdominal pain, nausea, and vomitting during the last 3 days. Physical examination indicated tenderness, rebound, and guarding in the right lower quadrant of abdomen. Abdominal X-ray revealed a few air-liquid levels in the left upper quadrant. In the operation, 2 Meckel’s diverticula were observed, one at the antimesenteric side, at 70 cm distance to the ileocecal valve, approximately in 3 cm size, and the other between the mesenteric and antimesenteric sides, approximately in 5 cm size. The first one had been perforated at the tip and wrapped with omentum. A 30 cm ileal resection, including both diverticula with end-to-end anastomosis, was performed. The diagnosis of symptomatic Meckel’s diverticulum is considerably hard, especially when it is complicated. Diverticulectomy or segmentary resections are therapeutic options. In patients with acute abdomen clinic, Meckel’s diverticulum and its complications should be kept in mind, and the intestines should be observed for an extra diverticulum for caution although it is a very rare condition.

  14. Torsion of a Giant Pedunculated Hemangioma of the Liver Presenting With Acute Abdomen: A Case Report

    Science.gov (United States)

    Darzi, Aliasghar; Taheri, Hassan; Kamali Ahangar, Sekineh; Mirzapour Shafiei, Alameh; Asghari, Yasser

    2016-01-01

    Introduction Hemangioma is the most common benign tumor of the liver. Most cases are asymptomatic and do not require treatment. A hemangioma can rarely be pedunculated; as a result, it may undergo torsion and infarction, which can make it symptomatic. Case Presentation We report the case of a 45-year-old woman with acute abdominal pain due to torsion of a giant pedunculated hepatic hemangioma around its vascular stalk. Conclusions Pedunculated hemangioma of the liver is an uncommon benign tumor, a rare differential diagnosis for a mass located in the upper abdomen. All incidentally detected pedunculated hemangiomas must be surgically managed, as these have a tendency to become torsioned, and there is also a risk of malignancy or rupture.

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

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    Fatma Turkan Ayan

    2013-09-01

    Full Text Available 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 laparotomy was performed because of diffuse intra-abdominal haemorrhage. A right-sided ectopic focus was recognized and excised, and dilatation - curettage was performed. Coclusion: Delay in diagnosing the condition can be fatal to both the mother and the intrauterine fetus. [J Contemp Med 2013; 3(3.000: 207-208

  16. Severe acute abdomen caused by symptomatic Meckel's diverticulum in three children with trisomy 18.

    Science.gov (United States)

    Hayashi, Anri; Kumada, Tomohiro; Furukawa, Oki; Nozaki, Fumihito; Hiejima, Ikuko; Shibata, Minoru; Kusunoki, Takashi; Fujii, Tatsuya

    2015-10-01

    Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the gastrointestinal tract and often presents a diagnostic challenge. Patients with trisomy 18 frequently have MD, but the poor prognosis and lack of consensus regarding management for neonates has meant that precise information on the clinical manifestations in infants and children with MD is lacking. We describe the cases of three children with trisomy 18 who developed symptomatic MD. Intussusception was diagnosed in Patient 1, intestinal volvulus in Patient 2, and gastrointestinal bleeding in Patient 3. All three patients underwent surgical treatment and only the Patient 1 died due to pulmonary hypertensive crisis. The other two patients experienced no further episodes of abdominal symptoms. In patients with trisomy 18, although consideration of postoperative complications and prognosis after surgical treatment is necessary, symptomatic MD should carry a high index of suspicion in patients presenting with acute abdomen.

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

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    Yasutaka Onoda

    2015-03-01

    Full Text Available 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.

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

    Science.gov (United States)

    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

  19. Diagnosis of acute surgical abdomen - The best diagnostic tool to reach a final diagnosiscin

    Institute of Scientific and Technical Information of China (English)

    Wong CS; Al-Ajami AK; Boshahri M; Naqvi SA

    2012-01-01

    Objective: To evaluate the best diagnostic tool (clinical, radiological, laboratory, or endoscopy) used to reach a final diagnosis of four most common presentations of acute abdomen to the surgical unit in the Limerick University Hospital, Limerick, Ireland. Methods: Data was analyzed retrospectively of prospective collected data of all patients who had been admitted at a single academic institution from July 2011 till September 2011. Radiology, operating theatre and histopathology, haematology and endoscopy databases were searched from the Hospital Inpatient Enquiry (HIPE) department for patients who had presented with acute abdominal pain. Patients’ charts were searched manually and final diagnosis of each patient was recorded. Results: Out of 30 confirmed final diagnosis of appendicitis or appendicular mass, 9/30 (30.0%) were diagnosed with radiological (either on ultrasonography or CT scan). The remaining 21 cases (70.0%) were diagnosed clinically. Majority cases of diverticulitis 16/22 (72.7%) was diagnosed radiologically compared to only 6/22 (27.3%) of those confirmed by endoscopy. All diagnosis of gallstone-related diseases (cholecytitis, biliary colic, or cholelithiasis and/or choledocholithiasis) and bowel obstruction were confirmed by radiological investigation. Conclusions: Appendicitis can be accurately diagnosed clinically based on history and clinical examination alone. Diagnosis of diverticular disease, gallstone disease, and bowel obstruction further requires radiology intervention to confirm the provisional diagnosis.

  20. INTRA-ABDOMINAL INFECTION AND ACUTE ABDOMEN-EPIDEMIOLOGY, DIAGNOSIS AND GENERAL PRINCIPLES OF SURGICAL MANAGEMENT

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    Jovanović Dušan

    2015-03-01

    Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.

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

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    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.

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

    Science.gov (United States)

    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.

  3. Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients.

    Science.gov (United States)

    Fernandes, Bianca Furlan; Moraes, Érika Neves de Souza; de Oliveira, Francini Rossetto; Benevides, Gabriel Núncio; Felipe-Silva, Aloísio; Ferreira, Cristiane Rúbia; de Alcântara, Paulo Sérgio Martins; Tokeshi, Flavio; Martinês, João Augusto Dos Santos; Ferronato, Ângela Espósito

    2015-01-01

    Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman's colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients.

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

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    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. Ileum perforation due to accidental chicken bone ingestion a rare cause of the acute abdomen

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    Doklestić Krstina S.

    2012-03-01

    Full Text Available Ingestion of foreign bodies is not an uncommon occurrence, but most of them will pass through the gastrointestinal tract without consequences. Complication such as perforation is rare. We present a case of small bowel perforation secondary to the accidental ingestion of a chicken bone. The patient presented with abdominal pain, constipation and vomiting. Clinical examination confirmed generalized abdominal tenderness and rebound tenderness. Abdominal radiography showed multiple dilated loops of small bowel, and abdominal ultrasound (US showed inflammatory changes on small bowel loops, with free fluid and fluid collection around intestinal loops. The patient underwent an emergency laparotomy. Intra operative findings revealed diffuse fibro purulent peritonitis with abscess between central small bowels loops. At about 60 cm from Bauchini valve we found a perforation of ileum at the anti-mesenteric site caused by a sharp chicken wishbone. The patient was treated with resection of the ileum segment (10 cm and primary end-to-end anastomosis. Even that intestinal perforation by a foreign body is rare, physicians should consider possibility of intestinal perforation by a foreign body in the differential diagnosis of acute abdomen in patients presenting with abdominal pain.

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

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    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.

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

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

    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 com...

  8. Experience in Prehospital Emergency of Acute Abdomen%急腹症的院前急救体会

    Institute of Scientific and Technical Information of China (English)

    杨国成

    2015-01-01

    Objective:To explore the prehospital first-aid and effect of acute abdomen. Methods:78 cases of acute abdomen adopted prehospital emer-gency, and then sent to emergency room of hospital, observing the prognosis of patients. Results:75 patients were successfully rescued and cured, 3 patients died in the intensive care unit because of excessive hemorrhage. Conclusion:Timely and effective prehospital emergency measures can in-crease the successful rescue rate of acute abdomen, and improve the prognosis.%目的:探讨急腹症患者入院前的急救方法和效果。方法:78例急腹症患者进行院前急救后送医院急救室,观察患者预后。结果:75例患者抢救成功并治愈出院,3例患者在重症监护室抢救时因失血过多死亡。结论:及时有效的院前急救措施可提高急腹症患者的抢救成功率,改善其预后。

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

    Science.gov (United States)

    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 spontaneously perforated pyometra in our hospital’s general surgery department. Both underwent exploratory laparotomy: one had a total hysterectomy and bilateral salpingo-oophorectomy, while the other had an evacuation of the uterine cavity, primary repair of uterine perforation and a peritoneal washout. A literature search was conducted and all reported cases reviewed in order to describe the clinical presentations and management of the condition. Of the 40 cases to date, including 2 of our cases, the most common presenting symptoms were abdominal pain (97.5%), fever (37.5%) and vomiting (25.0%). The main indication for exploratory laparotomy was pneumoperitoneum (97.5%). Conclusions: Pyometra is an unusual but serious condition in elderly women presenting with an acute abdomen. A high index of suspicion is needed to make the appropriate diagnosis. PMID:23569488

  10. Abscess of urachal remnants presenting with acute abdomen: a case series

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    Tazi Fadl

    2012-07-01

    Full Text Available Abstract Introduction Urachal diseases are rare and may develop from a congenital anomaly in which a persistent or partial reopening of the fetal communication between the bladder and the umbilicus persists. The most frequently reported urachal anomalies in adults are infected urachal cyst and urachal carcinoma. The diagnosis of this entity is not always easy because of the rarity of these diseases and the atypical symptoms at presentation. Imaging techniques, such as ultrasonography and computed tomography have a significant role in recognizing the presence of urachus-derived lesions. Cases presentations Case presentation 1: A 25-year-old Arab-Berber man presented with a 10-day history of progressive lower abdominal pain accompanied by fever, vomiting, and low urinary tract symptoms to our emergency department. Laboratory data revealed leucocytosis. The diagnosis of an acute peritonitis was made initially. Abdominal ultrasonography revealed a hypoechoic tract from the umbilicus to the abdominal wall, and the diagnosis was rectified (infected urachal remnants. The patient was initially treated with intravenous antibiotics in combination with a percutaneous drainage. Afterwards an extraperitoneal excision of the urachal remnant including a cuff of bladder was performed. The histological analysis did not reveal a tumor of the urachal remnant. Follow-up examinations a few months later showed no abnormality. Case presentation 2: A 35-year-old Arab-Berber man, without prior medical history with one week of abdominal pain, nausea and vomiting, associated with fever but without lower urinary tract symptoms visited our emergency department. Laboratory data revealed leucocytosis. Abdominal ultrasonography was not conclusive. Computed tomography of the abdomen was the key to the investigation and the diagnosis of an abscess of urachal remnants was made. The patient underwent the same choice of medical-surgical treatment as previously described for case

  11. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Surgical acute abdomen in the elderly. Hospital Nacional Daniel Alcides Carrión - Callao - 1992-1996

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    Arrus Soldi, José; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    The aim of this descriptive and retrospective study was to assess the main causes leading to Surgical Acute Abdomen (S.A.A.) in the elderly, as well as their clinical manifestations and morbi-mortality. All individuals older than 60 years which were admitted with the diagnosis of S.A.A. and underwent surgery at the emergency room of the Hospital Nacional Daniel A. Carión (HNDAC) between january 1th, 1992 and december 31th, 1996, were considered. There were 317 cases of S.A.A. in elderly patie...

  13. RETROPERITONEAL NECROTIZING FASCIITIS WITH ADNEXITIS PRESENTING AS ACUTE ABDOMEN IN A 40 YEAR UNMARRIED FEMALE PATIENT: A CASE REPORT

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    Sribatsa Kumar

    2014-12-01

    Full Text Available Retroperitoneal Necrotizing Fasciitis is a rare variant of Necrotizing fasciitis (NF which is fulminant and potentially lethal. Although NF is a common occurrence in Indian Subcontinent due to low standard of living and poor hygiene Necrotizing fasciitis of retroperitoneum is extremely rare and only few cases have been reported till now. Herein we report a case of a 40yr unmarried female patient presenting to emergency department for acute abdomen and on exploratory laparotomy it was found out to be a case of extensive retroperitoneal necrotizing fasciitis with pregangrenous right ovary and adjacent fallopian tube.

  14. 急腹症中血管疾病的诊断与治疗%Diagnosis and treatment of vascular diseases in the acute abdomen

    Institute of Scientific and Technical Information of China (English)

    陆清声; 陈燕青

    2015-01-01

    Acute abdominal pain is a major clinical symptom of acute abdomen,and vasogenic acute abdomen caused by vascular diseases is rare and difficult to diagnose at its early stage with atypical clinical symptom and high mortality.Therefore,there is an urgent need to strengthen and improve the knowledge of surgeons about vasogenic acute abdomen.%急腹症是以急发腹痛为主要表现的常见外科疾病,而由血管疾病导致的急腹症,即血管源性急腹症却很少见.血管源性急腹症因其临床表现不典型,早期缺乏特异性体征而诊断困难.一旦发生,病情危重,病死率高.故临床医师亟须加强对该疾病的认识.

  15. Meckel’s Diverticulitis as a Cause of an Acute Abdomen in the Second Trimester of Pregnancy: Laparoscopic Management

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    Ivilina Pandeva

    2015-01-01

    Full Text Available Introduction. Meckel’s diverticulitis is an extremely rare cause of an acute abdomen in pregnancy. Its clinical presentation tends to be rather unusual and therefore commonly delaying diagnosis. The surgical method of exploration can be either by laparoscopy or through an open incision. Case Report. We report a case of a 34-year-old, P1 with previous Caesarean section, who presented at 20 weeks with worsening right-sided abdominal pain, distention, and peritonism. Ultrasound scan showed an area of a possibly thickened loop of bowel inconsistent with an appendicitis. The findings at laparoscopy were purulent fluid in the pelvis, a congested appendix, and inflamed Meckel’s diverticulum. An appendectomy and excision of the diverticulum was performed using stapler technique. Discussion. Meckel’s diverticulitis in pregnancy can have nonspecific presentation and poses difficulties for preoperative diagnosis. Delay in diagnosis and management poses significant maternal and fetal risks. The use of laparoscopy if the gestational age and uterine size permit its use allows a thorough exploration of the abdominal cavity and management of rarer and unexpected pathology. Laparoscopic management of acute abdomen in the midtrimester of pregnancy has been found to be safe and effective.

  16. Repeat acute abdomen and hemoperitoneum during the same pregnancy due to a ruptured ectopic treated by salpingostomy.

    Science.gov (United States)

    Canelas, Caroline M; Shih, Richard D; Clayton, Lisa M; Giroski, Laura J; Alter, Scott M; Feinstein, Stacey; Learman, Lee A

    2017-06-01

    A leading cause of maternal mortality in the first trimester is hemorrhage due to a ruptured ectopic pregnancy. With the advent of tube salvage surgery, ectopic pregnancies can be removed while ensuring hemostasis and preserving the integrity of the fallopian tube. A major drawback of tube salvage surgery is the significant risk of persistent trophoblastic tissue being left behind. We report a case of a 30year old female who presented to the ED with acute abdomen and hemoperitoneum due to a ruptured ectopic pregnancy. She was treated with salpingostomy and the pathologic report confirmed removal of the ectopic pregnancy. After an initially uneventful post-operative recovery, she presented to the ED 27days later with signs of acute abdomen and hemoperitoneum. Surgical intervention confirmed a ruptured ectopic pregnancy in the same site as previous, and salpingectomy was performed, after which the patient recovered without complications. The increased risk of persistent trophoblastic tissue associated with tube salvage surgery can lead to subsequent reoperation for tubal rupture. Patients undergoing these procedures should be closely monitored in the following weeks and undergo serial β-hCG testing in order to confirm successful removal of the ectopic. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  18. Acute Abdomen in the 17th Week of Twin Pregnancy due to Ovarian Torsion – A Late Complication of IVF

    Science.gov (United States)

    Habek, D.; Bauman, R.; Rukavina Kralj, L.; Hafner, T.; Turudic, T.; Vujisic, S.

    2016-01-01

    Background: A 32-year-old woman with tubal factor infertility due to bilateral laparoscopic salpingectomy conceived twins with in vitro fertilization (IVF). She developed moderate ovarian hyperstimulation syndrome which was treated with anticoagulant therapy. The subsequent course of the twin pregnancy was normal until the 17th week of gestation when she presented to hospital because of a sharp pain in the right lower abdomen which ceased after admission. Case: Except for a single incident of vomiting, patient had no other subjective symptoms. The clinical examination showed tenderness of the lower right abdominal segment on palpation. The surgeon and the urologist found no signs of an acute surgical or urologic condition, and laboratory findings were within normal reference ranges for pregnant women. Two days after admission the pain reappeared; it was now much stronger and colic-like. The pain was initially located supraumbilically but subsequently spread diffusely across the lower abdomen. Abdominal guarding was present and laboratory findings showed an increase in inflammatory parameters. An enlarged and edematous right ovary was found on transvaginal ultrasound. Conclusion: Exploratory laparotomy via a vertical midline abdominal transection revealed a torqued necrotic right ovary with elements of inflammation and inflammatory adhesions involving the entire pelvis. The patient underwent right-sided ovariectomy and adhesiolysis. Recovered was normal and the patient was delivered of healthy twins in the 37th week of gestation. PMID:28017976

  19. Diagnosis and treatment of acute abdomen and analysis of its misdiagnosis%急腹症的诊治和误诊分析

    Institute of Scientific and Technical Information of China (English)

    赵一奇; 郭桂刚; 焦峰; 王发恒

    2012-01-01

    目的:探讨急腹症的诊断、治疗及误诊情况.方法:回顾性分析我院2001-02-2010-02收治的1 629例急腹症患者的临床资料.结果:急腹症患者临床表现复杂、病情重、确诊困难,本组误诊36例,死亡21例,其中因误诊死亡9例.结论:急腹症的明确诊断,对于患者的预后具有十分重要的意义.%Objective:To study the diagnosis and treatment of acute abdomen, and to analyze its misdiagnosis. Method:The clinical data of 1 629 patients with acute abdomen admitted to our hospital between February 2001 and February 2010 were analyzed retrospectively. Result:The clinical manifestations of acute abdomen were complicated, the conditions were severe and the diagnoses were difficult in some cases. Among these cases, 36 were misdi-agnosed, and 21 died, in which 9 were due to misdiagnoses. Conclusion: Accurate diagnosis and management play an important role in the prognosis of patients with acute abdomen.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. 70岁以上老年人急腹症诊治对策%Strategies for diagnosis and treatment of acute abdomen in elderly patients

    Institute of Scientific and Technical Information of China (English)

    孙宏

    2012-01-01

    目的 总结70岁以上老年人急腹症早期诊断和治疗体会.方法 回顾性分析和总结芜湖市第五人民医院院普外科2000年1月~2011年7月收治82例70岁以上老年人急腹症临床资料.结果 70岁以上老年人急腹症,病情危重、合并症多、变化快,早期诊断困难;痊愈79例(96.3%),死亡3例(3.7%).结论 70岁以上老年人急腹症不是手术绝对禁忌证.早期诊断、早期手术、重视围手术期处理和积极预防并发症,是70岁以上老年人急腹症治疗的关键.%Objective To summarize the experience in early diagnosis and treatment of acute abdomen in elderly patients aged 70 years and over. Methods The clinical data of 82 cases of acute abdomen in elderly patients between January 2000 and July 2011 in surgery department of Wuhu Fifth People' s Hospital were analyzed retrospectively. Results The acute abdomen in elderly patients was serious, with much complications and faster change,so early diagnosis was difficult. 79 cases( 96. 3% ) were cured, and 3 cases( 3. 7% )died. Conclusion Acute abdomen is not contraindication for operation in elderly patients. Early diagnosis and operation, good perioperative management and prevention of postoperative complications are the key for acute abdomen in elderly patients.

  2. 超声检查对妇科急腹症的诊断价值%The Diagnostic Value of Ultrasonography in Gynecologic Acute Abdomen

    Institute of Scientific and Technical Information of China (English)

    孝文娜; 姜艳娜

    2015-01-01

    Objective: The value of ultrasonography in the diagnosis of gynecologic acute abdomen were discussed. Methods: 80 cases in our hospital gynecological acute abdomen patients as objects, implementing ultrasound for all patients for ultrasound imaging characteristics and to analyze the value of gynecologic acute abdomen. Results: 80 cases of gynecological acute abdomen types include acute pelvic inflammatory disease, ectopic pregnancy, ruptured corpus luteum and ovarian cyst torsion, ultrasonography were detected 73 patients, the diagnostic accuracy was 91.3%. Conclusion: Ultrasonography of the abdomen in patients with gynecological examination, diagnosis accuracy, safe and noninvasive, help clinicians diagnose and provide more evidence for the treatment, it is worth popularization and application.%目的:对超声检查对妇科急腹症的诊断价值进行探讨。方法选取我院收治的80例妇科急腹症患者为对象,对所有患者实施超声检查,对妇科急腹症的影像学特点以及超声检查价值进行分析。结果80例妇科急腹症的疾病类型主要包括急性盆腔炎、异位妊娠、黄体破裂以及卵巢囊肿蒂扭转,超声检查共检出73例患者,诊断准确率为91.3%。结论采用超声检查对妇科急腹症患者进行检查,诊断准确率高,安全无创,有利于临床医师的诊断,为治疗提供更多依据,值得普及和应用。

  3. Spontaneous large renal pelvis hematoma in ureteropelvic junction obstruction presenting as an acute abdomen: Rare case report.

    Science.gov (United States)

    Sawant, Ajit; Kasat, Gaurav; Pawar, Prakash; Tamhankar, Ashwin

    2016-01-01

    Patients with ureteropelvic junction (UPJ) obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64) in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48.4 ml/min with the relative function of 43%, Peak to half peak was not achieved. The patient was managed by retrograde ureteropyelography and double J stenting. After 1 month, clot size decreased to 4 cm × 3 cm × 2 cm. The patient had undergone open reduction Anderson hynes dismembered pyeloplasty with the removal of pelvis clot after 6 weeks. We report the first case of UPJ obstruction presenting as an acute abdomen and spontaneous hematuria with large pelvis clot without rupture of the renal pelvis.

  4. Spontaneous large renal pelvis hematoma in ureteropelvic junction obstruction presenting as an acute abdomen: Rare case report

    Directory of Open Access Journals (Sweden)

    Ajit Sawant

    2016-01-01

    Full Text Available Patients with ureteropelvic junction (UPJ obstruction can present with flank pain or hematuria. We present 20-year-old male presenting with acute pain in lumbar and right fossa with tenderness and guarding, this case was clinically mimicking general surgical emergency. On computed tomography with urography and angiography, there was 15 cm × 11 cm × 10 cm size non-enhancing hyperdense lesion (average Hounsfield units - +64 in right renal pelvis suggestive of hematoma. Patient's diethylenetriaminepentaacetic acid diuretic renography was suggestive of right kidney glomerular function rate of 48.4 ml/min with the relative function of 43%, Peak to half peak was not achieved. The patient was managed by retrograde ureteropyelography and double J stenting. After 1 month, clot size decreased to 4 cm × 3 cm × 2 cm. The patient had undergone open reduction Anderson hynes dismembered pyeloplasty with the removal of pelvis clot after 6 weeks. We report the first case of UPJ obstruction presenting as an acute abdomen and spontaneous hematuria with large pelvis clot without rupture of the renal pelvis.

  5. [Acute abdominal pain of the upper abdomen: which imaging to choose?].

    Science.gov (United States)

    Excoffier, S; Poletti, P-A; Brandstatter, H

    2013-09-25

    The aim of this article is to review the imaging modalities to be performed in patients with acute diffuse upper abdominal pain. Conventional radiography, ultrasound and computerized tomography (CT) are most often used in this setting. The choice of the initial imaging technique will depend from the localization of the pain and the probability of a particular pathology in the involved area.

  6. Perforated Jejunal Diverticula Secondary to a Large Faecolith: A Rare Cause of the Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Peter John Webster

    2014-01-01

    Full Text Available Jejunal diverticula are uncommon and usually asymptomatic. Very rarely, they can lead to acute complications such as bleeding, obstruction, and perforation. This report describes our experience of a case of jejunal diverticula perforation secondary to a large faecolith, with particular focus on the aetiology and management of this rare condition.

  7. Clinical characteristics and management stratege of acute abdomen in elderly patients%老年急腹症临床特点与治疗对策

    Institute of Scientific and Technical Information of China (English)

    孙宏

    2012-01-01

    Objective To investigate the clinical characteristics and management stratege of acute abdomen in elderly patients. Methods The clinical data of 375 cases of acute abdomen in elderly patients between January 2000 and March 2011 in surgery department of Wuhu the fifth people's hospital were analyzed retrospectively. Results The incidence of actue abdomen is high in elderly patients and with multiple complications. Early diagnosis is difficult,so misdiagnosis happening easily. 363 cases (96. 8% ) were cured, and 12 cases(3. 2% ) died. Conclusion Acute abdomen is not contraindication for operation in elderly patients. Early diagnosis,active preparation before operation,good clinical decision and prevention of postoperative complications are the key for acute abdomen in elderly patients.%目的 探讨老年急腹症的临床特点及治疗策略.方法 回顾性分析我院普外科2000年1月~2011年3月收治的375例老年急腹症临床资料.结果 老年急腹症发病率高,早期诊断困难,易发生误诊,且并发症多.治愈363例(96.8%),死亡12例(3.2%).结论 老年急腹症并不是手术的绝对禁忌.早期诊断,积极的术前准备,及时恰当的临床决策,预防并发症的发生是老年急腹症治疗的关键.

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

    Science.gov (United States)

    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 are not uncommonly encountered by the general surgeon. Moreover, good appreciation of pelvic anatomy and close collaboration with gynaecology colleagues is essential as operative intervention is often required. PMID:23131215

  9. A Case of Acute Budd-Chiari Syndrome Complicating Primary Antiphospholipid Syndrome Presenting as Acute Abdomen and Responding to Tight Anticoagulant Therapy

    Directory of Open Access Journals (Sweden)

    Naofumi Chinen

    2016-01-01

    Full Text Available A 34-year-old woman with primary antiphospholipid syndrome was admitted to the Gastroenterology Department of our hospital with fever, acute abdomen, watery diarrhea, and extremely high levels of inflammatory parameters. She had a history of left lower limb deep vein thrombosis and pulmonary embolism and was taking warfarin potassium. Acute gastroenteritis was suspected and an antibiotic was administered, but symptoms progressed. Abdominal ultrasonography showed occlusion of the left hepatic vein and the middle hepatic vein and her D-dimer level was high. Accordingly, Budd-Chiari syndrome was diagnosed and high-dose intravenous infusion of heparin was initiated. Her abdominal symptoms improved and the levels of inflammatory parameters and D-dimer decreased rapidly. It is known that antiphospholipid syndrome can be complicated by Budd-Chiari syndrome that usually occurs as subacute or chronic onset, but acute onset is rare. It is difficult to diagnose acute Budd-Chiari syndrome complicating antiphospholipid syndrome and this complication generally has a poor outcome. However, the present case can get early diagnosis and successful treatment with tight anticoagulant therapy.

  10. Clinical experience of diagnosis and treatment for 8 cases with acute abdomen caused by mesenteric vascular lesions

    Institute of Scientific and Technical Information of China (English)

    CHEN Qi-long; Hanipa; YE De-cun

    2002-01-01

    Objective: To recognize diagnostic factors of acute abdomen and investigate the control methods. Methods: A total of 8 patients caused by mesenteric vascular lesions were treated, followed up and analyzed on. Results: Six patients were operated on and confirmed pathologically; of two cases being superior mesenteric arterial embolism with abdominal aorta straddle and arterial embolism in both lower extremities (1 case died of whole bowel gangrene in 5 hours postoperatively, another one was recovered smoothly by resection of 60cm necrotic jejunum, removal of emboli in both iliofemoral artery, thrombolysis, and anticoagulatant therapy postoperatively); one patient with mesenteric artery thrombosis; of two cases with mesenteric venous thrombosis (1 case was removal of emboli and thrombolysis, anticoagulatant therapy postoperatively, another one was resection of 95% small intestine), one case with false aneurysm in superior mesenteric artery, resection of aneurysm and permutation of artificial blood vessel was performed successfully. The remained 2 cases with mesenteric vascular insufficiency were recovered by anticoagulatant and antispasmodic therapy. Seven cases cured. Conclusions: Mesenteric vascular diseases were relatively uncommon, symptoms and signs showed to be rather nonspecific, therefore, one should not merely rely on them for accurate diagnosis. Uhrasonography, CT are the sensitive examinations and benefit to diagnosis. Early interventions such as resecting bowel gangrene involved their mesentery and anticoagulant therapy may be essential to reduce the fatality and recurrence.

  11. Torsion of a Wandering Pelvic Spleen; Acute Abdomen in a Child

    Directory of Open Access Journals (Sweden)

    Metin GUNDUZ

    2012-06-01

    Full Text Available Wandering spleen is an uncommon clinical entity. Acute splenic torsion of wandering spleen is a potentially fatal surgical emergency case, and its correct and early identification continues to represent a challenge especially in children. A 11 years old girl was taken to the operative room for an explorative laparotomy due to abdominal pain, tenderness, and a midabdominal mass. Preoperative computerise tomography showed a torsion of an enlarged wandering pelvic spleen which was in a serious ischemic suffering due to a 720 degrees clock torsion around its exceptionally long pedicle. Splenectomy has been the treatment for symptomatic wandering spleen as in our case. [J Contemp Med 2012; 2(2.000: 115-117

  12. [Gallstone ileus as a cause of acute abdomen. Importance of early diagnosis for surgical treatment].

    Science.gov (United States)

    Martín-Pérez, Jesica; Delgado-Plasencia, Luciano; Bravo-Gutiérrez, Alberto; Burillo-Putze, Guillermo; Martínez-Riera, Antonio; Alarcó-Hernández, Antonio; Medina-Arana y, Vicente

    2013-10-01

    Gallstone ileus is an uncommon type of mechanical intestinal obstruction caused by an intraluminal gallstone, and preoperative diagnosis is difficult in the Emergency department. This study is a retrospective analysis of the clinical presentation of 5 patients with gallstone ileus treated between 2000-2010. Clinical features, diagnostic testing, and surgical treatment were analyzed. Five patients were included: 2 cases showed bowel obstruction; 2 patients presented a recurrent gallstone ileus with prior surgical intervention; and one patient presented acute peritonitis due to perforation of an ileal diverticula. In all cases CT confirmed the preoperative diagnosis. In our experience, gallstone ileus may present with clinical features other than intestinal obstruction. In suspicious cases CT may be useful to decrease diagnostic delay, which is associated with more complications.

  13. Application of Ultrasonography in Diagnosis of Acute Abdomen%超声在急腹症诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    闫研

    2011-01-01

    目的探讨超声在急腹症诊断中的应用价值.方法回顾性分析285例急腹症的超声表现,并与手术病理及临床随访结果进行对照.结果285例急腹症中以急性胆囊炎、胆石症、胰腺炎、阑尾炎、泌尿系结石、妇科急症常见.其中235例经手术和病理证实,50例经临床随访证实.超声符合率94%,%Objective To analyse the application of ultrasonography in diagnosis of acute abdomen. Methods 285 patients with acute abdomen were diagnosed by ultrasonograph.The ultrasonic diagnosis were compared with surgical pathology or clinical follow-up results.Results The incidence of acute cholecystitis, cholelithiasis, pancreatitis, appendicitis,urinary stones, gynecological emergency are higher than others in the 285 acute abdomen patients, of which 235 cases were confirmed by surgery and pathology, and 50 cases were confirmed by clinical diagnosis.The ultrasonic diagnosis results were consistent with the final clinical results(94%).

  14. 多层螺旋CT在急腹症诊断中的应用%Application of Multislice Spiral Computed Tomography in the Diagnosis of Acute Abdomen

    Institute of Scientific and Technical Information of China (English)

    付子文

    2016-01-01

    目的:探讨多层螺旋CT(MSCT)在急腹症诊断中的应用效果。方法分析237例于2012年6月~2014年5月间在本院疑诊急腹症患者的多层螺旋CT结果,与临床诊断结果进行比较,统计多层螺旋CT诊断急腹症的灵敏度、特异度、准确度、阳性预测值和阴性预测值。结果MSCT诊断的灵敏度为86.2%,特异度为67.6%,准确度为83.5%,阳性预测值为94%,阴性预测值为45.1%。结论MSCT诊断急腹症具有较高的灵敏度、准确度以及阳性预测值,能够实现对急腹症的快速成像,可为病因诊断提供有价值的参考信息,值得临床推广。%Objective To discuss the application effect of multi-slice spiral computed tomography (MSCT) in the diagnosis of acute abdomen. Methods 237 cases of patients with suspected acute abdomen were selected as research subjects in the hospital from June 2012 to May 2014. In comparison with clinical diagnosis, statistical analysis was made by results obtained by MSCT diagnosis in categories of acute abdomen sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results MSCT diagnostic sensitivity was 86.2%;diagnostic specificity was 67.6%and accuracy was 83.5%;positive predictive value was 94%and negative predictive value was 45.1%. Conclusion The use of MSCT in diagnosis of acute abdomen was characterized by high sensitivity, accuracy, and a high positive predictive value, which could realize rapid imaging of the abdomen, and provide valuable reference information for the diagnosis of the causes of acute abdomen. It was worthy of clinical promotion.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Ultrasonography in the Diagnosis of Acute Abdomen in the Value%超声检查在急腹症诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    杜喜莲

    2013-01-01

    Objective:To evaluate ultrasound in diagnosis of acute abdomen in the application.Method:268 cases of acute abdomen in patients with ultrasound and with surgical and pathological findings of non-surgical cases were followed up to observe the effect.Result:68 cases of gynecologic acute abdomen,acute appendicitis,67 cases,gallstones,cholecystitis,64 cases of traumatic rupture of internal organs in real terms in 40 cases,17 cases of acute pancreatitis,gastrointestinal perforation in 14 cases,6 cases of intussusception,ultrasound diagnostic accuracy rate was 97.0%,94.0%, 96.9%,90.0%,88.2%,85.7%,83.3%.Conclusion:Ultrasound diagnosis of acute abdomen with high accuracy,check the quick,convenient operation,can be used as routine examination of acute abdomen.%  目的:探讨超声检查在急腹症诊断中的应用价值.方法:对268例急腹症患者进行超声检查,并与手术及病理结果对照,对非手术的病例进行随访观察其疗效.结果:妇科急腹症68例,急性阑尾炎67例,胆结石、胆囊炎64例,外伤性实质脏器破裂40例,急性胰腺炎17例,胃肠穿孔14例,肠套叠6例,超声诊断准确率为97.0%、94.0%、96.9%、90.0%、88.2%、85.7%、83.3%.结论:超声检查对急腹症诊断准确率高,检查迅速,操作方便,可作为急腹症常规检查.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 腹腔镜在普外急腹症的临床应用%Clinical application of laparoscopy in acute abdomen of general surgery

    Institute of Scientific and Technical Information of China (English)

    丁爱民

    2013-01-01

    Objective To investigate the effect of the laparoscopic technology in the treatment of acute abdomen. Methods 86 acute abdomen patients were diagnosed and treated by the laparoscopic technology.Results 85 patients underwent the laparoscopic surgery successfuly, the success rate was 98.8%, 1 patient was converted to laparotomy, no serious complications occurred.Conclusion There are obviously advantage and effect for the application of the laparoscopic techbology in diagnosis and treatment of acute abdomen in general surgery.%  目的观察普外科急腹症采用腹腔镜手术治疗的效果.方法选择86例急腹症患者采用腹腔镜技术诊断和治疗.结果85例患者在腹腔镜下完成手术,成功率98.8%,1例中转开腹,无严重并发症.结论普外科急腹症采用腹腔镜技术探查、诊断及治疗有优势且效果好.

  19. 腹腔镜在妇科急腹症诊治中的应用%Application of laparoscopy in the diagnosis and treatment of gynecological acute abdomen

    Institute of Scientific and Technical Information of China (English)

    焦薇

    2012-01-01

    目的 探讨腹腔镜手术在妇科急腹症诊治中的应用价值.方法 回顾分析应用腹腔镜诊断和治疗妇科急腹症353例(A组)的临床资料,并与同期开腹手术297例(B组)比较,分析腹腔镜手术应用于妇科急腹症的应用价值.结果 A组353例顺利完成手术,包括异位妊娠286例,黄体破裂29例,巧克力囊肿破裂18例,卵巢囊肿蒂扭转12例,盆腔炎性疾病8例;中转开腹3例,未出现并发症.与B组比较,A组的手术时间短、术中出血量少、术后疼痛程度轻、肠道功能恢复早、住院时间短,无切口感染病例.结论 腹腔镜技术应用于妇科急腹症创伤小,在可明确诊断的同时,又能实施治疗.%Objective To investigate the role of laparoscopy in the diagnosis and treatment of gynecological acute abdomen. Methods Data of 353 patients (group A) with gynecological acute abdomen underwent laparoscopy were analyzed retrospectively. The results were compared to those in 297 patients (group B) with gynecological acute abdomen underwent open surgery. Results The diagnosis and surgery in group A were successfully performed, which included ectopic pregnancy in 286 cases,corpus luteum rupture in 29 cases,chocolate cyst burst in 18 cases,ovarian cyst Wendy turn in 12 cases,and pelvic inflammatory disease in 8 cases. Laparoscopy in group A had to be changed to open surgery in 3 cases. Compared to group B, laparoscopic surgery for gynecological acute abdomen had the advantages of shorter operation time, less blood loss and postoperative pain,early recovery of bowel function, and shorter hospital stay. Conclusion Compared to open operation, laparoscopic surgery for gynecological acute abdomen has minimal injury, and the diagnosis and surgery can be carried out simultaneously.

  20. Value of Spiral CT in Diagnosis of Causes of Acute Abdomen%螺旋CT在诊断急腹症病因中的价值

    Institute of Scientific and Technical Information of China (English)

    王波

    2016-01-01

    目的:探讨螺旋CT在诊断急腹症病因中的价值。方法整群选取回顾性分析2010年3月—2015年10月间共267例急腹症患者资料,226例行CT扫描,腹部平片检查191例,以临床治疗或手术结果作为诊断标准。结果在267例患者中,CT、腹部平片分别明确诊断急腹症病因213例、96例,正确诊断率分别为94.2%、50.2%,比较这两种方法差异有统计学意义(P<0.05)。结论螺旋CT可以作为诊断急腹症病因的首选检查方法,对临床治疗方法选择具有重要意义。%Objective To study the value of spiral CT in diagnosis of causes of acute abdomen. Methods The data of 267 cases of patients with acute abdomen from March 2010 to October 2015 were retrospectively analyzed, 226 cases underwent CT scanning, 191 cases underwent abdominal plain film examination, and the clinical treatment and operative results were used as the diagnostic standards. Results Of 267 cases of patients, the causes of acute abdomen of 213 cases were definite-ly diagnosed by CT, and the causes of acute abdomen of 96 cases were definitely diagnosed by abdominal plain film, the accurate diagnostic rates were respectively 94.2% and 50.2%, the difference had statistical significance by comparison(P<0.05). Conclusion Spiral CT can be used as the preferred examination method of diagnosis of causes of acute abdomen, which is of important significance to the choice of clinical treatment methods.

  1. Diagnosis and Management of Acute Abdomen in Primary Hospital%基层医院急腹症临床诊治体会

    Institute of Scientific and Technical Information of China (English)

    宋进军

    2015-01-01

    Objective:To improve the acute abdomen's treatment level of grass -roots medical professionals by comprehensive analysis to diagnose and treatment of common acute abdomen from primary hospital.Method:Retrospectively analyzed diagnose and treatment of patients with acute abdomen collected in the hospital in recent years.Results:By detailed analysis of clinical history from patients,and by taking both physical and laboratory examination to patients,as well as cooperation consultation with other departments,to make a definite diagnose in time,reduce the misdiagnosed,and win the best treatment time,alleviate the suffering of patients.Conclusion:Primary hospital should increase the acute abdomen cure rate,pay attention to detailed clinical history of patients and take reasonable check carefully,follow the treatment principles of acute abdomen in order to reduce the missed diagnosis and misdiagnosis.%目的:对基层医院常见急腹症的诊断与治疗进行综合分析,以提高基层医务人员对急腹症的救治水平。方法:对本院近几年内收治的急腹症患者的诊断、治疗进行回顾性分析研究。结果:通过对患者详尽病史分析、全面的体格检查及辅助检查,以及他科合作会诊,及时确诊,减少误诊,为患者赢得最佳治疗时间,减轻患者痛苦。结论:基层医院要提高急腹症救治率,必须重视对患者进行病史综合分析及认真仔细合理的检查,掌握急腹症的救治处理原则,才能减少的误诊、漏诊。

  2. 急腹症手术30例的麻醉处理%The Anesthesia Treatment of 30 Cases of Acute Abdomen Surgeries

    Institute of Scientific and Technical Information of China (English)

    于晓玲

    2014-01-01

    目的:探讨急腹症手术的麻醉处理。方法对2013年1月~2014年6月收治的急腹症手术患者30例,麻醉前准备,麻醉实施方法资料进行分析。结果所有急腹症患者经手术治疗均恢复良好,无麻醉并发症。结论根据急腹患者的具体情况,选择适合的麻醉方式进行操作,有效降低和避免手术中不良反应的发生,提高手术效果。%Objective The anesthesia treatment of abdomen surgeries to be investigated. Methods Analyzing the pre-anesthesia prepare work and anesthesia treatment data selected from 30 cases of patients with acute abdomen who are treated in hospital from January 2013 to June 2014.Results All of patients with acute abdomen have improved health state after surgery and no complications relapsed. Conclusion Choosing proper anesthesia way to cure patients based on their personal condition in order to reduce the side-effects of surgery and improve the surgical efficacy.

  3. Divertículo duodenal perforado como causa de abdomen agudo quirúrgico Perforated duodenal diverticulum as cause of surgical acute abdomen

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    Nizahel Estévez Álvarez

    2011-12-01

    Full Text Available La enfermedad diverticular duodenal es considerada en el ámbito de la cirugía de vías digestivas como inusual. Por su parte, la complicación menos frecuente referida en la literatura médica lo constituye la perforación aguda, y cuando esta ocurre siempre se practicará tratamiento quirúrgico de urgencia. Resulta polémico llegar a un consenso general que dirija la metodología diagnóstica, debido a su atípica forma de presentación. La tomografía abdominal ha resultado de gran utilidad en el diagnóstico de esta entidad. Se reportan tasas de mortalidad altas (25-30 % originadas, generalmente, por la dificultad diagnóstica frente a esta enfermedad. Se presenta un nuevo caso de divertículo duodenal perforado en una paciente, del sexo femenino, de 60 años de edad. La técnica quirúrgica empleada en esta oportunidad consistió en la exclusión duodenal y el drenaje del retroperitoneo.The duodenal diverticular disease is considered within surgery of digestive tracts as unusual. The less frequent complication referred in medical literature is the acute perforation and when it occurs always will be carried out the emergency surgical treatment. It is polemic to arrive to a general consensus directing the diagnostic methodology due to its atypical way of presentation. The abdominal tomography has been very useful in diagnosis of this entity. Authors report high mortality rates (25-30 % in general originated by the diagnostic difficulty in face of this disease. A new case of perforated duodenal diverticulum of a female sex patient aged 60. The surgical technique used in this opportunity was the duodenal exclusion and the retroperitoneal drainage.

  4. Abdomen abierto

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    Mario Sánchez Arias

    2000-06-01

    Full Text Available El manejo del paciente con condiciones abdominales que no se pueden resolver en una primera intervención, ha tenido una evolución progresiva desde inicios de siglo. Las intervenciones posibles van desde cerrarlos de inicio, hasta el manejo totalmente abierto, que permite reingresar al abdomen en forma repetida (incluso en la misma unidad de cuidado intensivo, de acuerdo a la condición del enfermo. Este tipo de manejo ha hecho que disminuya la mortalidad de estos pacientes de cifras tan altas como de 87% a 30% según la literatura. El objetivo de esta investigación fue evidenciar las indicaciones por las que se dejan los pacientes con abdomen abierto (AbAb, saber qué es lo que ocurre con un paciente a quién se trata de esta forma, que es lo que puede esperar un cirujano de su enfermo y como podemos mejorar nuestra práctica al respecto. De un total de 149 pacientes que se manejaron con AbAb en la Unidad de Cuidado Intermedio del Hospital Dr. R. A. Calderón Guardia entre los años 92-98, obtuvimos el expediente de 73 que cumplían todos los criterios a analizar. Los pacientes fueron de una edad promedio de 48 años (20-83. Un 65% de ellos fueron masculinos y el promedio de APACHE fue de 12.2 puntos al momento de dejarlos con AbAb. El diagnóstico más frecuente fue de sepsis abdominal y fuga anastomótica. Fueron manejados fundamentalmente con dos métodos (malla o bolsa plástica y tuvieron una mortalidad global de 35%. El promedio de cirugías fue de 4.2 operaciones por paciente, una estancia promedio en el hospital de 42 días, un manejo en cuidados intensivos de 24 días y un tiempo de abdomen abierto de 20 días. Los pacientes que fueron tratados por un solo cirujano tuvieron una mortalidad del 12.5% y los que fueron manejados por varios del 34%. Podemos concluir que este es un método válido en nuestro medio para tratar pacientes con esta clase de problemas abdominales, que de otro modo tendrían mortalidad de casi 100%, y se

  5. A rare case of perforated "sub-hepatic appendicitis" - a challenging differential diagnosis of acute abdomen based on the combination of appendicitis and maldescent of the caecum.

    Science.gov (United States)

    Chiapponi, Costanza; Jannasch, Olof; Petersen, Manuela; Lessel, Wiebke; Bruns, Christiane; Meyer, Frank

    2017-01-01

    Unusual locations of the appendix vermiformis can result in delay in appropriate diagnosis and treatment of appendicitis. So an inflamed appendix in a sub-hepatic caecum caused by caecal maldescent for example can mimic cholecystitis, the pain being localized in the right upper quadrant. Here, we present a case of perforated sub-hepatic appendicitis with peritonitis, requiring open ileocaecal resection. Review of the existing literature has demonstrated that this pathology is uncommon, yet not so rare as one might presume. In conclusion, surgeons should be aware of this possibility in the diagnostic and therapeutic management of acute abdomen. Copyright © 2016. Published by Elsevier GmbH.

  6. Abdomen abierto

    Directory of Open Access Journals (Sweden)

    Mario Sánchez Arias

    2000-06-01

    Full Text Available El manejo del paciente con condiciones abdominales que no se pueden resolver en una primera intervención, ha tenido una evolución progresiva desde inicios de siglo. Las intervenciones posibles van desde cerrarlos de inicio, hasta el manejo totalmente abierto, que permite reingresar al abdomen en forma repetida (incluso en la misma unidad de cuidado intensivo, de acuerdo a la condición del enfermo. Este tipo de manejo ha hecho que disminuya la mortalidad de estos pacientes de cifras tan altas como de 87% a 30% según la literatura. El objetivo de esta investigación fue evidenciar las indicaciones por las que se dejan los pacientes con abdomen abierto (AbAb, saber qué es lo que ocurre con un paciente a quién se trata de esta forma, que es lo que puede esperar un cirujano de su enfermo y como podemos mejorar nuestra práctica al respecto. De un total de 149 pacientes que se manejaron con AbAb en la Unidad de Cuidado Intermedio del Hospital Dr. R. A. Calderón Guardia entre los años 92-98, obtuvimos el expediente de 73 que cumplían todos los criterios a analizar. Los pacientes fueron de una edad promedio de 48 años (20-83. Un 65% de ellos fueron masculinos y el promedio de APACHE fue de 12.2 puntos al momento de dejarlos con AbAb. El diagnóstico más frecuente fue de sepsis abdominal y fuga anastomótica. Fueron manejados fundamentalmente con dos métodos (malla o bolsa plástica y tuvieron una mortalidad global de 35%. El promedio de cirugías fue de 4.2 operaciones por paciente, una estancia promedio en el hospital de 42 días, un manejo en cuidados intensivos de 24 días y un tiempo de abdomen abierto de 20 días. Los pacientes que fueron tratados por un solo cirujano tuvieron una mortalidad del 12.5% y los que fueron manejados por varios del 34%. Podemos concluir que este es un método válido en nuestro medio para tratar pacientes con esta clase de problemas abdominales, que de otro modo tendrían mortalidad de casi 100%, y se

  7. Point tenderness - abdomen

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003273.htm Point tenderness - abdomen To use the sharing features on this page, ... over a certain part of the belly area (abdomen). Considerations The abdomen is an area of the ...

  8. Clinical analysis of 749 cases with gynecological acute abdomen%妇科急腹症749例临床分析

    Institute of Scientific and Technical Information of China (English)

    杜洁; 徐英芳

    2013-01-01

    Objective To investigate the diagnosis,differential diagnosis and treatment of gynecological acute abdomen,and provide a basis for treatment.Methods The clinical data of 749 cases with gynecological acute abdomen in our hospital were retrospectively analyzed.Results The diagnostic accuracy was 100% of the preoperative uterine perforation,acute pelvic inflammatory disease,tubal ovarian abscess,ovarian cyst torsion and.ruptured ovarian cysts.19 cases with ovarian corpus luteum rupture were misdiagnosed for ectopic pregnancy,1 case with acute hemorrhagic salpingitis were misdiagnosed for ectopic pregnancy,1 case with IUD of ectopic pregnancy lead to pelvic abscess was misdiagnosed for ovarian cyst torsion secondary infection,the total misdiagnosis patients were 21 cases,and the misdiagnosis rate was 2.8%.217 cases with acute abdomen received the surgical treatment,532 cases were given non-surgical treatment.All patients were cured and discharged by the hospital treatment,the average hospitalization time was (8.2 ± 2.5) d.Conclusion In the diagnosis of gynecological acute abdomen,detailed ask the patients' medical history,symptoms,and comprehensive physical examination and collection of signs are important means.The understanding of acute hemorrhagic fallopian tubes,ovarian corpus luteum rupture and ovarian cyst torsion secondary infection should be further strengthened to reduce misdiagnosis rate.%目的 探讨妇科急腹症的诊断、鉴别诊断以及治疗经验,为临床治疗提供依据.方法 对在某院妇科治疗的749例经诊断为妇科急腹症患者的临床就诊资料进行回顾性分析.结果 术前子宫穿孔、急性盆腔炎、输卵管卵巢脓肿、卵巢囊肿蒂扭转、卵巢囊肿破裂的诊断正确率为100%;其中19例卵巢黄体破裂患者误诊为异位妊娠,1例急性出血性输卵管炎患者均被误诊为异位妊娠患者,1例宫内节育器异位妊娠患者导致盆腔脓肿被误诊为卵巢囊肿

  9. 彩色多普勒超声在妇科急腹症中应用价值%Application Value of Color Doppler Ultrasound in Gynecological Acute Abdomen

    Institute of Scientific and Technical Information of China (English)

    吴春山; 苏丹萍

    2013-01-01

    Objective:To explore ultrasound diagnosis value in gynecologic acute abdomen. Methods :The application of ultrasonic diagnosis for gynecological acute abdomen in 157 cases were confirmed by clinical operation. Results:color Dopper flow ima ultrasonic accuracy rate was 94%.Conclusion:Color Doppler ultrasonic diagnostic occupies an important position in the gynecological acute abdomen.%  目的:探讨彩色多普勒超声在妇科急腹症的诊断价值,方法:应用超声对157例妇科急腹症进行诊断并经临床治疗或手术证实;结果:彩色多普勒超声诊断正确率为94%。结论:彩色多普勒超声诊断在妇科急腹症中占重要地位。

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

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    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.

  11. Treatment of a case of emphysematous pyelonephritis that presented with acute abdomen and pneumoperitoneum: a case report.

    Science.gov (United States)

    Park, Sang Hyun; Kim, Ki Hoon

    2015-08-01

    Emphysematous pyelonephritis is a severe, life-threatening infection of the renal parenchyma and perinephric tissues. This condition is primarily encountered in patients with diabetes mellitus or ureteral obstruction, and is characterized by the production of intrarenal and perinephric gas. Emphysematous pyelonephritis is associated with a high degree of morbidity and a high mortality rate. A 72-year-old woman with a history of diabetes mellitus, hypertension, and renal calculi was referred to our emergency department following 6 days of abdominal pain. She suddenly developed pain in the entire abdomen, and was transferred. Physical examination was a distended abdomen with hypoactive bowel sounds. The tenderness was diffuse, but was most prominent in the right upper abdominal quadrant; moreover, rebound tenderness was noted. Laboratory tests revealed a white blood cell count of 4,480/mm(3), platelet count of 17,000/mm(3), creatinine level of 1.64 mg/dl, and serum glucose level of 603 mg/dl. Abdominal computed tomography indicated the presence of free air in the intraperitoneal cavity and right perirenal space, hydronephrosis of the right kidney, and stones in the right distal ureter. After 1 hour, the vital signs changed and she appeared to become drowsy. Therefore, the patient was transferred to the operation room for laparotomy. On exploration of the abdomen, 1.5 L of pus-colored fluid was removed. Although the abdominal viscera and pelvic organs were examined, hollow viscus perforation site could not be observed. Moreover, tissue necrosis and a perforation site were identified at the superior border of the right kidney. Thus, emphysematous pyelonephritis was diagnosed and she underwent right radical nephrectomy. After the surgery, the patient was admitted to the intensive care unit for postoperative management. Follow-up CT performed after 10 days showed fluid collection and hematoma at the nephrectomy site. Hence, percutaneous drainage was performed. Another

  12. Application Value of Ultrasound in the Diagnosis of Gynecological Acute Abdomen%探讨超声在妇产科急腹症临床诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    孟秋霞; 腾晓亮; 石杨

    2015-01-01

    Objective To explore the abdomen combined transvaginal ultrasound in obstetrics and gynecology application value in clinical diagnosis of acute abdominal pain, aims to improve the diagnosis of gynecological acute abdomen. Methods Using the abdominal combined transvaginal ultrasound in our hospital 132 cases of patients with gynecological acute abdomen ultrasound, record the patient's operation or pathology results, with pathologic results as the"gold standard", compare the dif erences and ultrasound results. Results 132 patients with gynecological acute abdomen in 122 patients were of two kinds of results, accuracy of 92.42%. Conclusion The abdomen combined transvaginal ultrasound can fast accurate diagnosis of gynecological acute abdomen, is worth promoting.%目的:探讨经腹部联合经阴道超声在妇产科急腹症临床诊断中的应用价值,旨在提高妇产科急腹症的诊断率。方法运用腹部联合经阴道超声对我院132例妇产科急腹症患者行超声检查,记录患者的手术或者病理结果,以病理结果为“金标准”,比较其与超声结果的差异。结果本组132例妇产科急腹症患者中122例患者的两种结果相符合,准确率达92.42%。结论经腹部联合经阴道超声能快速准确诊断妇产科急腹症,值得推广。

  13. Constitution and clinical characteristic analysis of adult non-traumatic acute abdomen disease%成年人非外伤性急腹症病种构成及临床特点分析

    Institute of Scientific and Technical Information of China (English)

    吴鹏程; 郑焕城; 陆品端

    2013-01-01

    Objective To explore constitution and the clinical features of adult non - traumatic acute abdomen disease, for purpose of providing reference for diagnosis and treatment about acute abdomen. Methods Totally 17 082 cases of a-dult non traumatic acute abdomen patients from June 1, 2011 to May 31, 2012 were collected by a retrospective analysis at emergency department of our hospital. According to the age, 17082 cases were divided into young group, middle age group, the older group, according to subject,the cases were divided into surgery acute abdomen, internal medicine acute abdomen and gynecology acute abdomen, According to the primary site of pain and disease relations respectively,the cases numbers were added up. Results The occurrence probability of young group, middle age group, the older group were 70. 17% , 21. 82% , 8% ; occurrence probability of internal medicine, surgery, gynecology acute abdomen were 72.46% , 22. 15% , 5. 39% ; research shows that every primary position of pain have relative diseases, the misdiagnosed rate of non traumatic acute abdomen was 0. 88% . Conclusions Adult non traumatic acute abdomen diseases are varied, different a-ges, different subjects, different positions of non traumatic acute abdomen in adult have different diseases, Clinicians need to grasp the characteristics of non traumatic acute abdomen in order to reduce the misdiagnosis and mistreatment.%目的 探讨成人非外伤性急腹症的病种构成及临床特点,为急腹症的诊断和治疗提供参考依据,降低误诊、漏诊的发生率,以减少医疗纠纷.方法 回顾性分析2011年6月1日至2012年5月31日17 082例成年人非外伤性急腹症患者的病例资料.按照年龄分为青年组、中年组、老年组;按学科划分为外科急腹症、内科急腹症、妇科急腹症,按初发疼痛部位与原发病对应关系分别统计例数.结果 青年、中年、老年发病分别为69.74%、22.29%、7.96%;内科、外科、妇产

  14. 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

    Directory of Open Access Journals (Sweden)

    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.

  15. Acute abdomen caused by bladder rupture attributable to neurogenic bladder dysfunction following a stroke: a case report

    Directory of Open Access Journals (Sweden)

    Court Fiona

    2011-06-01

    Full Text Available Abstract Introduction Spontaneous bladder rupture is a rare and serious event with high mortality. It is not often considered in the patient presenting with peritonitis. This often leads to delays in diagnosis. There are very few case reports of true spontaneous rupture in the literature. This is the first such reported case in which bladder rupture was attributable to neurogenic bladder dysfunction following a stroke. Case presentation We report the case of a 67-year-old Caucasian man who presented with lower abdominal pain and a peritonitic abdomen. He had a long-term urethral catheter because of urinary retention following a previous stroke. He was treated conservatively with antibiotics before a surgical opinion was sought. Exploratory laparotomy confirmed the diagnosis of spontaneous bladder rupture. After repair of the defect, he eventually made a full recovery. Conclusion In this unusual case report, we describe an example of a serious event in which delays in diagnosis may lead to increased morbidity and mortality. To date, no unifying theory explaining why rupture occurs has been postulated. We conducted a thorough literature search to examine the etiological factors in other published cases. These etiological factors either increase intra-vesical pressure or decrease the strength of the bladder wall. We hope that by increasing awareness of these etiological factors, spontaneous bladder rupture may be diagnosed earlier and appropriate therapy started.

  16. Abscess - abdomen or pelvis

    Science.gov (United States)

    ... infected fluid and pus located inside the belly (abdominal cavity). This type of abscess can be located near ... abdominal abscesses: Abdominal x-ray Ultrasound of the abdomen and pelvis CT scan of the abdomen and ...

  17. Basic idea of diagnosis and differential diagnosis of acute abdomen%浅谈外科急腹症诊断和鉴别诊断的基本思路

    Institute of Scientific and Technical Information of China (English)

    陈百励

    2014-01-01

    目的:深入探究外科急腹症的最优诊断和鉴别诊断方式。方法对2011年2月~2013年2月之间参与的132例外科急腹症患者的诊断和鉴别进行回顾性分析。结果132例外科急腹症通过诊断鉴别后,采取保守治疗84例,手术治疗48例,其中2例患者经保守治疗无效后进行手术治疗,最终痊愈131例,死亡1例。结论实施各种有效的辅助检查手段,对急腹症的临床特点进行分析总结,再加上采用合适的检测方式对于急腹症患者的正确诊断和有效治疗具有重大的临床意义。%Objective To delve into the best way of diagnosis and differential diagnosis of acute abdomen. Methods The differential diagnosis between participating from February 2011 to February 2013 132 Surgical patients with acute abdomen were retrospectively analyzed. Results 132 cases of surgical acute abdomen through the differential diagnosis, conservative treatment in 84 cases, 48 cases of surgical treatment, some patients after conservative treatment for surgical treatment, and ultimately cured 131cases, 1 deaths. Conclusion The implementation of a variety of effective means of laboratory examinations, clinical features of acute abdomen were analyzed and summarized, together with the use of appropriate testing methods for accurate diagnosis and effective treatment of acute abdomen in patients with significant clinical significance.

  18. The types and related conditions analysis of 637 cases of gynecological acute abdomen%妇科急腹症637例类型及相关情况分析

    Institute of Scientific and Technical Information of China (English)

    周雪梅; 吴羽; 廖芸

    2015-01-01

    ObjectiveTo investigate the types and related conditions change of gynecological acute abdomen in nearly 10 years.Methods637 cases of gynecologic acute abdomen during the years of 2004 to 2013 were retrospectively analyzed. ResultsBetween different period group,the age of gynecological acute abdomen patients,the proportion of unmarried women and the ratio of patients with uterine cavity operation history or inflammatory disease history was statistically significant(P0.05).ConclusionThe incidence of gynecologic acute abdomen rate decreases, however,the trend of incidence age of patients gradually gets younger,and the proportion of inflammatory disease leaded acute abdomen is rising year by year.%目的:探讨妇科急腹症的类型及相关情况变化。方法对2004年—2013年期间我院收治的637例妇科急腹症患者的临床资料进行回顾性分析。结果妇科急腹症患者年龄、患者中未婚女性比例以及有宫腔操作史或者炎性疾病史的比例在不同时间段组间比较差异均有统计学意义(P0.05)。结论妇科急腹症的发病率呈下降趋势,但是发病年龄有年轻化趋势,炎性疾病导致的急腹症比例正在逐年上升。

  19. Ultrasound: Abdomen (For Parents)

    Science.gov (United States)

    ... for TV, Video Games, and the Internet Ultrasound: Abdomen KidsHealth > For Parents > Ultrasound: Abdomen Print A A A What's in this article? ... Child If You Have Questions en español Ultrasonido: abdomen What It Is An abdominal ultrasound is a ...

  20. Ultrasound: Abdomen (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Ultrasound: Abdomen KidsHealth > For Parents > Ultrasound: Abdomen A A A What's in this article? ... español Ultrasonido: abdomen What It Is An abdominal ultrasound is a safe and painless test that uses ...

  1. The Use of ~(99m)Tc-Scanning in Children with Acute Abdomen%~(99m)锝在小儿急腹症的选择应用

    Institute of Scientific and Technical Information of China (English)

    刘唐彬; 李伟龙; 李穗生; 莫家骢

    1988-01-01

    ~(99m)Tc-scanning is used extensively in the examination of the thyroid gland,salivary glands and stomach. The affinity of this isotope to the parietal cells of the gastric mucosa makes it useful in detecting the ectoic gastric mucosa.~(99m)Te has a half-life period of only six hours and is used in blood pool studies.Seven children with acute abdomen were examined with ~(99m)Tc-scanning,5 of them were positive,Discussed in the article are: (1) the general indication;(2)its use in acute gastrointestinal bleeding;(3)the diagnosis of Meckel's diverticulum and (4)the screening study of recurrent vomiting and abdominal pain.%文章利用~(99m)锝半衰期短,主要经胃粘膜壁细胞排泄,及可作为血池显像剂特点,对7例急腹症小儿进行筛选检查,核素诊断阳性者5例.指出~(99m)锝腹部扫描,不仅有助于美克耳氏憩室出血的诊断,也可作为鉴别消化道出血的一个方法,对反复腹痛、呕吐患儿的病因筛选检查研究具有一定的临床价值.

  2. MDCT of the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    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

  3. Ultrasound in Cyesis with Acute Abdomen%妊娠合并急腹症的超声诊断-附686例临床病例分析

    Institute of Scientific and Technical Information of China (English)

    施冬梅; 靳元

    2011-01-01

    Objective: To evaluate the clinical application value of ultrasound in cyesis with acute abdomen.Methods: We summarized the character of sonogram in cyesis with acute abdomen, the clinical data were retrospectively analyzed in 686 cases of cyesis with acute abdomen.Results: The overall diagnosis accordance rates reached 100%(43/43) for incomplete abortion and inevitable abortion,hysteromyoma intortion, hysteromyoma red degeneration, placental abruption, urinary system calculus, acute cholecystitis and gallstone,acute gastroenteritis, acute ileus while those of ectopic pregnancy;acute appendicitis,ovarian cyst and acute pancreatitis pediculotorsion reached 87.2%(184/211), 84.2%(16/19); 90.0%(9/10) and 66.7%(2/3), respectively.Conclusion: Ultrasound could be adopted as the first choice of all therapeutic tools in cyesis with acute abdomen as it can provide the reliability evidence of early diagnosis for clinic.%目的:评价超声在诊断妊娠合并急腹症中的临床应用价值.方法:回顾分析686例妊娠合并急腹症患者的临床资料,总结妊娠合并急腹症超声图像特征.结果:超声诊断符合率为:异住妊娠87.2%(184/211),急性阑尾炎84.2%(32/39),卵巢囊肿蒂扭转90.0%(27/30),急性胰腺炎66.7%(6/9),不全流产及难免流产、子宫肌瘤扭转、子宫肌瘤红色变性、胎盘早剥、泌尿系结石、急性胆囊炎和胆结石、急性胃肠炎、急性肠梗阻的诊断率为100%(43/43).结论:超声可以作为妊娠合并急腹症首选的检查手段,为临床早期诊断及治疗提供可靠依据.

  4. 80岁以上患者外科急腹症的诊治特点%Characteristics in elderly patients over 80 years old with acute abdomen

    Institute of Scientific and Technical Information of China (English)

    郑亚民; 曹锋; 刘强; 刘东斌; 王悦华; 刘家峰; 李非

    2011-01-01

    目的 分析≥80岁外科急腹症住院患者的诊治特点.方法 将2002年1月1日至2009年12月31日外科急腹症入院治疗的5426例患者按年龄分为≥80岁组和<80岁组.观察≥80岁急腹症患者人数、所占比例、病种分布、伴发疾病等特点;统计分析手术比率、治疗效果、病死率、住院时间和住院花费.结果我院8年来纳入患者5426例,≥80岁患者420例,数量和所占百分比总体呈逐年增加趋势.患者从症状发作到就诊时间差2 h至21 d不等.常伴发多种疾病,以呼吸和心血管系统疾病居多.≥80岁组与<80岁组比较,急诊手术率下降(48.09% 比 64.19%,P<0.01),病死率增加(3.33% 比 1.38%,P<0.01),住院时间延长[(16.76±11.49)d 比 (14.50±16.08)d,P<0.01)],人均住院花费增加[(23 733.11±30 571.75)元比(18 530.83±29 637.46)元,P<0.01)].结论 根据≥80岁患者的发病特点制定个体化诊治方案;在制定卫生经济学政策和医疗保险制度时,注意考虑年龄对住院患者病死率、住院时间和治疗费用的影响.%Objective To evaluate the characteristics of diagnosis and treatment in elderly patients over 80 years old with acute abdomen. Methods 5426 elderly patients with acute abdomen were enrolled from January 1,2002 to December 31, 2009 in our hospital and were divided into two groups according age: one group with patients ≥ 80 years old(420 cases) and another group < 80 years old( 5006 cases). Data were analyzed include operability rate, mortality, lenght of stay and admission fee. Results More and more aged patients were treated in hospital. They went to hospital in from 2 h to 21 d after unfitness. They often have several complications including respiratory, cardiovascular system diseases. Compared with < 80 group, operability rate was lower (48.09% vs 64. 19%, P < 0. 01 ), mortality was higher ( 3.33% vs 1.38% ,P <0. 01 ) ,mean hospital length of stay was longer ( 16.76 ± 11.49 d vs 14. 50

  5. 182例急腹症的误诊原因分析与对策%Analysis of the Misdiagnose on 182 Cases Acute Abdomen and the Countermeasures

    Institute of Scientific and Technical Information of China (English)

    张国锦

    2016-01-01

    Objective In order to take preventive measures promptly against acute abdomen misdiagnose, the reasons of that on clinical cases were analyzed.Methods Retrospective analysis of the 182 cases of acute abdomen misdiagnosed by each hospitals in Xiangcheng and some of its’ township health hospitals, which happened during the years 2006-2012.Results 56 cases of them were appendicitis misdiagnosed, 27 cases were gastrointestinal perforation misdiagnosed, 14 cases were cholecystitis misdiagnosed, 6 cases were obstructive suppurative cholangitis misdiagnosed, 8 cases were liver abscess misdiagnosed, 3 cases were diaphragmatocele misdiagnosed, 4 cases were meckel diverticulitis misdiagnosed, 7 cases were torsion of the pedicle of ovarian cyst misdiagnosed, 29 cases were ectopic pregnancy misdiagnosed, 6 cases were pancreatitis misdiagnosed, 2 cases were colon cancer misdiagnosed, 12 cases were intestinal obstruction misdiagnosed, and 8 cases were Primary peritonitis misdiagnosed.Conclusion The misdiagnoses were caused by the accurate medical history collection, uncareful physical examination, believing too much in medical examination, being unfamiliar with the basic knowledge, the imperfect medical hardware facilities, the junior doctors lacking in experience, the incomprehensive analysis of patients’s condition is, and the specialist narrowing in knowledge.%目的:对临床工作中急腹症误诊的原因进行分析,及时采取防治措施,尽量减少误诊的发生。方法回顾性分析项城市级各医院及部分乡镇卫生院2006年~2012年发生的182例急腹症误诊的原因。结果阑尾炎误诊56例,消化道穿孔误诊27例,胆囊炎误诊14例,急性梗阻化脓性胆管炎误诊6例,肝脓肿误诊8例,膈疝误诊3例,麦克尔憩室炎误诊4例,卵巢囊肿蒂扭转误诊7例,异位妊娠误诊29例,胰腺炎误诊6例,结肠癌误诊2例,肠梗阻误诊12例,原发性腹膜炎误诊8例。结论病史采集不

  6. Clinical value of laparoscopy in the diagnosis and treatment of gynecological acute abdomen%腹腔镜对妇科急腹症的诊疗价值

    Institute of Scientific and Technical Information of China (English)

    覃睿

    2015-01-01

    Objective To investigate the clinical value of laparoscopy in the diagnosis and treatment of gynecological acute abdomen.Methods Data of 152 cases with acute abdomen in Guangxi Zhuang Autonomous Region National Hospital during March 2011 to March 2013 were retrospectively analyzed .76 cases with laparoscopic surgery were selected into observe group , 76 cases under laparotomy operation were selected into control group .The success rate of surgery patients , surgical index , and surgical complications and postoperative pain VAS pain scores recorded recovery time , simultaneously with traditional open surgery were analyzed .Results Surgical success rate of two groups were 100%, the amount of bleeding (37.6 ±9.7) mL, operative time (53.8 ±6.2) min, anus exhaust time ( 22.3 ±3.5 ) h, hospitalization time ( 7.5 ±2.6 ) d, 4 hours postoperative VAS pain score 2.2 ±2.3, 24 hours postoperative VAS pain score 4.8 ±4.5, postoperative pain recovery time (5.7 ±2.3) h of study group were less than that of control group [(81.7 ±8.4)mL、(74.9 ±8.1)min、(32.2 ±5.7)h、(12.9 ±3.7)d、(6.9 ±4.9) score、(7.3 ±5.7) score、(12.6 ±4.9) h ] ( all P<0.05 ) .Conclusion Laparoscopy is safe and effective in treatment of gynecological acute abdomen with a high clinical application value .%目的:探讨腹腔镜对妇科急腹症的诊疗价值。方法回顾性分析广西壮族自治区民族医院妇产科2011年3月至2013年3月收治的152例妇科急腹症患者的临床资料,76例经腹腔镜手术治疗患者为观察组,76例经普通开腹手术治疗患者为对照组,比较两组患者手术成功率、手术指标、术后并发症及术后疼痛视觉模拟评分法( visual analog scale , VAS)评分和术后疼痛恢复时间。结果两组患者手术成功率均为100%,观察组患者术中出血量(37.6±9.7)mL、手术时间(53.8±6.2)min、肛门排气时间(22.3±3.5)h、住院天数(7.5±2.6) d、术后4 h VAS

  7. CT angiography - abdomen and pelvis

    Science.gov (United States)

    Computed tomography angiography - abdomen and pelvis; CTA - abdomen and pelvis; Renal artery - CTA; Aortic - CTA; Mesenteric CTA ... belly or pelvis Masses and tumors in the abdomen or pelvis, including cancer, when needed to help ...

  8. 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

    Directory of Open Access Journals (Sweden)

    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.

  9. Abdomen, digestive system; Abdomen, appareil digestif

    Energy Technology Data Exchange (ETDEWEB)

    Pradel, J. [Hopital Saint-Eloi, 34 - Montpellier (France); Siauve, N. [Hopital Laennec, 75 - Paris (France); Alexandre, M. [Centre Hospitalier Universitaire, 06 - Nice (France); Lorenzetti, J. [Centre Hospitalier Universitaire, 63 - Clermont Ferrand (France)

    1997-03-01

    The Radiological Society of North America (RNSA) ` 96 has devoted a broad part to abdomen and digestive imaging. we find hepatic pathology and comparative evaluation between computed tomography and NMR imaging. The question of contrast products and their advance in hepatic pathology are studied. The biliary tracts and MRI do not present any surprise. The pancreas with the computerized tomography and finally the digestive system, always with computerized tomography are exposed. (N.C.).

  10. Lump in the abdomen

    Science.gov (United States)

    Abdominal hernia; Hernia - abdominal; Abdominal wall defects; Lump in the abdominal wall; Abdominal wall mass ... Most often, a lump in the abdomen is caused by a hernia. An abdominal hernia occurs when there is a weak spot in the abdominal ...

  11. Comparison of Two Kinds of Imaging Methods in Acute Abdomen Patients%两种影像学检查方法在急腹症患者中的应用比较

    Institute of Scientific and Technical Information of China (English)

    蔡拥军; 王晓刚; 陈义荣; 钱慕周

    2014-01-01

    Objective:To observe and compare the diagnostic effects of spiral CT and CR KUB on acute abdomen patients.Method:100 patients admitted to hospital in recent years were used in patients with acute abdominal spiral CT,CR KUB checks,combined with surgery and pathology of the relevant information,a comprehensive analysis of the advantages and disadvantages of the two imaging.Result:The positive rate of Spiral CT and CR KUB imaging methods were 96% and 51%,the difference was statistically significant(χ²=23.76,P<0.05).CT was higher positive rate with common acute abdomen,especially for acute cholecystitis,abdominal tumors,acute pancreatitis positive rate of up to 100%.CR KUB for peptic ulcer perforation,abdominal foreign body was also positive rate of 100%,while acute pancreatitis,acute appendicitis,urinary tract stones,acute abdomen abdominal tumors positive rate were 0,35.7%,71.4% and 20.0%. Conclusion:CR KUB is a routine clinical screening method in patients with acute abdomen,while MSCT examination for higher accuracy of diagnosis of acute abdomen.%目的:观察比较螺旋CT、CR腹部平片对急腹症患者的诊断效果及意义。方法:对近年来笔者所在医院收治的100例急腹症患者分别采用螺旋CT、CR腹部平片进行检查,并结合手术、病理的相关资料,综合分析两种影像学检查的优缺点。结果:螺旋CT、CR腹部平片两种影像学方法的阳性检出率分别为96%、和51%,差异有统计学意义(χ²=23.76,P<0.05)。其中CT对各种常见急腹症的阳性检出率均较高,特别是对急性胆囊炎、腹部肿瘤、急性胰腺炎的阳性检出率高达100%;CR腹部平片对消化道溃疡穿孔、腹部异物阳性检出率也为100%,而对急性胰腺炎、急性阑尾炎、泌尿系统结石、腹部肿瘤等急腹症的阳性检出率分别为0、35.7%、71.4%、20.0%。结论:CR腹部平片可作为急腹症患者临床常规的检查方法,而MSCT检查对于急腹症诊断的准确度更高。

  12. A Discussion on Clinical Diagnosis and Treatment of Colon Cancer with the Symptom of Acute Abdomen%以急腹症为表现的结肠癌临床诊断及治疗探讨

    Institute of Scientific and Technical Information of China (English)

    胡建华

    2012-01-01

    目的:探讨以急腹症为表现的结肠癌临床诊治经验.方法:对2009年2月~2011年7月我院收治的56例结肠癌致使急腹症的患者资料进行回顾性分析.结果:56例中治愈出院共29例;好转出院共16例;4例伤口感染,5例肺部感染;2例分别在术后1d、4d因中毒性休克经抢救无效死亡.结论:对于结肠癌并发急腹症,做好术前准备工作,选择合理的手术方式及加强术后综合治疗是减少术后并发症及提高患者生存质量的重要保障.%Objective:To discuss the experiences in the clinical diagnosis and treatment of colon cancer with the symptom of acute abdomen.Methods:Took a review analysis on 56 patients with colon cancer caused acute abdomen from February 2009 to July 2011. Results:29 of 56 cases left hospital with recovery; 16 cases left hospital with better symptoms; 4 cases had wound infection and 5 cases had pulmonary infection; 2 cases died 1 day and 4 days after the operation because of the toxic shock.Conclusion:For the colon cancer companiedwith the acute abdomen, it should do preparation before the operation, choose the reasonable operation method and strengthen the post-operative comprehensive treatment, which are the important guarantee to reduce the post-operative complications and enhance the survival quality of patients.

  13. Open abdomen in the treatment of intra-abdominal hypertension in patients with severe acute pancreatitis%重症急性胰腺炎的腹腔高压与腹腔开放治疗

    Institute of Scientific and Technical Information of China (English)

    李宁

    2010-01-01

    @@ 早在20世纪初期,就有学者注意到腹腔高压对患者心血管、肾脏等的功能产生不利影响.重症急性胰腺炎(severe acute pancreatitis,SAP)常导致腹腔高压,不仅限制腹式呼吸,减少机体氧供,而且对泌尿、循环、消化和中枢神经系统等产生一系列严重影响,如不及时治疗,将导致腹腔间室综合征(abdominal compartment syndrome,ACS).%Severe acute pancreatitis (SAP) can induce intra-abdominal hypertension, which has an adverse effect on the function of urinary, circulatory, digestive and neurological system, and finally leads to abdominal compartment syndrome (ACS) if patients were not timely treated. This article focuses on the close relationship between SAP and ACS, which included the definition, classification, pathogenesis of ACS and its pathophysiologic effects on other important organs. The different types and indications of surgical interventions of ACS were discussed in detail. For SAP patients complicated with ACS, urgent open abdomen is important to decrease the abdominal pressure and to prevent the incidence of multi-organ dysfunction syndrome. Complications after open abdomen, such as intestine fistula,abdominal sepsis, intestinal dysfunction and abdominal deficit,should be managed prudently.

  14. Clinical analysis of acute abdomen patients complicated with septic shock and distribution of pathogens%急腹症患者感染性休克的临床分析及病原菌分布

    Institute of Scientific and Technical Information of China (English)

    田霞; 亓剑凤; 高伟

    2014-01-01

    OBJECTIVE To explore the clinical characteristics of the acute abdomen patients complicated with septic shock ,analyze the distribution of pathogens ,and formulate the intervention measures so as to improve the level of clinical treatment .METHODS A total of 65 acute abdomen patients complicated with septic shock ,who were trea-ted from Jan 2010 to Jan 2013 ,were randomly recruited in the study ,then the clinical manifestations of the partic-ipants were retrospectively analyzed ,the conventional blood collection or abdominal puncture was performed before surgery ,the specimens were sampled intraperitoneally or intestinally for the bacterial culture during surgery ,and the distribution of the pathogens was observed .RESULTS The major clinical manifestations of the acute abdomen patients with septic shock included the apathy ,dysphoria ,pale and clammy extremities ,and mucocutaneous cya-nosis ;the major physical signs included the hypotension ,low pulse ,slow heart rate ,and oliguria .Totally 73 strains of pathogens have been isolated ,including 53 (72 .60% ) strains of gram-negative bacteria ,17 (23 .29% ) strains of gram-positive bacteria ,and 3 (4 .11% ) strains of fungi .The multivariate logistic regression analysis in-dicated that the age ,disease course ,types of disease ,and timing of treatment were the risk factors for the septic shock in the acute abdomen patients (P<0 .05) .The total cure rate was 93 .85% .CONCLUSIONS The acute abdo-men patients complicated with septic shock have typical clinical manifestations ;the symptomatic treatments such as active anti-shock and anti-infection ,in combination with surgery ,may achieve good prognosis .%目的:探讨急腹症患者合并感染性休克的临床分析及病原菌分布,制定干预对策,以期提高临床治疗水平。方法随机选取2010年1月-2013年1月65例急腹症合并感染性休克患者为研究对象,对其临床表现等进行回顾性分析,术前进行常规的采血或腹

  15. 急腹症合并急性脑梗死的预后相关危险因素分析%Analysis of the prognostic risk factors of acute abdomen with acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    白金娟

    2013-01-01

    Objective To analyze the prognostic risk factors and preventive measures of acute abdomen with acute cerebral infarction (AAACI). Methods 130 cases of AAACI patients who were admitted into our hospital in 2012 were retrospectively analyzed, among them, 65 cases of patients with acute cerebral infarction, their prognosis, ages, dietary habit, blood pressure, blood glucose, blood lipid, electrocardiogram, water electrolyte balance and leukocyte were statistically analyzed. Results There was a significant difference of the condition of prognosis between the AAACI patients with eating disorders, high blood pressure, glucose and lipid, abnormal ECG, disturbance of water and electrolyte, high leucocytes and those patients without these risks (P<0.05). Conclusion The main risk factors of AAACI are ages, dietary habit, blood pressure, blood glucose, electrocardiogram, water electrolyte balance and leukocyte, et al.%目的分析急腹症合并急性脑梗死的预后危险因素及预防措施。方法回顾性分析我院2012年度收治的130例急腹症的患者,其中有65例患者合并的有急性脑梗死,分析这65例急腹症合并急性脑梗死患者的预后,统计其年龄、饮食习惯、血压、血糖、血脂、心电图、水电解质平衡及白细胞的危险因素。结果急腹症合并急性脑梗死患者的预后与再合并有饮食不规律、高血压、高血糖、、高血脂、心电图异常、水电解质紊乱、白细胞升高的高龄患者其预后情况与不合并这些危险因素的患者差异有统计学意义(P<0.05)。结论急腹症并发脑梗死的预后主要危险因素有年龄、饮食习惯、血压、血糖、心电图、水电解质及白细胞等。

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

    Directory of Open Access Journals (Sweden)

    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

  17. 艾滋病合并外科急腹症患者的快速康复护理%Fast track nursing of patients with AIDS complicated with acute abdomen during perioperative period

    Institute of Scientific and Technical Information of China (English)

    李丹丹; 肖艳玲

    2016-01-01

    目的:探讨艾滋病合并外科急腹症患者的快速康复护理方法。方法:回顾性分析2012年7月至2015年7月42例艾滋病合并外科急腹症的患者的临床特点及护理对策。结果:38例患者围手术期经快速康复外科(fast track surgery,FTS)护理治疗(术前患者心理干预;避免胃管、尿管的置入;减少术中引流管留置、术中液体控制、体温控制;术后胃肠功能、肺功能的加速康复、疼痛的管理、切口的管理、管道的早期拔除),未出现院内感染及其他重大并发症,护理治疗效果满意,康复出院。4例因重度的免疫功能缺陷,术后出现难以控制的腹腔感染后继而多器官功能衰竭死亡。结论:快速康复护理治疗可减少艾滋病合并急腹症患者的术后并发症,降低围手术期病死率,促进患者术后早期康复。%Objective: To investigate the perioperative nursing methods on AIDS complicated with acute abdomen diseases. Methods: 42 cases of AIDS complicated with acute abdomen diseases from July 2012 to July 2015 were studied, the clinical features of patients and nursing treatment were analyzed.Results: 38 cases were healed without nosocomial infection and other serious complications by fast track nursing treatment (preoperative psychological intervention; avoid gastric tube, urine tube placement; reduce intraoperative drainage tube indwelling, intraoperative lfuid control, temperature control, accelerate postoperative gastrointestinal function, rehabilitate pulmonary function, pain management, postoperative incision management, early removal of pipeline). Four cases with severe immune function defects suffered uncontrollable abdominal postoperative infection and multiple organ failure which led to death.Conclusion: Fast track nursing can prevent postoperative complications, reduce perioperative mortality and promote the fast-tract recovery on patients with AIDS complicated with acute abdomen

  18. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Acute Abdomen as the First Symptom of Diabetes:Misdiagnosis Analysis%以急腹症为首发表现的糖尿病误诊分析

    Institute of Scientific and Technical Information of China (English)

    郭静霞; 任巧华; 王欣; 苏白玉

    2014-01-01

    Objective To analyze the clinical features, reasons for misdiagnosis and precautionary measures in pa-tients with acute abdomen as the first symptom of diabetes. Methods Clinical data of 9 patients with acute abdomen as the first symptom of diabetes in our hospital was retrospectively analyzed. Results The misdiagnosis rate in the group was 22.5% and the misdiagnosis time was from 3 hours to 2 days. 3 cases with bellyache and vomiting up, whose upright abdomi-nal X-ray showed liquid-air interface in intestinal canal were misdiagnosed as acute intestinal obstruction;3 patients had diar-rhea and white blood cell in stool routine test, and were misdiagnosed as acute enteritis;2 cases had hypogastralgia, leukocy-tosis and a fever, and were misdiagnosed as acute appendicitis;1 case had hematuria increased amylase and unclear head of pancreas showed in abdominal color Doppler ultrasound, and was misdiagnosed as acute pancreatitis. It was ineffective for all the 9 patients treated as misdiagnosis disease. After being asked about medical history carefully, checked with blood glucose, urine glucose, urine ketone and blood gas analysis, they were diagnosed as diabetic ketoacidosis. After treated accordingly, 9 cases were all discharged with symptoms improvement. Conclusion The diabetes patients with acute abdomen as the first symptom and indeterminate medical history may be misdiagnosed easily. It can avoid misdiagnosis and missed treatments, if we reinforce the knowledge of diabetes and complications, ask medical history carefully and have the relevant laboratory tests in time.%目的:探讨以急腹症为首发表现的糖尿病的临床特点、误诊原因及防范措施。方法回顾性分析我院收治的以急腹症为首发表现误诊的糖尿病9例的临床资料。结果本组误诊率22.5%,误诊时间3 h~2 d。3例因腹痛、呕吐行腹部立位X线检查示肠管内有气液平误诊为急性肠梗阻;3例因腹泻、便常规有白

  20. Takotsubo Syndrome as a Cause of False Acute Abdomen in the Early Postoperative Period After Bariatric Surgery-a Report of Two Cases.

    Science.gov (United States)

    Viegas, Fabio; Viegas, Carla; França, Enio; Kleuser, Klaus; de Barros, Fernando

    2016-10-01

    Takotsubo syndrome, also known as broken-heart syndrome, stress-induced cardiomyopathy or transient apical ballooning syndrome, is a transient disorder characterized by segmental left ventricular failure in the absence of obstructive coronary artery disease. Most cases of Takotsubo syndrome are caused by acute stress that leads to a sudden, temporary weakening of the cardiac musculature. This stress triggers a rise in circulating catecholamine levels that results in acute ventricular dysfunction. In this report, we describe two cases of Takotsubo syndrome in the early postoperative period after bariatric surgery.

  1. 临床路径在急腹症接诊分诊中的应用探析%The investigation of clinical pathway applied in admissions and triage of patients with acute abdomen

    Institute of Scientific and Technical Information of China (English)

    恽建波

    2015-01-01

    目的:探讨临床路径在急腹症接诊分诊中的应用。方法:2012年5月-2013年5月收治急腹症患者80例,基于患者临床资料的分析,随机将其划分为对照组与观察组,各40例,其中对照组在接诊分诊时采取传统法,观察组在接诊分诊时采取临床路径,对两组患者满意度、不同时间确诊率与并发症发生率进行对比分析。结果:对照组并发症发生率37.5%,观察组并发症发生率5.0%;对照组满意度62.5%,观察组满意度87.5%,两组差异具有统计学意义, P<0.05。结论:在急腹症接诊分诊中应用临床路径,不仅可为患者获得及时的抢救时间,同时在很大程度上还可有效降低各种并发症发生率,确保患者的安全,提升患者满意度,加快患者的康复,在临床中具有一定的推广价值以及应用价值。%Objective:To explore the application of clinical pathway in admissions and triage of patients with acute abdomen. Methods:80 patients with acute abdomen were selected from May 2012 to May 2013,and we analyzed their clinical data,all of those patients were randomly divided into the control group and the observation group with 40 cases in each.Patients in the control group were given traditional method in the admissions and triage,while in the observation group,clinical pathway were taken in the admissions and triage,then we compared the patient satisfaction,diagnosis rate in different time and the complication occurrence in two groups.Results:The complication rate of the control group was 37.5% ,while the observation group was 5% ;patients satisfaction of the control group was 62.5%,while the observation group was 87.5%,the differences was statistically significant between two groups,P<0.05.Conclusion:Clinical pathway applied in admissions and triage of patients with acute abdomen can provide timely rescue time for patients,and also can reduce the incidence of various complications

  2. Low Transmission of Airway Pressures to the Abdomen in Mechanically Ventilated Patients With or Without Acute Respiratory Failure and Intra-Abdominal Hypertension.

    Science.gov (United States)

    Heijnen, Bram G A D H; Spoelstra-de Man, Angelique M E; Groeneveld, A B Johan

    2017-03-01

    Intra-abdominal pressure, measured at end expiration, may depend on ventilator settings and transmission of intrathoracic pressure. We determined the transmission of positive intrathoracic pressure during mechanical ventilation at inspiration and expiration into the abdominal compartment. We included 9 patients after uncomplicated cardiac surgery and 9 with acute respiratory failure. Intravesical pressures were measured thrice (reproducibility of 1.8%) and averaged, at the end of each inspiratory and expiratory hold maneuvers of 5 seconds. Transmission, the change in intra-abdominal over intrathoracic pressures from end inspiration to end expiration, was about 8%. End-expiratory intra-abdominal pressure was lower than "total" intra-abdominal pressure over the entire respiratory cycle by 0.34 cm H2O. It was 0.73 cm H2O higher than "true" intra-abdominal pressure over the entire respiratory cycle, taking transmission into account. The percentage error was 3% for total and 10% for true pressure. Results did not differ among patients with or without acute respiratory failure and decreased respiratory compliance or between those with (≥12 mm Hg, n = 5) or without intra-abdominal hypertension. Transmitted airway pressure only slightly affects intra-abdominal pressure in mechanically ventilated patients, irrespective of respiratory compliance and baseline intra-abdominal pressure values. End-expiratory measurements referenced against atmospheric pressure may suffice for clinical practice.

  3. 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%Clinical effect of fast track surgery nursing for acute abdomen complicated with depression

    Institute of Scientific and Technical Information of China (English)

    古金花; 邹艳花; 陈小银

    2015-01-01

    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。方法选取我院普外科于2010年8月~2012年7月收治的39例急腹症并发抑郁症患者,设为对照组,实施常规普外科护理干预;选取我院普外科于2012年8月~2014年7月收治的43例急腹症并发抑郁症患者,设为研究组,实施快速康复外科护理干预。两组患者均于住院当天及干预后第5天末均接受简明抑郁症评定量表(BPRS)测评,同时记录两组患者术后进食时间、下床活动时间、医疗费用、住院时间、并发症发生率。结果研究组下次活动时间、术后进食时间、住院时间短于对照组(P<0.05),并发症发生率及医疗费用低于对照组(P<0.05)。两组干预前BPRS评分差异无统计学意义(P>0.05);干预后,研究组焦虑忧郁因子、缺乏活力因子、思维障碍因子及敌对猜疑因子均低于对照组(P<0.05),激活性因子高于对照组(P<0.05)。结论对于并发抑郁症的急腹症患者,快速康复外科理念能促进患者病情预后康复,降低并发症发生率,且有助于改善患者情感状态,促进社会功能的早日回归,取得较为满意的临床成效。%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

  4. Abdomen X-Ray (Radiography)

    Science.gov (United States)

    ... Professions Site Index A-Z X-ray (Radiography) - Abdomen Abdominal x-ray uses a very small dose ... to produce pictures of the inside of the abdominal cavity. It is used to evaluate the stomach, liver, ...

  5. 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 ?

    Directory of Open Access Journals (Sweden)

    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.

  6. 49 CFR 572.186 - Abdomen assembly.

    Science.gov (United States)

    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...). When subjected to tests procedures specified in paragraph (b) of this section, the abdomen assembly...

  7. 49 CFR 572.197 - Abdomen.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Abdomen. 572.197 Section 572.197 Transportation..., Small Adult Female § 572.197 Abdomen. (a) The abdomen assembly is part of the upper torso assembly (180...). The abdomen test is conducted on the complete dummy assembly (180-0000) with the arm (180-6000) on the...

  8. 醋酸奥曲肽用于小儿急腹症术后的疗效观察%Efficacy Observation of Octreotide Acetate after Pediatric Acute Abdomen Surgery

    Institute of Scientific and Technical Information of China (English)

    杨广承; 王玉红; 徐晓青; 邹大军; 魏炜

    2016-01-01

    目的:观察醋酸奥曲肽用于小儿急腹症患儿术后的疗效及安全性。方法:选择急腹症患儿130例,按照随机数字表法分为观察组和对照组,各65例。对照组患儿术后给予注射用头孢曲松钠50 mg/kg,iv,qd,以及维持水电解质平衡;观察组患儿在对照组基础上采用微泵持续给予醋酸奥曲肽注射液0.01 mg/(kg·d),ivgtt(术后即刻),1~3 d。观察两组患儿腹内压、胃肠功能恢复时间、肿瘤坏死因子α(TNF-α)水平、肝/肾功能指标、血/尿淀粉酶水平,并记录不良反应发生情况。结果:观察组患儿的总有效率(98.5%)明显高于对照组(92.3%),差异有统计学意义(P<0.05)。术后第3、5天,两组患儿腹内压、TNF-α、血/尿淀粉酶水平均较术前明显降低,且观察组患儿明显低于对照组,胃肠功能恢复时间亦明显短于对照组,差异均有统计学意义(P<0.05)。手术前后,两组患儿的肝、肾功能指标比较,差异均无统计学意义(P>0.05)。两组患儿治疗过程中均未见明显不良反应发生。结论:醋酸奥曲肽用于小儿急腹症术后可有效降低患儿腹内压、TNF-α、血/尿淀粉酶水平,改善胃肠功能,且安全性较高。%OBJECTIVE:To observe the effects and safety of octreotide acetate after pediatric acute abdomen surgery. METH-ODS:130 children with acute abdomen were selected and randomly divided into observation group and control group,with 65 cas-es in each group. Control group was given Ceftriaxone sodium for injetion 50 mg/kg,iv,qd;after surgery to maintain water-elec-trolyte balance. Observation group was additionally given continuous pump of Octreotide acetate injection 0.01 mg/(kg·d),ivgtt (immediately after surgery),for 1-3 d,on the basis of control group. The intra-abdominal pressure,the time of gastrointestinal function recovery,TNF-α level,liver/renal function index and blood

  9. Drug interaction presenting as acute abdomen

    Institute of Scientific and Technical Information of China (English)

    Rajesh; Pendlimari; Rajeswari; Anaparthy; Aravind; Sugumar

    2010-01-01

    Warfarin is the most common oral anticoagulant prescribed around the world. Adverse drug interactions with warfarin are a huge problem especially in the elderly and in patients who take multiple medications. Most adverse drug interactions involve concomitantly prescribed oral or intravenous medications. Occasionally, topical or mucosally absorbed drugs can interact, leading to fluctuations in warfarin levels with adverse consequences. In this case report, we describe a case of intestinal intramural hematoma, a rare but known consequence of a supra therapeutic international normalized ratio (INR). The supra therapeutic INR was a consequence of mucosally absorbed miconazole, prescribed for vaginal candidiasis. We wish to highlight this rare and potentially fatal drug interaction, along with the need for frequent INR monitoring when new drugs are added or removed in patients taking warfarin.

  10. Necrotizing Faciitis-Acute Abdomen And Anaesthesia

    OpenAIRE

    Güleç, Handan; Akın Kepek, Yurdal; Yaşar, Hansa; Kurtay, Aysun; Tutal, Zehra; Babayiğit, Münire; Horasanlı, Eyüp

    2014-01-01

    Necrotizing fasciitis ( NF) is a rare  soft-tissue infection characterized by progressive necrosis of the skin, subcutaneous tissue, and fascia with a high morbidity and mortality.  This infection, which is usually induced by  toxin producing bacteria, can occur in any region of the body but it is predominantly located in the abdominal wall, perineum and extremities . NF treatments consist of  radical surgical debridement of all involved necrotic tissue, use of broad spectrum antibiotics, and...

  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

    Directory of Open Access Journals (Sweden)

    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. Electrical burns of the abdomen

    Directory of Open Access Journals (Sweden)

    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.

  13. Pancreatic laceration and portal vein thrombosis in blunt trauma abdomen

    Directory of Open Access Journals (Sweden)

    Rastogi Rajul

    2008-01-01

    Full Text Available Injuries to the pancreas by blunt trauma are uncommon. The association of pancreatic injury with acute portal vein thrombosis secondary to blunt trauma abdomen is furthermore rare. The early diagnosis of the pancreas with injury to the portal vein is challenging and difficult. These injuries are associated with high morbidity and mortality, particularly if the diagnosis is delayed. Accurate and early diagnosis is therefore imperative and computed tomography plays a key role in detection. We present a case of child with a rare combination of pancreatic laceration and acute portal vein thrombosis following a blunt trauma to the abdomen. With extensive literature search we found no such cases has been described previously.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. Management of the open abdomen.

    Science.gov (United States)

    Demetriades, Demetrios; Salim, Ali

    2014-02-01

    The open abdomen has become the standard of care in damage-control procedures, the management of intra-abdominal hypertension, and in severe intra-abdominal sepsis. This approach has saved many lives but has also created new problems, such as severe fluid and protein loss, nutritional problems, enteroatmospheric fistulas, fascial retraction with loss of abdominal domain, and development of massive incisional hernias. Early definitive closure is the basis of preventing or reducing the risk of these complications. The introduction of new techniques and materials for temporary and subsequent definitive abdominal closure has improved outcomes in this group of patients.

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

    Directory of Open Access Journals (Sweden)

    Ioannis D. Kyriazanos

    2015-01-01

    Full Text Available 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  18. 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

    Directory of Open Access Journals (Sweden)

    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.

  19. Macrodystrophia lipomatosa extending into the upper abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, Traci R. [The University of Texas Medical Branch, Galveston, TX (United States); Swischuk, Leonard E. [The University of Texas Medical Branch, Departments of Radiology and Pediatrics, Galveston, TX (United States); The University of Texas Medical Branch, Pediatric Radiology, Galveston, TX (United States)

    2007-12-15

    We report a case of macrodystrophia lipomatosa in an infant with extension of hypertrophied fatty tissue into the abdomen and abdominal wall. The patient not only presented with typical limb abnormalities but also an abdominal mass. We reviewed the literature on the subject, and believe that our case is rare because the hypertrophied lipomatous tissue extended into the abdomen. (orig.)

  20. How to deal with an open abdomen?

    LENUS (Irish Health Repository)

    De Waele, Jan J

    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 progressive approximation of the fascial edges, high closure rates can be obtained. Intra-abdominal pressure measurement can be used to guide the surgical strategy and continued attention to intra-abdominal hypertension is necessary. This paper reviews recent advances as well as identifying the remaining challenges in patients requiring open abdomen treatment. The new classification system of the open abdomen is an important tool to use when comparing the efficacy of different strategies, as well as different systems of temporary abdominal closure.

  1. Multiple Organ Failure in Children with Acute Abdomen:A Report of 140 Cases%小儿急腹症多器官功能衰竭140例临床分析

    Institute of Scientific and Technical Information of China (English)

    金先庆; 林涛

    1988-01-01

    本文报告10年中收治的小儿急腹症多器官功能衰竭(MOF)140例,占同期急腹症总数的2.23%.本组MOF的病死率为49.3%,略高于小儿内科MOF病死率.本文总结小儿急腹症MOF病死率主要与患儿年龄、受累器官数目、是否早期手术以及原发疾病性质等因素有关.循环及呼吸是最常受累的两个系统,也是抢救MOF成败的关键.%From 1977 to 1986,140 childrea with multiple organ failure(MOF)in lacute abdomen were admitted.The total mortality(49.3%)is a little higher than that of MOF in pediatric diseases as reported in Chinese medical literatures.The factors related to the mortality of MOF are:(1)the age of patients,(2)the number of organs or systems involved,(3)the primary disease in abdomen,and (4)the treatment (operation)undertaken.As the circulatory or respiratory failure is the most common cause of death,protection of taese organs would be the key to a sucessful salvage of MOF.

  2. Bronchogenic cyst of the abdomen

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2005-01-01

    Full Text Available A bronchogenic cyst is a rare congenital anomaly that appears in the thorax, usually the lungs or the mediastinum, being much rarer in the retrosternal space, within the pericardium or the diaphragm, as well as in the neck, while localization within the abdomen is extremely rare, with only about 30 reported cases. We present the case of a 68-year-old woman. During an investigation for an epigastric pain, a cystic lesion in the area of the body and tail of the pancreas was found. During open surgery, a cystic lesion, spanning 95x75x70 mm, above the body and tail of the pancreas was excised. The wall of the cyst was 8-12mm thick; it contained viscous fluid, the culture of which stayed sterile. Histology determined that it was a bronchogenic cyst. After an early uneventful recovery, the patient developed a left colonic fistula, which healed spontaneously within 3 weeks, probably because of the unnoticed operative damage to the splenic flexure of the colon during splenectomy, which was adherent to the cystic mass and impossible to save during excision. Six months after surgery, the patient continued to remain symptom free.

  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

    Directory of Open Access Journals (Sweden)

    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

    Institute of Scientific and Technical Information of China (English)

    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. Echogeleide percutane drainage : toepassingen in het abdomen

    NARCIS (Netherlands)

    J.S. Laméris (Johan )

    1987-01-01

    textabstractDit proefschrift behandelt een aantal toepassingen van de echogeleide punctie en drainagetechniek in het abdomen, namelijk: - de percutane abcesdrainage - de percutane galblaasdrainage - de percutane galwegdrainage Abdominale abcessen zijn in de chirurgische praktijk altijd een groot pro

  6. 49 CFR 572.9 - Lumbar spine, abdomen, and pelvis.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis. 572.9 Section... Percentile Male § 572.9 Lumbar spine, abdomen, and pelvis. (a) The lumbar spine, abdomen, and pelvis consist... minutes after the release. (d) When the abdomen is subjected to continuously applied force in accordance...

  7. 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

    Directory of Open Access Journals (Sweden)

    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

  8. Effects of manual lymph drainage for abdomen on the brain activity of subjects with psychological stress

    Science.gov (United States)

    Shim, Jung-Myo; Yeun, Young-Ran; Kim, Hye-Young; Kim, Sung-Joong

    2017-01-01

    [Purpose] The present study investigated the effects of manual lymph drainage for abdomen on electroencephalography in subjects with psychological stress. [Subjects and Methods] Twenty-eight subjects were randomly allocated to undergo a 20-min session of either manual lymph drainage or abdominal massage on a bed. [Results] Analysis of electroencephalograms from the manual lymph drainage group showed a significant increase in relaxation, manifested as an increase in average absolute, relative alpha activity and a decrease in relative gamma activity. [Conclusion] Our results suggest that the application of manual lymph drainage from the abdomen provides acute neural effects that increase relaxation in subjects with psychological stress. PMID:28356638

  9. Treatment of Secondary Amenorrhea with Abdomen Acupuncture

    Institute of Scientific and Technical Information of China (English)

    韩燕

    2004-01-01

    @@ Abdomen acupuncture is a newly-emerged branch of body acupuncture, that has been used in clinic and gradually accepted by the patients. In recent years, the author has treated 33 cases of secondary amenorrhea with this art. The therapeutic results were satisfactory and reported as follows.

  10. Study on the clinical efficacy of transversal abdominal plane blockade in treatment of acute herpes zoster on abdomen%腹横肌平面阻滞治疗腹部急性带状疱疹的临床观察

    Institute of Scientific and Technical Information of China (English)

    刘永彬; 万磊; 罗克金

    2016-01-01

    目的:观察腹横肌平面阻滞治疗急性期下腹部带状疱疹的临床疗效。方法28例急性带状疱疹患者随机分为肋间神经阻滞组(IC 组,n =14)和腹横肌平面阻滞组(TP 组,n =14),分别接受 T10、T11、T12椎旁肋间神经阻滞(1次/周,共4次)和患侧腹横肌平面阻滞(1次/周,共4次)。观察两组的阻滞平面范围评分值、结痂时间、4周后通常痛视觉模拟评分和爆发痛视觉模拟评分。结果 TP 组阻滞平面评分值明显高于 IC 组( P <0.05)。TP 组皮肤结痂时间明显短于 IC 组( P <0.05)。TP 组疼痛视觉模拟评分值明显低于 IC 组( P <0.05)。结论腹横肌平面阻滞可以有效控制急性期下腹部带状疱疹所致皮神经疼痛,同时有助于带状疱疹皮损区的愈合。%Objective To observe the efficacy of transversal abdominal plane blockade in treatment of patients with acute herpes zoster in lower abdomen. Methods Twenty - eight patients with acute herpes zoster in lower abdomen were randomly assigned into group IC(n = 14),pa-tients in this group received paravertebral intercostal nerve blockade at T10 ,T11 and T12(once a week and four times as one course)and patients in group TP( n = 14)received transversal abdominal plane blockade( once a week and four times as one course). Scales of blockade level (SBL),time for forming scab(TFB),visual analogue scales(VAS)of common pain and visual analogue scales(VAS)of burst pain after four weeks were observed and recorded. Results Scales of blockade level(SBL)in group TP were higher than those of group IC( P < 0. 05). The duration for forming scab in patients of group TP was shorter than that of patients in group IC( P < 0. 05). Visual analogue scales(VAS)of com-mon pain and burst pain in patients of group TP were lower than those of patients in group IC( P < 0. 05). Conclusion Transversal abdominal plane blockade is effective in alleviating cutaneous nerve pain

  11. [Abnormal gas collections in the abdomen in infants].

    Science.gov (United States)

    Cohen, M D; Robinson, A E; Neuffer, F; Smith, W L

    1985-01-01

    Many unusual and uncommon abnormal gas collections within the abdomen may be encountered. This paper reviews the reported causes for unusual gas collections in the abdomen and describes several new causes of abnormal bowel gas collections.

  12. Abdomen agudo quirúrgico en el anciano

    Directory of Open Access Journals (Sweden)

    Jesús M Valdés Jiménez

    2002-04-01

    Full Text Available Se presenta un estudio descriptivo retrospectivo de 156 enfermos mayores de 65 años, con diagnóstico de abdomen agudo quirúrgico (AAQ, operados en el Hospital Clinicoquirúrgico «Manuel Fajardo» e ingresados en la Unidad de Cuidados Intermedios Polivalente, durante el trienio comprendido entre 1995 y 1998. Las causas más frecuentes del síndrome fueron la oclusión intestinal (58,9 %, la colecistitis aguda (13,5 % y la úlcera péptica gastroduodenal perforada (10,9 %. Las enfermedades asociadas de mayor prevalencia eran la cardiopatía isquémica (62,2 % y la hipertensión arterial (48,7 %. La mortalidad aumentó con el avance de la edad, y alcanzó el 70,4 % en los mayores de 85 años. Entre las complicaciones predominaron la infección de la herida quirúrgica (12,8 % y la bronconeumonía (5,8 %. La principal causa de muerte fue la sepsis (10,3 %A descriptive and retrospective study of 156 patients over 65 with diagnosis of acute surgical abdomen (ASA that were operated on at "Manuel Fajardo" Clinical and Surgical Hospital and admitted at the Polyvalent Intermediate Care Unit, from 1995 to 1998, was conducted. The most common causes of the syndrome were intestinal occlusion (58.9 %, acute cholecystitis (13.5 % and the gastroduodenal perforated peptic ulcer (10.9 %. The associated diseases of highest prevalence were ischemic heart disease (62.2 % and arterial hypertension (48.7 %. Mortality increased with age and amounted to 70.4 % in patients over 85. The infection of the surgical wound (12.8 % and bronchopneumonia (5.8% prevailed among the complications. Sepsis (10.3 % was the main cause of death

  13. 49 CFR 572.19 - Lumbar spine, abdomen and pelvis.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen and pelvis. 572.19 Section 572.19 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY...-Year-Old Child § 572.19 Lumbar spine, abdomen and pelvis. (a) The lumbar spine, abdomen, and pelvis...

  14. A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

    Directory of Open Access Journals (Sweden)

    G. Kishore Babu

    2016-10-01

    Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

  15. DIAGNOSTIC ACCURACY AND CLINICAL VALUE OF PRE - TRIAGE MANAGEMENT SYSTEM ON A-CUTE ABDOMEN PATIENTS%预检分诊管理制度对急腹症患者分诊准确性及临床价值探讨

    Institute of Scientific and Technical Information of China (English)

    余茂琼

    2015-01-01

    Objective To explore the diagnostic accuracy and clinical value of pre - triage management sys‐tem in patients with acute abdomen .Methods All of 180 acute abdomen patients in accordance with the compliance inspection system were divided into the triage group of 97 cases and self - selection group of 83 cases ,triage group underwent pre - triage management system ,self - selection group choose departments by self .Some indicators were compared between the two groups included accuracy rate ,treatment success rate ,waiting time ,waiting for the examination time ,the degree of anxiety and patient satisfaction .Results Triage group was significantly higher on accuracy rate ,treatment success rate than that self - selection group ,but whose waiting time ,waiting for the examination time were less than self - selection group(P<0 .05) .Anxiety improvement rate ,satisfaction degree were obviously higher in the triage group than those in the self - selection group(P < 0 .05) .Conclusion Pre - triage management system can improve clinical outcomes and patient satisfaction according to the patients'clinical signs arrangements reasonable treatment order ,it is worthy of clinical application .%目的:探讨预检分诊管理制度对急腹症患者分诊准确性及临床价值。方法将180例患者按照是否依从预检制度分为预检分诊组97例和自主选择组83例,预检分诊组护士对患者进行预检分诊,自主选择组患者自主选择科室。比较二组患者就诊准确率、救治成功率、候诊时间、待诊时间以及焦虑程度改善率和患者满意度。结果预检分诊组就诊准确率、救治成功率均显著高于自主选择组,候诊时间、确诊时间均少于自主选择组,二组比较差异具有统计学意义(P <0.05)。预检分诊组患者焦虑程度改善率显著优于自主选择组,患者满意度也明显高于自主选择组,组间相比差异亦有统计学意义(P<0.05)。结

  16. Basic interventional radiology in the abdomen.

    Science.gov (United States)

    Calero García, R; Garcia-Hidalgo Alonso, M I

    2016-05-01

    This article describes the different basic nonvascular interventional techniques in the abdomen that all general radiologists should be familiar with. It explains the indications and approaches for the different procedures (punctures, biopsies, drainage of collections, cholecystostomies, and nephrostomies). It also discusses the advantages and disadvantages of the different imaging techniques that can be used to guide these procedures (ultrasound, CT, and fluoroscopy) as well as the possible complications that can develop from each procedure. Finally, it shows the importance of following up patients clinically and of taking care of catheters.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Laparoscopic surgery in pregnant patients with acute abdomen.

    Science.gov (United States)

    Kocael, Pinar Cigdem; Simsek, Osman; Saribeyoglu, Kaya; Pekmezci, Salih; Goksoy, Ertugrul

    2015-01-01

    Nonostante i significativi vantaggi della chirurgia laparoscopica rispetto a quella laparotomica, essa era considerata controindicata per le donne gestanti. Attualmente si confrontano opinioni contrastanti riguardo alla sicurezza durante la gestazione della chirurgia laparoscopica, specie se nell’ultimo trimestre. Lo scopo di questo studio è quello di valutare la fattibilità della chirurgia laparoscopica in donne gestanti in caso di addome acuto analizzando retrospettivamente la casistica della pazienti ricoverate tra il gennaio 1995 ed il gennaio 2013 presso l’Emergency Department della Cerrahpasa Medical Faculty. Sono stati pertanto analizzati tutti i dati clinici riguardanti le gestanti sottoposte a chirurgia laparoscopica, comprese le cartelle cliniche, gli interventi eseguiti, i reperti anatomopatologici, e le informazioni riguardanti il parto. Nella casistica sono rientrate 14 donne gravide (in media alla 19,2° settimana di gestazione, distribuite tra 9 e 33 settimane), di cui 11 sottoposte ad appendicectomia laparoscopica, 2 a colecistectomia laparoscopica ed 1 per scopi diagnostici. In media il parto si è espletato alla 37,4° settimana di gestazione (tra la 35° e la 40° settimana). Due pazienti hanno avuto un parto prematuro, ma in nessune dei casi si sono verificate complicazioni durante le manovre laparoscopiche, e cioè danni all’utero, morti fetali o mortalità materna. Si conclude che la chirurgia laparoscopica può essere effettuata nel corso di tutti i trimestri della gravidanza, con il possibile vantaggio di una utile diagnosi differenziale in caso di dolori addominali acuti durante la gravidanza, e diminuzioni delle morti fetali dovute a ritardi diagnostici, e che tempi chirurgici più brevi riducono gli effetti negativi sulla madre e sul feto.

  19. [Intestinal tuberculosis--cause of acute surgical abdomen].

    Science.gov (United States)

    Ciurea, M; Ion, D; Ionescu, S; Tica, M R

    2001-01-01

    Tuberculosis, in its various forms, remains an important cause of morbidity and mortality in developing countries in immunodeficitary patients. The indicatives of epidemiology of tuberculosis show that Romania presents a fresh outbreak of the disease in the last few years. The purpose of this paper is to present from the various forms of extrapulmonary tuberculosis, the intestinal tipe which have a high incidence. The authors describe theirs preliminary experience of intraoperative small and large bowel emergencies resections in a short period (1 year) of three young patients (between 30 and 40 years old) with history of pulmonary tuberculosis. The pathology was complex (bowel obstructions, peritonitis) and so were the surgical operations (resections, devirations). The patients showed short and long term good results.

  20. A Rare Cause of Acute Abdomen: Jejunal Diverticulosis with Perforation

    Directory of Open Access Journals (Sweden)

    Ibrahim Aydin

    2013-01-01

    Full Text Available Jejunal diverticulosis is generally asymptomatic and is associated with high morbidity and mortality secondary to complications, especially in elderly patients. We present a case report of a 74-year-old female patient with jejunal diverticulosis and perforation due to diverticulitis.

  1. Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

    Directory of Open Access Journals (Sweden)

    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.

  2. Upper Lumbar Disc Herniation Presenting as Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Borghei- Razavi Hamid

    2009-10-01

    Full Text Available A woman presenting with severe right lower quadrant (RLQ abdominal pain is presented here. She was evaluated for all usual cause of such pain. Laboratory tests and abdominal and pelvic sonography was normal. MRI revealed L1-L2 disc herniation.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Metallic sewing needle ingestion presenting as acute abdomen

    African Journals Online (AJOL)

    2011-10-12

    Oct 12, 2011 ... toothpicks, metallic nails, needles, and dental bridgework. Patients suspected of ... Postoperative adhesions are well‑known clinical entity following ... ingested foreign bodies within the appendix: A case report with review of.

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

    Science.gov (United States)

    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.

  6. Localized Castleman disease of plasma cell type in the abdomen

    Institute of Scientific and Technical Information of China (English)

    LU Zhi-hua; WU Mei

    2011-01-01

    Castleman disease is a relatively rare entity,with the hyaline-vascular type the predominant form.Although the plasma cell type is uncommon,it still comprises approximately 10% of cases of localized diseases.In addition,the abdomen is a rare site for involvement and localized Castleman disease of the plasma cell type in the abdomen is rare.The radiologic features of localized plasma cell type in the abdomen are mostly limited to case reports.In addition to the conventional imaging findings,we present some new imaging findings of localized plasma cell type in the abdomen.

  7. Trunk, abdomen, and pressure sore reconstruction.

    Science.gov (United States)

    Rubayi, Salah; Chandrasekhar, Bala S

    2011-09-01

    After reading this article, the participant should be able to: 1. Describe the principles of wound closure, torso reconstruction, and pressure sore reconstruction. 2. Outline standard options to treat defects of the chest, abdomen, and back and pressure ulcers in all anatomical areas. 3. Manage and prevent pressure ulcers. Chest wall reconstruction is indicated following tumor resection, radiation wound breakdown, or intrathoracic sepsis. Principles of wound closure and chest wall stabilization, where indicated, are discussed. Principles of abdominal wall reconstruction continue to evolve with the introduction of newer bioprosthetics and the application of functional concepts for wound closure. The authors illustrate these principles using commonly encountered clinical scenarios and guidelines to achieve predictable results. Pressure ulcers continue to be devastating complications to patients' health and a functional hazard when they occur in the bedridden, in patients with spinal cord injuries, and in patients with neuromuscular disease. Management of pressure ulcers is also very expensive. The authors describe standard options to treat defects of the chest, abdomen, and back and pressure ulcers in all anatomical areas. A comprehensive understanding of principles and techniques will allow practitioners to approach difficult issues of torso reconstruction and pressure sores with a rational confidence and an expectation of generally satisfactory outcomes. With pressure ulcers, prevention remains the primary goal. Patient education and compliance coupled with a multidisciplinary team approach can reduce their occurrence significantly. Surgical management includes appropriate patient selection, adequate débridement, soft-tissue coverage, and use of flaps that will not limit future reconstructions if needed. Postoperatively, a strict protocol should be adapted to ensure the success of the flap procedure. Several myocutaneous flaps commonly used for the surgical

  8. Severe Acute Pancreatitis in Pregnancy

    Directory of Open Access Journals (Sweden)

    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.

  9. Open abdomen management of intra-abdominal sepsis.

    Science.gov (United States)

    Adkins, Amy L; Robbins, James; Villalba, Mario; Bendick, Phillip; Shanley, Charles J

    2004-02-01

    Despite surgical advances, antimicrobial therapy, and intensive care, the morbidity and mortality of intra-abdominal sepsis remains high. The primary purpose of this study was to determine whether open abdomen management of intra-abdominal sepsis reduces intensive care unit (ICU) and hospital mortality. The records of 81 consecutive patients with open abdomen management for intra-abdominal sepsis admitted to the surgical ICU from January 1998 to April 2002 were retrospectively reviewed. Outcomes were compared to a historical control group with primary abdominal closure, also admitted to the surgical ICU with intra-abdominal sepsis and matched for sex, age, source of sepsis, and APACHE III score. ICU mortality for the open abdomen group was 25 per cent versus 17 per cent for the control group. Hospital mortality was 33 per cent and 25 per cent for the open abdomen patients and historical controls, respectively. Both ICU and hospital length of stay were significantly longer for the open abdomen group. An overall fistula rate of 14.8 per cent was demonstrated in the open abdomen patients. A significant difference in overall ICU and hospital mortality was not demonstrated between patients treated with open abdomen management and historical controls. A prospective randomized study accounting for extent of sepsis may define a role for open abdomen management in selected subgroups of patients.

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

    Science.gov (United States)

    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. A RETROSPECTIVE STUDY ON PENETRATING INJURIES ABDOMEN

    Directory of Open Access Journals (Sweden)

    Alli Muthiah

    2017-02-01

    Full Text Available BACKGROUND Penetrating abdominal injuries forms an important component of surgical emergencies. It remains one of the commonest reasons for preventable deaths in any trauma systems. 1 Abdominal injuries may be parietal or visceral or perforating through and through injury. Unnecessary exploration leads to increased morbidity. The goal in managing penetrating abdominal injuries is to identify and treat all the damages caused by the weapon and to reduce negative laparotomy and avoid missed injuries. MATERIALS AND METHODS A retrospective study that was carried out in 53 patients in Government Kilpauk Medical College and Government Royapettah Hospital from May 2007 to July 2009 on penetrating injuries abdomen. RESULTS Among 53 patients, maximum number of cases were in the age group of 30-40 years. Assault injuries account for 87% of cases of penetrating abdominal injuries. Small bowel was the commonly injured organ in this study. Laparotomy was therapeutic in 94% of the cases (64% of the cases underwent laparotomy. CONCLUSION Careful and serial clinical examination and appropriate diagnostic investigations leads to successful treatment in these patients. Computed tomography is highly sensitive in predicting both peritoneal penetration and intra-abdominal visceral injuries.

  12. Unusual Cause of Acute Abdomen—Ruptured Retroperitoneal Paraganglioma

    Directory of Open Access Journals (Sweden)

    Kwok-Kay Yau

    2008-01-01

    Full Text Available Ruptured retroperitoneal paraganglioma is a rare cause of acute abdomen. Its clinical presentation and laparoscopic features have seldom been reported in the literature. Herein, we report a case of ruptured retroperitoneal paraganglioma that presented as acute abdomen, and its subsequent management.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Noncommunicating isolated enteric duplication cyst in the abdomen ...

    African Journals Online (AJOL)

    review of the literature. Hyun-Young Kim, Soo-Hong ... Keywords: abdomen, children, duplication, isolated, noncommunicating. Department of ... He also had a fever with a body ... unknown origin is observed in the abdominal cavity in children.

  15. Benign Multicystic Peritoneal Mesothelioma: A Rare Tumour of the Abdomen

    Directory of Open Access Journals (Sweden)

    Soundappan Somasundaram

    2015-01-01

    Full Text Available Benign multicystic peritoneal mesothelioma: a rare tumor of the abdomen, is a diagnostic dilemma. This report emphasizes the importance of diagnostic laparoscopy in the diagnosis of the tumour.

  16. sonography in chronic distension of the abdomen and apparent ...

    African Journals Online (AJOL)

    bbshehu

    pregnant; and the role of sonography in their management. Method: A ... The differential diagnoses of chronic distension of the abdomen ... Cushing's syndrome and pseudo pregnancy. Each of these can be diagnosed with certainty in modern.

  17. 49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Lumbar spine, abdomen, and pelvis assembly and...) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine, abdomen, and pelvis consist of...

  18. New indications in the approach to the pendulous abdomen.

    Science.gov (United States)

    Planas, J; Morais, B B

    1999-01-01

    The appearance of the superficial liposuction technique has permitted the surgeon to advance in his indications for treating localized lipodystrophy, without skin resection. With the cutaneous retraction phenomenon that follows superficial liposuction, pendulous abdomen, which was once treated by classical dermolipectomies, can now be treated with liposuction alone, obtaining satisfactory results. The authors recommend this form of treatment for patients with pendulous abdomen and with good skin quality, with few or no stretch marks, and with little or no diastasis of the rectoabdominal musculature.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  20. Abdomen agudo por peritonitis tuberculosa. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Abraham Reyes Pérez

    2016-08-01

    Full Text Available Extrapulmonary tuberculosis is a bacterial infection that occurs outside the lung parenchyma. It is caused by different types of mycobacteria; the most common causative agent in humans is Mycobacterium tuberculosis. The case of a 17-year-old Angolan patient treated in a municipal hospital in Angola due to severe abdominal pain with generalized peritoneal reaction is presented. Several tests were performed, but they did not clarify the patient’s condition. Finally, she underwent surgery and an omental biopsy was taken. The histological study revealed the presence of tuberculoid granulomas, which led to the diagnosis of miliary tuberculosis. Cases of acute abdomen due to tuberculous peritonitis are very uncommon, in fact, this is the first case seen by the author of this report in forty years practicing as a surgeon.

  1. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. [Huge cystic tumor in the left upper abdomen].

    Science.gov (United States)

    Dornbusch, J; Hasselmann, J

    2012-04-01

    ABTRACT: We report the case of a 71-year-old man with a cystic tumor in the left upper abdomen and a long-standing history of symptoms. After completing clinical tests and imaging studies a laparotomy was performed. The tumor was removed together with the first jejunal loop and bowel reconstruction was completed by hand-sewn anastomosis. Histopathological analysis revealed a gastrointestinal stromal tumor classified as high risk.

  3. Auscultation of the Chest and Abdomen by Athletic Trainers.

    Science.gov (United States)

    McChesney, John A.; McChesney, John W.

    2001-06-01

    OBJECTIVE: To present a practical overview of the methods and techniques of auscultation of the chest and abdomen for use during the physical examination of athletes. Our intent is to provide information on this clinical technique to assist athletic trainers in recognizing and referring athletes presenting with potentially serious internal organ conditions. BACKGROUND: Use of the stethoscope is a clinical skill increasingly necessary for athletic trainers. Given the expanding breadth of both the assessment techniques used by athletic trainers and the populations they care for and the fact that clinical instruction guidelines have changed in the newly adopted National Athletic Trainers' Association Educational Competencies, our goal is to provide a framework upon which future instruction can be based. DESCRIPTION: This review covers the use of a stethoscope for auscultation of the chest and abdomen. Auscultation of the heart is covered first, followed by techniques for auscultating the breath sounds. Lastly, auscultation of the abdomen describes techniques for listening for bowel sounds and arterial bruits. CLINICAL ADVANTAGES: During the assessment of injuries to and illnesses of athletes, knowledge of auscultatory techniques is valuable and of increasing importance to athletic trainers. Athletic trainers who do not know how to perform auscultation may fail to recognize, and therefore fail to refer for further evaluation, athletes with potentially serious pathologic conditions.

  4. High-speed seatbelt pretensioner loading of the abdomen.

    Science.gov (United States)

    Foster, Craig D; Hardy, Warren N; Yang, King H; King, Albert I; Hashimoto, Syuzo

    2006-11-01

    This study characterizes the response of the human cadaver abdomen to high-speed seatbelt loading using pyrotechnic pretensioners. A test apparatus was developed to deliver symmetric loading to the abdomen using a seatbelt equipped with two low-mass load cells. Eight subjects were tested under worst-case scenario, out-of-position (OOP) conditions. A seatbelt was placed at the level of mid-umbilicus and drawn back along the sides of the specimens, which were seated upright using a fixed-back configuration. Penetration was measured by a laser, which tracked the anterior aspect of the abdomen, and by high-speed video. Additionally, aortic pressure was monitored. Three different pretensioner designs were used, referred to as system A, system B and system C. The B and C systems employed single pretensioners. The A system consisted of two B system pretensioners. The vascular systems of the subjects were perfused. Peak anterior abdominal loads due to the seatbelt ranged from 2.8 kN to 10.1 kN. Peak abdominal penetration ranged from 49 mm to 138 mm. Peak penetration speed ranged from 4.0 m/s to 13.3 m/s. Three cadavers sustained liver injury: one AIS 2, and two AIS 3. Cadaver abdominal response corridors for the A and B system pretensioners are proposed. The results are compared to the data reported by Hardy et al. (2001) and Trosseille et al. (2002).

  5. Perforated second trimester appendicitis with abdominal compartment syndrome managed with negative pressure wound therapy and open abdomen.

    Science.gov (United States)

    Turnock, Adam R; Fleischer, Brian P; Carney, Martin J; Vanderlan, Wesley B

    2016-06-14

    Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated with a novel approach, using non-commercial negative pressure wound therapy and open abdomen technique. Gestational integrity was preserved and the patient went on to experience a normal spontaneous vaginal delivery. At 5 years post-delivery the patient has had no surgical complications and her baby has met all developmental milestones.

  6. Diagnostic approach and management of acute abdominal pain.

    Science.gov (United States)

    Abdullah, Murdani; Firmansyah, M Adi

    2012-10-01

    The incidence of acute abdominal pain ranges between 5-10% of all visits at emergency department. Abdominal emergencies of hospital visits may include surgical and non-surgical emergencies. The most common causes of acute abdomen are appendicitis, biliary colic, cholecystitis, diverticulitis, bowel obstruction, visceral perforation, pancreatitis, peritonitis, salpingitis, mesenteric adenitis and renal colic. Good skills in early diagnosis require a sound knowledge of basic anatomy and physiology of gastrointestinal tract, which are reflected during history taking and particularly, physical examination of the abdomen. Advanced diagnostic approaches such as radiography and endoscopy enhance the treatment for acute abdomen including pharmacological and surgical treatment. Therapeutic endoscopy, interventional radiology treatment and therapy using adult laparoscopy are the common modalities for treating patients with acute abdomen.

  7. Clinical Study on Simple Obesity Treated with Abdomen Acupuncture

    Institute of Scientific and Technical Information of China (English)

    穆美君; 袁宜勤

    2008-01-01

    目的:观察腹针治疗单纯性肥胖症的临床疗效.方法:根据随机对照原则,将60例单纯性肥胖患者分为腹针组30例和体针组30例.治疗15次为1个疗程,共治疗2个疗程.以人体质量指数和体重下降情况来进行疗效评定.结果:第1个疗程后两组人体质量指数变化和疗效无统计学差异,两个疗程结束时两组人体质量指数和疗效有显着差异.结论:腹针治疗单纯性肥胖症效果较好,疗效持久稳定.%Objective: To observe the clinical effects of simple obesity treated with abdomen acupuncture. Methods: Sixty patients with simple obesity were allocated to abdomen acupuncture group and body acupuncture group based on the randomized and controlled principle, 30 patients in each group. Fifteen treatments made up one course. The cases were treated for 2 courses. The clinical effects were evaluated by body mass index (BMI) and the declining of body height. Result: The change of BMI and clinical effects were of no significant difference between two groups after 1 course, but there were significant differences after two courses. Conclusion: The clinical effect of abdomen acupuncture treating simple obesity is better, and the effect is persistent and stable.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. [Contribution of abdominal sonography in acute appendicitis diagnostics--our experience].

    Science.gov (United States)

    Smíd, D; Skalický, T; Treska, V

    2009-08-01

    Acute apendicitis is the most frequent case of acute abdomen. During a two year period (2006-2007) it was performed in Department of Surgery of Faculty Hospital in Pilsen 678 appendectomies, 30 days post-operative mortality rate was 0%. Abdomen ultrasonography like helping method to clinic examination was performed in 313 patients, suspect of acute appendicitis was in 191 patients (61%), in remaining patients was normal ultrasound picture.

  10. Acute leukemic appendicitis in a patient with acute promyelocytic leukemia

    Directory of Open Access Journals (Sweden)

    Hatim Karachiwala

    2012-01-01

    Full Text Available Leukemic and lymphomatous infiltration of the appendix is a rare complication. We present the case of a 31-year-old male with acute promyelocytic leukemia who developed acute abdomen on day 11 of induction chemotherapy with idarubicin and cytarabine. After appropriate work-up, a clinical diagnosis of acute appendicitis was made. Despite severe pancytopenia, he successfully underwent laparoscopic appendectomy. The final pathology revealed leukemic infiltration of the appendix. It is hypothesized that the leukemic infiltration may play a role in the development of acute appendicitis. Further, this case demonstrates the need to maintain a high index of suspicion and prompt surgical intervention for surgical pathologies in neutropenic patients.

  11. The larval abdomen of the enigmatic Nannochoristidae (Mecoptera, Insecta).

    Science.gov (United States)

    Fraulob, Maximilian; Wipfler, Benjamin; Hünefeld, Frank; Pohl, Hans; Beutel, Rolf G

    2012-03-01

    External and internal structures of the larval abdomen of Nannochorista are described in detail, with emphasis on the posterior segments. The results are compared with conditions found in other groups of Antliophora, especially the mecopteran subgroups Boreidae and Pistillifera. Like the entire postcephalic body, the larval abdomen of Nannochorista is extremely slender and nearly cylindrical. The anterior segments are largely unmodified. The surface is smooth and lacks any protuberances or prolegs. The term "cloaca" for the posterior membranous pouch of Nannochorista sp. is morphologically unjustified. A list of muscles of segments IX and X is presented. The abdominal musculature was partly homologized following Snodgrass. The muscles of segment X are highly modified. They move the membranous pouch, the anal papillae, and the terminal lobes. The presence of these structures is likely an adaptation to the specific aquatic life style of nannochoristid larvae. The anal papillae are possibly homologous to the 4-lobed terminal attachment apparatus of larvae of Caurinus (Boreidae) and Pistillifera (Panorpidae, Bittacidae, Choristidae) but this is uncertain. The specific condition in both groups, i.e. two retractile papillae with tracheae and Malpighian tubules in Nannochoristidae, and a 4-lobed exposed attachment device in Pistillifera + Boreidae (groundplan) are very likely autapomorphic for both groups, respectively. A slender abdomen with smooth surface is very likely plesiomorphic within Antliophora and Mecopterida. This condition is found in Trichoptera (partim), Nannochoristidae, Siphonaptera, and many basal groups of Diptera. An eruciform or scarabaeiform body shape with a soft, largely unsclerotised cuticle is probably a synapomorphy of Boreidae and Pistillifera. The presence of ventral protuberances resembling prolegs on the anterior segments is an autapomorphy of the latter group. The homology of paired or unpaired terminal appendages of segment X is

  12. Case of choledochal cyst presenting as perforation abdomen

    Directory of Open Access Journals (Sweden)

    Gobbur RH, Baradol R RV, Nyammannavar

    2013-01-01

    Full Text Available Choledochal cyst is an uncommon congenital anomaly of Hepoatobiliary system. It is a case of choledocal cyst presenting as perforation and biliary ascites which is rare in infants. Clinical picture: An infant was admitted at BLDE hospital with history of convulsion and breathlessness, on examination child had abdominal distension. Investigations like erect X ray abdomen done which revealed ascites with features of peritonitis, so exploratory laparotomy done which showed a choledochal cyst with perforation causing biliary ascites. Treatment: Child was treated in the pediatric intensive care unit for convulsion. Exploratory laparotomy done and the perforated choledochal cyst was sutured and drain placed in situ. The child improved from 2nd post operative day. Conclusion: Choledochal cyst can present as perforation, biliary ascites and peritonitis in infants. Therefore treatment should be oriented to this aspect also.

  13. Air gun injuries of the abdomen in children.

    Science.gov (United States)

    Morgan, J C; Turner, C S; Pennell, T C

    1984-12-01

    From July 18, 1978 to Sept 15, 1982, four boys were treated for air gun injuries of the abdomen at the North Carolina Baptist Hospital, Winston-Salem. Three patients had wounds of one or more of the hollow viscera, and one patient had an injury only of the liver. There was no morbidity or mortality following repair. Some present-day air (pneumatic) weapons have muzzle velocities that equal or exceed those of common civilian handguns, and they are frequently used by unsupervised children. These weapons are not restricted and regulated as are other firearms, and are believed to be incapable of serious injury other than to the eye. These cases and others in the literature dispute that belief.

  14. [Abdomen pendulum and subcutaneous injections: the complications. Two case reports].

    Science.gov (United States)

    Benhaim, T; Sinna, R; Garson, S; Boloorchi, A; Crozet, C; Robbe, M

    2007-06-01

    The authors present the complications due to subcutaneous injections on two patients suffering from morbid obesity with an abdomen pendulum. In the first case, injections of heparin of low molecular weight at curative dose, for treatment of a pulmonary embolism, have been complicated with a giant abdominal wall haematoma, the biggest ever reported. The initial treatment was insufficient so we had to practice a dermolipectomy to take off the haematoma of four litters. In the second case, insulin injections were complicated with cellulitis of the abdominal wall and a surgical treatment has been practiced in emergency. The first case reminds us the importance to change the sites of injections and to accommodate the dose, surgical treatment staying as simple as possible. The second case allows us to report a rare complication, not often published but known with obese patients. These two cases illustrate the importance of therapeutic education of the patient and the fact that a simple injection can be life threatening.

  15. Non-contrast-enhanced MR angiography of the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Miyazaki, Mitsue, E-mail: mmiyazaki@tmriusa.com [Toshiba Medical Research Institute, USA, 706N. Deerpath Dr., Vernon Hills, IL 60061 (United States); Isoda, Hiroyoshi [Toshiba Medical Research Institute, USA, 706N. Deerpath Dr., Vernon Hills, IL 60061 (United States); Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto (Japan)

    2011-10-15

    Non-contrast-enhanced magnetic resonance angiography (MRA) techniques have experienced a resurgence of interest in the MR community, in part because of safety concerns related to the possible link between gadolinium-based contrast agents and nephrogenic systemic fibrosis (NSF). In abdominal MRA, NSF is of particular concern, given that many of the patients may have renal disease. After introducing various non-contrast-enhanced MRA techniques, this article focuses on MRA applications in the abdomen, specifically the renal arteries and portal and hepatic veins. Developments on the horizon are discussed, including techniques that provide standardization of renal artery imaging, challenges in imaging of the hepatic arteries, and further advancement at 3 T.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Subperitoneal extension of disease processes between the chest, abdomen, and the pelvis.

    Science.gov (United States)

    Osman, Sherif; Moshiri, Mariam; Robinson, Tracy J; Gunn, Martin; Lehnert, Bruce; Sundarkumar, Dinesh; Katz, Douglas S

    2015-08-01

    The subserous space is a large, anatomically continuous potential space that interconnects the chest, abdomen, and pelvis. The subserous space is formed from areolar and adipose tissue, and contains branches of the vascular, lymphatic, and nervous systems. As such, it provides one large continuous space in which many disease processes can spread between the chest, abdomen, and the pelvis.

  18. Development of a Reusable, Rate-Sensitive Abdomen for the Hybrid III Family of Dummies.

    Science.gov (United States)

    Rouhana, S W; Elhagediab, A M; Walbridge, A; Hardy, W N; Schneider, L W

    2001-11-01

    The objective of this work was to develop a reusable, rate-sensitive dummy abdomen with abdominal injury assessment capability. The primary goal for the abdomen developed was to have good biofidelity in a variety of loading situations that might be encountered in an automotive collision. This paper presents a review of previous designs for crash dummy abdomens, a description of the development of the new abdomen, results of testing with the new abdomen and instrumentation, and suggestions for future work. The biomechanical response targets for the new abdomen were determined from tests of the mid abdomen done in a companion biomechanical study. The response of the abdominal insert is an aggregate response of the dummy's entire abdominal area and does not address differences in upper versus lower abdominal response, solid versus hollow organs, or organ position or mobility. While the abdomen developed has demonstrated good biofidelity in rigid bar, seat belt and airbag loading situations, some work remains to be done before it can be used in crash testing.

  19. Geographic variation in resource allocation to the abdomen in geometrid moths

    Science.gov (United States)

    Kivelä, Sami M.; Välimäki, Panu; Carrasco, David; Mäenpää, Maarit I.; Mänttäri, Satu

    2012-08-01

    A resource allocation trade-off is expected when resources from a common pool are allocated to two or more traits. In holometabolous insects, resource allocation to different functions during metamorphosis relies completely on larval-derived resources. At adult eclosion, resource allocation to the abdomen at the expense of other body parts can be seen as a rough estimate of resource allocation to reproduction. Theory suggests geographic variation in resource allocation to the abdomen, but there are currently no empirical data on it. We measured resource allocation to the abdomen at adult eclosion in four geometrid moths along a latitudinal gradient. Resource (total dry material, carbon, nitrogen) allocation to the abdomen showed positive allometry with body size. We found geographic variation in resource allocation to the abdomen in each species, and this variation was independent of allometry in three species. Geographic variation in resource allocation to the abdomen was complex. Resource allocation to the abdomen was relatively high in partially bivoltine populations in two species, which fits theoretical predictions, but the overall support for theory is weak. This study indicates that the geographic variation in resource allocation to the abdomen is not an allometric consequence of geographic variation in resource acquisition (i.e., body size). Thus, there is a component of resource allocation that can evolve independently of resource acquisition. Our results also suggest that there may be intraspecific variation in the degree of capital versus income breeding.

  20. Hernia interna de Quain como causa de abdomen agudo

    Directory of Open Access Journals (Sweden)

    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. Endoluminal contrast for abdomen and pelvis magnetic resonance imaging.

    Science.gov (United States)

    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.

  2. Stereo Matching Based on Immune Neural Network in Abdomen Reconstruction

    Directory of Open Access Journals (Sweden)

    Huan Liu

    2015-01-01

    Full Text Available Stereo feature matching is a technique that finds an optimal match in two images from the same entity in the three-dimensional world. The stereo correspondence problem is formulated as an optimization task where an energy function, which represents the constraints on the solution, is to be minimized. A novel intelligent biological network (Bio-Net, which involves the human B-T cells immune system into neural network, is proposed in this study in order to learn the robust relationship between the input feature points and the output matched points. A model from input-output data (left reference point-right target point is established. In the experiments, the abdomen reconstructions for different-shape mannequins are then performed by means of the proposed method. The final results are compared and analyzed, which demonstrate that the proposed approach greatly outperforms the single neural network and the conventional matching algorithm in precise. Particularly, as far as time cost and efficiency, the proposed method exhibits its significant promising and potential for improvement. Hence, it is entirely considered as an effective and feasible alternative option for stereo matching.

  3. [Two women with a chronic process in the lower abdomen].

    Science.gov (United States)

    van de Lande, J; Spanjaard, L; Burger, M P

    2003-11-29

    Two women, aged 50 and 45 years, had a chronic process in the lower abdomen. The first presented with cough and progressive dyspnoea, and her chest X-ray raised the suspicion of a metastasis of a malignancy. The second patient had abdominal pain, frequent urination and irregular vaginal bleeding. She was initially treated for a urinary-tract infection. Diagnostic investigations showed pelvic actinomycosis in both patients. Both had used an intrauterine device (IUD). In the first patient a pelvic abscess was drained. Antimicrobial treatment consisted of penicillin i.v. for several weeks and orally for 6 months. Actinomycosis is a slowly progressive bacterial infection that characteristically expands through anatomic structures and can lead to fistulae and abscesses. The disease is caused by Actinomyces species. Diagnosis is often delayed because other diseases (e.g. malignancy) are considered more probable. Actinomycosis is associated with prolonged use of an IUD, but it is rare and removal of the IUD is not indicated unless symptoms of pelvic inflammatory disease are present. The mainstay of actinomycosis therapy is administration of an effective antibiotic (e.g. penicillin). Except for drainage of abscesses, surgical intervention is rarely necessary. When antimicrobial therapy is continued for 6-9 months, prognosis is favourable, as was the case in both patients.

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

    Science.gov (United States)

    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.

  5. Acute amebic appendicitis: report of a rare case.

    Science.gov (United States)

    Singh, Naorem Gopendro; Mannan, A A S Rifat; Kahvic, Mirza

    2010-01-01

    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.

  6. Case Report and Management of Suspected Acute Appendicitis in Pregnancy

    OpenAIRE

    Murariu, Daniel; Tatsuno, Brent; Hirai, Cori-Ann M; Takamori, Ryan

    2011-01-01

    Suspected cases of acute appendicitis in pregnancy are considered surgical emergencies due to the potentially devastating outcomes for both mother and unborn child if the appendix perforates. Acute appendicitis is also the number one cause of non-traumatic acute abdomen in pregnancy, as well as the number one cause of fetal death. We present a case report with a typical presentation of suspected acute appendicitis in a pregnant woman. The work up and diagnostic tools available are discussed a...

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

    Directory of Open Access Journals (Sweden)

    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

  8. Quantification of the thorax-to-abdomen breathing ratio for breathing motion modeling.

    Science.gov (United States)

    White, Benjamin M; Zhao, Tianyu; Lamb, James; Bradley, Jeffrey D; Low, Daniel A

    2013-06-01

    The purpose of this study was to develop a methodology to quantitatively measure the thorax-to-abdomen breathing ratio from a 4DCT dataset for breathing motion modeling and breathing motion studies. The thorax-to-abdomen breathing ratio was quantified by measuring the rate of cross-sectional volume increase throughout the thorax and abdomen as a function of tidal volume. Twenty-six 16-slice 4DCT patient datasets were acquired during quiet respiration using a protocol that acquired 25 ciné scans at each couch position. Fifteen datasets included data from the neck through the pelvis. Tidal volume, measured using a spirometer and abdominal pneumatic bellows, was used as breathing-cycle surrogates. The cross-sectional volume encompassed by the skin contour when compared for each CT slice against the tidal volume exhibited a nearly linear relationship. A robust iteratively reweighted least squares regression analysis was used to determine η(i), defined as the amount of cross-sectional volume expansion at each slice i per unit tidal volume. The sum Ση(i) throughout all slices was predicted to be the ratio of the geometric expansion of the lung and the tidal volume; 1.11. The Xiphoid process was selected as the boundary between the thorax and abdomen. The Xiphoid process slice was identified in a scan acquired at mid-inhalation. The imaging protocol had not originally been designed for purposes of measuring the thorax-to-abdomen breathing ratio so the scans did not extend to the anatomy with η(i) = 0. Extrapolation of η(i)-η(i) = 0 was used to include the entire breathing volume. The thorax and abdomen regions were individually analyzed to determine the thorax-to-abdomen breathing ratios. There were 11 image datasets that had been scanned only through the thorax. For these cases, the abdomen breathing component was equal to 1.11 - Ση(i) where the sum was taken throughout the thorax. The average Ση(i) for thorax and abdomen image datasets was found to be 1.20

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

    Science.gov (United States)

    Chen, Yang; Yin, Xindao; Shi, Luyao; Shu, Huazhong; Luo, Limin; Coatrieux, Jean-Louis; Toumoulin, Christine

    2013-08-01

    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.

  10. Síndrome de abdomen en ciruela pasa y dextrocardia, asociación infrecuente

    OpenAIRE

    2015-01-01

    Se describe un neonato con Síndrome de abdomen en ciruela pasa, de sexo masculino, nacido de 36 semanas de gestación y pesó 3 650 g al nacer. El examen clínico mostró un neonato con un abdomen globuloso, con redundancia de la piel que huelga a los costados rebosantes, la palpación del abdomen no descubre la tonalidad muscular. No se palpa visceromegalia y hay presencia normal de ruidos hidroaéreos. El examen físico del tórax y cardiovascular fueron aparentemente normales. Normocéfalo y facies...

  11. [Acupuncture and tuina clinical thoughts of "treating the back from abdomen" for low back pain].

    Science.gov (United States)

    Liu, Jinlong; Li, Rui

    2015-07-01

    In clinical treatment, it is found that certain patients always have some positive reaction points those are relevant with low back pain in the abdomen area. When the simple treatment on the low back is ineffective, the efficacy could be significantly improved if acupuncture or tuina is performed at the abdomen areas, which is called "regulating yin to treat yang", or "treating the back from abdomen". In this paper, with the diagnosis and treatment method of "treating the back from abdomen" for low back pain as principal line, the detailed manipulation is explained for low back pain that is induced by TCM meridian diseases or modern anatomy, which could open the methods for clinical treatment of low back pain and enrich the therapeutic options.

  12. The effect of the abdomen deformation on the longitudinal stability of flying insects

    Science.gov (United States)

    Choi, Sang-Yeon; Kim, Joong-Kwan; Han, Jong-seob; Han, Jae-Hung

    2015-03-01

    In this paper, we derive longitudinal nonlinear equations of motion of a hovering insect with deformable abdomen to investigate the effect of the abdominal motion to the longitudinal dynamics. The blade-element theory, which is based on experimentally obtained aerodynamic coefficients, is used for the periodic force and moment excitation to the system. Here, we focus on the role of the deformable abdomen to investigate whether or not the flexible body is a decisive factor to the longitudinal flight dynamic stability. Three cases: 1) rigid connection between the thorax and abdomen, 2) flexible connection, and 3) active connection with a feedback control, are compared to check the role of the abdomen deformation on the longitudinal flight dynamic stability, by examining eigenvalues of the linearized system model of each case. The results show that an active control of the abdominal angle can stabilize the longitudinal flight dynamics of the insect modeled in this study.

  13. Open abdomen management: A review of its history and a proposed management algorithm

    Science.gov (United States)

    Kreis, Barbara Elize; de Mol van Otterloo, Johan Coenraad Alexander; Kreis, Robert Walter

    2013-01-01

    In this review we look into the historical development of open abdomen management. Its indication has spread in 70 years from intra-abdominal sepsis to damage control surgery and abdominal compartment syndrome. Different temporary abdominal closure techniques are essential to benefit the potential advantages of open abdomen management. Here, we discuss the different techniques and provide a new treatment strategy, based on available evidence, to facilitate more consistent decision making and further research on this complicated surgical topic. PMID:23823991

  14. Acute Ischaemic Colitis- A Case Report

    Directory of Open Access Journals (Sweden)

    M Basra

    2012-03-01

    Full Text Available Acute ischaemic colitis (AIC is being increasingly recognised as an uncommon cause of abdominal pain associated with fresh bleeding per rectum. It is paramount to maintain a high index of suspicion and adopt appropriate management strategies to avoid complications and inappropriate interventions. In this paper, we describe a case of AIC and review literature pertinent to the management of this condition. Keywords: Ischaemic colitis, acute abdomen, management.

  15. The Onset of Intra-Abdominal Adhesions During Closed-Abdomen Hyperthermic Intraperitoneal Chemotherapy.

    Science.gov (United States)

    Lotti, Marco; Giulii Capponi, Michela; Campanati, Luca; Poiasina, Elia; Ansaloni, Luca; Poletti, Eugenio; Frigerio, Luigi

    2016-12-01

    Hyperthermic intraperitoneal chemotherapy (HIPEC) is delivered after cytoreductive surgery (CRS) in selected patients with peritoneal carcinomatosis. The closed-abdomen technique, preferred by many centers, prevents heat loss and drug spillage, but does not warrant homogeneous distribution of the perfusion fluid (PF). The hypothesized formation of intra-abdominal adhesions during the closed-abdomen perfusion period has never been described. From March 2014 to April 2016, 10 consecutive patients with peritoneal carcinomatosis, selected for CRS, underwent the Laparoscopy-Enhanced HIPEC technique to explore the abdominal cavity during the perfusion. The aim of the study was to investigate the incidence and the extent of intra-abdominal adhesions that are formed after CRS during the perfusion period of closed-abdomen HIPEC. During the perfusion, adhesions developed in 70% of the patients. Adhesions developed mainly in the period between the closure of the abdomen and the subsequent filling of the abdomen with the PF. After their first division, during the following perfusion period, adhesions between the bowel and the abdominal wall reformed in 3 patients (30%). Intra-abdominal adhesions are frequently formed during closed-abdomen HIPEC and can hamper the adequate circulation of the PF. The Laparoscopy-Enhanced technique enables the early detection and the division of any intra-abdominal adhesions.

  16. Management of the open abdomen using combination therapy with ABRA and ABThera systems

    Science.gov (United States)

    Mukhi, Alfin N.; Minor, Samuel

    2014-01-01

    Background The open abdomen is an increasingly used technique that is applied in a wide variety of clinical situations. The ABThera Open Abdomen Negative Pressure Therapy System is one of the most common and successful temporary closure systems, but it has limited ability to close the fascia in approximately 30% of patients. The abdominal reapproximation anchor system (ABRA) is a dynamic closure system that seems ideal to manage patients who may not achieve primary fascial closure with ABThera alone. We report on the use of the ABRA in conjunction with the ABThera in patients with an open abdomen. Methods We retrospectively analyzed patients with an open abdomen managed with the ABThera and ABRA between January 2007 and December 2012 at the Halifax Infirmary, QEII Health Science Centre, Halifax, Nova Scotia. Results Sixteen patients had combination therapy using the ABRA and ABThera systems for treatment of the open abdomen. After removing patients who died prior to closure, primary fascial closure was achieved in 12 of 13 patients (92%). Conclusion We observed a high rate of primary fascial closure in patients with an open abdomen managed with the ABThera system in conjuction with the ABRA. Applying mechanical traction in addition to the ABThera should be considered in patients predicted to be at high risk for failure to achieve primary fascial closure. PMID:25265104

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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.

  19. Diagnosis of acute surgical abdomen – The best diagnostic tool to reach a final diagnosiscin

    Directory of Open Access Journals (Sweden)

    CS Wong

    2012-01-01

    Conclusions: Appendicitis can be accurately diagnosed clinically based on history and clinical examination alone. Diagnosis of diverticular disease, gallstone disease, and bowel obstruction further requires radiology intervention to confirm the provisional diagnosis.

  20. Peritoneal Lavage in the Diagnosis of Acute Surgical Abdomen Following Thermal Injury.

    Science.gov (United States)

    1995-01-01

    disease, others6𔄂-15 have confirmed his Sepsis syndrome 13 findings. Hoffman16 reviewed the literature on the use of Abdominal distension 11 Ileus 7 DPL...developed sepsis, ileus , and abdominal distention 98 Fourteen of the 17 patients died, a mortality rate of 82%. days following injury. Lavage fluid...the greater omentum. The difficulty in diag- whelming pulmonary sepsis or multisystem organ failure, nosing biliary disease with DPL has been

  1. A Child with Severe Malaria Presenting with Acute Surgical Abdomen (Duodenal Perforation

    Directory of Open Access Journals (Sweden)

    Tika Ram Bhandari

    2016-01-01

    Full Text Available Plasmodium falciparum, the commonest cause of severe malaria in children, is an important cause of mortality in developing nations like Nepal. Duodenal perforation in a case of complicated malaria, although a rare entity, can occur in children. Early diagnosis, proper medical treatment, and early surgical repair can be a lifesaving measure in such cases. Here, we report a case of a 5-year-old male child with falciparum malaria complicated by a duodenal perforation that was successively managed with appropriate antimalarial drugs and early surgical repair.

  2. A Child with Severe Malaria Presenting with Acute Surgical Abdomen (Duodenal Perforation).

    Science.gov (United States)

    Bhandari, Tika Ram; Shahi, Sudha; Poudel, Rajesh; Chaudhary, Nagendra

    2016-01-01

    Plasmodium falciparum, the commonest cause of severe malaria in children, is an important cause of mortality in developing nations like Nepal. Duodenal perforation in a case of complicated malaria, although a rare entity, can occur in children. Early diagnosis, proper medical treatment, and early surgical repair can be a lifesaving measure in such cases. Here, we report a case of a 5-year-old male child with falciparum malaria complicated by a duodenal perforation that was successively managed with appropriate antimalarial drugs and early surgical repair.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    OpenAIRE

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

    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 b...

  5. LESIONES VASCULARES TRAUMÁTICAS DE CUELLO, TÓRAX Y ABDOMEN / Traumatic vascular injuries of the neck, thorax and abdomen

    Directory of Open Access Journals (Sweden)

    Luis Reinerio Rodríguez Delgado

    2010-03-01

    Full Text Available Introduction and Objectives: Vascular injuries have been described since the ancient times. They represent 3 percent of traumatisms; and the most worrisome aspect is their dangerousness, because more than half of the patients die within the first 24 hours due to the hemorrhages they cause. This investigation was carried out with the objective of determining the incidence of the different types of vascular injuries at the Arnaldo Milian Castro Hospital. Method: A retrospective study in 21 patients who were hospitalized with diagnoses of vascular injuries in the neck, thorax and abdomen was carried out. The medical histories of the patients were analyzed, as well as the surgery reports and the necropsy protocols in the case of the deceased. Results: There was a predominance of penetrating wounds in the abdomen (38.9 % and in the thorax (19.05 %, as well as thoracic and abdominal closed traumas. The accidental cause was present in 57.2 percent of the patients. The most affected anatomical region was the abdomen (42.86 %, and the most used surgical procedure was the exploratory laparotomy (76.2 %. An average of 1.21 procedures per patient was carried out. The hypovolemic shock was the complication with the highest incidence, because it appeared in 11 patients (52.38 %, this represents 68.75 percent of all complications. Eleven patients (52.38 % stayed less than 3 days in hospital. The lesions of the spleen and its vascular pedicle appeared in 23.81 percent of the patients. Conclusions: Penetrating wounds in the abdomen, accidents as a cause of them, and the exploratory laparotomy were predominant. The most affected anatomical area was the abdomen and the hypovolemic shock was the most common complication.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. ANSWER: Recurrent abdomen pain and tympanic right upper quadrant.

    Directory of Open Access Journals (Sweden)

    Vui Heng CHONG

    2011-06-01

    Full Text Available Answer: Chilaiditi’s sign and Chilaiditi’s syndromeChilaiditi’s sign is defined by the asymptomatic interposition of part of the intestine(commonly the hepatic flexure of the colonbetween the right hemi-diaphragm and the liver. It is usually an incidental finding. When symptomatic, it is referred to as the Chilaiditi’s syndrome. Presentations may range from intermittent recurrent mild abdominal pain to acute intestinal volvulus, though the symptoms reported so far have been inconsistent between different patients and can be nonspecific.

  8. 3D deformation and dynamics of the human cadaver abdomen under seatbelt loading.

    Science.gov (United States)

    Lamielle, Sophie; Vezin, Philippe; Verriest, Jean-Pierre; Petit, Philippe; Trosseille, Xavier; Vallancien, Guy

    2008-11-01

    According to accident analysis, submarining is responsible for most of the frontal car crash AIS 3+ abdominal injuries sustained by restrained occupants. Submarining is characterized by an initial position of the lap belt on the iliac spine. During the crash, the pelvis slips under the lap belt which loads the abdomen. The order of magnitude of the abdominal deflection rate was reported by Uriot to be approximately 4 m/s. In addition, the use of active restraint devices such as pretensioners in recent cars lead to the need for the investigation of Out-Of-Position injuries. OOP is defined by an initial position of the lap belt on the abdomen instead of the pelvis resulting in a direct loading of the abdomen during pretensioning and the crash. In that case, the penetration speed of the belt into the abdomen was reported by Trosseille to be approximately 8 to 12 m/s. The aim of this study was to characterize the response of the human abdomen in submarining and OOP. A total of 8 PMHS abdomens were loaded using a lap belt. In order to investigate the injury mechanisms, the abdominal deflection rate and the compression were imposed such that they were not correlated. The specimens were seated upright in a fixed back configuration. The lap belt was placed at the level of the mid-umbilicus, between the iliac crest and the 12th rib. The belt was pulled horizontally along the sides of the specimens causing a symmetrical loading of the abdomen. In addition to the local parameters such as the belt and back forces or the belt displacements, the 3D external deformation of the abdomen was recorded. The forces measured between the back of the cadaver and the seat showed that a mass effect should be taken into account in the abdominal behaviour in addition to viscosity. The back force was greater than the belt force in low speed (submarining like) tests while it was lower for high-speed (OOP like) tests. A lumped parameter model was developed to confirm the experimental results and

  9. Abdominal wall muscle elasticity and abdomen local stiffness on healthy volunteers during various physiological activities.

    Science.gov (United States)

    Tran, D; Podwojewski, F; Beillas, P; Ottenio, M; Voirin, D; Turquier, F; Mitton, D

    2016-07-01

    The performance of hernia treatment could benefit from more extensive knowledge of the mechanical behavior of the abdominal wall in a healthy state. To supply this knowledge, the antero-lateral abdominal wall was characterized in vivo on 11 healthy volunteers during 4 activities: rest, pullback loading, abdominal breathing and the "Valsalva maneuver". The elasticity of the abdominal muscles (rectus abdominis, obliquus externus, obliquus internus and transversus abdominis) was assessed using ultrasound shear wave elastography. In addition, the abdomen was subjected to a low external load at three locations: on the midline (linea alba), on the rectus abdominis region and on lateral muscles region in order to evaluate the local stiffness of the abdomen, at rest and during "Valsalva maneuver". The results showed that the "Valsalva maneuver" leads to a statistically significant increase of the muscle shear modulus compared to the other activities. This study also showed that the local stiffness of the abdomen was related to the activity. At rest, a significant difference has been observed between the anterior (0.5N/mm) and the lateral abdomen locations (1N/mm). Then, during the Valsalva maneuver, the local stiffness values were similar for all locations (ranging from 1.6 to 2.2N/mm). This work focuses on the in vivo characterization of the mechanical response of the human abdominal wall and abdomen during several activities. In the future, this protocol could be helpful for investigation on herniated patients.

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

    Directory of Open Access Journals (Sweden)

    Pramod Kumar

    2013-01-01

    Full Text Available 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 study the gross anatomy of future localized fat deposits (LFDs area of abdomen in fetus. Materials and Methods: Four fetus (two male & two female of four month of intrauterine life were dissected. Attachments & layers of superficial fascia and future subcutaneous fat deposit area of upper and lower abdomen were noted. Results: Superficial fascia of the abdomen was multi layered in mid line and number of layers reduced laterally as in adult. The future abdominal LFD (localized fat deposits area in fetus shows brownish-white blubbary tissue without well-defined adult fat lobules. Conclusion: The attachment and gross anatomy of superficial fascia of the fetus was similar to that in adults. The future LFD areas showed brownish white blubbary tissue with ill-defined fat lobules.

  11. Abdomen-thigh contact during forward reaching tasks in obese individuals.

    Science.gov (United States)

    Singh, Bhupinder; Brown, Thomas D; Callaghan, John J; Yack, H John

    2013-10-01

    During seated forward reaching tasks in obese individuals, excessive abdominal tissue can come into contact with the anterior thigh. This soft tissue apposition acts as a mechanical restriction, altering functional biomechanics at the hip, and causing difficulty in certain daily activities such as bending down, or picking up objects from the floor. The purpose of the study was to investigate the contact forces and associated moments exerted by the abdomen on the thigh during seated forward-reaching tasks in adult obese individuals. Ten healthy subjects (age 58.1 ± 4.4) with elevated BMI (39.04 ± 5.02) participated in the study. Contact pressures between the abdomen and thigh were measured using a Tekscan Conformat pressure-mapping sensor during forward-reaching tasks. Kinematic and force plate data were obtained using an infrared motion capture system. The mean abdomen-thigh contact force was 10.17 ± 5.18% of body weight, ranging from 57.8 N to 200 N. Net extensor moment at the hip decreased by mean 16.5 ± 6.44% after accounting for the moment generated by abdomen-thigh tissue contact. In obese individuals, abdomen-thigh contact decreases the net moment at the hip joint during seated forward-reaching activities. This phenomenon should be taken into consideration for accurate biomechanical modeling in these individuals.

  12. Evaluation of dosimetry and image quality of computerized tomography abdomen protocols; Avaliacao de dose e qualidade da imagem em protocolos de abdomen em tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Maues, Nadine H.P.B.; Alves, Allan F.F.; Bacchim Neto, Fernando A.; Pina, Diana R. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil)

    2016-07-01

    In this study, we evaluate the dosimetry and image quality of computed tomography multislice abdomen protocols for different tube current modulation techniques (ATCM). We used the 16-slice Toshiba Activion CT scanner with the 'SureExposure3D' ATCM system. Thermoluminescent dosimeters were placed inside the anthropomorphic phantom Alderson-Rando for dosimetric assessments. An analytical phantom was used for the objective evaluation of image quality. It is observed that the higher standard deviation technique (SD) has the lowest value of effective dose. The use of different tube current modulation techniques showed significant reduction of radiation doses for the abdomen exams in computed tomography. The ATCM protocols can be an excellent alternative to dose reduction in CT scans, since it does not impair the diagnostic image quality. (author)

  13. A phantom pig abdomen as an alternative for testing robotic surgical systems: our experience.

    Science.gov (United States)

    Ristolainen, Asko; Colucci, Gianluca; Kruusmaa, Maarja

    2013-11-01

    The use of animals for testing and validating new medical devices and surgical techniques has raised ethical issues for a long time. Following the introduction of the Three Rs principle, significant efforts have been made to achieve a reduction in the numbers of animals used in testing. Nevertheless, the number of large animals used for testing purposes is still too high. This article describes a potential alternative to the use of large animals in the early phase of the development of surgical equipment -- a high-definition phantom pig abdomen. The phantom pig abdomen was developed from computed tomography scans by using affordable materials, and it was used with two different robotic platforms. It permitted the testing of minimally-invasive robotic pancreatic enucleation, with or without intraoperative ultrasound guidance. The phantom pig abdomen has proven to be a realistic tool, with the potential to reduce the cost and time-frame of the experiments. 2013 FRAME.

  14. Verifique sus conocimientos sobre radiología del abdomen (II)

    OpenAIRE

    Galimany Masclans, Jordi

    2008-01-01

    Esta entrega, que forma parte de una serie sobre las pruebas complementarias que se inició en Nursing 2007 de abril, está dedicada a la radiología del abdomen. La primera parte del estudio de abdomen se dedicó a las características generales, las densidades y la descripción de las imágenes radiológicas normales más usuales y cómo diferenciarlas. Esta segunda entrega de abdomen profundiza en el estudio de las imágenes radiológicas normales y las compara con las imágenes radiológicas patológica...

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

    Institute of Scientific and Technical Information of China (English)

    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

  16. Foreign bodies in the abdomen: self-harm and personality disorders.

    Science.gov (United States)

    Dunphy, Louise; Syed, Farah; Raja, Mazhar

    2015-08-05

    A 52-year-old woman presented to the accident and emergency department 5 h after deliberately stabbing herself with two pens through her midline laparotomy scar. Her medical history included an emotionally unstable (borderline) personality disorder and she was currently an inpatient in a psychiatric hospital. She had multiple accident and emergency attendances with previous episodes of self-harm. Clinical examination revealed evidence of trauma to her midline laparotomy scar with congealed blood covering the puncture site. Her abdomen was soft and non-tender on palpation. A chest radiograph revealed no air beneath her diaphragm and her abdominal radiograph identified a radiopacity in her upper right abdomen and dilated loops of small bowel. CT of the abdomen and pelvis confirmed two pens, with the lower pen tip reaching the pancreas. A midline laparotomy was performed and both foreign bodies were extricated unremarkably. The patient's postoperative recovery was uneventful. The second case involves a 22-year-old woman, a psychiatric hospital resident, presenting to the accident and emergency department 5 h after deliberately inserting the metal nib and inner plastic ink containing tube of a pen through her umbilicus. Her medical history included an emotionally unstable (borderline) personality disorder and paranoid schizophrenia. She had multiple accident and emergency department attendances with previous episodes of self-harm. Clinical examination revealed a soft, non-tender abdomen. Her chest radiograph was unremarkable and her abdominal radiograph identified a radiopaque foreign body at the right upper quadrant of the abdomen. CT of the abdomen and pelvis confirmed a metallic foreign body in the small bowel mesentery. An exploratory laparotomy converted to a midline laparotomy was performed and the foreign body was extricated. The patient's postoperative recovery was uneventful.

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

    OpenAIRE

    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 ...

  18. UNUSUAL PRESENTATION OF EXTRASKELETAL MESENCHYMAL CHONDROSARCOMA OF ABDOMEN IN 10 YR OLD GIRL- A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ramani

    2013-01-01

    Full Text Available ABSTRACT: Mesenchymal chondrosarcoma (MSC is rare form of ch ondrosarcoma which usually arises in bone. Extraskeletal mesenchymal c hondrosarcomas are far less common and accounts approximately 30–50% of all mesenchymal chon drosarcomas. We report a rare case of intra-abdominal extraskeletal MSC in a 10 yr old gi rl who presented with biliary vomitings and abdominal pain. Ultrasound abdomen showed 42x24 mm h ypoechoic mass in right iliac fossa. CT abdomen showed calcified granulomas in spleen, Soft tissue dense lesion in right iliac fossa, suggestive of lymphadenopathy. Histopathology and immu nohistochemistry confirmed the diagnosis of MSC

  19. Experiencia en el cuidado de enfermería: herida de abdomen abierto en el adulto

    OpenAIRE

    Castro Becerra, Ricardo Alfonso; Rubiano Mesa, Yurian Lida

    2012-01-01

    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 ...

  20. Acute gastric ulcer perforation in a 35 weeks' nulliparous patient with gastric banding.

    Science.gov (United States)

    Erez, Offer; Maymon, Eli; Mazor, Moshe

    2004-11-01

    We present a case of a primiparous patient at 35 weeks' gestation who had had laparoscopic gastric banding, and who presented to labor and delivery with protracted vomiting followed by an acute abdomen and fetal distress. An emergency surgery revealed acute gastric ulcer perforation. This complication, although rare, should be considered.

  1. Acute abdominal conditions in people with sickle cell disease: A 10 ...

    African Journals Online (AJOL)

    2011-06-15

    Jun 15, 2011 ... Six cases of surgical acute abdomen in sickle cell disease patients ... Acute abdominal conditions, Port Harcourt, sickle cell anaemia ... un diagnostic précoce et le traitement approprié. .... [10,11] This approach has been.

  2. Partitioning of the contributions of rib cage and abdomen to ventilation in ankylosing spondylitis

    Science.gov (United States)

    Grimby, Gunnar; Fugl-Meyer, Axel R.; Blomstrand, Ann

    1974-01-01

    Grimby, G., Fugl-Meyer, A. R., and Blomstrand, A. (1974).Thorax,29, 179-184. Partitioning of the contributions of rib cage and abdomen to ventilation in ankylosing spondylitis. The relative contributions of the rib cage and abdomen to ventilation were studied in the sitting position in patients with ankylosing spondylitis, using measurements of changes in the anteroposterior diameters. The functional impairment of the spine and adjacent joints was also evaluated. In most patients vital capacity and total lung capacity were reduced, but functional residual capacity was normal. The relative contribution of the rib cage to ventilation was reduced at rest compared to normal subjects, and decreased further during hyperventilation induced by rebreathing. The end-expiratory level of the abdomen decreased more markedly during hyperventilation than in normal subjects and even the end-inspiratory level of the abdomen increased somewhat. The findings are consistent with a reduced mobility of the ribs and a greater than normal excursion of the diaphragm during breathing. PMID:4831523

  3. Underdiagnosis of Vertebral Collapse on Routine Multidetector Computed Tomography Scan of the Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Obaid, H.; Husamaldin, Z.; Bhatt, R. (Doncaster Royal Infirmary, Doncaster (United Kingdom))

    2008-09-15

    Background: Vertebral fractures are commonly associated with osteoporosis and have significant morbidity and mortality rates. Osteoporotic vertebral fractures are presently considered as a treatable and preventable condition, and early detection is vital for further management. The evaluation of vertebral compression on multidetector computed tomography (MDCT) scans of the abdomen has, to our knowledge, not been reported before. Purpose: To assess the prevalence of vertebral collapse on routine abdominal CT scans, and to evaluate the usefulness of the multiplanar reconstruction (MPR) capability of MDCT scans in accurately identifying vertebral abnormalities such as vertebral collapse, spondylolisthesis, and retrolisthesis. Material and Methods: A retrospective review of 307 MDCT scans of the abdomen was carried out at a university teaching hospital. Identifiable patient information was anonymized for data protection. All images were reviewed on a picture archiving and communications system (PACS) using sagittal MPR and bone window for the assessment of the vertebrae. Data were collected from the Computerized Radiology Information System (CRIS). Results: Vertebral collapse was seen in 42 (13.6%) of the 307 patients undergoing routine MDCT of the abdomen. Multilevel and single-level collapses were seen in 24 and 18 patients, respectively. Spondylolisthesis was identified in 5.5% (n=17), and retrolisthesis was seen in 0.6% (n=2). All patients with vertebral fracture were older than 50 years. Women were more commonly affected than men. Conclusion: A significant number of patients with vertebral collapse were diagnosed using MPR on MDCT routine scans of the abdomen

  4. Critical Structure for Telescopic Movement of Honey bee (Insecta: Apidae) Abdomen: Folded Intersegmental Membrane.

    Science.gov (United States)

    Zhao, Jieliang; Yan, Shaoze; Wu, Jianing

    2016-01-01

    The folded intersegmental membrane is a structure that interconnects two adjacent abdominal segments; this structure is distributed in the segments of the honey bee abdomen. The morphology of the folded intersegmental membrane has already been documented. However, the ultrastructure of the intersegmental membrane and its assistive role in the telescopic movements of the honey bee abdomen are poorly understood. To explore the morphology and ultrastructure of the folded intersegmental membrane in the honey bee abdomen, frozen sections were analyzed under a scanning electron microscope. The intersegmental membrane between two adjacent terga has a Z-S configuration that greatly influences the daily physical activities of the honey bee abdomen. The dorsal intersegmental membrane is 2 times thicker than the ventral one, leading to asymmetric abdominal motion. Honey bee abdominal movements were recorded using a high-speed camera and through phase-contrast computed tomography. These movements conformed to the structural features of the folded intersegmental membrane. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America.

  5. Commentary on Predictors of Failed Primary Abdominal Closure in the Trauma Patient with an Open Abdomen

    Science.gov (United States)

    2013-05-01

    the other. A review suggested that although the generic three-layer vacuum pack technique (nonadhesive bowel drape, towel, closed suction drains) for...initial TAC after index laparotomy, nutrition sup- port in patients with an open abdomen, methods for ongoing TAC to include fascial-based and negative

  6. Daily and seasonal patterns in abdomen color in Diaphoria citri (Hemiptera: Psyllidae)

    Science.gov (United States)

    Diaphorina citri Kuwayama, a psyllid vector of huanglongbing (citrus greening disease), exhibits three more or less distinct abdomen colors in the adult psyllid: gray/brown, blue/green, and orange/yellow. We explored the daily (in individuals in the laboratory) and seasonal (in a field population) p...

  7. miR-965 controls cell proliferation and migration during tissue morphogenesis in the Drosophila abdomen

    DEFF Research Database (Denmark)

    Verma, Pushpa; Cohen, Stephen M

    2015-01-01

    Formation of the Drosophila adult abdomen involves a process of tissue replacement in which larval epidermal cells are replaced by adult cells. The progenitors of the adult epidermis are specified during embryogenesis and, unlike the imaginal discs that make up the thoracic and head segments...

  8. Medical Student Satisfaction in Learning the Physical Exam of the Abdomen.

    Science.gov (United States)

    Dalessandri, Kathie M.; Guernsey, James M.

    1990-01-01

    A study evaluated a teaching model in which contact between medical students, patients, and physicians was maximized. Each student (n=96) learned the physical examination of the abdomen and genitourinary system through contact with four patients, a plastic model, and five physicians. Students appreciated the interaction and physician role models.…

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

    DEFF Research Database (Denmark)

    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...

  10. Medical Student Satisfaction in Learning the Physical Exam of the Abdomen.

    Science.gov (United States)

    Dalessandri, Kathie M.; Guernsey, James M.

    1990-01-01

    A study evaluated a teaching model in which contact between medical students, patients, and physicians was maximized. Each student (n=96) learned the physical examination of the abdomen and genitourinary system through contact with four patients, a plastic model, and five physicians. Students appreciated the interaction and physician role models.…

  11. 505 Effective Medicated Abdomen Wrapper Best External Care for Lingering Diseases Unconventional Product for Vigorous Health

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    505 Effective Medicated Abdomen Wrapper,a national patent product(patent num-ber 90202386.1),together with its serial products,has filled in the gaps in the field ofChina’s medical science and health care products.The development of the product wasbrought into line with the State Spark Programme by the State Commission for Science

  12. Abdomen/pelvis computed tomography in staging of pediatric Hodgkin Lymphoma: is it always necessary?

    Science.gov (United States)

    Farruggia, Piero; Puccio, Giuseppe; Sala, Alessandra; Todesco, Alessandra; Terenziani, Monica; Mura, Rosamaria; D'Amico, Salvatore; Casini, Tommaso; Mosa, Clara; Pillon, Marta; Boaro, Maria Paola; Bottigliero, Gaetano; Burnelli, Roberta; Consarino, Caterina; Fedeli, Fausto; Mascarin, Maurizio; Perruccio, Katia; Schiavello, Elisabetta; Trizzino, Angela; Ficola, Umberto; Garaventa, Alberto; Rossello, Mario

    2016-09-01

    The purpose of the study was to determine if abdomen/pelvis computed tomography (CT) can be safety omitted in the initial staging of a subgroup of children affected by Hodgkin Lymphoma (HL). Every participating center of A.I.E.O.P (Associazione Italiana di Ematologia ed Oncologia Pediatrica) sent local staging reports of 18F-fluorodeoxyglucose positron emission tomography (PET) and abdominal ultrasound (US) along with digital images of staging abdomen/pelvis CT to the investigation center where the CT scans were evaluated by an experienced pediatric radiologist. The local radiologist who performed the US was unaware of local CT and PET reports (both carried out after US), and the reviewer radiologist examining the CT images was unaware of local US, PET and CT reports. A new abdominal staging of 123 patients performed on the basis of local US report, local PET report, and centralized CT report was then compared to a simpler staging based on local US and PET. No additional lesion was discovered by CT in patients with abdomen/pelvis negativity in both US and PET or isolated spleen positivity in US (or US and PET), and so it seems that in the initial staging, abdomen/pelvis CT can be safety omitted in about 1/2 to 2/3 of children diagnosed with HL.

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

    Science.gov (United States)

    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.

  14. Normal sonographic anatomy of the abdomen of coatis (Nasua nasua Linnaeus 1766).

    Science.gov (United States)

    Ribeiro, Rejane G; Costa, Ana Paula A; Bragato, Nathália; Fonseca, Angela M; Duque, Juan C M; Prado, Tales D; Silva, Andrea C R; Borges, Naida C

    2013-06-23

    The use of ultrasound in veterinary medicine is widespread as a diagnostic supplement in the clinical routine of small animals, but there are few reports in wild animals. The objective of this study was to describe the anatomy, topography and abdominal sonographic features of coatis. The urinary bladder wall measured 0.11 ± 0.03 cm. The symmetrical kidneys were in the left and right cranial quadrant of the abdomen and the cortical, medullary and renal pelvis regions were recognized and in all sections. The medullary rim sign was visualized in the left kidney of two coatis. The liver had homogeneous texture and was in the cranial abdomen under the rib cage. The gallbladder, rounded and filled with anechoic content was visualized in all coatis, to the right of the midline. The spleen was identified in the left cranial abdomen following the greater curvature of the stomach. The parenchyma was homogeneous and hyperechogenic compared to the liver and kidney cortex. The stomach was in the cranial abdomen, limited cranially by the liver and caudo-laterally by the spleen. The left adrenal glands of five coatis were seen in the cranial pole of the left kidney showing hypoechogenic parenchyma without distinction of cortex and medulla. The pancreas was visualized in only two coatis. The left ovary (0.92 cm x 0.56 cm) was visualized on a single coati in the caudal pole of the kidney. The uterus, right adrenal, right ovary and intestines were not visualized. Ultrasound examination of the abdomen of coatis may be accomplished by following the recommendations for dogs and cats. It is possible to evaluate the anatomical and topographical relationships of the abdominal organs together with the knowledge of the peculiarities of parenchymal echogenicity and echotexture of the viscera.

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

    DEFF Research Database (Denmark)

    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......-over study human GH (Norditropin) was injected s.c. in the thigh or abdomen in random order. Ultrasonography of the thigh and abdomen was performed in order to evaluate the thickness of the s.c. tissue. After each treatment period (4 weeks), serum profiles of GH, IGF-I, IGF binding proteins 1 and 3 (IGFBP-1.......c. tissue (mm) was higher on the abdominal site (9.35 +/- 1.38 (thigh), and 22.61 +/- 2.19 (abdomen), P abdomen) (P = 0.91). AUC (m...

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

    DEFF Research Database (Denmark)

    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......-over study human GH (Norditropin) was injected s.c. in the thigh or abdomen in random order. Ultrasonography of the thigh and abdomen was performed in order to evaluate the thickness of the s.c. tissue. After each treatment period (4 weeks), serum profiles of GH, IGF-I, IGF binding proteins 1 and 3 (IGFBP-1.......c. tissue (mm) was higher on the abdominal site (9.35 +/- 1.38 (thigh), and 22.61 +/- 2.19 (abdomen), P abdomen) (P = 0.91). AUC (m...

  17. Acute intermittent porphyria and pregnancy: an obstetric challenge

    Directory of Open Access Journals (Sweden)

    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

  18. Addison's Disease Mimicking as Acute Pancreatitis: A Case Report.

    Science.gov (United States)

    Chaudhuri, Sayani; Rao, Karthik N; Patil, Navin; Ommurugan, Balaji; Varghese, George

    2017-04-01

    Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.

  19. letter to editor: Torsion of a Wandering Spleen: A Pediatric Acute Abdominal Presentation

    Directory of Open Access Journals (Sweden)

    Sharath GG

    2009-11-01

    Full Text Available Dear editor:"n"nWandering spleen is a rare pediatric emergency. Persistent torsion of the splenic pedicle causes splenic infarction, which results as an acute abdomen and severe pain. An abdominal mass is present in the majority of cases. We emphasize that whenever a pediatric patient comes with acute abdomen and the spleen is not in the usual position and a mass is found elsewhere in the abdomen or pelvis, the possible diagnosis of wandering spleen with acute torsion should be kept in mind. Ultrasonography (US is the initial study of choice, but CT scan of the liver and the spleen are excellent adjuncts when the diagnosis remains in question.    

  20. FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer.

    Science.gov (United States)

    Arens, Anne I J; Postema, Jan W A; Schreurs, Wendy M J; Lafeber, Albert; Hendrickx, Baudewijn W; Oyen, Wim J G; Vogel, Wouter V

    2016-01-01

    This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly.

  1. FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer

    Science.gov (United States)

    Postema, Jan W. A.; Schreurs, Wendy M. J.; Lafeber, Albert; Hendrickx, Baudewijn W.; Oyen, Wim J. G.; Vogel, Wouter V.

    2016-01-01

    Purpose This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in patients with no history of malignancy or complaints outside the thorax. Methods FDG-PET/CT scans of 1059 patients with suspected or recently proven lung cancer, with no history of malignancy or complaints outside the thorax, were analysed in a retrospective multi-centre trial. Suspect FDG-avid lesions in the chest and upper abdomen, the head and neck area above the shoulder line and in the abdomen and pelvis below the caudal tip of the liver were noted. The impact of lesions detected in the head and neck area and abdomen and pelvis on additional diagnostic procedures, staging and treatment decisions was evaluated. Results The head and neck area revealed additional suspect lesions in 7.2%, and the abdomen and pelvis in 15.8% of patients. Imaging of the head and neck area and the abdomen and pelvic area showed additional lesions in 19.5%, inducing additional diagnostic procedures in 7.8%. This resulted in discovery of additional lesions considered malignant in 10.7%, changing patient management for lung cancer in 1.2%. In (suspected) lung cancer, PET/CT limited to the chest and upper abdomen resulted in correct staging in 98.7% of patients, which led to the identical management as full field of view PET in 98.8% of patients. Conclusion High value of FDG-PET/CT for staging and correct patient management is already achieved with chest and upper abdomen. Findings in head and neck area and abdomen and pelvis generally induce investigations with limited or no impact on staging and treatment of NSCLC, and can be interpreted accordingly. PMID:27556809

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Acute amebic appendicitis: Report of a rare case

    Directory of Open Access Journals (Sweden)

    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.

  4. Case report and management of suspected acute appendicitis in pregnancy.

    Science.gov (United States)

    Murariu, Daniel; Tatsuno, Brent; Hirai, Cori-Ann M; Takamori, Ryan

    2011-02-01

    Suspected cases of acute appendicitis in pregnancy are considered surgical emergencies due to the potentially devastating outcomes for both mother and unborn child if the appendix perforates. Acute appendicitis is also the number one cause of non-traumatic acute abdomen in pregnancy, as well as the number one cause of fetal death. We present a case report with a typical presentation of suspected acute appendicitis in a pregnant woman. The work up and diagnostic tools available are discussed at length, as well as the finer points in treatment of this population.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Nutrición enteral temprana, en pacientes con abdomen abierto

    Directory of Open Access Journals (Sweden)

    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

  7. The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

    Science.gov (United States)

    Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

    2017-04-01

    Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Mechanical response of the herniated human abdomen to the placement of different prostheses.

    Science.gov (United States)

    Hernández-Gascón, Belén; Peña, Estefanía; Grasa, Jorge; Pascual, Gemma; Bellón, Juan M; Calvo, Begoña

    2013-05-01

    This paper describes a method designed to model the repaired herniated human abdomen just after surgery and examine its static mechanical response to the maximum intra-abdominal pressure provoked by a physiological movement (standing cough). The model is based on the real geometry of the human abdomen bearing a large incisional hernia with several anatomical structures differentiated by MRI. To analyze the outcome of hernia repair, the surgical procedure was simulated by modeling a prosthesis placed over the hernia. Three surgical meshes with different mechanical properties were considered: an isotropic heavy-weight mesh (Surgipro®), a slightly anisotropic light-weight mesh (Optilene®), and a highly anisotropic medium-weight mesh (Infinit®). Our findings confirm that anisotropic implants need to be positioned such that the most compliant axis of the mesh coincides with the craneo-caudal direction of the body.

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

    Science.gov (United States)

    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. An Experience in the Management of the Open Abdomen in Severely Injured Burn Patients

    Science.gov (United States)

    2012-07-01

    of abdominal operations undergone. • Outcomes: mortality, dehiscence, bowel necrosis, sepsis , adult respiratory distress syndrome, multi- system...643–50. 15. Schecter WP, Ivatury RR, Rotondo MF, Hirshberg A. Open abdomen after trauma and abdominal sepsis : a strategy for management. J Am Coll...491 Current surgical practice in the era of damage con- trol has led to the practice of planned relaparotomy to address intra- abdominal issues that

  11. INADEQUACY IN DIAGNOSIS OF BLUNT TRAUMA ABDOMEN - CAN ANAESTHESIOLOGIST BE BAFFLED BY CATASTROPHIC INTRAOPERATIVE FINDINGS?

    Directory of Open Access Journals (Sweden)

    Joyanta Kumar

    2015-08-01

    Full Text Available The magnitude of injury inflicted by Blunt trauma abdomen has varied manifestations ranging from minor single - system injury to devastating, multi - system injury .Blunt trauma abdomen alone or in association with polytrauma is a frequent presentation in the emergency department. High index of suspicion and clinical acumen is required during evaluation of blunt abdominal injuries because physical signs and symptoms indicating presence of visceral lesions may poorly correlate with clinical presentation. Diagnostic peritoneal tapping is considered safe initial option with high accuracy but carries possibility of significant false positive and false negative result. Ultrasonography (FAST ha s its own limitations; although CT findings can be conclusive it involves time for analysis and the patient should be cooperative. Blunt trauma abdomen may present with life threatening internal haemorrhage due to visceral or vascular injuries prompting em ergency surgical intervention at odd hours with limited investigations and resources, Pre anaesthetic optimization by maintenance of adequate tissue oxygenation with optimal blood volume replacement and judicious use of inotropes, determine outcome of such emergency procedures. Careful selection of anaesthetic techniques and drugs particularly the inducing agents can be life - saving. Agility of the attending anesthesiologist to handle unforeseen intra operative critical events plays a pivotal role in overall outcome. We are discussing Anaesthetic management of a 23 year old victim of road traffic accident, who sustained blunt trauma abdomen about 24 hrs. Back, was conscious, oriented and ambulatory till the time of shifting to the operating theatre but on exp loration sudden gush of blood from a preoperatively undetected 7 cms long tear of the sub diaphragmatic part of IVC, and lacerated liver almost exsanguinated the patient.

  12. Development of a Deflection Measurement System for the Hybrid III Six-Year Old Biofidelic Abdomen

    OpenAIRE

    2012-01-01

    Despite advancements in automotive safety, motor vehicle collisions remain the leading cause of unintentional death for children ages 5 to 14. Enhancement of child occupant protection depends on the ability to accurately assess the effectiveness of restraint systems. Booster seat design and proper belt fit require evaluation using child anthropomorphic test devices, yet biofidelity of the abdomen and pelvis of the current anthropomorphic test device, the Hybrid III 6-year-old, needs improveme...

  13. Nutrición enteral temprana, en pacientes con abdomen abierto

    Directory of Open Access Journals (Sweden)

    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.

  14. Acute primary haemorrhagic omental torsion mimicking perforated appendicitis: an unorthodox surgical paradox.

    Science.gov (United States)

    Rehman, Abdul

    2014-08-01

    Acute primary haemorrhagic omental torsion is an atypical and deceptive cause of acute abdomen that could closely mimic a myriad of intra-abdominal catastrophes, especially perforated appendicitis. The author reports a 30 years man who had presented with gradually worsening right-sided abdominal pain of 2 days duration. Laboratory work-up and abdominal radiographs were inconclusive. Abdominal sonography detected presence of free fluid in the pelvic cul-de-sac. Based on clinical and sonographic findings, presumptive diagnosis of perforated appendicitis was made and the patient was explored through extended Rockey-Davis incision. About 500 - 700 ml of dark-coloured blood (haemoperitoneum) was present in the peritoneal cavity and the pelvis secondary to acute haemorrhagic omental torsion. The appendix was grossly normal. Omentectomy and prophylactic appendicectomy resulted in uneventful recovery of the patient. Acute primary omental torsion is an uncommon pathology that must be kept in mind during differential diagnosis of acute abdomen, especially acute or perforated appendicitis.

  15. Honey bees (Apis mellifera ligustica) swing abdomen to dissipate residual flying energy landing on a wall

    Science.gov (United States)

    Zhao, Jieliang; Huang, He; Yan, Shaoze

    2017-03-01

    Whether for insects or for aircrafts, landing is one of the indispensable links in the verification of airworthiness safety. The mechanisms by which insects achieve a fast and stable landing remain unclear. An intriguing example is provided by honeybees (Apis mellifera ligustica), which use the swinging motion of their abdomen to dissipate residual flying energy and to achieve a smooth, stable, and quick landing. By using a high-speed camera, we observed that touchdown is initiated by honeybees extending their front legs or antennae and then landing softly on a wall. After touchdown, they swing the rest of their bodies until all flying energy is dissipated. We suggested a simplified model with mass-spring dampers for the body of the honeybee and revealed the mechanism of flying energy transfer and dissipation in detail. Results demonstrate that body translation and abdomen swinging help honeybees dissipate residual flying energy and orchestrate smooth landings. The initial kinetic energy of flying is transformed into the kinetic energy of the abdomen's rotary movement. Then, the kinetic energy of rotary movement is converted into thermal energy during the swinging cycle. This strategy provides more insight into the mechanism of insect flying, which further inspires better design on aerial vehicle with better landing performance.

  16. Proneural and abdominal Hox inputs synergize to promote sensory organ formation in the Drosophila abdomen.

    Science.gov (United States)

    Gutzwiller, Lisa M; Witt, Lorraine M; Gresser, Amy L; Burns, Kevin A; Cook, Tiffany A; Gebelein, Brian

    2010-12-15

    The atonal (ato) proneural gene specifies a stereotypic number of sensory organ precursors (SOP) within each body segment of the Drosophila ectoderm. Surprisingly, the broad expression of Ato within the ectoderm results in only a modest increase in SOP formation, suggesting many cells are incompetent to become SOPs. Here, we show that the SOP promoting activity of Ato can be greatly enhanced by three factors: the Senseless (Sens) zinc finger protein, the Abdominal-A (Abd-A) Hox factor, and the epidermal growth factor (EGF) pathway. First, we show that expression of either Ato alone or with Sens induces twice as many SOPs in the abdomen as in the thorax, and do so at the expense of an abdomen-specific cell fate: the larval oenocytes. Second, we demonstrate that Ato stimulates abdominal SOP formation by synergizing with Abd-A to promote EGF ligand (Spitz) secretion and secondary SOP recruitment. However, we also found that Ato and Sens selectively enhance abdominal SOP development in a Spitz-independent manner, suggesting additional genetic interactions between this proneural pathway and Abd-A. Altogether, these experiments reveal that genetic interactions between EGF-signaling, Abd-A, and Sens enhance the SOP-promoting activity of Ato to stimulate region-specific neurogenesis in the Drosophila abdomen.

  17. A Regional Dose and Image Quality Survey for Chest, Abdomen and Pelvis Radiographs in Paediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, M.; Morant, J.J.; Geleijns, K.; Calzado, A

    2000-07-01

    A dosimetric survey in paediatric radiology is currently being carried out, aiming at the assessment of patient dose and image quality for chest, abdomen and pelvis radiographs in some age categories at five hospitals in the Tarragona area. Entrance surface dose measurements were performed using homogeneous PMMA phantoms. Effective doses were assessed through the application of published conversion factors. The range of entrance doses averaged by sites was 75-729 {mu}Gy for pelvis radiographs of children aged 5 months, 813-1600 {mu}Gy for pelvis radiographs of children aged 5 years, 94-250 {mu}Gy for chest radiographs of children aged 5 years and 980-2300 {mu}Gy for abdomen radiographs of children aged 5 years. The reference dose values given in the European Guidelines on Quality Criteria for Diagnostic Radiographic Images in Paediatrics were exceeded at two or more hospitals for all projections. The range of average effective dose for the analysed examinations was 14-245 {mu}Sv. The maximum ratios of effective dose by sites varied between 2.2 and 11 for the analysed projections. By examination type, average values in the range 100 to 245 {mu}Sv were estimated for 5 year pelvis and abdomen examinations. (author)

  18. A rare entity of acute bilateral cortical renal necrosis following acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Kruti D Dave

    2015-01-01

    Full Text Available Acute bilateral renal cortical necrosis following acute pancreatitis is extremely rare condition. Among all cases of acute renal failure, the incidence of renal cortical necrosis was 3.8% in one of the study in North India. Till date, only eight cases of bilateral cortical necrosis following acute pancreatitis were reported in the literature. We report a case of a 27-year-old male patient with abdominal pain, nausea and vomiting since 2 days duration and anuria since 24 h. Serum amylase and lipase were raised, and elevated serum creatinine was noted on admission. Contrast-enhanced computed tomography scan of the abdomen revealed changes of acute pancreatitis with hypoenhancement of renal cortex compared to medulla on both sides (reverse rim sign-stronger enhancement of the renal medulla compared to cortex, suggest an acute renal cortical necrosis.

  19. Acute Appendagitis Presenting with Features of Appendicitis: Value of Abdominal CT Evaluation

    Directory of Open Access Journals (Sweden)

    Sukhpreet Dubb

    2008-05-01

    Full Text Available We report a case of acute appendagitis in a patient who presented initially with typical features of acute appendicitis. The diagnosis of acute appendagitis was made on pathognomonic signs on computed tomography (CT scan. Abdominal pain is a common surgical emergency. CT is not always done if there are clear features of acute appendicitis. The rare but important differential diagnosis of acute appendagitis must be borne in mind when dealing with patients with suspected acute appendicitis. A CT scan of the abdomen may avoid unnecessary surgery in these patients.

  20. A comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Chiranjeev Kumar Gathwal

    2016-12-01

    Conclusions: We concluded that Plain X rays can be used as screening modality in the diagnosis of acute abdominal emergencies; however ultrasound examination is cheaper, non-invasive, quick, reliable and highly accurate modality in diagnosing the exact cause of pain and its origin in a patient presenting with an acute abdomen and thus helps the physician or surgeon to plan the timely management.

  1. Abdomen - swollen

    Science.gov (United States)

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

    Science.gov (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  5. Acute Dilatation, Ischemia, and Necrosis of Stomach without Perforation

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    Manash Ranjan Sahoo

    2013-01-01

    Full Text Available Acute gastric dilatation can have multiple etiologies which may lead to ischemia of the stomach. Without proper timely diagnosis and treatment, potentially fatal events such as gastric perforation, haemorrhage, and other serious complications can occur. Here we present a 36-year-old man who came to the casualty with pain abdomen and distension for 2 days. Clinically, abdomen was asymmetrically distended more in the left hypochondrium and epigastrium region. Straight X-ray abdomen showed opacified left hypochondrium with nonspecific gaseous distension of bowel. Exploratory laparotomy revealed dilated stomach with patchy gangrene over lesser curvature and fundic area. About 4 litres of brownish fluid along with semisolid undigested food particles was sucked out (mainly undigested pieces of meat. Limited resection of gangrenous areas and primary repair were done along with feeding jejunostomy. Necrosis of the stomach was confirmed on histopathology. The patient recovered well and was discharged on the tenth postoperative day.

  6. Pancreaticoatmospheric fistula following severe acute necrotising pancreatitis.

    Science.gov (United States)

    Simoneau, Eve; Chughtai, Talat; Razek, Tarek; Deckelbaum, Dan L

    2014-12-17

    Severe acute necrotising pancreatitis is associated with numerous local and systemic complications. Abdominal compartment syndrome requiring urgent decompressive laparotomy is a potential complication of this disease process and is associated with increased morbidity and mortality. We describe the case of a pancreaticoatmospheric fistula following decompressive laparotomy in a patient with severe acute necrotising pancreatitis. While this fistula was managed successfully using the current standard of care for pancreatic fistulas, the wound care for in this patient with drainage of the fistula through an open abdomen, is a significant challenge.

  7. [Treatment of acute pancreatitis].

    Science.gov (United States)

    Naumovski-Mihalić, Slavica

    2009-01-01

    Acute pancreatitis is an autodigestive disease in which the pancreatic tissue is damaged by the digestive enzimes produces by the acinar cells and is associated with severe upper abdominal pain. The severity of acute pancreatitis ranges from edema to necrosis of the gland. The edematous form of the disease occurs in about 80-85% of patients and is self-limited, with recovery in few days. In the 15-20% of patients with the most severe form of pancreatitis, hospitalization is prolonged and commonly associated with infection and other complications including multiple organ failure. The main causes of acute pancreatitis in adults are gallstones, other gallbladder (biliary) diseases and alcohol abuse. Treatment of acute pancreatitis-depends on the severity oft he condition. Generaly, the patients need, hospitalisation with administration of intravenous fluid to help restore blood volume, pain control, supplemental oxygen as required and correction of electrolite and metabolic abnormalities. Antibiotic prophylaxis has not been shown as an effective preventive treatment. Early enteral feeding is based on a high level of evidence, resulting in a reduction of local and sistemic infection. Begin oral feeding once abdominal pain has resolved and the patients regains appetite. The diet should be low in fat and protein. Patients suffering from infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. During recent years the management of acute pancreatitis has changed. This has been due particulary in response to the general availability of computed tomography, improved intensive care facilities, knowledge about the central role of pancreatic infection and refinements in surgical and other interventional techniques.

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

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    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.

  9. Clinical outcome of Fitz-Hugh-Curtis syndrome mimicking acute biliary disease

    Institute of Scientific and Technical Information of China (English)

    Seong Yong Woo; Jin Il Kim; Dae Young Cheung; Se Hyun Cho; Soo-Heon Park; Joon-Yeol Han; Jae Kwang Kim

    2008-01-01

    AIM: To analyze the clinical characteristics of patients diagnosed with Fitz-Hugh-Curtis syndrome.METHODS: The clinical courses of patients that visited St. Mary's Hospital with abdominal pain from January 2005 to December 2006 and were diagnosed with Fitz-Hugh-Curtis syndrome were examined.RESULTS: Fitz-Hugh-Curtis syndrome was identified in 22 female patients of childbearing age; their mean age was 31.0 + 8.1 years. Fourteen of these cases presented with pain in the upper right abdomen alone or together with pain in the lower abdomen,and six patients presented with pain only in the lower abdomen. The first impression at the time of visit was acute cholecystitis or cholangitis in 10 patients and acute appendicitis or pelvic inflammatory disease in eight patients. Twenty-one patients were diagnosed by abdominal computer tomograghy (CT), and the results of abdominal sonography were normal for 10 of these patients. Ch/amydia trichomatis was isolated from 18 patients. Two patients underwent laparoscopic adhesiotomy and 20 patients were completely cured by antibiotic treatment.CONCLUSION: For women of childbearing age with acute pain in the upper right abdomen alone or together with pain in the lower abdomen, Fitz-HughCurtis syndrome should be considered during differential diagnosis. Moreover, in cases suspected to be Fitz-HughCurtis syndrome, abdominal c-r, rather than abdominal sonography, assists in the diagnosis.

  10. Radiation dose for investigation of the chest and abdomen. Comparison of sequential, spiral and electron beam computed tomography; Strahlenexposition bei der CT-Untersuchung des Thorax und Abdomens. Vergleich von Einzelschicht-, Spiral- und Elektronenstrahlcomputertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Becker, C.R.; Schaetzl, M.; Bruening, R.; Schoepf, U.J.; Reiser, M.F. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Radiologische Diagnostik; Feist, H. [Muenchen Univ. (Germany). Radiologische Klinik und Poliklinik; Baeuml, A. [Bundesamt fuer Strahlenschutz, Oberschleissheim (Germany). Inst. fuer Strahlenhygiene

    1998-09-01

    Comparison of radiation exposure applied by different types of CT scanners for the investigation of the chest and abdomen. Determination of radiation exposure applied by multi-phase spiral CT. Estimation of the dose in air in the system axis of the scanner, the CT dose index (CTDI) and the effective dose for electron beam tomography (EBT) and two conventional CT scanners (sequence, SEQ; spiral, SCT). For EBT, dose in system axis for investigation of the abdomen was above 50 mGy. Effective dose for investigation of the chest and abdomen was higher with EBT (11 and 26 mSv, respectively), than with conventional CT (SEQ, 4 and 20 mSv; SCT, 2 and 7 mSv). The effective dose for a biphasic investigation (liver 5 mSv, kidney 4 mSv) was below, for a triphasic investigation of the abdomen (6 mSv). Investigation of the abdomen with the EBT should only be performed for certain indications. With spiral CT, effective dose is much lower than with EBT. (orig.) [Deutsch] Die Strahlenexposition bei der Untersuchung von Thorax und Abdomen mit verschiedenen CT-Scannertypen sollte verglichen werden. Zusaetzlich sollte die Exposition beim Mehrphasen-Spiral-CT ermittelt werden. Die Dosis in der Systemachse, gemessen in freier Luft, (Achsendosis), der Computertomographie-Dosis-Index (CTDI) und die effektive Dosis nach ICRP 60 wurden bei einem Elektronenstrahl-CT (EBT) und zwei konventionellen CT-Scannern (sequentiell=SEQ, spiral=SCT) bestimmt. Beim EBT liegt die Achsendosis bei der Untersuchung des Abdomens ueber 50 mGy. Die effektive Dosis fuer die Untersuchung von Thorax und Abdomen war bei der EBT (11 bzw. 26 mSv) hoeher als beim konventionellen CT (SEQ 4 bzw. 20 mSv; SCT 2 bzw. 7 Sv). Die effektive Dosis einer 2-Phasen-Untersuchung (Leber 5 mSv, Niere 4 mSv) liegt unter, die einer 3-Phasen-Untersuchung (Leber 7 mSv) ueber der effektiven Dosis einer Untersuchung des gesamten Abdomens (6 mSv). Die Untersuchung des Abdomens sollte mit dem EBT nur nach strenger Indikationsstellung

  11. Método de las invariantes en la conducta a seguir ante un paciente con abdomen agudo quirúrgico en el nivel primario de atención

    Directory of Open Access Journals (Sweden)

    Esteban Regalado García

    2003-08-01

    other levels of the system. Acute surgical abdomen is a health problem to be faced immediately to avoid complications, even fatal, in our patients. A pedagogic method for acquiring with quality the necessary knowledge and orienting the correct behaviour to each patient is the method of invariants. The concept of Invariant covers the identification of essential and necessary questions to arrive at a diagnosis. When the Comprehensive General Physician knows the invariants of an entity, then he/she can take decisions with a high margin of safety. An Acute Surgical Abdomen may be caused by hundreds of diseases, therefore, it will be impossible to study them, one by one. Since this is a serious entity, any mistake made in managing this disease can be fatal. We have identified seven (7 Invariant signs in Acute Surgical Abdomen, which can be recognized in 9 out of 10 patients that go to the doctor’s with acute abdominal pain. There are difficulties due to the identification of these signs just in a small number of patients to whom we call "Special Situations"

  12. Caecal diverticulitis presenting as acute appendicitis: a case report

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    Ayantunde Abraham A

    2009-07-01

    Full Text Available Abstract Solitary caecal diverticulum is an uncommon entity and therefore difficult to diagnose except at surgery. Caecal diverticulitis is an infrequent cause of acute abdomen and usually presents in a manner similar to acute appendicitis. It is extremely difficult to differentiate it preoperative from acute appendicitis and such distinction is usually made in the operating room. The optimal management of this clinical condition is still controversial, ranging from conservative treatment with antibiotics to aggressive surgical resections. We report a case of a 61 year old Caucasian who presented with acute onset right iliac fossa pain indistinguishable from acute appendicitis. The true diagnosis of a perforated acute caecal diverticulitis with an abscess mass was only made at operation in the presence of a macroscopically normal appendix. We reviewed the literature to highlight the difficulty of a preoperative diagnosis and the need for a high index of suspicion especially in the older age group presenting in manner similar to acute appendicitis.

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

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    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

  14. Noise-Optimized Virtual Monoenergetic Dual-Energy CT Improves Diagnostic Accuracy for the Detection of Active Arterial Bleeding of the Abdomen.

    Science.gov (United States)

    Martin, Simon S; Wichmann, Julian L; Scholtz, Jan-Erik; Leithner, Doris; D'Angelo, Tommaso; Weyer, Hendrik; Booz, Christian; Lenga, Lukas; Vogl, Thomas J; Albrecht, Moritz H

    2017-09-01

    To evaluate diagnostic accuracy of a noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique for detection of active arterial abdominal bleeding on dual-energy (DE) CT angiography compared with standard image reconstruction. DE CT angiography data sets of 71 patients (46 men; age 63.6 y ± 13.3) with suspected arterial bleeding of the abdomen or pelvis were reconstructed with standard linearly blended (F_0.5), VMI+, and traditional virtual monoenergetic imaging (VMI) algorithms in 10-keV increments from 40 to 100 keV. Attenuation measurements were performed in the descending aorta, area of hemorrhage, and feeding artery to calculate contrast-to-noise ratios (CNRs) in patients with active arterial bleeding. Based on quantitative image quality results, the best series for each reconstruction technique were chosen to analyze the diagnostic performance of 3 blinded radiologists. DE CT angiography showed acute arterial bleeding in 36 patients. Mean CNR was superior in 40-keV VMI+ compared with VMI series (all P VMI and F_0.5 (21.6 ± 7.9, 12.9 ± 4.7, and 10.4 ± 3.6) images. Area under the curve analysis for detection of arterial bleeding showed significantly superior (P VMI+ (0.963) compared with 70-keV VMI (0.775) and F_0.5 (0.817) series. Diagnostic accuracy in patients with active arterial bleeding of the abdomen can be significantly improved using VMI+ reconstructions at 40 keV compared with standard linearly blended and traditional VMI series in DE CT angiography. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  15. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia.

    Science.gov (United States)

    Mutreja, Deepti; Sivasami, Kartik; Tewari, Vanmalini; Nandi, Bhaskar; Nair, G Lakhsmi; Patil, Sunita D

    2015-01-01

    Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Clinical Presentation of a Patient with Localized Acquired Cutis Laxa of Abdomen: A Case Report

    Directory of Open Access Journals (Sweden)

    Tugomir Gverić

    2010-01-01

    Objective. The aim of this case report was to present our patient suffering from CL, and to evaluate clinical presentation, diagnostic and therapeutic difficulties in this rare condition. Case Report. A 30-year-old female patient was admitted to our Hospital due to localized loose and sagging skin of abdomen, induced by prior cesarean section 6 years ago. CL has been diagnosed based on the clinical picture and pathohistological appearance. Conclusion. Reconstructive surgery provides a dramatic cosmetic improvement with significant psychosocial benefit. Repeated surgical procedures may be required to correct the lax skin, which worsens with age.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. Abdominal actinomycosis mimicking acute appendicitis.

    Science.gov (United States)

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  1. Imaging of acute pancreatitis and its complications. Part 1: acute pancreatitis.

    Science.gov (United States)

    Türkvatan, A; Erden, A; Türkoğlu, M A; Seçil, M; Yener, Ö

    2015-02-01

    Acute pancreatitis is an acute inflammatory disease of the pancreas that may also involve surrounding tissues or remote organs. The Atlanta classification of acute pancreatitis was introduced in 1992 and divides patients into mild and severe groups based on clinical and biochemical criteria. Recently, the terminology and classification scheme proposed at the initial Atlanta Symposium have been reviewed and a new consensus statement has been proposed by the Acute Pancreatitis Classification Working Group. Generally, imaging is recommended to confirm the clinical diagnosis, investigate the etiology, and grade the extend and severity of the acute pancreatitis. Ultrasound is the first-line imaging modality in most centers for the confirmation of the diagnosis of acute pancreatitis and the ruling out of other causes of acute abdomen, but it has limitations in the acute clinical setting. Computed tomography not only establishes the diagnosis of acute pancreatitis, but also enables to stage severity of the disease. Magnetic resonance imaging has earned an ever more important role in the diagnosis of acute pancreatitis. It is especially useful for imaging of patients with iodine allergies, characterizing collections and assessment of an abnormal or disconnected pancreatic duct. The purpose of this review article is to present an overview of the acute pancreatitis, clarify confusing terminology, underline the role of ultrasound, computed tomography and magnetic resonance imaging according to the proper clinical context and compare the advantages and limitations of each modality.

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

    Science.gov (United States)

    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.

  3. Stage IVB endometrial cancer confined to the abdomen: is chemotherapy superior to radiotherapy?

    Science.gov (United States)

    Cirik, D Akdag; Karalok, A; Ureyen, I; Tasci, T; Koc, S; Turan, T; Tulunay, G

    2016-01-01

    To determine the impact of clinical variables and adjuvant therapy on survival in patients with Stage IVB endometrial cancer (EC) confined to abdomen. A total of 65 patients were included. Curative chemotherapy was defined as using only chemotherapy (platin based) or sandwich therapy. Patients receiving only radiotherapy had standard pelvic radiotherapy and extended-field radiotherapy when necessary. The optimal cytoreduction was achieved in 89.3% of patients. With a median follow-up of 18 months, two-year progression free survival (PFS) and overall survival (OS) were calculated as 33.4% and 42.2%, respectively. Optimal cytoreduction provided more longer PFS and OS compared to suboptimal cytoreduction. In univariate analysis, curative chemotherapy instead of radiotherapy improved the two-year PFS and two-year OS. Type of adjuvant therapy, tumor grade, and peritoneal cytology were found as the independent prognostic factors for PFS. Peritoneal cytology, adnexal involvement, and adjuvant therapy were independent prognostic factor for OS. Curative chemotherapy significantly improved both two-year PFS and OS in patients with Stage IVB endometrial disease confined to abdomen over only radiotherapy.

  4. The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper.

    Science.gov (United States)

    Sartelli, Massimo; Abu-Zidan, Fikri M; Ansaloni, Luca; Bala, Miklosh; Beltrán, Marcelo A; Biffl, Walter L; Catena, Fausto; Chiara, Osvaldo; Coccolini, Federico; Coimbra, Raul; Demetrashvili, Zaza; Demetriades, Demetrios; Diaz, Jose J; Di Saverio, Salomone; Fraga, Gustavo P; Ghnnam, Wagih; Griffiths, Ewen A; Gupta, Sanjay; Hecker, Andreas; Karamarkovic, Aleksandar; Kong, Victor Y; Kafka-Ritsch, Reinhold; Kluger, Yoram; Latifi, Rifat; Leppaniemi, Ari; Lee, Jae Gil; McFarlane, Michael; Marwah, Sanjay; Moore, Frederick A; Ordonez, Carlos A; Pereira, Gerson Alves; Plaudis, Haralds; Shelat, Vishal G; Ulrych, Jan; Zachariah, Sanoop K; Zielinski, Martin D; Garcia, Maria Paula; Moore, Ernest E

    2015-01-01

    The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal. However, the OA may require multiple returns to the operating room and may be associated with significant complications, including enteroatmospheric fistulas, loss of abdominal wall domain and large hernias. Surgeons should be aware of the pathophysiology of severe intra-abdominal sepsis and always keep in mind the option of using open abdomen to be able to use it in the right patient at the right time.

  5. [Efficacy of intestinal splinting in hostile abdomen secondary to postoperative flanges in pediatric patients].

    Science.gov (United States)

    Bracho-Blanchet, Eduardo; Langarica-Bulos, Mónica; Dávila-Pérez, Roberto; Fernández-Portilla, Emilio; Zalles-Vidal, Cristian; Nieto-Zermeño, Jaime

    2016-10-01

    Objetivo: Mostrar la eficacia de la FI para prolongar el tiempo libre de oclusión intestinal quirúrgica en niños con abdomen hostil secundario a bridas posquirúrgicas. Método: Análisis retrospectivo de FI por abdomen hostil de 2000 a 2011 y su seguimiento a largo plazo. Comparamos el tiempo libre de oclusión quirúrgica antes y después de la FI. Resultados: Se incluyeron 20 FI en 19 pacientes. Predominaron las causas congénitas, la mediana de edad en la cirugía fue de 6 meses, todos tenían cirugías previas con mediana de tres, y dos de ellas fueron por oclusión intestinal previa. La férula se quitó a los 28 días (mediana). Con un seguimiento de 1-183 meses, hubo una recurrencia de oclusión quirúrgica. El tiempo libre de oclusión quirúrgica posferulización fue significativamente mayor que el preferulización mediante la prueba de Wilcoxon, con un valor Z = -3.594; p = oclusión quirúrgica.

  6. Swordfish bill injury involving abdomen and vertebral column: case report and review

    Directory of Open Access Journals (Sweden)

    Drossos Charalambos

    2010-10-01

    Full Text Available Abstract Background Penetrating injuries of the abdomen and spinal canal that involve organic material of animal origin are extremely rare and derive from domestic and wild animal attacks or fish attacks. Case presentation In this case report we present the unique, as far as the literature is concerned, unprovoked woman's injury to the abdomen by a swordfish. There are only four cases of swordfish attacks on humans in the literature - one resulted to thoracic trauma, two to head trauma and one to knee trauma, one of which was fatal - none of which were unprovoked. Three victims were professional or amateur fishermen whereas in the last reported case the victim was a bather as in our case. Our case is the only case where organic debris of animal's origin remained in the spinal canal after penetrating trauma. Conclusions Although much has been written about the management of penetrating abdominal and spinal cord trauma, controversy remains about the optimal management. Moreover, there is little experience in the management of patients with such spinal injuries, due to the fact that such cases are extremely rare. In this report we focus on the patient's treatment with regard to abdominal and spinal trauma and present a review of the literature.

  7. Closed hyperthermic intraperitoneal chemotherapy with open abdomen: a novel technique to reduce exposure of the surgical team to chemotherapy drugs

    Science.gov (United States)

    Benoit, Laurent; Cheynel, Nicolas; Ortega-Deballon, Pablo; Giacomo, Giovanni Di; Chauffert, Bruno; Rat, Patrick

    2008-01-01

    Exposure of the surgical team to toxic drugs during hyperthermic intraperitoneal chemotherapy (HIPEC) remains a matter of great concern. In closed-abdomen HIPEC operating room staffs are not exposed to drugs, but the distribution of the heated liquid within the abdomen is not optimal. In open-abdomen HIPEC, the opposite is true. Even though the open-abdomen method is potentially more effective, it has not become a standard procedure because of the risk of exposure of members of the team to drugs. We present a new technique (closed HIPEC with open abdomen) which ensures protection against potentially contaminating exposure to liquids, vapours and aerosols, and allows permanent access to the whole abdominal cavity. Its principle is to extend the abdominal surgical wound upwards with a sort of “glove-box”. The cutaneous edges of the laparotomy are stapled to a latex «wall expander». The expander is draped over a special L-section metal frame placed above the abdomen. A transparent cover containing a « hand-access » port like those used in laparoscopic surgery is fixed inside the frame. In 10 patients, this device proved to be hermetic both for liquids and vapours. Intra-abdominal temperature was maintained between 42 and 43°C during most of the procedure. The whole abdominal cavity was accessible to the surgeon allowing optimal exposure of all peritoneal surfaces. This technique allows optimal HIPEC while limiting the potential toxic effects for the surgical, medical and paramedical teams. PMID:17929098

  8. First case of a vermiform appendix duplication type A volvulus: A very rare cause of acute abdomen

    Directory of Open Access Journals (Sweden)

    Gustavo H. Peniche González

    2015-09-01

    Full Text Available The duplication of the vermiform appendix is a rare anatomical variant. Most of the cases reported with symptomatology of appendicitis and the finding of a duplication of vermiform appendix. A seven year old female, with abdominal septic shock, plain abdominal radiography with distended transverse intestinal loop with air-fluid levels and absence of air in distal colon and rectal ampula. Emergency laparotomy was performed finding a blind loop with secondary necrosis volvulus, with the torsion being at the base of the duplication, connected at the middle portion of the vermiform appendix; desvolvulus and resection was performed in a block fashion with Parker-Kerr technique using a 4-0 polyglactin suture. There are 100 cases of duplication of appendix reported worldwide. In our case, a duplication of the vermiform appendix type A was presented, shown by the surgical findings and corroborated by pathology samples of intestinal tissue featuring smooth muscle tissue and transmural necrosis and fibrinopurulent exudate in serous.

  9. Lumbar facet joint septic arthritis presenting atypically as acute abdomen – A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Aysha Rajeev

    2016-01-01

    Conclusion: The atypical presentation of facet joint septic arthritis is one of the reasons why early diagnosis is elusive. Definitive diagnoses with MRI and bacterial culture as well as prolonged antibiotic therapy are recommended in this condition.

  10. Acute abdomen in patients with systemic lupus erythematosus and antiphospholipid syndrome: importance of early diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Alberto Titos-García

    2015-01-01

    Full Text Available Systemic lupus erithematosus (SLE is an autoimmune disease with multiorgan involvement caused principally by vasculitis of small vessels. The gastrointestinal tract is one of the most frequently affected by SLE, with abdominal pain as the most common symptom. An early diagnosis and treatment of lupus enteritis is essential to avoid complications like hemorrhage or perforation, with up to 50 % of mortality rate. However, differential diagnosis sometimes is difficult, especially with other types of gastrointestinal diseases as digestive involvement of antiphospholipid syndrome (APS, moreover when both entities may coexist. We describe the case of a patient with both diseases that was diagnosed with lupus enteritis and treated with steroid therapy; the patient had an excellent response.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  12. Safety of enteral feeding in patients with open abdomen, upper gastrointestinal bleed, and perforation peritonitis.

    Science.gov (United States)

    Guillaume, Alexandra; Seres, David S

    2012-08-01

    Provision of enteral nutrition (EN) has historically been withheld after major abdominal operations until bowel activity returns. Evidence suggests that EN is safe in critically ill patients with a variety of illnesses, specifically after abdominal surgery. There is a strong association between poor nutrition status and worse outcomes in critically ill patients. The fear has been that EN, by virtue of increased luminal pressure or demand to the splanchnic circulation, may compromise the integrity of anastomotic repairs and place patients at risk for complications. In this review, the authors analyze the safety of EN in the setting of the open abdomen, upper gastrointestinal bleeding, and perforation peritonitis, with evidence from published clinical trials and meta-analyses.

  13. A 36-year-old man with vomiting, pain abdomen, significant weight loss, hyponatremia, and hypoglycemia

    Directory of Open Access Journals (Sweden)

    Deepti Mutreja

    2015-01-01

    Full Text Available Diagnosis of Strongyloides stercoralis hyperinfection can be a challenge. The key to a timely diagnosis is to have a high index of suspicion. We present a rare case of a 36-year-old human immunodeficiency virus negative male patient, who was on multidrug therapy for lepromatous leprosy and was treated for type 2 lepra reactions with steroids in the past. The patient presented with vomiting and pain abdomen, persistent hyponatremia, and terminal hypoglycemia. He had features of malnutrition and had a rapid downhill course following admission. A diagnosis of S. stercoralis hyperinfection with sepsis and multiorgan failure, adrenal hemorrhage, and syndrome of inappropriate antidiuretic hormone secretion was established on a postmortem examination.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kivelitz, D.; Taupitz, M.; Hamm, B. [Universitaetsklinikum Charite, Berlin (Germany). Inst. fuer Radiologie; Gehl, H.B. [Medizinische Univ. Luebeck (Germany). Inst. fuer Radiologie; Heuck, A. [Muenchen Univ. (Germany). Radiologische Klinik; Krahe, T. [Koeln Univ. (Germany). Inst. fuer Radiologische Diagnostik; Lodemann, K.P. [Bracco-Byk Gulden GmbH, Konstanz (Germany)

    1999-07-01

    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.)

  15. Deflection measurement system for the hybrid iii six-year-old biofidelic abdomen.

    Science.gov (United States)

    Gregory, T Stan; Howes, Meghan K; Rouhana, Stephen W; Hardy, Warren N

    2012-01-01

    Motor vehicle collisions are the leading cause of death for children ages 5 to 14. Enhancement of child occupant protection is partly dependent on the ability to accurately assess the interaction of child-size occupants with restraint systems. Booster seat design and belt fit are evaluated using child anthropomorphic test devices, such as the Hybrid III 6-year-old dummy., A biofidelic abdomen for the Hybrid III 6-year-old dummy is being developed by the Ford Motor Company to enhance the dummy’s ability to assess injury risk and further quantify submarining risk by measuring abdominal deflection. A practical measurement system for the biofidelic abdominal insert has been developed and demonstrated for three dimensional determination of abdominal deflection. Quantification of insert deflection is achieved via differential signal measurement using electrodes mounted within a conductive medium. Signal amplitude is proportional to the distance between the electrodes. A microcontroller is used to calculate distances between ventral electrodes and a dorsal electrode in three dimensions. This system has been calibrated statically, and its performance demonstrated in a series of sled tests. Deflection measurements from the instrumented abdominal insert indicate performance differences between two booster seat designs, yielding an average peak anterior to posterior displacement of the abdomen of 1.0 ± 3.4 mm and 31.2 ± 7.2 mm for the seats, respectively. Implementation of a 6-year-old abdominal insert with the ability to evaluate submarining potential will likely help safety researchers further enhance booster seat design and interaction with vehicle restraint systems , and help to further understand child occupant injury risk in automobile collisions.

  16. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale

    OpenAIRE

    Bossuyt Patrick MM; Dijkgraaf Marcel GW; van Randen Adrienne; Laméris Wytze; Stoker Jaap; Boermeester Marja A

    2007-01-01

    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....

  17. Multiple myeloma presenting as acute pancreatitis.

    Science.gov (United States)

    Mishra, Shakti Bedanta; Azim, Afzal; Mukherjee, Arindam

    2017-09-01

    A 36 year old male presented to the emergency department with severe epigastric pain, nausea, vomiting without hematemesis, diarrhea and anorexia. He presented with respiratory distress, shock and fever at the emergency. He was intubated and shifted to the intensive care unit with the diagnosis of acute pancreatitis with hypercalcemia and an elevated amylase and lipase's well as thrombocytopenia and elevated creatinine. CT scan of abdomen was done which showed lytic bone lesions in the spine and necrosis of the pancrease. He was evaluated for multiple myeloma and it was confirmed in a bone marrow biopsy. Multiple myeloma usually is seen in patients aged more than 60 yrs. The typical presentation of multiple myeloma is anemia, back pain, and an elevated sedimentation rate. Patients with multiple myeloma have hypercalcemia but it's rarely manifested as acute pancreatitis. This case shows a rare presentation of multiple myeloma as acute pancreatitis in a younger adult. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. FDG-PET/CT Limited to the Thorax and Upper Abdomen for Staging and Management of Lung Cancer

    NARCIS (Netherlands)

    Arens, A.I.; Postema, J.W.; Schreurs, W.M.; Lafeber, A.; Hendrickx, B.W.; Oyen, W.J.G.; Vogel, W.V.

    2016-01-01

    PURPOSE: This study evaluates the diagnostic accuracy of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) of the chest/upper abdomen compared to the generally performed scan from head to upper thighs, for staging and management of (suspected) lung cancer in

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

    NARCIS (Netherlands)

    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

  20. Higher incidence of injection site reactions after subcutaneous bortezomib administration on the thigh compared with the abdomen.

    Science.gov (United States)

    Kamimura, Tomohiko; Miyamoto, Toshihiro; Yokota, Noriko; Takashima, Shuichiro; Chong, Yong; Ito, Yoshikiyo; Akashi, Koichi

    2013-02-01

    Subcutaneous (sc) rather than intravenous administration of bortezomib (Bor) is becoming more common for treating multiple myeloma (MM) because scBor results in lower incidence and severity of peripheral neuropathy and has equivalent efficacy. Bor is an irritant cytotoxic agent when it leaks out; therefore, it is recommended that injections of scBor should be rotated among eight different sites on the abdomen and thigh. However, detailed information about injection site reaction (ISR) has not been sufficiently documented. We retrospectively analyzed the incidence and severity of ISR following scBor administration in 15 Japanese patients with MM. Grade 1 ISR occurred following 40 of 158 (25.3%) scBor injections in ten patients, whereas grade 2 ISRs occurred following seven injections (4.4%) in five patients. Five patients did not develop ISR. Of note, grade 2 ISR was documented in 6 of 65 (9.2%) thigh injections but only in 1 of 93 (1.1%) abdominal injections. These data show that grade 2 ISRs were more common in the thigh compared with the abdomen possibly because the thigh contains lesser adipose tissue than the abdomen. Grade 2 ISRs resolved without any sequela within a median of 7 d. scBor administration on the abdomen instead of the thigh should be considered, especially for emaciated patients, because ISR rapidly resolves within the interval before the next injection even if it occurs. © 2012 John Wiley & Sons A/S.

  1. Bladder rupture causing pseudo acute renal failure

    Directory of Open Access Journals (Sweden)

    Luciana Andrea Avena Smeili

    2011-09-01

    Full Text Available Bladder rupture is a rare condition associated with significant morbidityand mortality. It is classified into traumatic, nontraumatic or idiopathic andspontaneous. The nonspecific initial clinical presentation is followed bydiscomfort in the lower abdomen, oliguria, hematuria and ascitis. Laboratoryabnormalities simulate the picture of acute renal failure and occurs by amechanism called auto reverse dialysis, with absorption of excreta throughthe peritoneal membrane. The authors describe a case of bladder rupturein morphologically and functionally normal urinary bladder associated withalcohol intake in young healthy man, manifested by abdominal discomfort,pseudo renal failure and massive ascitis. The diagnosis was made by anabdominal multidetector computed tomography confirmed by the finding of7 cm laceration at laparotomy.

  2. Acute appendicitis in a premature baby

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. Acute pancreatitis

    Science.gov (United States)

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  4. Cystitis - acute

    Science.gov (United States)

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  5. Comparison of virtual unenhanced CT images of the abdomen under different iodine flow rates.

    Science.gov (United States)

    Li, Yongrui; Li, Ye; Jackson, Alan; Li, Xiaodong; Huang, Ning; Guo, Chunjie; Zhang, Huimao

    2017-01-01

    To assess the effect of varying iodine flow rate (IFR) and iodine concentration on the quality of virtual unenhanced (VUE) images of the abdomen obtained with dual-energy CT. 94 subjects underwent unenhanced and triphasic contrast-enhanced CT scan of the abdomen, including arterial phase, portal venous phase, and delayed phase using dual-energy CT. Patients were randomized into 4 groups with different IFRs or iodine concentrations. VUE images were generated at 70 keV. The CT values, image noise, SNR and CNR of aorta, portal vein, liver, liver lesion, pancreatic parenchyma, spleen, erector spinae, and retroperitoneal fat were recorded. Dose-length product and effective dose for an examination with and without plain phase scan were calculated to assess the potential dose savings. Two radiologists independently assessed subjective image quality using a five-point scale. The Kolmogorov-Smirnov test was used first to test for normal distribution. Where data conformed to a normal distribution, analysis of variance was used to compare mean HU values, image noise, SNRs and CNRs for the 4 image sets. Where data distribution was not normal, a nonparametric test (Kruskal-Wallis test followed by stepwise step-down comparisons) was used. The significance level for all tests was 0.01 (two-sided) to allow for type 2 errors due to multiple testing. The CT numbers (HU) of VUE images showed no significant differences between the 4 groups (p > 0.05) or between different phases within the same group (p > 0.05). VUE images had equal or higher SNR and CNR than true unenhanced images. VUE images received equal or lower subjective image quality scores than unenhanced images but were of acceptable quality for diagnostic use. Calculated dose-length product and estimated dose showed that the use of VUE images in place of unenhanced images would be associated with a dose saving of 25%. VUE images can replace conventional unenhanced images. VUE images are not affected by varying iodine

  6. Thermal territories of the abdomen after caesarean section birth: infrared thermography and analysis.

    Science.gov (United States)

    Childs, C; Siraj, M R; Fair, F J; Selvan, A N; Soltani, H; Wilmott, J; Farrell, T

    2016-09-01

    To develop and refine qualitative mapping and quantitative analysis techniques to define 'thermal territories' of the post-partum abdomen, the caesarean section site and the infected surgical wound. In addition, to explore women's perspectives on thermal imaging and acceptability as a method for infection screening. Prospective feasibility study undertaken at a large University teaching hospital, Sheffield UK. Infrared thermal imaging of the abdomen was undertaken at the bedside on the first two days after elective caesarean section. Target recruitment: six women in each of three body mass index (BMI) categories (normal, 18.5-24.9 kg/m²; overweight 25-29.9 kg/m²; obese ≥30 kg/m²). Additionally, women presenting to the ward with wound infection were eligible for inclusion in the study. Perspectives on the use of thermal imaging and its practicality were also explored via semi-structured interviews and analysed using thematic content analysis. We recruited 20 women who had all undergone caesarean section. From the booking BMI, eight women were obese (including two women with infected wounds), seven women were overweight and five women had a normal BMI. Temperature (ºC) profiling and pixel clustering segmentation (hierarchical clustering-based segmentation, HCS) revealed characteristic features of thermal territories between scar and adjacent regions. Differences in scar thermal intensity profiles exist between healthy scars and infected wounds; features that have potential for wound surveillance. The maximum temperature differences (∆T) between healthy skin and the wound site exceed 2º C in women with established wound infection. At day two, two women had a scar thermogram with features observed in the 'infected' wound thermogram. Thermal imaging at early and later times after caesarean birth is feasible and acceptable. Women reported potential benefits of the technique for future wound infection screening. Thermal intensity profiling and HCS for pixel

  7. Acute colonic disease: How to image in emergency

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Lombardo, Patrizia [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy); Cinque, Teresa [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy); Tortora, Giovanni [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy)

    2007-03-15

    The diseases affecting the large intestine represent a diagnostic problem in adult patients with acute abdomen, especially when clinical symptoms are not specific. The role of the diagnostic imaging is to help clinicians and surgeons in differential diagnosis for an efficient early and prompt therapy to perform. This review article summarizes the imaging spectrum of findings of colonic acute disease, from mechanical obstruction to inflammatory diseases and perforation, offering keys to problem solving in doubtful cases as well as discussing regarding the more indicated imaging method to use in emergency, particularly MDCT.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Acute Bronchitis

    Science.gov (United States)

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. MR imaging of the abdomen and pelvis in infants, children, and adolescents.

    Science.gov (United States)

    Darge, Kassa; Anupindi, Sudha A; Jaramillo, Diego

    2011-10-01

    Recent developments in magnetic resonance (MR) imaging have profoundly changed the investigation of abdominal and pelvic disease in pediatrics. Motion reduction techniques, such periodically rotated overlapping parallel lines with enhanced reconstruction, or PROPELLER, have resulted in reliable imaging with quiet breathing. Faster imaging sequences minimize artifact and allow for more efficient studies. Diffusion-weighted imaging has become increasingly important in the evaluation of neoplastic disease, depicting disease with increased cellularity and helping to differentiate benign from malignant masses. MR enterography helps visualize intra- and extraluminal bowel pathologic conditions. MR cholangiopancreatography can depict congenital and acquired causes of pancreatic and biliary abnormalities. MR urography is an effective technique for a one-stop-shop evaluation of structural urinary tract abnormality and renal function. Three-dimensional acquisitions allow volumetric display of structures from multiple angles. Specialized techniques allow quantification of iron and fat in the viscera in children with hemolytic anemia and obesity, respectively. This article covers current techniques and strategies to perform and optimize MR imaging of the abdomen and pelvis in infants, children, and adolescents and describes important practical applications. © RSNA, 2011.

  13. Granuloma a cuerpo extraño en abdomen secundario a sutura no absorbible

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    Marlyn González

    2016-08-01

    Full Text Available Los granulomas a cuerpo extraño son inducidos por cuerpos relativamente inertes, es típico que se formen alrededor de material como talco o suturas. Algunos estudios describen que las suturas no absorbibles especialmente la seda tiene mayor índice de complicaciones como son la formación de granuloma a cuerpo extraño y dolor postoperatorio. Se reporta el caso de una paciente femenino de 40 años de edad, quién consulta por presentar dolor abdominal de moderada intensidad a nivel de epigástrio, de dos meses de evolución acompañado de náuseas y vómitos, presenta como antecedente quirúrgico una miomectomía realizada hace dos meses. Al examen físico de ingreso abdomen globoso a expensas de panículo adiposo, ruidos hidroaéreos presentes, blando, depresible, doloroso a la palpación en epigástrico donde se evidencia tumoración móvil de 10 x 10 cm aproximadamente, sin signos de irritación peritoneal. Se realizó laparotomía exploradora con los siguientes hallazgos: tumoración de 10 x 15 cm a nivel de epigastrio formado por epiplón mayor adherido a colon transverso y colon sigmoides formando plastrón alrededor de sutura no absorbible.

  14. Application of high-frequency ultrasound for the detection of surgical anatomy in the rodent abdomen.

    Science.gov (United States)

    Chen, J Y; Chen, H L; Wu, S H; Tsai, T C; Lin, M F; Yen, C C; Hsu, W H; Chen, W; Chen, C M

    2012-02-01

    Rats are used extensively in abdominal disease research. To monitor disease progress in vivo, high-frequency ultrasound (HFU) can be a powerful tool for obtaining high-resolution images of biological tissues. However, there is a paucity of data regarding the correlation between rat anatomy and corresponding HFU images. Twenty-four adult male Sprague-Dawley (SD) rats underwent abdominal scans using HFU (40 MHz) surgical procedures to identify abdominal organs and major vessels as well as in situ scanning to confirm the imaging results. The results were compared with those of human abdominal organs in ultrasonographic scans. The rat liver, paired kidneys, stomach, intestines, and major blood vessels were identified by HFU and the ultrasonic morphologies of the liver and kidneys showed clear differences between rats and humans. Clinically relevant anatomical structures were identified using HFU imaging of the rat abdomen, and these structures were compared with the corresponding structures in humans. Increased knowledge with regard to identifying the anatomy of rat abdominal organs by ultrasound will allow scientists to conduct more detailed intra-abdominal research in rodents.

  15. Rotura de aneurisma de aorta abdominal: su importancia como diagnostico diferencial en abdomen agudo

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2008-01-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  16. Fine focal spot size improves image quality in computed tomography abdomen and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Goh, Yin P.; Low, Keat; Kuganesan, Ahilan [Monash Health, Diagnostic Imaging Department, 246, Clayton Road, Clayton, Victoria (Australia); Lau, Kenneth K. [Monash Health, Diagnostic Imaging Department, 246, Clayton Road, Clayton, Victoria (Australia); Monash University, Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Victoria (Australia); Buchan, Kevin [Philips Healthcare, Clinical Science, PO Box 312, Mont Albert, Victoria (Australia); Oh, Lawrence Chia Wei [Flinders Medical Centre, Division of Medical Imaging, Bedford Park South (Australia); Huynh, Minh [Swinburne University, Department of Statistics, Data Science and Epidemiology, School of Health Sciences, Faculty of Health, Arts and Design, Hawthorn (Australia)

    2016-12-15

    To compare the image quality between fine focal spot size (FFSS) and standard focal spot size (SFSS) in computed tomography of the abdomen and pelvis (CTAP) This retrospective review included all consecutive adult patients undergoing contrast-enhanced CTAP between June and September 2014. Two blinded radiologists assessed the margin clarity of the abdominal viscera and the detected lesions using a five-point grading scale. Cohen's kappa test was used to examine the inter-observer reliability between the two reviewers for organ margin clarity. Mann-Whitney U testing was utilised to assess the statistical difference of the organ and lesion margin clarity. 100 consecutive CTAPs were recruited. 52 CTAPs were examined with SFSS of 1.1 x 1.2 mm and 48 CTAPs were examined with FFSS of 0.6 x 0.7 mm. Results showed that there was substantial agreement for organ margin clarity (mean κ = 0.759, p < 0.001) among the reviewers. FFSS produces images with clearer organ margins (U = 76194.0, p < 0.001, r = 0.523) and clearer lesion margins (U = 239, p = 0.052, r = 0.269). FFSS CTAP improves image quality in terms of better organ and lesion margin clarity. Fine focus CT scanning is a novel technique that may be applied in routine CTAP imaging. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

    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.

  19. Childhood motocross truncal injuries: high-velocity, focal force to the chest and abdomen.

    Science.gov (United States)

    Kennedy, Raelene D; Potter, D Dean; Osborn, John B; Zietlow, Scott; Zarroug, Abdalla E; Moir, Christopher R; Ishitani, Michael B; McIntosh, Amy

    2012-01-01

    To review the need for operative intervention and critical care services for motocross truncal injuries in children. DESIGN COHORT: Retrospective review of patients identified via the hospital trauma registry. Our Level 1 Pediatric Trauma Center serves five motocross tracks. These patients require frequent medical care for injuries. All patients ≤17 years of age with truncal injuries sustained during motocross activities, between 2000 and 2011, were identified through the trauma registry. Operative intervention, intensive care unit (ICU) admission, length of stay, morbidity and demographics were reviewed. Motocross injured 162 children. Thirty (18.5%) were thoracic or abdominal injuries. Operative intervention was required in eight (27%) patients. Mean injury severity score (ISS) was 11.8. ICU admission was required in 50% and average hospital length of stay was 4.1 days. The most common injuries include pulmonary contusion, pneumothorax, spleen and liver lacerations. 13% of subjects suffered truncal injury from motocross on more than one occasion. Paediatric motocross-related truncal injuries are significant. Surgical intervention is required in 27% of patients. The lower ISS incurred from motocross combined with high surgical and ICU admission rates suggests focal high-impact injuries to the chest and abdomen. Despite significant injury, 13% of motocross patients suffer recurrent injuries. Parents and children need injury prevention education.

  20. The application of nursing behavior intervention on the post-operation pain in abdomen

    Directory of Open Access Journals (Sweden)

    Xiao-fei WU

    2014-08-01

    Full Text Available Objective: To investigate the effect of behavioral intervention for the post-operation pain in abdomen. Methods: Forty patients from the county hospital during October 2013 to January 2014 were selected as the observation objects and randomly divided into two groups, intervention group and control groups with 20 patients in each.The control group received conventional general care and the intervention group received nursing behavior interventions,including, the effective evaluation of pain, improvement of health education, strengthening of physical intervention, psychological intervention and psychosocial intervention etc. Two sets of VAS scores and nursing intervention effects were analyzed with statistical methods. Results: After taking nursing behavior interventions,the intervention group had significantly lower VAS scores,and lower level was more significant than that in the control group,The difference has statistically significant P<0.05.The intervention group has higher satisfaction for nursing service. Conclusion: The implementation of nursing behavior interventions can significantly relieve the patient pain, improve the postoperative analgesic treatment effect, and raise the quality of nursing and the comfort and satisfaction of the patients. Thereby reducing the incidence of postoperative complications, and promoting the patient recover. 

  1. ROTURA DE ANEURISMA DE AORTA ABDOMINAL: SU IMPORTANCIA COMO DIAGNOSTICO DIFERENCIAL EN ABDOMEN AGUDO

    Directory of Open Access Journals (Sweden)

    Vanessa Orellana-Villazón

    2012-02-01

    Full Text Available El aneurisma aórtico abdominal (AAA roto es una forma de presentación poco frecuente de los AAA. Presentamos un caso de rotura de aneurisma de aorta abdominal (AAAr de un paciente varón de 76 años de edad que ingresa al servicio de emergencias del Hospital Elizabeth Setón por presentar dolor abdominal punzante en región lumbar derecha de inicio súbito e intensidad creciente, llegando a perder el conocimiento. La impresión diagnóstica inicial incluye cólico ureteral e hipertensión arterial; sin embargo después realizar una ecografía abdominal y posteriormente una tomografía abdominal se concluye con el diagnostico de AAAr. El paciente es sometido a cirugía de emergencia, y después de permanecer tres días en terapia intensiva y tres días en sala, es dado de alta. Consideramos importante informar este caso clínico por la frecuencia con que se le confunde con patologías renales o abdomen agudo, pese a la sintomatología característica que presenta, que en muchos casos lleva a un diagnostico retrasado y posteriormente a la muerte.

  2. Acute inflammatory bowel disease of the small intestine in adult: MDCT findings and criteria for differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy)], E-mail: stefromano@libero.it; Russo, Anna [Institute of Radiology, Second University of Naples, Naples (Italy); Daniele, Stefania; Tortora, Giovanni [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy); Maisto, Francesco [Institute of Radiology, Second University of Naples, Naples (Italy); Romano, Luigia

    2009-03-15

    Inflammatory changes of the intestine leading to acute abdomen could represent a frequent diagnostic challenge for radiologists actively involved in the emergency area. MDCT imaging findings needs to be evaluated considering the clinical history and symptoms and other abdominal findings that could be of help in differential diagnosis. Several protocols have been suggested and indicated in the imaging of patient with acute intestine. However, a CT protocol in which the precontrast scanning of the abdomen is followed by i.v. administration of contrast medium using the 45-55 s delay could be effective for an optimal visualization of the bowel wall. It is important to learn to recognize how the intestine reacts to the injury and how it 'talks', in order to become aware of the different patterns of disease manifestation related to an acute intestinal condition, for an effective diagnosis of active and acute inflammatory bowel disease.

  3. [Conservative treatment of acute diverticulitis].

    Science.gov (United States)

    Busser, Nienke; van Hee, Koen; van Dullemen, Hendrik H M; Schipper, D L Lucette

    2013-01-01

    Scientific evidence concerning the treatment of acute diverticulitis is scarce. We describe 2 patients with this condition in this article. The first, a 64-year-old man, came to the emergency room because he had experienced persistent abdominal pain for the previous 4 days. He was diagnosed with uncomplicated diverticulitis. The second patient, a 58-year-old woman, had had pain in her left lower abdomen for 4 weeks; the pain appeared to have been caused by complicated diverticulitis. Both patients were treated conservatively. Only the patient with complicated diverticulitis was administered antibiotics; she underwent surgery at a later date because of persistent pain. Several guidelines recommend the administration of antibiotics; however, a number of recent studies have revealed no benefit to the clinical course from the use of antibiotics. The Dutch guideline, therefore, recommends withholding antibiotics in the acute phase. Conclusive evidence on the best treatment for patients with frequent recurrences or chronic symptoms after an episode of acute diverticulitis is not available. Guidelines advise a personalised treatment strategy for each patient. More research is necessary on the effect of mesalazine in these cases.

  4. Vivencia de la persona en el proceso de tener una herida crónica por abdomen abierto

    OpenAIRE

    Fuentes Ramírez, Alejandra

    2014-01-01

    Las personas sometidas a la técnica quirúrgica de abdomen abierto debido a la severidad de la infección, pueden permanecer con la herida abierta por más de seis semanas, necesitando de un cierre por segunda intención. Ello condiciona una lenta recuperación y cambios en la vida que aún no han sido descritos. Los objetivos fueron la descripción de los significados y la comprensión de la experiencia de tener una herida crónica por abdomen abierto, luego se planteó una propuesta teórica que de...

  5. The muscle pattern of the Drosophila abdomen depends on a subdivision of the anterior compartment of each segment

    OpenAIRE

    Krzemień, Joanna; Fabre, Caroline C. G.; Casal, José; Lawrence, Peter A

    2012-01-01

    In the past, segments were defined by landmarks such as muscle attachments, notably by Snodgrass, the king of insect anatomists. Here, we show how an objective definition of a segment, based on developmental compartments, can help explain the dorsal abdomen of adult Drosophila. The anterior (A) compartment of each segment is subdivided into two domains of cells, each responding differently to Hedgehog. The anterior of these domains is non-neurogenic and clones lacking Notch develop normally; ...

  6. The abdomen of Drosophila: does planar cell polarity orient the neurons of mechanosensory bristles?

    Directory of Open Access Journals (Sweden)

    Fabre Caroline CG

    2008-04-01

    Full Text Available Abstract Background In the adult abdomen of Drosophila, the shafts of mechanosensory bristles point consistently from anterior to posterior. This is an example of planar cell polarity (PCP; some genes responsible for PCP have been identified. Each adult bristle is made by a clone of four cells, including the neuron that innervates it, but little is known as to how far the formation or positions of these cells depends on PCP. The neurons include a single dendrite and an axon; it is not known whether the orientation of these processes is influenced by PCP. Results We describe the development of the abdominal mechanosensory bristles in detail. The division of the precursor cell gives two daughters, one (pIIa divides to give rise to the bristle shaft and socket cell and the other (pIIb generates the neuron, the sheath and the fifth cell. Although the bristles and their associated shaft and socket cells are consistently oriented, the positioning and behaviour of the neuron, the sheath and the fifth cell, as well as the orientation of the axons and the dendritic paths, depend on location. For example, in the anterior zone of the segment, the axons grow posteriorly, while in the posterior zone, they grow anteriorly. Manipulating the PCP genes can reverse bristle orientation, change the path taken by the dendrite and the position of the cell body of the neuron. However, the paths taken by the axon are not affected. Conclusion PCP genes, such as starry night and dachsous orient the bristles and position the neuronal cell body and affect the shape of the dendrites. However, these PCP genes do not appear to change the paths followed by the sensory axons, which must, therefore, be polarised by other factors.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Diffusion-weighted imaging of the abdomen: Impact of b-values on texture analysis features.

    Science.gov (United States)

    Becker, Anton S; Wagner, Matthias W; Wurnig, Moritz C; Boss, Andreas

    2017-01-01

    The purpose of this work was to systematically assess the impact of the b-value on texture analysis in MR diffusion-weighted imaging (DWI) of the abdomen. In eight healthy male volunteers, echo-planar DWI sequences at 16 b-values ranging between 0 and 1000 s/mm(2) were acquired at 3 T. Three different apparent diffusion coefficient (ADC) maps were computed (0, 750/100, 390, 750 s/mm(2) /all b-values). Texture analysis of rectangular regions of interest in the liver, kidney, spleen, pancreas, paraspinal muscle and subcutaneous fat was performed on DW images and the ADC maps, applying 19 features computed from the histogram, grey-level co-occurrence matrix (GLCM) and grey-level run-length matrix (GLRLM). Correlations between b-values and texture features were tested with a linear and an exponential model; the best fit was determined by the smallest sum of squared residuals. Differences between the ADC maps were assessed with an analysis of variance. A Bonferroni-corrected p-value less than 0.008 (=0.05/6) was considered statistically significant. Most GLCM and GLRLM-derived texture features (12-18 per organ) showed significant correlations with the b-value. Four texture features correlated significantly with changing b-values in all organs (p GLCM features showed significant variability in the different ADC maps. Several texture features vary systematically in healthy tissues at different b-values, which needs to be taken into account if DWI data with different b-values are analyzed. Histogram and GLRLM-derived texture features are stable on ADC maps computed from different b-values.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  10. Acute appendicitis in a femoral hernia

    Directory of Open Access Journals (Sweden)

    Zdravković Darko

    2007-01-01

    Full Text Available INTRODUCTION Acute appendicitis in a femoral hernia is an uncommon condition that can be serious. Complications are more frequent if the diagnosis is delayed and surgery is not performed on time. CASE REPORT We present a 71-year-old man with a painful swollen mass. The patient presented with fatigue and loss of appetite, while body temperature was normal. The abdomen was not painful, and peristaltic was normal. All laboratory findings were normal. After anamnesis and physical examination, the presumed diagnosis was incarcerated femoral hernia and the patient was sent to the operating room. Intraoperative findings revealed an incarcerated femoral hernia within a phlegmonous inflammated appendix. Appendectomy and McVay hernioplastics were done. The postoperative course was without complications. CONCLUSION It is very important to bear in mind that right femoral hernia with signs of incarceration and inflammation may contain an acutely inflamed appendix. Delayed diagnosis and misdiagnosis cause greater morbidity and mortality.

  11. Borchardt Triade: A Symptom of Acute Gastric Volvulus

    Directory of Open Access Journals (Sweden)

    Salim Bilici

    2013-10-01

    Full Text Available Gastric volvulus, especially cases with an acute onset, may result in strangulation, perforation, peritonitis, shock and death. The disease is rarely seen in children, but early diagnosis and treatment is essential due to its life-threatening potential. In patients with acute gastric volvulus, the clinical Borchardt triade may be observed, which is characterized by acute severe pain and distension in the upper abdomen or lower thoracic region, retching and the inability to pass a nasogastric tube. In this article, We  aimed to emphasize the Borchardt’s triad by presenting a pediatric case who was diagnosed with Borchardt’s triad and who had acute mesenteric axial gastric volvulus which diaphragmatic hernia and mobile (wandering spleen were accompanied.

  12. A case report of acute acalculous cholecystitis due to Salmonella Paratyphi B complicated by biliary peritonitis.

    Science.gov (United States)

    Benjelloun, El Bachir; Chbani, Leila; Toughrai, Iman; Ousadden, Abdelmalek; Mazaz, Khalid; Taleb, Kahlid Ait

    2013-01-01

    Non-typhoidal salmonella are a rare case of acute acalculouscholecystitis (AAC). Salmonella Paratyphi B, which accounts for one of the less invasive NTS serotypes, has rarely been reported to cause cholecystitis. We describe a case of 65-year old previously healthy man, who present with signs of acute abdomen, due to biliary peritonitis as a complication of acute acalculouscholecystitis caused by Salmonella paratyphi B. Our case illustrates the potential severity of infection with Salmonella Paratyphi B especially in older patient. High index of awarenessshould be considered in endemic areas.

  13. Angioedema - a rare cause of acute episodic dysuria: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Panicker Radhakrishna

    2007-01-01

    Full Text Available The presentations of acute angioedema vary and depend upon the organs involved. Acute episodes of angioedema can be life-threatening if it involves the larynx leading to the obstruction of upper airways and it is a major cause of death. Angioedema involving the lips, cheek and tongue are common with bizarre presentations. Angioedema of the gastro intestinal tract frequently mimic an acute abdomen resulting in unnecessary surgical intervention and increased morbidity. Here we present an unusual case of angioedema involving the external urethra resulting in severe discomfort and burning sensation during micturition. He was later investigated and diagnosed as idiopathic urticaria with angioedema and promptly responded to antihistamines.

  14. Acute Bronchitis

    Science.gov (United States)

    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 ...

  15. Bronchitis - acute

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001087.htm Bronchitis - acute To use the sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflamed tissue in the main ...

  16. Clínica quirúrgica de los cuerpos extraños en el abdomen: oblito quirúrgico abdominal

    National Research Council Canada - National Science Library

    Edgar Nuñez Huerta

    1998-01-01

    .... The characteristics of the foreing body left in the abdomen during surgery from the nosographic and nosologic point of view, give this process an individuality, that allows to speak about its clinics...

  17. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Acute gastrointestinal emergencies requiring surgery in children

    Directory of Open Access Journals (Sweden)

    Pujari Amit

    2008-01-01

    Full Text Available Background: Although abdominal pain is common in the paediatric age group, problems of misdiagnosis and serious consequences are more particular in an emergency setting. This study examined the aetiologies of acute abdominal emergencies in children. Materials and Methods: This was a retrospective study of 100 children below the age of 12 years presenting with acute abdominal emergencies (gastrointestinal requiring operative interventions. All patients were operated on an emergency basis and the intraoperative findings were correlated with the clinical findings. Results: Acute abdominal emergencies in the paediatric age group were heterogenous, with a myriad of aetiological factors. Overall, 73% of patients were greater than 3 years of age. Early neonatal period formed the second most common group (12%. Acute appendicitis was the most common cause except in the infancy period where congenital abnormalities predominated. Conclusion: The correct diagnosis of acute abdomen in children requires attention to clinical details and a high degree of suspicion. Early surgical intervention in doubtful cases may be necessary to solve diagnostic problems.

  20. Detection of the Adamkiewicz artery in computed tomography of the thorax and abdomen.

    Science.gov (United States)

    Guziński, Maciej; Bryl, Maciej; Ziemińska, Katarzyna; Wolny, Kamila; Sąsiadek, Marek; Garcarek, Jerzy S

    2017-01-01

    The great anterior radiculomedullary artery, also known as the artery of Adamkiewicz (AKA), is a small-caliber vessel which arises from the intercostal or lumbar arteries branching out from the aorta. The aim of this study was to evaluate detection of the AKA, as well as its level and side of origin, with multi-slice contrast enhanced computed tomography (MSCT) of the abdomen and thorax performed during everyday clinical practice, and to compare the results with the literature. The study retrospectively evaluated 200 consecutive MSCT images of the thoracic and thoracoabdominal aorta performed at Wroclaw Medical University's Department of General and Interventional Radiology and Neuroradiology as part of normal clinical work-ups. The CT examinations were performed with a 64-slice CT scanner. Arterial-phase images were analyzed for detection of the AKA and for anatomical variants of the AKA. Recognition of the AKA was achieved in 43 of 200 patients (21.5%). Out of these 43 cases, the AKA originated on the left side in 36 instances (83.7%) - a significantly higher number than on the right side (only in 6 cases, 14%); in one case (2.3%) it arose from both sides (p < 0.05, T-test). Most of the AKAs (24 cases, 55.8%) originated on the left side at level T11 or T12. In 13 patients (30.2%) the AKA arose from T11 or from T12 intercostal arteries. The origin of the AKA varied greatly and ranged from T5 (2.3%) to L2 (2.3%). The AKA is characterized by left-side lateralization and is associated with a wide range of origin, from T5 to L2. Detection of the AKA is, relatively speaking, rarely possible in routine clinical CT in the arterial phase - only in 1/5 of the patients. Therefore it is necessary to perform dedicated, individual arterial phase bolus tracking enhancement CT scans from the T5 to L3 level.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  4. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    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.

  5. Acute pancreatitis

    Directory of Open Access Journals (Sweden)

    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.

  6. Biomechanical response of the pediatric abdomen, part 1: development of an experimental model and quantification of structural response to dynamic belt loading.

    Science.gov (United States)

    Kent, Richard; Stacey, Stephen; Kindig, Matthew; Forman, Jason; Woods, William; Rouhana, Stephen W; Higuchi, Kazuo; Tanji, Hiromasa; Lawrence, Schuyler St; Arbogast, Kristy B

    2006-11-01

    The abdomen is the second most commonly injured region in children using adult seat belts, but engineers are limited in their efforts to design systems that mitigate these injuries since no current pediatric dummy has the capability to quantify injury risk from loading to the abdomen. This paper develops a porcine (sus scrofa domestica) model of the 6-year-old human's abdomen, and then defines the biomechanical response of this abdominal model. First, a detailed abdominal necropsy study was undertaken, which involved collecting a series of anthropometric measurements and organ masses on 25 swine, ranging in age from 14 to 429 days (4-101 kg mass). These were then compared to the corresponding human quantities to identify the best porcine representation of a 6-year-old human's abdomen. This was determined to be a pig of age 77 days, and whole-body mass of 21.4 kg. The sub-injury, quasistatic response to belt loading of this porcine model compared well with pediatric human volunteer tests performed with a lap belt on the lower abdomen. A test fixture was designed to produce transverse, dynamic belt loading on the porcine abdomen. A detailed review of field cases identified the following test variables: loading location (upper/lower), penetration magnitude (23%-68% of initial abdominal depth), muscle tensing (yes/no), and belt penetration rate (quasistatic, dynamic 2.9 m/s - 7.8 m/s). Dynamic tests were performed on 47 post-mortem subjects. Belt tension and dorsal reaction force were cross-plotted with abdominal penetration to generate structural response corridors. Subcutaneous stimulation of the anterior abdominal muscle wall stiffened the quasistatic response significantly, but was of negligible importance in the dynamic tests. The upper abdomen exhibited stiffer response quasistatically, and also was more sensitive to penetration rate, with stiffness increasing significantly over the range of dynamic rates tested here. In contrast, the lower abdomen was relatively

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system

    Science.gov (United States)

    Moore, C. S.; Wood, T. J.; Avery, G.; Balcam, S.; Needler, L.; Joshi, H.; Saunderson, J. R.; Beavis, A. W.

    2016-11-01

    The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQm and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Joshi, H; Saunderson, J R; Beavis, A W

    2016-11-07

    The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQm and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

  11. Utility of anteroposterior diameter ratio of tumor and abdomen for laparoscopic approach for radical nephrectomy in large renal masses.

    Science.gov (United States)

    Yadav, Priyank; Srivastava, Devarshi; Arakere, Sachin; Gupta, Shashikant; Aga, Pallavi; Mandhani, Anil

    2017-08-07

    Laparoscopic radical nephrectomy (LRN) is now increasingly done for tumors larger than 10 cm. Despite selection of favorable cases, LRN may not be successful due to lack of adequate working space with large tumors. We describe a new feature on Contrast Enhanced Computed Tomography (CECT) abdomen to predict feasibility of LRN for large renal masses between 10 and 15 cm. From January 2005 to December 2015, renal tumors between 10 and 15 cm were selected retrospectively for LRN. Patients with retroperitoneal lymphadenopathy, Inferior vena cava (IVC) thrombus and involvement of adjacent organs were excluded. Anteroposterior (AP) diameter ratio of renal tumor and abdomen (APROTA) was calculated by dividing the maximum AP diameter of tumor along with normal renal parenchyma, by the AP diameter of abdomen on CECT. The patients were stratified into two groups: Group A (successful LRN) and Group B (conversion to open surgery) and outcomes were compared. The reasons for conversion were also noted. Of 29 patients, 16 (55.2%) had successful LRN (Group A), while 13 (44.8%) had conversion to open surgery (group B). The median tumor size in Group A was 11.3 ± 1.8 cm and in Group B was 13.6 ± 1.26 cm. Eleven of 13 patients had conversion due to large tumor size causing failure to progress. Two conversions were due to bleeding and injury to the colon each. There was a significant difference in the APROTA in group A and B [0.43 ± 0.09 in group A and 0.64 ± 0.14 in group B (p = 0.0001)]. Patients with APROTA of more than 0.65 are unlikely to have successful outcome with LRN.

  12. CLINICAL EVALUATION AND ROLE OF USG IN PATIENTS OF ACUTE APPENDICITIS IN A RURAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sandesh

    2014-12-01

    Full Text Available INTRODUCTION: Acute appendicitis is the commonest emergency met in surgical practice. The clinical features sometimes being non-specific and list of differential diagnosis is too long. Diagnosis being particularly difficult in females due to associated gynaecological and obstetric conditions. The aim is to reduce unnecessary laparotomies and incidence of appendiceal perforation which is associated with significant post-operative morbidity. Reported approaches to achieve this objective include emergency laparotomy, Ultrasonography (USG, scoring system, CT scan etc. In peripheral areas USG remains most widely available and preliminary investigative for establishing definitive diagnosis in addition to clinical suspicion. AIM: Clinical evaluation and role of ultrasonography in patients of acute appendicitis in a rural hospital. OBJECTIVES: To study clinical profile of acute appendicitis. Role of USG in diagnosis of acute appendicitis. METHODS: 50 patients of acute abdomen suspected to have acute appendicitis, of all age groups and both sexes, admitted with cardinal features of acute appendicitis like pain in abdomen (Right iliac fossa, vomiting, and fever were included in this study. Patients were studied according to the Proforma. Surgeons made a final clinical diagnosis on the basis of clinical impression and USG information. All the patients diagnosed as acute appendicitis (without any lump formation in RIF were treated surgically and diagnosis was confirmed histopathologically. Acute appendicitis was studied with special reference to clinical findings and ultrasonographic findings. Use of ultrasonography in the diagnosis of acute appendicitis was evaluated. CONCLUSION: USG remains most cost effective, efficient and valuable investigation for acute appendicitis in rural settings. The use of USG in suspected acute appendicitis should be complement to but not replacing clinical assessment.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Blood flow response in small intestinal loops at different depths during negative pressure wound therapy of the open abdomen.

    Science.gov (United States)

    Lindstedt, Sandra; Hlebowicz, Joanna

    2013-08-01

    High closure rates of the open abdomen have been reported following negative pressure wound therapy (NPWT). However, the method has occasionally been associated with increased development of intestinal fistulae. We have previously shown that the application of NPWT to the open abdomen causes a decrease in microvascular blood flow in the small intestinal loop and the omentum adjacent to the visceral protective layer of the dressing. In this study we investigate whether the negative pressure affects only small intestinal loops lying directly below the dressing or if it also affects small intestinal loops that are not in direct contact with the dressing. Six pigs underwent midline incision and application of NPWT to the open abdomen. The microvascular blood flow was measured in four intestinal loops at different depths from the visceral protective layer, at two different locations: beneath the dressing and at the anterior abdominal wall, before and after the application of NPWT of -50, -70, -100, -120, -150 and -170 mmHg, using laser Doppler velocimetry. Negative pressures between -50 and -170 mmHg caused a significant decrease in the microvascular blood flow in the intestinal loops in direct contact with the visceral protective layer. A slight, but significant, decrease in blood flow was also seen in the intestinal loops lying beneath these loops. The decrease in microvascular blood flow increased with the amount of negative pressure applied. No difference in blood flow was seen in the intestinal loops lying deeper in the abdominal cavity. A decrease in blood flow was seen in the upper two intestinal loops located apically and anteriorly, but not in the lower two, indicating that this is a local effect and that pressure decreases with distance from the source. A long-term decrease in blood flow in the intestinal wall may induce ischaemia and secondary necrosis in the intestinal wall, which could promote the development of intestinal fistulae. We believe that NPWT of

  15. Typhoid Fever Presenting With Acute Renal Failure And Hepatitis Simultaneously - A Rare Presentation

    OpenAIRE

    Rajput R.; Jain D; Kumar A.; Mittal A

    2016-01-01

    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...

  16. DEFICIENT PROTEIN C AND PROTEIN S INDUCED ACUTE VENOUS MESENTERIC ISCHEMIA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Darwin Britto

    2016-05-01

    Full Text Available BACKGROUND A 35 year old lady presented with unresolved severe abdominal pain and vomiting. She was diagnosed to have superior mesenteric vein thrombosis with gangrenous small bowel and multiple splenic infarcts secondary to Protein C and Protein S deficiency. She underwent emergency explorative laparotomy and extensive small bowel resection and anastomosis and splenectomy. This is to stress the importance of keeping mesenteric ischemia as an important differential diagnosis in cases of acute abdomen

  17. Abdominal separation in an adult male patient with acute abdominal pain

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    We report a male patient with prolonged post-prandial abdominal distension and a sudden onset of epigastric pain initially diagnosed as acute abdomen. The patient had no history of surgery. Physical examination revealed peritonitis and abdominal computed tomography scan showed upper abdominal mesentery intorsion. The patient then underwent surgical intervention. It was found that the descending mesocolon dorsal root was connected to the ascending colon and formed a membrane encapsulating the small intestine...

  18. In vitro dose measurements in a human cadaver with abdomen/pelvis CT scans

    Energy Technology Data Exchange (ETDEWEB)

    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

  19. Comportamiento Inusual de Sarcoma de alto grado de malignidad en abdomen. Reporte de un caso

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    Maryem Seco Meza

    2014-03-01

    Full Text Available Los sarcomas de tejidos blandos aparecen en cualquier localización y abarcan más de 50 tipos histológicos; se originan del tejido mesodérmico embrionario y del ectodermo o neuroectodermo. Son pocos frecuentes y representan el 1 % de tumores sólidos abdominales de alta agresividad en adultos. Los más agresivos y con mayor capacidad metastásica son los de alto grado, mientras que los de bajo grado son agresivos pero de forma local. Al respecto, se presenta el caso de una paciente femenina de 52 años, del área rural, con 3 meses de evolución del cuadro clínico, quien presentó aumento progresivo de volumen abdominal, sensación de peso y masa palpable, concomitantemente emesis, adinamia, pérdida de peso y edema en miembros inferiores. Se realizó ultrasonografía abdominal que evidenció tumoración ecomixta de 16 x 20 cm en línea media. La Tomografía Axial Computarizada abdominal reportó lesión ocupante de espacio heterogénea, ovalada, de bordes irregulares de 15 x 10 cm que desplaza asas delgadas. La laparotomía exploradora media mostró ausencia de implantes peritoneales y carcinomatosis, tumor muy vascularizado, encapsulado de contextura lisa, consistencia firme, con bordes definidos de 15 x 20 cm. Después de la resección, no se observaron adenopatías ni metástasis locales y a distancia. El reporte histopatológico identificó un sarcoma de alto grado. A dos años de la operación no se encontró metástasis. Contrario a lo que la literatura reporta, se mantuvo un comportamiento “benigno” a pesar de su histología, lo cual es inusual considerando la historia natural de la enfermedad. Unusual Behavior of High-grade sarcoma malignancy in abdomen. A case report Abstract Soft tissue sarcomas appear in any location and include more than 50 histological types; they originate from mesodermal embryonic tissue, ectoderm or neuroectoderm. They are infrequent and represent 1% of highly aggressive abdominal solid tumors in adults

  20. Acute cholecystitis

    OpenAIRE

    Halpin, Valerie

    2014-01-01

    Acute cholecystitis causes unremitting right upper quadrant pain, anorexia, nausea, vomiting, and fever, and if untreated can lead to perforations, abscess formation, or fistulae. About 95% of people with acute cholecystitis have gallstones.It is thought that blockage of the cystic duct by a gallstone or local inflammation can lead to acute cholecystitis, but we don't know whether bacterial infection is also necessary.

  1. Implications of respiratory motion for the quantification of 2D MR spectroscopic imaging data in the abdomen

    Science.gov (United States)

    Schwarz, A. J.; Leach, M. O.

    2000-08-01

    Magnetic resonance spectroscopic imaging (MRSI) studies in the abdomen or breast are acquired in the presence of respiratory motion. This modifies the point spread function (PSF) and hence the reconstructed spectra. We evaluated the quantitative effects of both periodic and aperiodic motion on spectra localized by MRSI. Artefactual signal changes, both the modification of native to a voxel and spurious signals arising elsewhere, depend primarily upon the motion amplitude relative to the voxel dimension. A similar dependence on motion amplitude was observed for simple harmonic motion (SHM), quasi-periodic motion and random displacements. No systematic dependence upon the period or initial phase of SHM or on the array size was found. There was also no significant variation with motion direction relative to the internal and external phase-encoding directions. In measured excursion ranges of 20 breast and abdominal tumours, 70% moved ≤ 5 mm, while 30% moved 6-23 mm. The diaphragm and fatty tissues in the gut typically moved ~ 15-20 mm. While tumour/organ excursions less than half the voxel dimension do not substantially affect native signals, the bleeding in of strong lipid signals will be problematic in 1H studies. MRSI studies in the abdomen, even of relatively well-anchored tumours, are thus likely to benefit from the addition of respiratory triggering or other motion compensation strategies.

  2. 胎儿腹部MRI诊断进展%Application of MRI in evaluation of fetal abdomen

    Institute of Scientific and Technical Information of China (English)

    丁立; 伍兵

    2015-01-01

    There are many special MRI sequences can be used to improve diagnosis accuracy of fetal abdominal diseases. Compared with ultrasound, MRI is superior in diagnosis of obstruction of the digestive tract, lesions in liver, gallbladder and urinary system. As a newly emerged technique, prenatal function-MRI now plays important role in evaluation of fetal abdomen, especially in the situation of low amniotic fluid. Prenatal MRI can make a greater contribution for prenatal and postnatal care by providing important information of fetal abdomen physiological functions.%MRI 技术用于腹部成像,有许多特殊序列可以帮助完善诊断,对于胃肠道梗阻、肝胆系统占位病变及泌尿系统异常的诊断均优于超声。随着胎儿腹部MRI诊断逐渐转向功能性研究,其在羊水偏少时更能发挥作用。 MRI有望在未来用于评价胎儿腹部系统生理功能,对优生优育的作用更大。

  3. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

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

    2015-09-27

    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. Seventy-two 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Acute nierschade

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; van Heurn, L.W.E.; Snoeijs, M.G.

    2012-01-01

    - 'Acute kidney injury' is modern terminology for a sudden decline in kidney function, and is defined by the RIFLE classification (RIFLE is an acronym for Risk, Injury, Failure, Loss and End-stage kidney disease).- Acute kidney injury occurs as a result of the combination of reduced perfusion in the

  8. Managing acute and chronic pancreatitis.

    Science.gov (United States)

    Skipworth, James R A; Shankar, Arjun; Pereira, Stephen P

    2010-10-01

    Pancreatitis may be acute or chronic. Although both can be caused by similar aetiologies, they tend to follow distinct natural histories. Around 80% of acute pancreatitis (AP) diagnoses occur secondary to gallstone disease and alcohol misuse. AP is commonly associated with sudden onset of upper abdominal pain radiating to the back that is usually severe enough to warrant the patient seeking urgent medical attention. Onset of pain may be related to a recent alcohol binge or rich, fatty meal. The patient may appear unwell, be tachycardic and have exquisite tenderness in the upper abdomen. Overall, 10-25% of AP episodes are classified as severe, leading to an associated mortality rate of 7.5%. Disease severity is best predicted from a number of clinical scoring systems which can be applied at diagnosis in association with repeated clinical assessment, measurement of acute inflammatory markers, and CT. All patients with suspected AP should be referred urgently. Chronic pancreatitis (CP) follows continued, repetitive or sustained injury to the pancreas and 70% of diagnoses occur secondary to alcohol abuse. The characteristic presenting feature of CP is insidious progression of chronic, severe, upper abdominal pain, radiating to the back, caused by a combination of progressive pancreatic destruction, inflammation and duct obstruction. Signs and symptoms include weight loss and steatorrhoea and later on diabetes. CP patients may also present with recurrent episodes mimicking AP, both symptomatically and metabolically. Diagnosis of CP should be based on symptom profile, imaging and assessment of exocrine and endocrine pancreatic function. CT should be the first-line imaging investigation.

  9. CLINICAL STUDY ON ACUTE PANCREATITIS

    Directory of Open Access Journals (Sweden)

    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

  10. 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)

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Accuracy Performance of the Medtronic NexSensor™ for 6 Days in an Inpatient Setting Using Abdomen and Buttocks Insertion Sites

    Science.gov (United States)

    Peoples, Tim; Bailey, Timothy; Brazg, Ronald; Zisser, Howard C; Janowski, Bob; Huang, Suiying; Talbot, Cary; Yang, Qingqing

    2011-01-01

    Background Users of continuous glucose monitoring are concerned with product accuracy and choice of insertion site. The Medtronic NexSensor™ was evaluated for accuracy during 6 days of wear when inserted in the abdomen and buttocks areas. Methods Adults (ages 18–75) with type 1 diabetes wore two sensors simultaneously for 6 days, one each inserted in the abdomen and buttocks. Subjects underwent a frequent blood sampling study for 12 hours, during which time reference blood glucose values were obtained every 15 minutes and compared to sensor values. Results Sixty-three subjects were enrolled, and 61 subjects completed the study. The mean agreement rate between sensor and blood glucose values was 75.5% [95% confidence interval (CI), 69.5, 81.4] at the abdomen site, 73.8% (95% CI, 68.8, 78.8) at the buttocks site, and 75.6% (95% CI, 70.8, 80.4) when sensor and reference data were combined between sites. Over 90% of paired sensor-reference values on Clarke error grids were within the A and B ranges. The mean absolute relative differences were 17.1% at the abdomen site, 16.5% at the buttocks site, and 16.8% when sites were combined. Conclusion The NexSensor was accurate for inpatient, frequent-sample testing for 6 days when inserted into the abdomen and buttocks. The results of this study also provide evidence that both the abdomen and buttocks are suitable as sensor insertion sites. PMID:21527106

  13. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  14. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  15. Acute Kidney Failure

    Science.gov (United States)

    ... out of balance. Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly over ... 2015. Palevsky PM. Definition of acute kidney injury (acute renal failure). http://www.uptodate.com/home. Accessed April ...

  16. [Ratio of amylase clearance and creatinine clearance in the diagnosis of acute pancreatitis].

    Science.gov (United States)

    Haffter, D; Reichlin, B; Gyr, K

    1981-05-30

    In 21 healthy volunteers the ratio of amylase clearance and creatinine clearance (Cam/Ccr) was determined in urine collected at admission, after a 1-hour collection period and after a 2-hour collection period. The normal values were 1.8 +/- 1.6%, 1.9 +/- 2% and 2.0 +/- 1.7% respectively. They were comparable with those published by others. The reproducibility of the method was acceptable (r = 0.62). When compared with serum amylase determinations, Cam/Ccr showed neither better sensitivity in 19 patients suffering an acute episode of proven pancreatitis, nor better specificity in 19 patients with acute abdomen but no evidence of pancreatitis.

  17. Urachal Cyst Causing Small Bowel Obstruction in an Adult with a Virgin Abdomen

    Directory of Open Access Journals (Sweden)

    Michael P. O’Leary

    2016-01-01

    Full Text Available Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia. On exam, he had evidence of small bowel obstruction. Computed tomography revealed high-grade small bowel obstruction secondary to presumed ruptured appendicitis. In the operating room, an infected urachal cyst was identified with adhesions to the proximal ileum. After lysis of adhesions and resection of the cyst, the patient was subsequently discharged without further issues. Conclusion. Although rare, urachal pathology should be considered in the differential diagnosis when evaluating a patient with small bowel obstruction without prior intraabdominal surgery, hernia, or malignancy.

  18. Diagnóstico del abdomen agudo en el consultorio del Médico de Familia

    Directory of Open Access Journals (Sweden)

    Caridad Soler Morejón1

    2001-08-01

    Full Text Available El diagnóstico de afecciones abdominales agudas es a menudo complejo y difícil para el médico práctico, pero más aún si contamos con los recursos diagnósticos limitados de un consultorio médico en el nivel de atención primaria. Es por ello que resulta de utilidad poder disponer de métodos simples y eficaces que permitan mejorar la certeza del diagnóstico y que puedan ser implementados con facilidad en este medio. Tal es el caso de la medición transuretral de la presión intraabdominal.Summary The diagnosis of acute abdominal affections is complex and difficult for practitioners, but it is even more complicated when the diagnostic tools are limited, as it is the case of the family physician’s office at the primary health care level. That’s why, it is useful to have simple and effective methods that allow to improve the accuracy of diagnosis and that may be applied in this setting. That’s what happens with the transurethral measurement of intraabdominal pressure

  19. Transplantation of an eight-organ multivisceral graft in a patient with frozen abdomen after complicated Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    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.

  20. Diffusion-weighted MR imaging of the abdomen with pulse triggering; Kardiale Triggerung zur verbesserten abdominellen MR-Diffusionsbildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Muertz, P.; Pauleit, D.; Traeber, F.; Kreft, B.P.; Schild, H.H. [Bonn Univ. (Germany). Radiologische Klinik; Gieseke, J.; Brink, J.S. van den [Philips Medical Systems, Eindhoven (Netherlands)

    2000-07-01

    Purpose: The aim of this work was to reduce the influence of motion on diffusion-weighted MR images of the abdomen by pulse triggering of single-shot sequences. Methods: Five healthy volunteers were examined both without and with finger pulse-triggering of a diffusion-weighted single-shot echo planar MR imaging sequence at 1.5 T. Series of diffusion-weighted images were acquired at different phases of the cardiac cycle by varying the time delay between finger pulse and sequence acquisition. The measurements were repeated three times. The diffusion weighted images were analysed by measuring the signal intensities and by determining the ADC values within the spleen, kidney and liver. Results: The magnitude of motion artifacts on diffusion weighted images shows a strong dependence on the trigger delay. The optimum trigger delay is found to be between 500 and 600 ms. For these values the abdominal organs appear homogeneous on all diffusion weighted images and the strongest signal intensities are detected. At optimum triggering the accuracy of the apparent diffusion coefficients is up to 10 times better than without triggering. Moreover, the standard deviation of the repeated measurements is smaller than 12% for all volunteers and for all organs. Without triggering the standard deviation is larger by a factor of 4 on average. Conclusion: Pulse triggering of single-shot sequences leads to significant reduction of motion related artifacts on diffusion weighted images of the abdomen and provides more accurate and reproducible ADC values. (orig.) [German] Ziel: In dieser Arbeit ist die Frage untersucht worden, ob sich die stoerenden Bewegungseinfluesse bei der Diffusionsbildgebung des Abdomens durch Pulstriggerung der Single-Shot-Sequenzen reduzieren lassen. Methoden: Fuenf Probanden wurden sowohl ohne als auch mit Fingerpulstriggerung einer Single-Shot-SE-EPI-Diffusionssequenz bei 1,5 T untersucht, wobei Diffusionsbildserien in verschiedenen Herzphasen durch Variation der

  1. Use of a device that applies external kneading-like force on the abdomen for treatment of constipation

    Institute of Scientific and Technical Information of China (English)

    Konstantinos Mimidis; David Galinsky; Efraim Rimon; Vassilios Papadopoulos; Yehuda Zicherman; Dimitrios Oreopoulos

    2005-01-01

    AIM: To evaluate the efficacy of a recently developed device that applies kneading-like motion on the abdomen in improving constipation in elderly long-term care patients.METHODS: Thirty constipated elderly patients were randomly selected from two nursing homes. They were instructed to use the device once daily for 20 min. Rate of bowel movements, volume and consistency of stool and the use of laxantia were all recorded during a 3-wk baseline period and for 12-wk treatment period. Colonic transit time (CTT) was measured in 13 patients by radiopaque markers during the baseline and at the end of treatment.RESULTS: Bowel movement rate (BM/week) increased from 1.4±0.4 BM/wk during baseline to 3.9±0.8 BM/wk during treatment (P<5.0×10-7). Stool amount that was "low" in 30 patients during baseline increased in 21 patients at the end of the study period (χ2 = 19.048-P =1.3×10-5). Stool consistency, that was "hard" in 25 patients and "soft" in 5 patients during baseline, ameliorated in 23 patients at the end of the study (only 2 patients referred "hard" stool) (χ2= 21.043-P = 4.0×10-6). The mean baseline CTT measured was 92.3±32.3 h at baseline and decreased to 49.4±31.3 h during the study period (P = 0.000208). No side effects were observed during the study period.CONCLUSION: External mechanical vibration of the abdomen reduced CTT and helped to relieve severe constipation in elderly constipated patients.

  2. Influence of image registration on ADC images computed from free-breathing diffusion MRIs of the abdomen

    Science.gov (United States)

    Guyader, Jean-Marie; Bernardin, Livia; Douglas, Naomi H. M.; Poot, Dirk H. J.; Niessen, Wiro J.; Klein, Stefan

    2014-03-01

    The apparent diffusion coefficient (ADC) is an imaging biomarker providing quantitative information on the diffusion of water in biological tissues. This measurement could be of relevance in oncology drug development, but it suffers from a lack of reliability. ADC images are computed by applying a voxelwise exponential fitting to multiple diffusion-weighted MR images (DW-MRIs) acquired with different diffusion gradients. In the abdomen, respiratory motion induces misalignments in the datasets, creating visible artefacts and inducing errors in the ADC maps. We propose a multistep post-acquisition motion compensation pipeline based on 3D non-rigid registrations. It corrects for motion within each image and brings all DW-MRIs to a common image space. The method is evaluated on 10 datasets of free-breathing abdominal DW-MRIs acquired from healthy volunteers. Regions of interest (ROIs) are segmented in the right part of the abdomen and measurements are compared in the three following cases: no image processing, Gaussian blurring of the raw DW-MRIs and registration. Results show that both blurring and registration improve the visual quality of ADC images, but compared to blurring, registration yields visually sharper images. Measurement uncertainty is reduced both by registration and blurring. For homogeneous ROIs, blurring and registration result in similar median ADCs, which are lower than without processing. In a ROI at the interface between liver and kidney, registration and blurring yield different median ADCs, suggesting that uncorrected motion introduces a bias. Our work indicates that averaging procedures on the scanner should be avoided, as they remove the opportunity to perform motion correction.

  3. Application of the Value of Prospective Nursing in the Abdomen Triage%前瞻性护理在急腹症分诊中的价值应用

    Institute of Scientific and Technical Information of China (English)

    钟楚燕

    2015-01-01

    目的:探讨前瞻性护理在急腹症分诊中的应用效果。方法:选择292例急腹症患者为研究对象,依据时间先后顺序分为观察组和对照组各146例。对照组按常规护理方法分诊,观察组采取前瞻性护理分诊。比较2组分诊准确率、患者满意度。结果:观察组分诊正确率、急救成功率(93.15%、90.41%)、患者对护理人员沟通能力、心理指导、护理技术操作熟练程度、巡视及态度评分(97.32±8.45、95.24±8.10、96.42±7.34、94.15±8.57、97.26±8.34)均明显高于对照组;并发症(3.42%)明显低于对照组。结论:在急腹症分诊中应用前瞻性护理,可提高分诊正确率及急救成功率,促进患者康复,提高患者满意度。%Objective: To investigate the effect of prospective nursing applications in the abdomen triage.Methods: 292 pa-tients with acute abdomen were studied, and were divided into two groups based on chronological order,146 cases in the observation group and the control group.Patients in the control group were given conventional nursing triage, patients in the observation group were given prospective nursing triage.Triage accuracy and patient satisfaction was compared.Results: The triage accuracy and e-mergency success rate was 93.15%and 90.41%, the ability of patients to communicate to nurses, psychological counseling, nurs-ing technical proficiency in the operation, inspection and attitude score was (97.32 ±8.45,95.24 ±8.10,96.42 ±7.34,94.15 ±8.57,97.26 ±8.34),significantly higher, complications was 3.42%, significantly lower than that in the control group.Con-clusion: Prospective nursing triage in the acute abdomen can improve the accuracy of triage and first aid success rate , and promote the rehabilitation of patients, improve patients'satisfaction.

  4. Acute abdominal pain in children: usefulness of three-view abdominal radiographs in the emergency department.

    Science.gov (United States)

    He, Lulu; Park, Ellen; Vachhani, Neil; Vogelius, Esben; Thupili, Chakradhar; Udayasankar, Unni

    2016-10-01

    Diagnostic imaging is often an integral component in the workup of a pediatric patient with acute abdominal pain. The purpose of this study was to compare the diagnostic value of a three-view acute abdominal series (AAS) with that of a single supine view (SSV) in children with acute abdominal pain. All subjects aged ≤18 years that underwent an emergency three-view AAS examination for acute abdominal pain at a single urban hospital system were included. Retrospective evaluation of radiological diagnosis, number of radiological images, further imaging, management, and clinical outcomes was performed. "Positive" AAS studies were compared with corresponding SSV images for direct comparison of diagnostic value. Standard nonparametric statistical evaluation was performed. Five hundred forty-one AAS studies were included in the study. Greater than three radiographs were acquired in 29 % (153/541) of the subjects. Two hundred ninety-nine out of 541 AAS studies included a technically adequate SSV of the abdomen and pelvis. Most AAS examinations were categorized as negative (n = 485; 90 %). Of the 56 examinations initially classified as positive, there was no significant statistical difference between diagnostic accuracy between the AAS and SSV on retrospective evaluation. For pediatric subjects with nontraumatic acute abdominal pain, the yield of conventional radiographic study is exceedingly low. If required, a technically adequate single supine anteroposterior (AP) view of the abdomen and pelvis is sufficient for initial radiographic evaluation while reducing unnecessary radiation exposure to the patient.

  5. Acute Pancreatitis and Ileus Postcolonoscopy

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    Hin Hin Ko

    2009-01-01

    Full Text Available Postpolypectomy bleeding and perforation are the most common complications of colonoscopy. A case of acute pancreatitis and ileus after colonoscopy is described. A 60-year-old woman underwent a gastroscopy and colonoscopy for investigation of iron deficiency anemia. Gastroscopy was normal; however, the colonoscope could not be advanced beyond the splenic flexure due to a tight angulation. Two polypectomies were performed in the descending colon. After the procedure, the patient developed a distended, tender abdomen. Bloodwork was remarkable for an elevated amylase level. An abdominal x-ray and computed tomography scan showed pancreatitis (particularly of the tail, a dilated cecum and a few air-fluid levels. The patient improved within 24 h of a repeat colonoscopy and decompression tube placement. The patient had no risk factors for pancreatitis. The causal mechanism of pancreatitis was uncertain but likely involved trauma to the tail of the pancreas during the procedure. Our patient developed ileus, likely secondary to pancreatitis. The present case is the first report of clinical pancreatitis and ileus associated with colonoscopy.

  6. [Sensitivity and specificity of blood amylase, amylase and creatinine clearance ratio and urinary amylase/urinary creatinine ratio in the diagnosis of acute pancreatitis].

    Science.gov (United States)

    Ligny, G; Meunier, J C; Hayard, P; Ligny, C; Van Cauter, J

    1987-12-01

    The sensitivity and specificity of amylasemia, the ratios of amylase/creatinine clearance and amylasuria/creatininuria were determined in four groups of patients: a control group (n = 43), patients with acute pancreatitis detected on computed tomography (n = 30, 25 cases of alcoholic pancreatitis), patients with an acute surgical abdomen without pancreatitis (n = 25), and patients with renal failure (n = 20). Sensitivity was defined for the acute pancreatitis group and specificity for the other groups. When amylasemia was greater than 20 UI/dl and the amylasuria/creatininuria ratio greater than 100, sensitivity was 98 per cent. The specificity of these two results in patients with an acute surgical abdomen was 98 per cent. When the ratio amylase/creatinine clearance ratio was greater than 4 sensitivity was 73 per cent and specificity in patients with acute surgical abdomen was 75 per cent. These two values were lower than those of the two preceding tests (p less than 0.01). Sensitivity of the association of an amylasemia greater than 13 UI/dl (m + 2SD) with a clearance ratio greater than 4 was 73 per cent. The amylase/creatinine clearance ratio did not seem to be reliable since its change was delayed with respect to the increase of amylasemia and amylasuria. This ratio has a poor specificity as it increased when the clearance of creatinine decreased in the group with an acute surgical abdomen associated with functional or organic renal failure. In these two groups, the correlation between the amylase/creatinine clearance ratio and creatininemia was significant. This suggested that the clearance of creatinine fell more rapidly than the clearance of amylase as renal failure increased.

  7. Helical CT in acute lower gastrointestinal bleeding

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    Ernst, Olivier; Leroy, Christophe; Sergent, Geraldine [Department of Radiology, Hopital Huriez, 1 rue Polonovski, 59037 Lille (France); Bulois, Philippe; Saint-Drenant, Sophie; Paris, Jean-Claude [Department of Gastroenterology, Hopital Huriez, 1 rue Polonovski, 59037 Lille (France)

    2003-01-01

    The purpose of this study was to assess the usefulness of helical CT in depicting the location of acute lower gastrointestinal bleeding. A three-phase helical CT of the abdomen was performed in 24 patients referred for acute lower gastrointestinal bleeding. The diagnosis of the bleeding site was established by CT when there was at least one of the following criteria: spontaneous hyperdensity of the peribowel fat; contrast enhancement of the bowel wall; vascular extravasation of the contrast medium; thickening of the bowel wall; polyp or tumor; or vascular dilation. Diverticula alone were not enough to locate the bleeding site. The results of CT were compared with the diagnosis obtained by colonoscopy, enteroscopy, or surgery. A definite diagnosis was made in 19 patients. The bleeding site was located in the small bowel in 5 patients and the colon in 14 patients. The CT correctly located 4 small bowel hemorrhages and 11 colonic hemorrhages. Diagnosis of the primary lesion responsible for the bleeding was made in 10 patients. Our results suggest that helical CT could be a good diagnostic tool in acute lower gastrointestinal bleeding to help the physician to diagnose the bleeding site. (orig.)

  8. Morfologia comparada do abdome das espécies sulbrasileiras de Morphinae (Lepidoptera, Nymphalidae Compared abdomen morphology of South brazilian Morphinae species (Lepidoptera, Nymphalidae

    Directory of Open Access Journals (Sweden)

    Ivana Gavassi Bilotta

    1994-01-01

    Full Text Available A detailed study of the morphology of abdomen and genitalia of adults, males and females, of the following south Brazilian Morphinae species (Lepidoptera, Nymphalidae is presented: Morpho helenor violacetis Fruhstorfer. 1912. Iphimedeia hercules (Daiman, 1823. Iphixibia anaxibia (Esper, 1801. Cytheritis portis thamyris (C. Felder & R. Felder, 1867, Cytheritis aega (Huebner, 1822, Pessonia catenaria (Perry, 1811, Grasseia menelaus nestira (Huebner, 1821.

  9. A prospective, controlled evaluation of the abdominal reapproximation anchor abdominal wall closure system in combination with VAC therapy compared with VAC alone in the management of an open abdomen.

    Science.gov (United States)

    Long, Kristin L; Hamilton, David A; Davenport, Daniel L; Bernard, Andrew C; Kearney, Paul A; Chang, Phillip K

    2014-06-01

    Dramatic increases in damage control and decompressive laparotomies and a significant increase in patients with open abdominal cavities have resulted in numerous techniques to facilitate fascial closure. We hypothesized addition of the abdominal reapproximation anchor system (ABRA) to the KCI Abdominal Wound Vac™ (VAC) or KCI ABThera™ would increase successful primary closure rates and reduce operative costs. Fourteen patients with open abdomens were prospectively randomized into a control group using VAC alone (control) or a study group using VAC plus ABRA (VAC-ABRA). All patients underwent regular VAC changes; patients receiving VAC-ABRA also underwent concomitant daily elastomer adjustment of the ABRA system. Primary end points included abdominal closure, number of operating room (OR) visits, and OR time use. Eight patients were included in the VAC-ABRA group and six patients in the control group. Primary closure rates between groups were not statistically different; however, the number of trips to the OR and OR time use were different. Despite higher Acute Physiology and Chronic Health Evaluation II scores, larger starting wound size, and higher rates of abdominal compartment syndrome, closure rates in the VAC-ABRA group were similar to VAC alone. Importantly, however, fewer OR trips and less OR time were required for the VAC-ABRA group.

  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

    Energy Technology Data Exchange (ETDEWEB)

    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. Recurrence of acute myeloid leukemia in cryptorchid testis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Góes, Luccas Santos Patto de [Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP (Brazil); Lopes, Roberto Iglesias [Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP (Brazil); Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Campos, Octavio Henrique Arcos [Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP (Brazil); Oliveira, Luiz Carlos Neves de; Sant' Anna, Alexandre Crippa; Dall' Oglio, Marcos Francisco; Srougi, Miguel [Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-07-01

    A 23-year-old male with a history of bone marrow transplant for acute myeloid leukemia. He presented a large mass in the right inguinal region 5 years ago. Upon physical examination, right-sided cryptorchidism was observed. The tumor markers alpha-fetoprotein and beta-HCG were within normalcy range and lactate dehydrogenase was raised. Computed tomography of the abdomen and pelvis revealed right testicular mass in contiguity with the inguinal canal to the ipsilateral retroperitoneum, associated with right hydronephrosis. Due to the risk of germ-cell tumor in undescended testicle, the patient underwent radical right orchiectomy. The pathological examination showed recurrence of acute myeloid leukemia in the testis. He was referred to oncology for adjuvant therapy. Our literature review found no similar cases described.

  12. Acute tonsillitis.

    Science.gov (United States)

    Sidell, Doug; Shapiro, Nina L

    2012-08-01

    Acute tonsillitis is an inflammatory process of the tonsillar tissues and is usually infectious in nature. Acute infections of the palatine tonsils predominantly occur in school-aged children, but patients of any age may be affected. Tonsillitis of viral origin is usually treated with supportive care. Bacterial tonsillitis is most commonly caused by Streptococcus pyogenes. Polymicrobial infections and viral pathogens are also important sources of infection. Penicillins remain the treatment of choice for S. pyogenes tonsillitis, and augmented aminopenicillins have gained utility in concert with the increasing incidence of beta-lactamase producing bacteria. We describe the anatomic features and the immunologic function of the palatine tonsils, including a detailed discussion of history and physical examination findings, treatment recommendations, and possible complications of acute tonsillitis. Establishing an accurate diagnosis and initiating appropriate treatment are key components of managing this common pathologic process.

  13. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA: Design and rationale

    Directory of Open Access Journals (Sweden)

    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.

  14. Intussusception: a rare complication in a patient with acute leukaemia after consolidation chemotherapy.

    Science.gov (United States)

    Qasrawi, Ayman; Abu Ghanimeh, Mouhanna; Abughanimeh, Omar; Qasem, Abdulraheem

    2017-02-28

    Intussusception is telescoping of one segment of the gastrointestinal tract into an adjacent one. It is more common in children than adults. When it occurs in adults, it is usually associated with a lead point. Intussusception is very rare in acute leukaemia and has only been reported in few cases. We present a case of an adult woman who presented with intussusception after a cycle of consolidation chemotherapy with high-dose cytarabine for acute myeloid leukaemia. Other causes of acute abdominal pain were excluded, and the diagnosis was established by CT scan of the abdomen and barium enema. No pathological lead points were found intraoperatively. She underwent a right-sided hemicolectomy with complete recovery. To the best of our knowledge, this is only the fourth case of intussusception that has been reported in an adult patient with acute myeloid leukaemia. 2017 BMJ Publishing Group Ltd.

  15. Dual-phase CT for the assessment of acute vascular injuries in high-energy blunt trauma: the imaging findings and management implications.

    Science.gov (United States)

    Iacobellis, Francesca; Ierardi, Anna M; Mazzei, Maria A; Magenta Biasina, Alberto; Carrafiello, Gianpaolo; Nicola, Refky; Scaglione, Mariano

    2016-01-01

    Acute vascular injuries are the second most common cause of fatalities in patients with multiple traumatic injuries; thus, prompt identification and management is essential for patient survival. Over the past few years, multidetector CT (MDCT) using dual-phase scanning protocol has become the imaging modality of choice in high-energy deceleration traumas. The objective of this article was to review the role of dual-phase MDCT in the identification and management of acute vascular injuries, particularly in the chest and abdomen following multiple traumatic injuries. In addition, this article will provide examples of MDCT features of acute vascular injuries with correlative surgical and interventional findings.

  16. Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

    Directory of Open Access Journals (Sweden)

    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.

  17. Gastrointestinal tract labeling for MDCT of abdomen: Comparison of low density barium and low density barium in combination with water

    Energy Technology Data Exchange (ETDEWEB)

    Gulati, Kavita; Shah, Zarine K.; Sainani, Nisha; Uppot, Raul; Sahani, Dushyant V. [Massachusetts General Hospital and Harvard Medical School, Department of Abdominal Imaging and Intervention, Boston, MA (United States)

    2008-05-15

    The purpose of the study was to compare the quality of stomach and small bowel marking/labeling using 1,350 ml of low-density barium alone (Volumen) with 900 ml of low-density barium and 450 ml of water for 16-MDCT scans of the abdomen and pelvis and assess cost benefits with the two protocols. In this IRB approved study, 80 consecutive patients scheduled for routine CECT (contrast-enhanced CT) of the abdomen-pelvis were studied. Patients were randomized into two groups and were administered either 1,350 ml of VoLumen (two bottles at 20-min intervals, one half bottle at 50 min and the last half on the table) or 900 ml of Volumen (two bottles at 20-min intervals and 450 ml water on the table). Portal venous phase scanning (detector collimation = 0.625 mm, speed = 18.75 mm, thickness = 5 mm) was subsequently performed. Images were reconstructed in axial and coronal plane at the CT console. Two blinded readers used a pre-designed template to assess distension and wall characteristics of the stomach and small bowel on a 5-point scale. Median scores with the two protocols were compared using the Wilcoxon rank sum test. The stomach and small bowel labeling was rated fair to optimal in all patients and did not differ significantly in the two protocols. The mean scores for distension of the small bowel and stomach were comparable. Inter-observer agreement for bowel labeling was found to be excellent (k 0.81). With the use of coronal images there was increased reader confidence in tracing the small bowel with both protocols. Acceptance for two bottles of Volumen and water was greater among patients as compared to three bottles of VoLumen. Use of two bottles of Volumen and water combination cost less than three bottles of Volumen. Stomach and small bowel labeling with administration of 900 ml of Volumen followed by 450 ml of water is cost effective and compares well to 1,350 ml of Volumen alone. (orig.)

  18. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale

    Science.gov (United States)

    Laméris, Wytze; van Randen, Adrienne; Dijkgraaf, Marcel GW; Bossuyt, Patrick MM; Stoker, Jaap; Boermeester, Marja A

    2007-01-01

    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 < 5 days will be enrolled in this multicentre trial. After clinical history, physical and laboratory examination all patients will undergo a diagnostic imaging protocol, consisting of plain X-ray (upright chest and supine abdomen), US and CT. The reference standard will be a post hoc assignment of the final diagnosis by an expert panel. The focus of the analysis will be on the added value of the imaging modalities over history and clinical examination, relative to the incremental costs. 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. PMID:17683592

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

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    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.

  20. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

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    Leonor Montoya

    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.

  1. Study on exposure dose according to change of source to image distance and additional filter using abdomen phantom

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    Kim, Ki Won [Dept. of Radiology, Kyung Hee University Hospital at Gang-dong, Seoul (Korea, Republic of); Son, Jin Hyun [Dept. of Radiological Science, Shingu University, Sungnam (Korea, Republic of)

    2016-09-15

    This study is to minimize the patient dose and maintain the image quality according to change of source to image receptor distance and applying additional filter. In this study, we used the DR system, the tissue-equivalent abdomen phantom and the aluminium filter. The exposure conditions were set to 80 kVp using AEC mode. The collimation size was 16 x 16 inch. The exposure dose were measured 10 times when the SID was changed with 100, 110, 120 and 130 cm, respectively. The pirana 657 for dosimeter was located on center of radiation irradiation. The acquired images were analyzed by using the image J. In the results, the tube current was increased with increasing the SID but ESD was decreased with increasing the SID. The decrease of ESD attribute to use of filter that remove the photon of lower energy. In the histogram results using image J, there were differences between the ESD and the exposure conditions according to change of SID. However, there were not differences in histogram. Therefore, the exposure dose could reduced when set the longer SID. For pediatric exam, the exposure dose could reduced when used the aluminium filter.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Comparison of muscular activities in the abdomen and lower limbs while performing sit-up and leg-raise.

    Science.gov (United States)

    Kim, Kanghoon; Lee, Taesik

    2016-01-01

    [Purpose] This study compared the muscle activities of sit-up and leg-raise. [Subjects and Methods] The subjects of this study were healthy students in their 20s. For electromyography of sit-ups and leg-raises in the supine position, 5 muscle groups of the abdomen were selected for the attachment of sensors: the upper and lower rectus abdominis, external oblique, rectus femoris, and the iliopsoas. SPSS 20.0 was used for the statistical analysis. One-way ANOVA with repeated measures of all factors was performed to verify the statistical significance of the measurements taken for the muscle activities and follow-up verification was made with the Bonferroni post hoc test. [Results] Sit-up and leg raise showed a significant difference. The eccentric sit-up exercise elicited a significant increase in the activation of the abdominal muscle. The leg raise and eccentric sit-up exercises elicited significant increases in the activation of hip flexor muscle. [Conclusion] The eccentric sit-up had the most outstanding effect on the abdominal muscles involved in stability of the trunk.

  5. Indium-111 leukocyte scanning of the abdomen. Analysis of its value for diagnosis and management of inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Poitras, P.; Carrier, L.; Chartrand, R.; Gagnon, M.; Graveline, R.; Lahaie, R.G.; Martin, F.; Mheir, H.; Picard, D.

    1987-08-01

    Indium-111 leukocyte scanning of the abdomen (IAS) was performed in 10 patients with ulcerative colitis and in 39 patients with Crohn's disease involving the small intestine (in 25 occasions) and/or the colon (17 cases). Radionuclide uptake by the gut was seen in 84% of the patients with active inflammation. We compared the extent of the disease displayed by IAS with the findings obtained by either radiological or endoscopic studies or at surgery. In two-thirds of the patients, the IAS gave an accurate evaluation of the extent of the disease (sensitivity 68%). False-positive IASs were not seen in small bowel disease (specificity 100%), but were observed on 4 occasions on the colon (specificity 86%). The intensity of the radionuclide uptake could not be correlated with the clinical activity of the disease as evaluated by the Crohn's disease activity index. These results suggest that IAS is not superior to the standard procedures used to detect and localize inflammatory bowel disease and that IAS cannot replace these techniques. However, the simplicity of IAS and the complete lack of complications associated with its use render it useful in the evaluation of the extent and distribution of inflammation in some patients, mainly those with severe disease in whom standard diagnostic procedures would be contraindicated.

  6. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    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)

  7. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  8. Malrotación intestinal en adultos: causa infrecuente de abdomen agudo oclusivo Intestinal malrotation in adults: infrecuent cause of acute oclusive syndrome

    OpenAIRE

    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...

  9. Malrotación intestinal en adultos: causa infrecuente de abdomen agudo oclusivo Intestinal malrotation in adults: infrecuent cause of acute oclusive syndrome

    Directory of Open Access Journals (Sweden)

    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.

  10. Diverticulite do intestino delgado, uma causa incomum de abdome agudo inflamatório = Diverticulitis of the small bowel, an unusual cause of inflamatory acute abdomen

    Directory of Open Access Journals (Sweden)

    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

  11. Phlegmonous gastritis: A rare entity as a differential diagnostic of an acute abdomen. Description of a case and a bibliographic review.

    Science.gov (United States)

    Rada-Palomino, Arantzazu; Muñoz-Duyos, Arantxa; Pérez-Romero, Noelia; Vargas-Pierola, Harold; Puértolas-Rico, Noelia; Ruiz-Campos, Laura; Espinós-Pérez, Jorge; Veloso-Veloso, Enrique

    2014-06-01

    Phlegmonous gastritis is a rare bacterial infection of the gastric wall, which progress rapidly. It is characterized by a purulent inflammation that can affect the entire gastrointestinal tract and presents a high mortality rate. We are reporting a case of phlegmonous gastritis in an HIV-seropositive man successfully treated with antibiotics. Moreover, a review of the English andSpanish literature is carried out, from 1980 to the present time.The most frequently involved microorganism is Streptococcus spp. (57 %), but the polimicrobial infection is also frequent (17 %). The most important symptom is the intensive epigastric pain associated with vomits and most cases were diagnosed by CT and/or fibrogastroscopy. There are many existing risk factors described.The main one is the immunesuppression, although in 40 % of the cases no risk factors were identified. The global mortality is 27 % without identifying significant differences between antibiotics and surgical treatment, for that reason it is recommended to initiate antibiotic treatment right from the beginning and postponing surgery for the refractory cases and complications.

  12. 白血病患儿并急腹症6例%Six Cases of Children with Leukemia Complicated with Acute Abdomen

    Institute of Scientific and Technical Information of China (English)

    官晓清; 罗学群; 林苑; 张映川; 丘小汕; 廖忠敬

    2009-01-01

    目的 探讨儿童白血病并急腹症的诊断、治疗及预后.方法 对2006年3月-2007年12月本院儿科收治的6例白血病并急腹症患儿的临床资料进行回顾性分析.按FAB诊断分型标准确诊为ALL 5例,AML 1例.化疗不同时期并急腹症,主要表现为腹痛、腹胀和肠鸣音改变,根据临床表现并结合腹部X线平片检查诊断为肠梗阻,其中4例并严重全身感染,1例并坏死性肠炎.6例均予禁食、胃肠减压、抗感染及营养支持疗法等内科保守治疗.结果 1例AML患儿急腹症发生在白血病初诊时;5例ALL患儿急腹症发生在化疗中,且均注射过长春新碱.经内科治疗,4例肠梗阻缓解后完成化疗;2例病情加重放弃治疗后死亡.结论 白血病患儿并急腹症时临床症状常重于实验室检查,故应以临床表现作为早期诊断依据;早期积极全面的内科保守治疗是挽救患儿生命的重要手段.ALL患儿化疗中发生肠梗阻可能与长春新碱有关.严重感染与急腹症互为因果,相互影响.

  13. Phlegmonous gastritis: a rare entity as a differential diagnostic of an acute abdomen. Description of a case and a bibliographic review

    Directory of Open Access Journals (Sweden)

    Arantzazu Rada-Palomino

    2014-06-01

    Full Text Available Phlegmonous gastritis is a rare bacterial infection of the gastric wall, which progress rapidly. It is characterized by a purulent inflammation that can affect the entire gastrointestinal tract and presents a high mortality rate. We are reporting a case of phlegmonous gastritis in an HIV-seropositive man successfully treated with antibiotics. Moreover, a review of the English and Spanish literature is carried out, from 1980 to the present time. The most frequently involved microorganism is Streptococcus spp. (57 %, but the polimicrobial infection is also frequent (17 %. The most important symptom is the intensive epigastric pain associated with vomits and most cases were diagnosed by CT and/or fibrogastroscopy. There are many existing risk factors described. The main one is the immunesuppression, although in 40 % of the cases no risk factors were identified. The global mortality is 27 % without identifying significant differences between antibiotics and surgical treatment, for that reason it is recommended to initiate antibiotic treatment right from the beginning and postponing surgery for the refractory cases and complications.

  14. Acute gallbladder torsion - a continued pre-operative diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    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.

  15. ACUTE TRAUMATIC VENTRAL HERNIA

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    Dinesh

    2013-10-01

    Full Text Available ABSTRACT : A traumatic abdominal wall hernia is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occu rs, with the overlying skin remaining intact. Associated abdominal injuries are infrequent. An elderly male patient was seen in emergency within 6 hrs of alleged history of bull gore injury, while working in the fields; he presented with complaints of pain abdomen and swelling in the right side of lower abdomen. On Examination, soft, tender swelling is noted in RIF with overlying contusion, which increased in size over the next two days, with expansile cough impulse. Swelling was completely reducible and vi sible peristalsis seen.USG Abdomen showed defect in right iliac fossa abdominal wall with bowel loops in subcutaneous plane. A local exploration was performed incorporating the site of injury. A defect in all layers of abdominal wall muscles in right iliac fossa with intact skin and subcutaneous tissue was found. Primary tension free repair of the defect in layers done with inlay placement of prolene mesh due to poor abdominal muscle tone. A high index of clinical suspicion is essential, as an accompanying hematoma often confounds the diagnosis. Mesh repair is desirable in the elderly with weak anterior abdominal wall so as to prevent the long - term complications of recurrences

  16. CT findings of foreign body reaction to retained endoloop ligature plastic tube mimicking acute appendicitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Dept. of Radiology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2016-07-15

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  17. CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Kang, Chae Hoon; Choi, Soo-Jung; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Shick; Shin, Dong Rock [Department of Radiology, Asan Foundation, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440 (Korea, Republic of)

    2016-11-01

    Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

  18. Refractory thrombotic thrombocytopenic purpura following acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Ebisa Bekele; Bethel Shiferaw; Alexandra Sokolova; Arpan Shah; Phillip Saunders; Alida Podrumar; Javed Iqbal

    2016-01-01

    Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder with an estimated incidence of 4–5 cases per million people per year. It is characterized by small-vessel platelet-rich thrombi that cause thrombocytopenia, microangiopathic hemolytic anemia and organ damage. There are reports in literature that TTP and acute pancreatitis are associated, indicating each can be the cause of the other. However, acute pancreatitis triggering TTP is very rare. A 71 years old female presented with abdominal pain of 3 days, followed by dark urine. She had icteric sclera, petechial rash and mild epigastric tenderness. Lab findings were significant for hemolytic anemia, thrombocytopenia and elevated lipase. CT of abdomen showed evidence of pancreatitis and cholelithiasis. After admission, patient developed symptoms of stroke. Further investigation showed elevated lactate dehydrogenase and normal coagulation studied with peripheral blood smear showed 5–6 schistocytes/high power field. Disintegrin and metalloproteinase with thrombospondin motifs-13 (ADAMTS13) activity showed less than 3% with high ADAMTS13 inhibitor 2.2. Patient required 6–7 weeks of daily plasmapheresis until she showed complete response. Our patient presented with clinical features of pancreatitis prior to having dark urine and petechial rash. Therefore, we strongly believe that our patient had pancreatitis which was followed by TTP. Patient's ADMTS13 activity was 6%after 10 plasma exchanges, signifying refractory TTP and higher risk for morbidity and mortality. There are limited data and consensus on the management of refractory TTP. TTP and acute pancreatitis are associated. However, refractory TTP following acute pancreatitis is rarely mentioned in the literature. We would like to emphasize the importance of having higher clinical suspicion of the association of both disease entities.

  19. Acute intermittent porphyria in the puerperium

    Directory of Open Access Journals (Sweden)

    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.

  20. Monte carlo simulation of pregnant female phantoms and dose assessment of fetus and pregnant female from diagnostics x-ray at abdomen examination

    Energy Technology Data Exchange (ETDEWEB)

    Kim, W. R.; Lee, C. S.; Lee, J. K. [Hanyang Univ., Seoul (Korea, Republic of)

    2001-10-01

    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.