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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. Radiological aspects of acute abdomen

    International Nuclear Information System (INIS)

    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)

  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. Obstructive acute abdomen: reviewing important points

    International Nuclear Information System (INIS)

    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)

  5. Dengue Haemorrhagic Fever presenting as Acute Abdomen

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

    2011-01-01

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

  6. Intestinal tuberculosis presenting as acute abdomen

    International Nuclear Information System (INIS)

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

  7. 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.

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

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

    2004-01-01

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

  9. 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.

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

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    Yavuz Koca

    2014-06-01

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

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

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    Yavuz Koca

    2014-01-01

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

  12. 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.

  13. Evaluating the Acute Abdomen in the Pregnant Patient.

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

    2015-11-01

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

  14. 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

  15. Analysis of the computed tomography in the acute abdomen

    International Nuclear Information System (INIS)

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

  16. 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.

  17. 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

  18. Marfan syndrome with acute abdomen: a case report

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    Beyazit Zencirci

    2010-01-01

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

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

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

    2013-01-01

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

  20. 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

    2013-01-01

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

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

    Science.gov (United States)

    2013-01-01

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

  2. 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.

  3. 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.

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

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    Lidia Torres Ajá

    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.

    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

  5. Roentogenologic diagnosis of an acute abdomen in children

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

    1983-05-01

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

  6. Omental torsion in acute abdomen: a case report

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    Alibakhshi A

    2010-01-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Management of acute abdomen usually does not necessitate accurate pre-operative diagnosis but the surgeon should make a decision about the need for emergent laparotomy. This fact is somehow different for localized peritonitis (e.g. acute appendicitis in which the clinical presentation directs straightly to the diagnosis. However, acute appendicitis has lots of differential diagnoses, finding the normal appendix during laparotomy is just a start point to look for other diagnoses. Omental torsion is a rare cause for acute abdomen that is usually missed. Knowing about this rare condition and its frequently encountered presentation at the operating room (sero-sanguinous fluid coming out of peritoneal cavity may prevent missing the diagnosis and doing a malpractice."n"nCase report: Report a 9 year- old boy presented with acute abdomen which turned out to be an omental torsion after the operation."n"nConclusion: Knowledge about this rare condition "omental torsion" and its clinical and intra operative presentations may prevent missing the diagnosis and a malpractice.

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

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    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

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

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

    2014-01-01

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

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

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    Karunya Lakshmi; Abubacker Sulaiman; Ashwin Kumar; Shriranjani

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

    Antecedentes: la enteritis eosinofílica es un padecimiento raro y los casos de abdomen agudo que origina suponen un mínimo porcentaje. Su etiología aún no está aclarada pero se asocia con enfermedades del colágeno, intolerancias alimentarias e infestaciones por parásitos, como anisakis, descubierto en una de las histologías de nuestros casos. Casos clínicos: de 1997 a 2011 se diagnosticaron seis casos de abdomen agudo; en tres de ellos la enteritis eosinofílica causó necrosis irreversible de un segmento intestinal y hubo que practicar una resección intestinal segmentaria. En dos de ellos había un segmento intestinal con aspecto inflamatorio, que fue el único hallazgo causante del cuadro agudo y en los que sólo se practicó biopsia y otro caso donde fue un hallazgo sin relación con el proceso agudo. Conclusiones: la enteritis eosinofílica puede ocasionar cuadros de abdomen agudo que requieren intervención quirúrgica urgente. El aspecto intraoperatorio es el de un segmento con aspecto inflamatorio que puede llegar a ser macroscópicamente irreversible y donde sólo la resección parcial es el tratamiento correcto, que puede hacerse por vía laparoscópica.

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

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    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.

  12. 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)

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

    International Nuclear Information System (INIS)

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

  14. 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

  15. 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

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

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    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.

  17. 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. PMID:25999354

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

    International Nuclear Information System (INIS)

    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

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    Massimiliano Rocchietti March

    2012-12-01

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

  1. 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......, specificity and kappa-agreement of the surgeon performed ultrasound examination was 1.00 (0.77-1.00), 0.96 (0.79-0.99), 0.94 (0.3-1.00) and 0.40 (0.12-0.77), 0.97 (0.83-0.99), 0.44 (0.00-0.96); respectively. Visualization of the common bile duct was poor having 73% non-diagnostic surgeon-performed ultrasound...... examinations. CONCLUSION: Surgeons in training without pre-existing ultrasound experience and only a minimum of formal ultrasound education can perform valid and reliable ultrasound examinations of the gallbladder in patients admitted with acute abdominal pain...

  2. [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.

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    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. Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  12. 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.

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

    OpenAIRE

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

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  1. 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.

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

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    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. Spontaneous Rupture and Hemorrhage of Adrenal Pseudocyst Presenting With Acute Abdomen and Shock

    Directory of Open Access Journals (Sweden)

    Rahim Mahmodlou

    2011-12-01

    Full Text Available Adrenal gland pseudocysts are not common conditions, and most of them are nonfunctional and asymptomatic. However, large pseudocysts may causes abdominal discomfort and have compressive effects on adjacent organs. They may rupture spontaneously or after trauma, and lead to retroperitoneal hemorrhage and surgical emergency. Herein, we report a case of 21-year-old female who presented with acute abdomen and hemorrhagic shock due to spontaneous rupture of adrenal pseudocyst. She was treated successfully by open surgery, removal of adrenal pseudocyst and unilateral adrenalectomy.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

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

    OpenAIRE

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

    2007-01-01

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

  9. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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. PMID:25628913

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Emanuel da Silva Vieira Júnior

    2007-02-01

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

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

    OpenAIRE

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

    2016-01-01

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

  17. Acute abdomen due to spontaneous splenic rupture as the first presentation of lung malignancy: a case report

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    Arulraj Nolan

    2011-09-01

    Full Text Available Abstract Introduction Spontaneous splenic rupture is well recognized in the context of hematological malignancies (lymphoproliferative and myeloproliferative disorders; a few case reports have also linked solid tumors, such as pancreatic and liver cancer, with the occurrence of spontaneous splenic rupture. This is the first case report of lung cancer as a likely cause of spontaneous splenic rupture. Case presentation A 61-year-old Caucasian woman presented to our hospital with non-specific symptoms. She developed an 'acute' abdomen and went into a state of shock within twelve hours of her presentation. She was diagnosed with spontaneous splenic rupture with radiology and following a laparotomy. She made an uneventful recovery postoperatively and was simultaneously found to have a bronchial adenocarcinoma. Conclusion Spontaneous splenic rupture is a potentially fatal but often unrecognized cause of acute abdomen. It should be routinely considered in the differential diagnosis of acute ('surgical' abdomen and when present it should be promptly dealt with, most commonly with a laparotomy. Once the diagnosis is confirmed there should be an aggressive drive to identify an underlying etiology; malignancy is the commonest culprit. Solid tumors should be considered as underlying causes despite being less common than hematological neoplasms. This case report demonstrates lung malignancy as an underlying precipitating cause of spontaneous splenic rupture.

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

    Science.gov (United States)

    Fernández, Luis G

    2016-09-01

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

  19. 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.

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

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    Klimek Peter

    2012-12-01

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

  1. 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.

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

    OpenAIRE

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

    2009-01-01

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

  3. 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.

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Koyama, Yasushi; Suzuki, Yasuo

    2016-01-01

    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. PMID:27672472

  7. 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.

  8. 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

  9. 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.

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

    OpenAIRE

    Juan Camilo Correa Gallego; Edward Alexander Blandón Castaño

    2006-01-01

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

  11. 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

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    岳艳; 周希; 高霞; 黄光荣

    2012-01-01

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

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

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    Antonio Carlos Valezi

    2003-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  16. 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.

  17. 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

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    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.

  18. Sonographische Diagnostik beim akuten Abdomen bei Kindern und Erwachsenen

    OpenAIRE

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

    2005-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

  1. CT in diagnosing and predicting site of traumatic acute abdomen%CT 在外伤性急腹症诊断定位中的价值

    Institute of Scientific and Technical Information of China (English)

    范开琴; 吴树材; 郭红

    2015-01-01

    目的:探讨外伤性急腹症的CT征象,提高CT对腹腔脏器损伤的诊断价值。方法回顾性分析经手术证实为腹腔脏器损伤的186例患者的术前CT图像,总结不同脏器损伤的CT表现特征。结果186例中共有271处脏器损伤,其中实质脏器损伤228处,空腔脏器损伤43处。腹腔出现腹水的有157例(84.4%),腹腔出现血肿的有65例(34.9%)。实质性脏器损伤CT主要表现为损伤处出现混杂密度影(71.9%),包膜或边界不光整(59.2%),包膜下积血或血肿形成(56.6%)和周围筋膜增厚或脂肪间隙模糊(78.9%)。空腔脏器损伤主要表现为损伤处结构紊乱(62.8%)或壁增厚(72.1%),腔内可出现血肿(20.9%)。结论不同的腹腔脏器损伤具有不同的CT表现,外伤性急腹症的诊断和定位需要结合外伤原因、临床表现和CT征象。%Objective To summarize CT signs of traumatic acute abdomen , and to assess clinical value of CT in diagnosing organ injury in the abdomen . Methods A retrospective analysis of 186 cases was performed and preoperative CT images were analyzed after intraoperative confirmation of abdominal organ injury.Therefore,CTfeaturesofdifferentorganinjuriesweresummarized.Results 271organinjuries were found in 186 patients, including 228 injuries involving parenchyma organs and 43 injuries involving hollow visceras.Abdominal ascites was found in 157 patients (84.4%) and abdominal hematoma in 65 patients (34.9%).CT manifestations of parenchyma injury were mixed density (71.9%) in damaging location, with incomplete capsule or border (59.2%), subcapsular hematoma (56.6%) and fascia thickening surrounding or fat fuzzy space (78.9%).CT manifestations of hollow visceral injury were structure disorders (62.8%) or wall thickening (72.1%), hematoma in cavity (20.9%). Conclusion There are different CT manifestations in different organ injuries , and the

  2. 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

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

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    Marcos Bettini Pitombo

    1999-08-01

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

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Eddie Fernando Candido Murta

    2001-02-01

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

  6. 外科急腹症伴糖尿病的诊治(附94例分析)%Diagnosis and Treatment of Surgical Acute Abdomen Complicated with Diabetes(Report of 94 Cases)

    Institute of Scientific and Technical Information of China (English)

    闫振山; 赖国修; 高华国

    2015-01-01

    目的:分析外科急腹症伴发糖尿病漏诊、误诊的原因和行手术治疗的关键。方法采用回顾性分析法对1991年5月~2005年8月普外科收治的94例外科急腹症伴糖尿病患者的临床资料加以分析,对其手术治疗方法和手术效果加以分析和总结。结果94例外科急腹症伴糖尿病患者中44例患者在入院后就接受了急诊手术,44例患者中术后死亡者共4例。90例患者中的另外50例患者首先接受降糖治疗,然后再接受手术治疗,术后绝大多数患者的血糖处于稳定状态,术后恢复效果理想,无死亡病例。结论注重外科急腹症伴发糖尿病的诊断和鉴别,可降低误诊、漏诊几率。术前注重控制血糖,术中、术后注重监测血糖,不任意扩大手术范围、延长手术时间,积极治疗,以促使患者顺利完成手术,获得良好的治疗效果。%Objective To analyze the causes of missed diagnosis and misdiagnosis of acute abdomen complicated with diabetes ,and analyze the key of surgical treatment of diabetes with surgical acute abdomen.Methods The clinical data 94 cases of surgical acute abdomen complicated with diabetes patients received and cured in department of general surgery by retrospective analysis methods. The surgical treatment method and effect were analyzed and summarized Results 44 cases of 94 cases acute abdomen complicated with diabetes mellitus patients received emergency surgery after admission,4 patients died in 44 patient.In 90 patients, the other 50 patients received hypoglycemic treatment, and then received surgical treatment, the vast majority of patients with blood glucose in stable condition, postoperative recovery effect is ideal, no death cases.Conclusion Pay attention to diagnosis and differential diagnosis of acute abdomen complicated with diabetes ,can reduce the rate of misdiagnosis and missed diagnosis.Pay attention to control blood sugar before operation,pay attention

  7. 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

  8. 彩色多普勒超声诊断妇科常见急腹症的价值评价%Value of Color Doppler Ultrasound Diagnosis of Common Gynecological Acute Abdomen

    Institute of Scientific and Technical Information of China (English)

    蒋天红

    2015-01-01

    目的:进一步分析彩色多普勒超声诊断在妇科常见急腹症诊断中的应用价值。方法随机选取160例在我院接受治疗且经彩色多普勒超声检查的妇科急腹症病患,分析所有患者彩色多普勒检查的图像特点,对比该超声诊断结果与常规病理诊断的异同,评价其在妇科急腹症中的优缺点。结果彩色多普勒超声诊断确诊共154例,误诊6例。,分别为异位妊娠、卵巢囊肿蒂扭转、卵巢囊肿破裂、盆腔炎症各有2例(98.37%)、1例(92.86%)、1例(92.31%)、2例(80%)。较之病理确诊,其总准确率高达96.25%。结论在妇科常见急腹症的诊断治疗中,尽管彩色多普勒超声诊断率高,方便快捷,但是在某急腹症中多普勒超声图像极为相似,易误诊;这时要根据临床实际情况及病理检查等手段进行诊断。%Objective To analyze the diagnostic value of color Doppler ultrasound in the diagnosis of acute abdomen common gynecology. Methods 160 cases were randomly selected for treatment in our hospital and by color Doppler ultrasonography in patients with gynecological acute abdomen,analyzing image color Doppler characteristics of al patients,and compare the results with conventional ultrasound diagnosis of pathological diagnosis of the similarities and dif erences to evaluate the strengths and weaknesses in gynecological acute abdomen. Results Color Doppler ultrasound diagnosis confirmed a total of 154 cases,6 cases of misdiagnosis. ,Respectively,ectopic pregnancy,ovarian cyst torsion,ovarian cyst rupture,pelvic inflammatory disease have two cases(98.37%),1(92.86%), 1 (92.31%),2 cases (80%). Compared with the pathological diagnosis,the total accuracy rate of 96.25%. Conclusion Diagnosis and treatment of common gynecological acute abdomen,although color Doppler ultrasound diagnosis rate,convenient,but at some acute abdomen Doppler ultrasound images are very similar,often misdiagnosed; then

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

    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

  10. 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.

  11. 妇科急腹症的超声诊断及误诊原因分析%Analysis on the Ultrasonic Diagnosis and Misdiagnosis Reasons of Gynecological Acute Abdomen

    Institute of Scientific and Technical Information of China (English)

    刘翠霞

    2014-01-01

    目的:探讨超声在妇科急腹症诊断中的应用价值,并分析误诊原因。方法选择2011年12月~2013年12月我院诊治的237例妇科急腹症患者,所有患者均进行腹部超声检查和阴道超声检查,随后经手术确诊,比较各自及联合检查的诊断准确率。结果阴道超声检查的诊断准确率(90.3%)明显高于腹部超声检查(83.5%),联合检查的诊断准确率(96.2%)明显高于单项检查,差异均有统计学意义(P<0.05)。结论腹部超声和阴道超声联合检查可显著提高妇科急腹症的诊断准确率,值得推广。%Objective To explore the application value of ultrasound in the diagnosis of gynecological acute abdomen and analyze the misdiagnosis reasons. Methods 237 patients with gynecological acute abdomen treated in our hospital from December 2011 to December 2013 were selected. All patients were examined by abdominal ultrasound and transvaginal ultrasound, and later conifrmed by operations. Then the diagnostic accuracy of both isolated and combined examinations was compared. Results The diagnostic accuracy of transvaginal ultrasound, abdominal ultrasound and combined diagnosis were 90.3%, 83.5%, 96.2%, respectively, so the accuracy of transvaginal ultrasound was signiifcantly higher than that of abdominal ultrasound and the combined diagnosis was also signiifcantly higher than isolated diagnosis (P<0.05). Conclusion Combined diagnosis by abdominal ultrasound and transvaginal ultrasound which can signiifcantly improve the diagnostic accuracy of gynecological acute abdomen is worthy to be widely applied.

  12. 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

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

    Institute of Scientific and Technical Information of China (English)

    邵立志

    2014-01-01

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

  14. 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.

  15. The Observation of Effect for Noninvasive Positive Pressure Ventilation in the Application of Acute Abdomen with Acute Respiratory Distress Syndrome/%无创正压通气在急腹症并发急性呼吸窘迫综合征中的应用效果

    Institute of Scientific and Technical Information of China (English)

    徐小琴; 钟惠清

    2013-01-01

      目的:探讨采用无创正压通气治疗因急腹症引起的急性呼吸窘迫综合征的临床效果以及对患者的影响.方法:选取本院2011年3月-2012年3月收治的急腹症合并出现急性呼吸窘迫综合征患者共39例,对患者采用无创正压通气治疗.结果:患者通过无创正压通气治疗后,其血气分析数据明显得到改善,血氧饱和度以及氧气分压分别为(92.1±6.1)%和(93.0±3.1)mm Hg.其中29例患者通过无创正压通气治疗后,其呼吸窘迫症状均得到明显改善,有效率为74.4%.结论:无创正压通气治疗急腹症并发呼吸窘迫综合征能取得较为满意的疗效,且不良反应少,患者耐受情况较好.%Objective:To explore the use of noninvasive positive pressure ventilation in the treatment of patients with acute abdomen caused by acute respiratory distress syndrome,the clinical effect and impact.Method:39 cases of patients with acute respiratory distress syndrome and acute abdomen admitted in our hospital from March 2011 to March 2012 were chosen.The control group was taken with noninvasive positive pressure ventilation in the treatment of acute respiratory distress syndrome.Result:After noninvasive positive pressure ventilation in the treatment,the blood gas analysis data was significantly improved. The oxygen saturation and oxygen partial pressure were respectively(92.1±6.1)% and(93.0±3.1)mm Hg.29 patients were significantly improved by noninvasive positive pressure ventilation in the treatment of respiratory distress symptoms,the effective rate was 74.4%. Conclusion:Noninvasive positive pressure ventilation in the treatment of acute abdomen with respiratory distress syndrome can achieve more satisfied treatment efficiency and with fewer adverse reactions,and it is with a better patient tolerance.

  16. Research on laparoscopy in diagnosis and treatment of acute abdomen%腹腔镜对急腹症的诊疗作用

    Institute of Scientific and Technical Information of China (English)

    黄仲昭

    2013-01-01

    Objective To study the laparoscopic technique in the diagnosis and treatment of surgical abdom-inal emergency application value and method Methods Retrospective analysis of 46 cases of application of la-paroscopy diagnosis and treatment of acute abdominal pain in patients with clinical data Results 43 cases (93.4%) completed in laparoscopic diagnosis and surgical treatment, 3 cases (6.4%), operation treatment, The con-trol group were significantly shorter than the control group, bleeding was significantly less than that in the control group, but the intraoperative diagnosis rate was significantly higher than that of the control group Conclusion Laparoscopy can be widely used in the diagnosis and treatment of patients with acute abdominal pain, but also need to pay attention to the application conditions.%  目的:探讨腹腔镜技术在外科急腹症诊断和治疗中的应用价值和方法方法:回顾性分析研究我院46例应用腹腔镜技术诊疗的急腹症患者的临床资料结果:43例(93.4%)在腹腔镜下完成诊断和手术治疗,3例(6.4%)中转行开腹治疗,对照组住院时间明显短于对照组,术中出血量明显少于对照组,但术中确诊率却明显高于对照组。结论:腹腔镜技术可广泛应用于急腹症患者的诊断与治疗,但也需注意应用条件。

  17. 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

  18. 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.

  19. 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.

  20. Abdomen X-Ray (Radiography)

    Science.gov (United States)

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

  1. 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

  2. Analysis of the clinical value of 64 CT in the diagnosis of vascular disease of acute abdomen%64层螺旋CT诊断血管性病变急腹症的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    梁汉欢; 张洪; 彭可雨

    2014-01-01

    目的:探讨血管性病变导致急性腹痛的64层螺旋C T诊断价值。方法分析38例血管源性急腹症平扫及增强CT ,分析CT表现。结果内脏动脉瘤合并出血6例;腹主动脉及右侧髂总动脉瘤合并出血3例;腹主动脉分支夹层7例;肠系膜上动静脉扭转3例;肠系膜上动静脉栓塞及血栓形成14例;肾动脉栓塞5例。结论通过64层螺旋C T平扫及增强扫描,腹部血管性病变能清晰显示其病因、病变范围及其继发改变,达到诊断明确,所以腹痛疑诊为血管性病变时,CTA应作为影像学的首选检查方法。%Objective To investigate the diagnostic value of 64 CT in vascular lesions of acute abdominal pain as the main symptom .Methods 38 cases of vasogenic abdomen CT scan were retrospectively analysed ,including plain and enhanced CT performance .Results Six cases were visceral aneurysm hemorrhage ,three cases presented with abdominal aorta and right common iliac artery aneurysm hemorrhage ,seven cases with aortic dissection branch ,three cases with the superior mesenteric vascular reversed ,14 case with arterial and venous thrombosis and mesenteric thrombosis formation ,and five cases with renal artery embolization .Conclusion After the multi-detector CT plain and enhanced scanning ,abdominal vascular lesions can be clearly shown its causes ,extent of leisions and secondary changes ,thereby reaching a clear diagno-sis .Hence ,CTA should be the preferred method of imaging examination when suspicious of abdominal vascular lesions .

  3. MR imaging of the abdomen in pregnancy

    International Nuclear Information System (INIS)

    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.)

  4. 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 part of the dummy assembly shown in drawing 175-0000 including load sensors specified in §...

  5. 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.

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

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    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.

  7. 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.)

  8. 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.

  9. 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.

  10. 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.)

  11. 阴道联合腹部超声在诊断妇科急腹症中的应用价值探讨%Application value of vaginal ultrasound combined with abdominal ultrasound in the diagnosis of gynecological acute abdomen

    Institute of Scientific and Technical Information of China (English)

    梁锡阳; 梁玉玲; 万芝兰; 黄冬玲; 刘兴斌; 陈奇辉; 邓艳芬

    2014-01-01

    Objective To study the application value of vaginal ultrasound combined with abdominal ultrasound in the diagnosis of gynecological acute abdomen. Methods 80 patients with gynecological acute abdomen from June 2010 to June 2013 in our hospital were chose as the research object,according to the method, 80 patients were randomly divided into two groups:the vaginal ultrasound group and abdominal ultrasound group, 40 cases in each group. The results of two groups were compared with pathologic surgical results eventually. Results Compared with surgical pathology results,the diagnosis coincidence rate in abdominal and transvaginal ultrasound diagnosis group was 95.0%, and the diagnostic coincidence rate in abdominal ultrasound diagnosis group was 82.5%, the diagnosis coincidence rate in vaginal ultrasound diagnosis group was significantly higher than that in abdominal ultrasound group(P < 0.05). Conclusion The application value of vaginal ultrasound combined with abdominal ultrasound in the diagnosis of gynecological acute abdomen is superior to pure abdominal ultrasound.%目的:探讨阴道联合腹部超声在诊断妇科急腹症中的应用价值。方法选择2010年6月~2013年6月于我院就诊的80例妇科急腹症患者,根据检查的方法不同,分成两组:经腹部超声组和经阴道联合腹部超声组,每组40例。对两组患者进行随访,与病理手术最终所得结果进行比较。结果以术后病理结果为对照,经阴道联合腹部超声组的诊断符合率为95.0%,单纯经腹部超声组的诊断符合率为82.5%,经阴道联合腹部超声组明显高于经腹部超声组,两组差异具有统计学意义(P<0.05)。结论经腹部和经阴道超声联合检查对妇产科急腹症的诊断价值明显优于单纯经腹部超声检查。

  12. 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

  13. 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

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

    Institute of Scientific and Technical Information of China (English)

    朱世纯; 李倩; 张文丽; 蒙国光; 李广洲

    2014-01-01

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

  15. 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

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

    OpenAIRE

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

    2000-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Florentino de Araújo Cardoso Filho

    2000-04-01

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

  18. 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.

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

    Institute of Scientific and Technical Information of China (English)

    王树楼; 王微

    2012-01-01

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

  20. Metformin induced acute pancreatitis

    OpenAIRE

    Alsubaie, Sadeem; Almalki, Mussa H.

    2013-01-01

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

  1. Multislice-CT of the abdomen

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1979-06-15

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

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

    International Nuclear Information System (INIS)

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

  4. 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.

  5. 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.

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

    Science.gov (United States)

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

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

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

    OpenAIRE

    Loabat Geranpayeh; Mohsen Fadaei-Araghi; Behnam Shakiba

    2006-01-01

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

  8. 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. PMID:25057420

  9. Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  12. 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.

  13. [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.

  14. 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.

  15. 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.

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

    International Nuclear Information System (INIS)

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

  17. 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.

  18. 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

  19. Simultaneous acute appendicitis and ectopic pregnancy

    OpenAIRE

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

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2015-01-01

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

  2. 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.)

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

    OpenAIRE

    Huang, Yu-Hua; Li, You-sheng

    2016-01-01

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

  4. 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.

  5. 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.

  6. [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.

  7. Acute pancreatitis complicating severe dengue

    OpenAIRE

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

    2014-01-01

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

  8. Hernia interna de Quain como causa de abdomen agudo

    OpenAIRE

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

    2012-01-01

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

  9. 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.

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

    OpenAIRE

    Abdulzahra Hussain; Shamsi El-Hasani; Ali Adnan

    2012-01-01

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

  11. [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.

  12. 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.

  13. 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.

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

    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

    2001-03-01

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

  15. 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.

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

    OpenAIRE

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

    2006-01-01

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

  17. 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. PMID:27610400

  18. 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.

  19. Automatically pairing measured findings across narrative abdomen CT reports.

    Science.gov (United States)

    Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

    2013-01-01

    Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements. PMID:24551406

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  2. The Reversal of Stoma Following Open Abdomen Management.

    Science.gov (United States)

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

    2016-06-01

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

  3. 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.

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1980-08-01

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

  10. 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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Martin, Sharolyn L; Tellez, M Geno

    2011-01-01

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

  13. 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)

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

    Directory of Open Access Journals (Sweden)

    Hemanta Kumar Nayak

    2013-01-01

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

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

    OpenAIRE

    Juan Camilo Correa Gallego; Edward Alexander Blandón Castaño

    2006-01-01

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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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 ...

  1. 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

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

    OpenAIRE

    Neumann, Dietrich; Woermann, Dietrich

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

  4. Acute pancreatitis

    Science.gov (United States)

    ... rate Lab tests that show the release of pancreatic enzymes will be done. These include: Increased blood amylase level Increased serum blood lipase level Increased urine amylase ... swelling of the pancreas include: CT scan of the abdomen MRI of ...

  5. Surgical treatment of acute pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-03-31

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

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

    OpenAIRE

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

    2004-01-01

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

  7. 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

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

    International Nuclear Information System (INIS)

    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)

  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. 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.

  11. 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.

  12. 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.

  13. 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.

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

    OpenAIRE

    Rafiullah,; Tanimu, Sabo

    2014-01-01

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

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

    OpenAIRE

    Yoshihiko Sakurai; Takaaki Murata; Hirohisa Hirata; Takeshi Morita

    2015-01-01

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

  16. 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.

  17. 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.

  18. 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. PMID:18350613

  19. 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

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Yu Shao

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

  3. 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.

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2008-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2009-03-01

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

  8. 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)

  9. 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.

  10. 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.

  11. The abdomen

    International Nuclear Information System (INIS)

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

  12. 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 ...

  13. 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.

  14. 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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Hlebowicz, Joanna; Hansson, Johan; Lindstedt, Sandra

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Abdulzahra Hussain

    2012-11-01

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

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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    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)

  1. 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.

  2. Sarcoma de Ewing extraesquelético que semeja abdomen agudo

    OpenAIRE

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2008-02-01

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

  4. 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.

  5. 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.

  6. 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)

  7. Acute Bronchitis

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Rajesh Gupta

    2008-07-01

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

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

    International Nuclear Information System (INIS)

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

  10. 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.

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

    Science.gov (United States)

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

    2016-08-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    Ribeiro, Ana Margarida de Bastos

    2013-01-01

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

  14. 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.

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

    Science.gov (United States)

    Low, Y N; Cheong, B M K

    2016-04-01

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

  16. Gastrointestinal stromal tumor: acute liquefaction necrosis

    International Nuclear Information System (INIS)

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

  17. Acute appendicitis in a premature baby

    International Nuclear Information System (INIS)

    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.)

  18. 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...... the s.c. tissue (mm) was higher on the abdominal site (9.35 +/- 1.38 (thigh), and 22.61 +/- 2.19 (abdomen), P < 0.001). Mean (+/- SEM) integrated levels (area under the curves (AUC) divided by time) of GH (mU/l) were identical: 5.54 +/- 0.70 (thigh) versus 5.48 +/- 0.64 (abdomen) (P = 0.91). AUC (m...

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    1993-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sitaram

    2013-03-01

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

  2. State of the art: dual-energy CT of the abdomen.

    Science.gov (United States)

    Marin, Daniele; Boll, Daniel T; Mileto, Achille; Nelson, Rendon C

    2014-05-01

    Recent technologic advances in computed tomography (CT)--enabling the nearly simultaneous acquisition of clinical images using two different x-ray energy spectra--have sparked renewed interest in dual-energy CT. By interrogating the unique characteristics of different materials at different x-ray energies, dual-energy CT can be used to provide quantitative information about tissue composition, overcoming the limitations of attenuation-based conventional single-energy CT imaging. In the past few years, intensive research efforts have been devoted to exploiting the unique and powerful opportunities of dual-energy CT for a variety of clinical applications. This has led to CT protocol modifications for radiation dose reduction, improved diagnostic performance for detection and characterization of diseases, as well as image quality optimization. In this review, the authors discuss the basic principles, instrumentation and design, examples of current clinical applications in the abdomen and pelvis, and future opportunities of dual-energy CT.

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

    Science.gov (United States)

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

    2016-01-01

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

  4. 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.

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

    Science.gov (United States)

    Stulz, P; Pfeiffer, K M

    1982-03-01

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

  6. The open abdomen: temporary closure with a modified negative pressure therapy technique

    DEFF Research Database (Denmark)

    Hougaard, Helene T.; Pedersen, Mark Ellebæk; Holst, U. T.;

    2014-01-01

    of applying the system - the narrowing technique - over a 5-year period. Endpoints included fascial closure and 30-day mortality rates and presence of enteroatmospheric fistulas. Secondary closure of the fascia was obtained in 92% (106/115) of the patients with a mortality rate of 17% (20/115) and a fistula......The most common indications for an open abdomen (OA) are abdominal compartment syndrome, damage control surgery, diffuse peritonitis and wound dehiscence, and often require a temporary abdominal closure (TAC). The different TAC methods that are currently available include skin closure techniques...... rate of 3.5% (4/115). The use of the narrowing technique to apply NPT may explain the high closure rates observed in the patient population of this study. Further studies are necessary to compare the different methods and to evaluate the long-term outcomes....

  7. 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.)

  8. SU-E-T-566: Comparison of VMAT and IMRT for Whole Abdomen Radiation Therapy (WART)

    Energy Technology Data Exchange (ETDEWEB)

    Briere, TM; Huh, WW; Hayes-Jordan, A; McAleer, MF [MD Anderson Cancer Ctr., Houston, TX (United States); Anderson, P [LCH - Pediatric Hematology and Oncology Center, Charlotte, NC (United States)

    2014-06-01

    Purpose: Whole Abdomen Radiation Therapy (WART) is used in the treatment of desmoplastic small round cell tumors as well as other tumors with peritoneal dissemination. Intensity modulated radiation therapy (IMRT) is conventionally used to cover the multiple planning target volumes (PTVs) while sparing nearby critical structures, but this approach often requires two isocenters and ≥20 individual treatment fields. Four-field volumetric arc therapy (VMAT) can produce clinically similar treatment plans with the potential to reduce treatment time substantially. Here we examine treatment times and plan robustness for patients undergoing WART. Methods: Twenty patients undergoing WART at our institution were included in this study. Twelve IMRT and 8 VMAT plans utilized upper and lower abdominal isocenters and met similar dose constraints. Treatment times were tabulated from start of daily kV imaging to beam delivery end. Daily treatment couch coordinates were also recorded. From these couch coordinates, difference between actual and planned separation between isocenters was computed. Plan robustness with regard to PTV coverage within the region of field overlap was analyzed for 3 VMAT and 3 IMRT plans assuming a 2σ deviation in isocenter location. Results: The average treatment time for VMAT was 15 minutes shorter than for IMRT (27 minutes vs. 42 minutes). The average deviation in isocenter separation was 0.0 – 0.1 cm in each direction, with a standard deviation of 0.2 – 0.3 cm. Compared with IMRT plans, VMAT plans showed similar loss in PTV coverage for increasing isocenter displacement and similar dose inhomogeneity with decreasing isocenter displacement. Conclusion: Use of VMAT results in substantial time-savings for 2-isocenter whole abdomen radiotherapy plans. VMAT plans show robustness similar to IMRT with respect to isocenter displacement. VMAT should be considered for these very complicated treatments to minimize risk of patient movement during therapy and

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-10-01

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

  11. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

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

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

    International Nuclear Information System (INIS)

    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)

  13. 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)

  14. 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

  15. 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.

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

    International Nuclear Information System (INIS)

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

  17. Bronchitis - acute

    Science.gov (United States)

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

  18. Acute pancreatitis

    OpenAIRE

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

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

  19. Acute pancreatitis

    OpenAIRE

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

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

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

    International Nuclear Information System (INIS)

    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

  1. A study on the image quality and patient dose in erect simple abdomen radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Min [Korea Univ. College of Health Sciences, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of simple abdomen erect projection is to see the fluid level which indicates gastrointestinal ileus or free air due to perforation. we do not have to insist on low kVp technique in simple abdomen erect position as long as we can detect the fluid level and free air shadow. Therefore, the author tried to decrease patient dose by high kVp technique and to improve the image quality due to motion artifact by reduction of exposure time. Experiment 1. *screen/flim : SRO1000/HRH *exposure factor : 140 kvp{+-}5 kv with added filters, 200 mA, 0.01 sec *phantom : Acryles : 15.0 cm(equivalent to 17 cm body thickness) 17.5 cm(equivalent to 21 cm body thickness) 20.0 cm(equivalent to 25 cm body thickness) With the exposure factor for same film density(D=0.8{+-}0.1) and with the materials above, we tried to find out entrance skin dose and gonad dose for both male and female. Experiment 2. Burger's phantom radiography were checked to see whether there was any change of image quality according to the kVp and the added filters. Experiment 3. Using rotating meter(self made), we examined the motion artifact and the exposure time limitation. [Results and conculution] 1. Using high voltage technique of 140 kVp with added filter, Skin dose, testicle dose and ovary dose decrease to 89.3%, 47% and 71.4% respectively compare to 70 kVp technique, 2. No great changes of Burger's phantom image has detected as from 70 kVp to 140 kVp and the air hole size of Burger's phantom over 0.028 cc(Diameter 3 mm, hight 4 mm) can be distinghished. 3. 0.01 sec(1 pulse) exposure time is possible in the single phase full wave rectification that why we can quitely reduce the unsharness caused by patient's movement.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

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

    International Nuclear Information System (INIS)

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

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

    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.)

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

    International Nuclear Information System (INIS)

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

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  11. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  15. 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.

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

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    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

  17. The diagnostic value of barium enema in acute appendicitis

    International Nuclear Information System (INIS)

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

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

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    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.

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

    OpenAIRE

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

    2010-01-01

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

  20. 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

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

    OpenAIRE

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

    2012-01-01

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

  2. 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...

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

    OpenAIRE

    Forster, Michael J.; Akoh, Jacob A.

    2008-01-01

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

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

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    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

  5. Neurological crisis mimicking acute pancreatitis in tyrosinemia type I.

    Science.gov (United States)

    Kalkanoğlu, H S; Coşkun, T

    1999-01-01

    Hereditary tyrosinemia results from an inborn error in the final step of tyrosine metabolism. Neurological manifestations have been reported in nearly half of patients during illness to have characteristics of altered consciousness, weakness, anorexia, vomiting, and pain in the extremities and abdomen. His physical findings and laboratory results pointed out acute pancreatitis. There have been some reports of acute and chronic pancreatitis in patients with metabolic diseases; however, this is the first case with tyrosinemia type I who exhibited clinical and biochemical findings of acute pancreatitis during neurological crisis. The presented case suggests the possibility that the pancreas is affected in neurological crisis. The determination of amylase concentration both in serum and urine samples of further cases will clarity the association between pancreatitis and neurological crisis. PMID:10770119

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

    Science.gov (United States)

    Appalsawmy, Usha Devi; Akbani, Habib

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

  8. 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

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

    Science.gov (United States)

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

    2012-12-01

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

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

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    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

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

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    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

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

    Directory of Open Access Journals (Sweden)

    Lindstedt Sandra

    2012-03-01

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

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

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    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.

  14. 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.

  15. 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.

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

    OpenAIRE

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

    2009-01-01

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

  17. 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.

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

    International Nuclear Information System (INIS)

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

  19. 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)

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

    Science.gov (United States)

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

    2012-01-01

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

  1. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

    OpenAIRE

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

    2014-01-01

    El objetivo del estudio fue describir las características en la presentación y el manejo del abdomen agudo (AA) en pacientes con el virus de la inmunodeficiencia humana (VIH). Se revisaron las historias clínicas de 97 pacientes portadores del VIH que cursaron con un cuadro de AA y que fueron atendidos en el período 2006-2011 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró que el 1,6% de los pacientes inmunosuprimidos ingresó a sala de operaciones. La apendicectomía fue el ...

  2. 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.

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

    OpenAIRE

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

    2010-01-01

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

  4. Acute dyspnea

    International Nuclear Information System (INIS)

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

  5. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  7. 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

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

    Directory of Open Access Journals (Sweden)

    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

  9. Computerized tomography in normal abdomen: retrospective study of renal hila angles

    International Nuclear Information System (INIS)

    To obtain mean angulation values for renal hila in relation to the horizontal plane traced over the right and left spinal erector muscles, considering the center of the lumbar vertebral spine as a parameter for measuring the renal hila angles. The authors have analyzed 250 abdominal computed tomography studies of both male and female healthy individuals (128 men with mean age 52.45 ± 17.42 years, and 122 women with mean age 54.39 ± 18.27 years), corresponding to 500 renal hila evaluated. The mean angulation of each hilum in relation to the horizontal plane was obtained taking acute angles into consideration. The comparative study have not found any statistically significant difference in acute angles of renal hila between male and female individuals. The statistical analysis demonstrated limits of 40.40 deg and 44.54 deg for mean right hilum angulation and 39.91 deg and 43.23 deg for mean left hilum angulation, with a confidence interval of 95% . Renal hila present similar angulation independently of sex. Higher angulation values correspond to hyper-rotation or excessive rotation, and lower angulation values, to incomplete or reverse rotation. (author)

  10. Heparin-induced thrombocytopenia with abdominal aortic stent-graft acute thrombosis.

    Science.gov (United States)

    Canaud, Ludovic; Hireche, Kheira; Marty-Ané, Charles; Alric, Pierre

    2013-08-01

    We report a case of heparin-induced thrombocytopenia in a patient on low molecular weight heparin bridge therapy who developed acute abdominal aortic stent-graft thrombosis 1 week after uncomplicated endovascular abdominal aortic aneurysm repair. The diagnosis was confirmed by a computed tomographic scan of the abdomen. The patient was successfully treated by conversion to open repair. The postoperative course was marked by subacute left limb ischemia related to an in vivo cross-reactivity of danaparoid with the heparin immune complex. To our knowledge, this is the first case report of heparin-induced thrombocytopenia with acute abdominal aortic stent-graft thrombosis. PMID:23711968

  11. [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.

  12. 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。

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

    International Nuclear Information System (INIS)

    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

  14. 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.

  15. Acute myelogenous leukemia (AML) - children

    Science.gov (United States)

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

  16. 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.

  17. [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.

  18. Use of CO2 as an angiographic contrast material in the diagnosis of acute hepatic hemorrhage a case report

    International Nuclear Information System (INIS)

    Selective abdominal arteriography with an iodinated contrast material is the method of choice for detecting the site of bleeding in patients with acute gastrointestinal hemorrhage in whom the results of endoscopic examination were negative CO2, has been used successfully as a contrast material for arteriography of abdomen and lower limbs. We present the case of a patient in whom suspected gastrointestinal bleeding was detected more rapidly and reliably with co2 than with an iodinated contrast material. (Author) 18 Refs

  19. Acute liver failure caused by concurrent autoimmune hepatitis and hepatitis B in a 16-year old girl

    OpenAIRE

    Pawłowska, Małgorzata; Halota, Waldemar

    2010-01-01

    A 16 year-old girl was admitted to hospital because of fatigue and somnolence, nausea, epistaxis and jaundice. Physical examination revealed jaundice, an enlarged liver and tenderness of upper right abdomen. Laboratory tests revealed an increased level of acute liver failure, bilirubin, bile acids, GGTP and a decreased prothrombin ratio, with elevated gamma-globulin and IgG levels, and the presence of anti-mitochondrial M2 antibodies and HBV infection markers. The patient was diagnosed with l...

  20. Dosimetric comparison of helical tomothearpy and linac-based IMRT in whole abdomen radiotherapy

    Science.gov (United States)

    Kang, Young-nam; Kim, Dae-Hyun; Jang, Hong Seok; Song, Jin Ho; Choi, Byung Ock; Cho, Seok Goo; Jung, Ji-Young; Kay, Chul Seung

    2012-10-01

    Recent advances in radiotherapy techniques have allowed a significant improvement in the therapeutic ratio of whole abdominal irradiation (WAI) through linear-accelerator (Linac) based intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT). IMRT has been shown to reduce the dose to organs at risk (OAR) while adequately treating the tumor volume. HT operates by adjusting 51 beam directions, couch speed, pitch and shapes of a binary multileaf collimator (MLC), with the purpose of clinically increasing the befit to the patient. We incorporated helical tomotherapy as a new modality for WAI for the treatment of non-Hodgkin's lymphoma patients whose disease involved the intestine and the mesenteric lymph nodes. Excellent tumor coverage with effective sparing of normal organ sparings, and homogeneous dose distribution could be achieved. This study dosimetrically compared HT and linac-based IMRT by using several indices, including the conformity index (CI) and the homogeneity index (HI) for the planning target volume (PTV), as well as the, max dose and the mean dose and the quality index (QI) for five organs at risk (OARs). The HI and the CI were used to compare the quality of target coverage while the QI was used compare the dosimetric performans for OAR systems. The target coverages between the two systems were similar, but the most QIs were lower than 1, what means that HT is batter at sparing OARs than IMRT. Tomotherapy enabled excellent target coverage, effective sparing of normal tissues, and homogeneous dose distribution without severe acute toxicity.

  1. 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.

  2. First clinical results of ultrafast, gadolinium-enhanced dual-phase 3D MR-angiography in the abdomen

    International Nuclear Information System (INIS)

    To assess the utility of breath-hold abdominal ultrafast three-dimensional (3D) gadolinium-enhanced dual-phase magnetic resonance angiography (MRA). Material and methods: 125 patients with various abdominal pathologies were imaged using a breath-hold ultrafast gadolinium-enhanced dual-phase 3D-MRA technique. Results: 119 (95%) of 125 MRA's were of good or excellent quality. The sensitivity in the detection of renal artery stenoses as well as stenoses of the celiac trunk and the superior mesenteric artery was 100%. Accessory renal arteries (n=9) and replaced hepatic arteries (n=4) were reliably detected by MRA. In 24 (71%) of 34 cases MR-angiographic delineation of the spleno-portal system and hepatic veins was superior compared to conventional angiography. Conclusion: Breath-hold gadolinium-enhanced dual-phase 3D-MRA has the potential to replace conventional angiography in the abdomen. (orig.)

  3. 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.

  4. Neoplastic and other pathologic effects of fractionated fast neutrons or photons on the thorax and anterior abdomen of beagles

    International Nuclear Information System (INIS)

    Thirty-nine adult male beagle dogs received either fast-neutron or photon irradiation to the right hemithorax and right rostral abdomen. Twenty-four dogs (six per group) received fast neutrons (15 MeV) to total doses of 1000, 1500, 2250, or 3375 cGy in four fractions per week for six weeks. Fifteen dogs received 3000, 4500, or 6750 cGy of photons in an identical fractionation pattern. One photon-irradiated dog and 13 neutron-irradiated dogs died or were euthanatized because of hepatic and gastrointestinal disturbances 47 to 708 days after irradiation; 20 dogs died of other causes. These 34 dogs were necropsied and have been studied microscopically; the remaining five dogs are still alive seven years after irradiation. Neutron-induced lesions included hemorrhage, necrosis, fibrosis, and atrophy of the heart, liver, pancreas, pylorus, duodenum, and kidney. All lesions were associated with degenerative and occlusive vascular changes including coronary arteriosclerosis. The relative biological effectiveness (RBE) of fast neutrons, assessed by clinical signs and by gross and microscopic pathology, is between 3 and 4.5 for pancreas, ∼4.5 for heart, pylorus, duodenum, and kidney, and greater than 6.75 for liver. Ten malignancies and two benign tumors developed in the irradiated field of six of 12 neutron-exposed dogs that survived over one year after irradiation. Two malignancies and one benign tumor arose in three of 12 photon-exposed dogs surviving over one year postirradiation. Only one neoplasm developed in the same field in 11 nonirradiated controls or in 62 dogs irradiated at sites other than the thorax or abdomen. The neutron RBE for neoplasia is approximately 6.75. 85 refs., 8 figs., 3 tabs

  5. Usefulness of computed tomography in patients with right inferior abdominal quadrant pain: acute appendicitis and its alternative diagnosis

    International Nuclear Information System (INIS)

    Purpose: To review the tomography findings of the acute appendicitis, their complications and alternative diagnosis. To value the use of helicoidal computed tomography (HCT) in the diagnosis of acute appendicitis and in the study of patients with right inferior abdominal quadrant (RIQ) pain and acute abdomen, for diagnosis and eventual complications, in order to decide treatment. Materials and method: For five months, the populations included in this retrospectively study were all patients delivered for presenting with RIQ pain for a HCT exam. These exams were made with oral and intravenous contrasts, when there were not contraindications. The HCT results were correlated with clinical follow up, surgery and histopathologic exams. Results: Over a total of 100 patients studied, 53 presented tomographic diagnosis of appendicitis, 22 of which presented perforation signs; 27 showed an alternative diagnosis (ovaries follicles, ureteral litiasis, tiphlitis, diverticulitis, colitis, salpingitis), 18 patients did not present tomographic findings to support the clinical symptoms and 2 presented indeterminated results. These data represented a sensibility of 100%, specificity of 95,7%, positive predictive value (PPV) of 96,2% and negative predictive value (NPV) of 100% for the tomography diagnosis of acute appendicitis and a sensibility of 100%, specificity of 81,8%, PPV of 95,1% and NPV of 100% for the tomography diagnosis of the different etiology in patient with right inferior acute abdomen. Conclusion: HCT is extremely useful in the study of patients with acute abdomen with origin in the RIQ, not only to make a diagnosis, but also to evaluate the complications, so as to decide proper treatment. (authors)

  6. Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis?

    International Nuclear Information System (INIS)

    To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 v. 6.2 h), hospital admission rates or post-test therapeutic interventions. Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients. (author)

  7. Does replacing intravenous pyelography with noncontrast helical computed tomography benefit patients with suspected acute urolithiasis?

    Energy Technology Data Exchange (ETDEWEB)

    Worster, A. [Hamilton Health Sciences Corp., Div. of Emergency Medicine, Hamilton, Ontario (Canada); Haines, T. [McMaster Univ., Health Sciences Centre, Faculty of Health Sciences, Hamilton, Ontario (Canada)

    2002-06-01

    To determine if replacing intravenous pyelography with noncontrast helical computed tomography (NHCT) scanning of the abdomen for the investigation of suspected acute urolithiasis results in shorter stays in the Emergency Department, reduced hospital admissions or fewer interventions. A retrospective review of the charts of all patients who were discharged from the Emergency Department with a diagnosis of acute urolithiasis or renal colic was conducted. Length of stay, hospital admissions and the number of therapeutic interventions were compared for the 5-month period before and the 5-month period after the implementation of NHCT scanning of the abdomen as the primary investigation of suspected acute urolithiasis. Of 230 cases reviewed, 119 met all of the inclusion criteria (61 in the intravenous pyelography group and 58 in the NHCT group). No significant differences were found between the 2 groups on median length of stay in the Emergency Department (7.6 v. 6.2 h), hospital admission rates or post-test therapeutic interventions. Replacing intravenous pyelography with NHCT scanning for the investigation of suspected acute urolithiasis does not result in significantly shorter stays, reduced hospital admissions or fewer interventions for patients. (author)

  8. ACUTE TRAUMATIC VENTRAL HERNIA

    Directory of Open Access Journals (Sweden)

    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

  9. The role and difficulties of the use of routine screening abdomen ultrasound for the detection of a liver metastasis in postoperative breast cancer patients

    International Nuclear Information System (INIS)

    To evaluate the role and difficulties of the use of routine abdomen ultrasound (US) in postoperative breast cancer patients. We reviewed the clinical records of 2460 patients who received breast cancer surgeries and underwent routine follow-up abdomen US for more than five years. We evaluated the number and clinical conditions of patients with a liver metastasis. We also evaluated the cut-off point of the breast cancer stage where a metastasis was likely to occur using the chi-squared test and receiver operator characteristic (ROC) analysis. A metastasis developed in 238 patients (9.7%), and the liver was the third most common organ site. However, just 24 (0.98%) patients presented only with a liver metastasis. Among these 24 patients, a metastasis was detected in 17 patients with the use of routine abdomen US. The cut-off point for a metastasis was Stage 3A. The use of routine screening abdomen ultrasound for the detection of a liver metastasis in postoperative breast cancer patients is not recommended. However, US can be used selectively in patients with clinical symptom or that present with a high stage equal or greater than Stage 3A

  10. 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.

  11. 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

  12. Gastric pH and motility in a porcine model of acute lung injury using a wireless motility capsule

    OpenAIRE

    Rauch, Stefan; Muellenbach, Ralf M.; Johannes, Amélie; Zollhöfer, Bernd; Roewer, Norbert

    2011-01-01

    Summary Background Evaluation of gastric pH and motility in a porcine model of acute lung injury using a novel, wireless motility capsule. Material/Methods A motility capsule was applied into the stomach of 7 Pietrain pigs with acute lung injury induced by high volume saline lavage. Wireless transmission of pH, pressure and temperature data was performed by a recorder attached to the animal’s abdomen. Gastric motility was evaluated using pH and pressure values, and capsule location was confir...

  13. Feasibilities of combination of hyperbaric oxygenation, ultraviolet blood irradiation, hemisorption in treating patients with sepsis as a complication of acute inflammatory diseases of abdomen

    International Nuclear Information System (INIS)

    Consideration is given to correlation of efficiency of results of treating patients with sepsis during traditional intensive therapy and during complex treatment, including hemosorption, hyperbaric oxygenation, ultraviolet blood irradiation, based on studying clinical picture, biochemical and immunological indices. Increase of treatment efficiency when using mentioned therapeutic measures, particularly their different combinations, is shown. 69 refs

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

    OpenAIRE

    Antonio Carlos Valezi; Jorge Mali Junior; Rodrigo Gomes de Oliveira; Mario Liberatti; Antonio César Marson; Edivaldo Macedo de Brito

    2003-01-01

    OBJETIVOS: O objetivo deste estudo foi analisar a eficácia do método laparoscópico em casos de abdome agudo inflamatório de difícil avaliação, quanto à acurácia, sensibilidade, especificidade e valores preditivos positivo e negativo. MÉTODO: Foram examinados, prospectivamente, 29 doentes com suspeita clínica de abdome agudo inflamatório, que após exames clínico e complementares não esclarecedores, foram submetidos à laparoscopia diagnóstica e/ou terapêutica. RESULTADOS: A precisão diagnóstica...

  15. 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.

  16. Diverticulite do intestino delgado, uma causa incomum de abdome agudo inflamatório = Diverticulitis of the small bowel, an unusual cause of inflamatory acute abdomen

    OpenAIRE

    Leão, Ari Ben-Hur Stefani

    2012-01-01

    Objetivos: Descrever a apresentação clínica, o diagnóstico diferencial e o tratamento de um caso de diverticulite do intestino delgado. Descrição do caso: Um homem de 58 anos de idade apresentou quadro clínico de dor e distensão abdominal, com exames de imagem demonstrando espessamento de alça de intestino delgado. Foi realizado exame videolaparoscópico do abdome e diagnosticada diverticulite do intestino delgado, a qual recebeu tratamento cirúrgico. O paciente teve boa evolução no pós ope...

  17. 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

    OpenAIRE

    Edison de Oliveira Freire Filho; Paulo Eduardo Marinho de Jesus; Giuseppe D'Ippolito; Jacob Szejnfeld

    2006-01-01

    A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discut...

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

    OpenAIRE

    Marcos Bettini Pitombo; José Luiz Guarino; Lizardo Augusto de Lima Martins; Cid Araújo Pitombo; Alexandra Mello Schmidt

    1999-01-01

    Os autores analisaram, retrospectivamente, 117 pacientes portadores de abdome agudo não-traumático, submetidos à laparoscopia diagnóstica e/ou terapêutica, na Casa de Saúde Santa Martha, em Niterói. A precisão diagnóstica do exame laparoscópico foi de 96,6%. Com relação à terapêutica, 74,4% dos pacientes foram tratados por laparoscopia, 21,4% por laparotomia e 4,3% foram tratados clinicamente. A precocidade na realização da laparoscopia relacionou-se à maior taxa de sucesso com o tratamento l...

  19. 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

    OpenAIRE

    André Vitorio Câmara Oliveira; Carlos Eduardo Costa Maranhão; Clístenes Dejane Sobral Coelho; Sabine de Lucena Martins Ferreira; Bruno Nogueira Bezerra Tavares; Larissa Cavalcanti Barros

    2008-01-01

    INTRODUÇÃO: Situs inversus totalis é descoberta importante para a conduta clínica cirúrgica. Corpo estranho no intestino grosso pode ocorrer devido a ingestão ou introdução anal. A perfuração intestinal é acompanhada de elevada morbidade e constitui-se em desafio aos cirurgiões. RELATO DO CASO: Paciente, masculino, 28 anos, deficiente mental, com dor e distensão abdominal há sete dias, anorexia há dois, parada de eliminação de gases e fezes, sem vômitos. Ao exame apresentava dispnéia leve, de...

  20. 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.

  1. 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.

  2. 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.

  3. 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.)

  4. 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.

  5. [Acute myocarditis].

    Science.gov (United States)

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  6. RECURRENT SEASONAL ACUTE PSYCHOSIS

    OpenAIRE

    Agarwal, Vivek

    1999-01-01

    Acute psychoses have been reported to occur more frequently in summer. This is a report of seasonal recurrence of acute psychosis in a patient. This case report emphasizes towards the biological etiology of acute psychoses.

  7. Acute kidney failure

    Science.gov (United States)

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... To prevent acute kidney failure: Health problems such as high blood pressure or diabetes should be well controlled. Avoid drugs and medicines that can cause kidney injury.

  8. Acute cerebellar ataxia

    Science.gov (United States)

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  9. 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)

  10. 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.

  11. Abdomen agudo en pacientes con VIH/SIDA atendidos en un hospital nacional de Lima, Perú

    Directory of Open Access Journals (Sweden)

    Leonor Montoya

    2014-09-01

    Full Text Available El objetivo del estudio fue describir las características en la presentación y el manejo del abdomen agudo (AA en pacientes con el virus de la inmunodeficiencia humana (VIH. Se revisaron las historias clínicas de 97 pacientes portadores del VIH que cursaron con un cuadro de AA y que fueron atendidos en el período 2006-2011 en el Hospital Nacional Cayetano Heredia en Lima, Perú. Se encontró que el 1,6% de los pacientes inmunosuprimidos ingresó a sala de operaciones. La apendicectomía fue el procedimiento quirúrgico más frecuentemente (33,3%. La morbilidad fue de 28,1%, y la mortalidad posoperatoria de 9,4%. La infección por Mycobacterium tuberculosis fue la causa más común de dolor abdominal agudo con el 26,8%. Los datos sugieren que una pronta decisión quirúrgica frente a un cuadro compatible con AA en pacientes con VIH podría evitar una importante morbimortalidad.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Sven Richter

    2013-01-01

    Full Text Available Introduction. The open abdomen (OA is often associated with complications. It has been hypothesized that negative pressure wound therapy (NPWT in the treatment of OA may provoke enteral fistulas. Therefore, we analyzed patients with OA and NPWT with special regard to the occurrence of intestinal fistulas. Methods. The present study included all consecutive patients with OA treated with NWPT from April 2010 to August 2011 in two hospitals. Patients’ demographics, indications for OA, risk factors, complications, outcome and incidence of fistulas before, during and after NPWT were recorded. Results. Of 81 patients with OA, 26 had pre-existing fistulas and 55 were free from a fistula at the beginning of NPWT. Nine of the 55 patients developed fistulas during ( or after NPWT (. Seventy-five patients received ABThera therapy, 6 patients other temporary abdominal closure devices. Only diverticulitis seemed to be a significant predisposing factor for fistulas. Mortality was slightly lower for patients without fistulas. Conclusion. The present study revealed no correlation between occurrence of fistulas before, during, and after NWPT, with diverticulitis being the only risk factor. Fistula formation during NPWT was comparable to reports from literature. Prospective studies are mandatory to clarify the impact of NPWT on fistula formation.

  15. [Removal of weremit from the abdomen. Interpretation and efficacy of an ancient Egyptian prescription by the newest scientific results].

    Science.gov (United States)

    Katona, Júlia; Győry, Hedvig; Blázovics, Anna

    2015-12-13

    Significant percentage of today's knowledge of ancient Egyptian medicine has been acquired from papyri left behind from various periods of Egyptian history. The longest and the most comprehensive is the Ebers papyrus, kept at the University Museum of Leipzig, which was written more than one thousand years before Hippocrates (c. 460-377 BC). One of the riddles among the prescriptions of the Ebers papyrus Eb20 has been used in order to remove the so called "wemyt" weremit from the abdomen with the help of a drink, which consists of "jnnk", Conyza dioscoridis in milk or sweet beer. The authors assume that the disease could be an infection of Schistosoma haematobium and/or Schistosoma mansoni. Nowadays the tea of Conyza dioscoridis is widely used as an important part of traditional medicine against rheumatism, intestinal distention and cramps, as well as an antiperspirant, and with external use for wound healing. The authors' intent is to interpret the efficacy of the above-mentioned ancient prescription with the help of modern medical and pharmaceutical knowledge. PMID:26639646

  16. 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.

  17. Evaluation of entrance surface-skin doses in animals submitted on exams of abdomen in veterinary radiology using Tl dosimetry

    International Nuclear Information System (INIS)

    The radiation protection has recently gained considerable attention in human medicine. In veterinary medicine has been some advances in radiodiagnostic and therapy for domestic animal like dogs and cats. It is notable the increase of the costs with domestic animals that are considered, by many people in the whole world, like members of family. However, an important parameter that must be taken into account is the increasing use of computed tomography and other equipment s that uses ionizing radiation, which may lead to comparatively high exposure of critical organs. The radiation dose is determined by the balance between therapeutic benefit and possible damage to surrounding normal tissues. This study aimed the evaluation of entrance surface-skin doses in dogs submitted to radiodiagnostic procedures of abdomen using the technique of thermoluminescent dosimetry (TLD). The radiation doses were measured using thermoluminescent dosimeters of LiF:Mg,Ti (TLD 100) and a dog phantom made with a plastic container, proportional to the dog size, fulfilled with water. (Author)

  18. CLINICAL STUDY OF ACUTE PANCREATITIS AND ITS COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Raj Siddharth

    2016-03-01

    Full Text Available BACKGROUND More than a century after its comprehensive description, acute pancreatitis remains a common disorder with devastating consequences. The presentation of wide spectrum of symptoms gives the clinician a heart breaking exercise to bring back the patient from the clutches of the disease process. Pancreatitis by itself is a disease which is unique, protean and extrudes into the diagnostic arena. It cannot be too strongly emphasized that the primary treatment of acute pancreatitis is conservative only, but it is the Pandora’s box of manifestation with its inherent complications from surgery comes into play as diagnostic, prognostic and therapeutic endeavour. To study age and sex incidence of acute pancreatitis, to study and analyse the etiopathological factors associated with acute pancreatitis, especially alcohol aetiology in our study. To analyse the prognosis of acute pancreatitis using CT scan abdomen. To analyse the complications, to analyse the role of surgery in acute pancreatitis. METHODS This study was carried out on patients admitted in the General Surgery Department, MGM Hospital, from December 2013 to June 2015. RESULTS The incidence of acute pancreatitis was found to be in a younger age group in our study. Serum amylase and lipase both (80% sensitivity should be used for diagnosis wherever possible. Ideally, all cases should be stratified during the first 48 hours according to one of the scoring systems (Balthazar’s. Scoring systems help to identify patients who are more likely to have a severe attack and they should be referred to higher centres if adequate facilities are not available.

  19. Non-Hodgkin lymphoma as a cause of acute intestinal obstruction/perforation in patients with adenocarcinoma of the sigmoidcolon: a case report

    OpenAIRE

    Marcelo Pandolfi Basso; Adriana Borgonovi Christiano; Letícia Vieira Guerrer; Francisco De Assis Gonçalves-Filho; João Gomes Netinho

    2011-01-01

    Report of a rare case of an 83-year-old patient with lymphoma of the terminal ileum causing obstructive/perforated acute abdomen synchronous with sigmoid colon adenocarcinoma and review of literature data about small bowel malignancies, particularly lymphomas. It seems to correspond to a rare disease (2% of all bowel cancers), more prevalent in elderly and immunocompromised patients, whose symptoms are vague and early diagnosis is difficult, often making it impossible to establish the correct...

  20. The Comparison of Apotel plus Low Dose of Morphine and Full Dose of Morphine in Pain Relief in Patients with Acute Renal Colic

    OpenAIRE

    Morteza-Bagi, Hamid Reza; Amjadi, Mohsen; Mirzaii-Sousefidi, Reyhaneh

    2015-01-01

    Background Renal colic is an acute flank pain which may radiate to the groin, lower abdomen, or external genitalia due to the passage of a urinary stones. Pain management is the most important task in emergency wards when a patient with renal colic attends. This study aims to compare intravenous acetaminophen plus a low dose of morphine with a full dose of morphine in renal colic. Methods In present randomized clinical trial, 100 patients with confirmed renal colic were recruited from the Eme...

  1. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    OpenAIRE

    Seval İzdeş; Neriman Defne Altıntaş; Gülin Karaaslan; Recep Uygun; Abdulkadir But

    2011-01-01

    Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to dis...

  2. Progress in research into the mechanism of Radix salviae miltiorrhizae in treatment of acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Xi-Ping Zhang; Zhi-Jun Li; Da-Ren Liu

    2006-01-01

    BACKGROUND: Acute pancreatitis (AP) is a common acute abdomen with high mortality, multiple complications and complicated causes. There is no effective therapy for AP. Radix salviae miltiorrhizae (Danshen), a traditional herbal medicine, has a low price and a wide range of clinical applications. It is effective to promote blood lfow, eliminate stagnancy, and relieve pain. It is also found to be effective in treating AP. We reviewed the progress in research into the mechanism of Radix salviae miltiorrhizae in treatment of AP. DATA SOURCES: An english-language literature search was conducted using MEDLINE (1988-2005) on Radix salviae miltiorrhizae (Danshen) and acute pancreatitis. RESULTS:The mechanisms of Danshen in the treatment of AP include improvement of microcirculatory disturbances;elimination of oxygen free radicals; modulation of the metabolism of lipid inlfammatory mediator;and blocking of calcium inlfow and prevention of calcium overload. CONCLUSION:Danshen can effectively reduce the mortality and complications of AP.

  3. Abdominal compartment syndrome in severe acute pancreatitis treated with percutaneous catheter drainage.

    Science.gov (United States)

    Park, Soonyoung; Lee, Seungho; Lee, Hyo Deok; Kim, Min; Kim, Kyeongmin; Jeong, Yusook; Park, Seon Mee

    2014-09-01

    Acute pancreatitis is one of the main causes of intra-abdominal hypertension (IAH). IAH contributes to multiple physiologic alterations and leads to the development of abdominal compartment syndrome (ACS) that induces multiorgan failure. We report a case of ACS in a patient with severe acute pancreatitis. A 44-year-old man who was admitted in a drunk state was found to have severe acute pancreatitis. During management with fluid resuscitation in an intensive care unit, drowsy mentality, respiratory acidosis, shock requiring inotropes, and oliguria developed in the patient, with his abdomen tensely distended. With a presumptive diagnosis of ACS, abdominal decompression through percutaneous catheter drainage was performed immediately. The intraperitoneal pressure measured with a drainage catheter was 31 mm Hg. After abdominal decompression, the multiorgan failure was reversed. We present a case of ACS managed with percutaneous catheter decompression. PMID:25325011

  4. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    International Nuclear Information System (INIS)

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet

  5. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    Energy Technology Data Exchange (ETDEWEB)

    Justin L, Regner, E-mail: Justin.Regner@BSWHealth.org; Angela, Lomas [Department of Surgery, Baylor Scott and White Health and Texas A& M Health Science Center College of Medicine, Temple, TX (United States)

    2016-03-25

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.

  6. Severe acute pancreatitis: Clinical course and management

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Severe acute pancreatitis (SAP) develops in about 25% of patients with acute pancreatitis (AP). Severity of AP is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis pathomorphologically.Risk factors determining independently the outcome of SAP are early multi-organ failure, infection of necrosis and extended necrosis (> 50%). Up to one third of patients with necrotizing pancreatitis develop in the late course infection of necroses. Morbidity of SAP is biphasic, in the first week strongly related to early and persistence of organ or multi-organ dysfunction. Clinical sepsis caused by infected necrosis leading to multi-organ failure syndrome (MOFS) occurs in the later course after the first week. To predict sepsis, MOFS or deaths in the first 48-72 h, the highest predictive accuracy has been objectified for procalcitonin and IL-8; the SepsisRelated Organ Failure Assessment (SOFA)-score predicts the outcome in the first 48 h, and provides a daily assessment of treatment response with a high positive predictive value. Contrast-enhanced CT provides the highest diagnostic accuracy for necrotizing pancreatitis when performed after the first week of disease. Patients who suffer early organ dysfunctions or at risk of developing a severe disease require early intensive care treatment. Early vigorous intravenous fluid replacement is of foremost importance. The goal is to decrease the hematocrit or restore normal cardiocirculatory functions.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 systemic infection. Patients suffering infected necrosis causing clinical sepsis, pancreatic abscess or surgical acute abdomen are candidates for early intervention. Hospital mortality of SAP after interventional or surgical debridement has decreased in high volume centers to below 20%.

  7. A Case of Acute Aortic Dissection Type B Associated with Cushing's Syndrome

    Science.gov (United States)

    Petramala, Luigi; Cotesta, Dario; Sapienza, Paolo; Zinnamosca, Laura; Moroni, Enrico; di Marzio, Luca; De Toma, Giorgio; Letizia, Claudio

    2009-01-01

    We report a case of a 63-year-old man, with a previous history of hypertension and glucose intolerance associated troncular obesity that was emergently admitted to our Institution for evaluation of a severe, constant posterior chest pain which radiated anteriorly and dyspnoea with a suspected diagnosis of acute aortic dissection. A CT scan of thorax and abdomen demonstrated a dissection starting just below left succlavian artery and extending downward to the left renal artery, involving the celiac tripod and superior mesenteric artery. The dissection was classified as Stanford B, De Bakey III. Moreover, CT scan of abdomen revealed incidentally a left adrenal tumor of 25 mm of diameter. An emergent prosthetic graft was placed just below the origin of the left succlavian artery up-to the diaphragmatic hiatus. Furthermore, a diagnostic evaluation of the mass revealed an increase of cortisol production, and a diagnosis of Cushing's syndrome was done and the patient underwent an adrenalectomy via laparotomic approach. We report an association of acute aortic dissection of acute aortic dissection type B associated to Cushing's syndrome. Keywords Cushing's syndrome; Adrenocortical adenoma; Aortic dissection type B PMID:22505966

  8. Evaluation of Absorbed Dose of Critical Organ in Rando Phantom under Head, Abdomen and Pelvis Spiral CT Scan by Thermo Luminescent Dosimetery - TLD

    OpenAIRE

    Gholamhosein Haddadi; Simin Mehdizadeh; Mohammad Bagher Haddadi; Mohammad Hasan Meshkibaf

    2011-01-01

    Background & Objectives: Computed tomography (CT) represents 11% of all diagnostic radiology procedures but it contributes to almost 67% of the total effective dose to the human population. In head and neck CT which consist of 1/3 of total CT scans, other critical organs such as lenses and thyroid are in the radiation field. Also in the abdomen and pelvis scan, irradiation of ovaries is unavoidable. Because of high sensitivity of these organs, the probability of abnormality and cancer in thes...

  9. Differential gene expression in abdomens of the malaria vector mosquito, Anopheles gambiae, after sugar feeding, blood feeding and Plasmodium berghei infection

    OpenAIRE

    Romans Patricia A; Kern Marcia K; Hillenmeyer Maureen E; Lobo Neil F; Dana Ali N; Collins Frank H

    2006-01-01

    Abstract Background Large scale sequencing of cDNA libraries can provide profiles of genes expressed in an organism under defined biological and environmental circumstances. We have analyzed sequences of 4541 Expressed Sequence Tags (ESTs) from 3 different cDNA libraries created from abdomens from Plasmodium infection-susceptible adult female Anopheles gambiae. These libraries were made from sugar fed (S), rat blood fed (RB), and P. berghei-infected (IRB) mosquitoes at 30 hours after the bloo...

  10. Comparison of the Effectiveness of the Treatment Using Standard Methods and Negative Pressure Wound Therapy (NPWT in Patients Treated with Open Abdomen Technique

    Directory of Open Access Journals (Sweden)

    Szmyt Krzysztof

    2015-03-01

    Full Text Available Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg.

  11. Macroscopic changes during negative pressure wound therapy of the open abdomen using conventional negative pressure wound therapy and NPWT with a protective disc over the intestines

    OpenAIRE

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

    2011-01-01

    Abstract Background Higher closure rates of the open abdomen have been reported with negative pressure wound therapy (NPWT) than with other wound management techniques. However, the method has occasionally been associated with increased development of fistulae. We have previously shown that NPWT induces ischemia in the underlying small intestines close to the vacuum source, and that a protective disc placed between the intestines and the vacuum source prevents the induction of ischemia. In th...

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

    Directory of Open Access Journals (Sweden)

    Rajput R.

    2016-05-01

    Full Text Available Typhoid fever is an important health problem worldwide but its incidence is more in developing countries. Hepatic involvement is common, but both hepatic and renal involvement is rare in typhoid fever. We report a case of typhoid fever presenting with hepatitis and acute renal failure. A 17 year old male presenting with fever and pain abdomen was found to have raised blood urea, creatinine, liver enzymes and bilirubin. Widal and typhidot (IgM,IgG test were positive. His symptoms subsided and deranged parameters resolved with treatment of typhoid fever.

  13. HIGH-INTENSITY FOCUSED ULTRASOUND FOR TREATMENT OF UNRESECTABLE TUMORS LOCATED IN THE WALLS OF CHEST AND ABDOMEN IN 10 PATIENTS

    Institute of Scientific and Technical Information of China (English)

    郑国强; 郭峰; 霍苓; 李正

    2003-01-01

    Objective: To present our results of high-intensity focused ultrasound (HIFU) treatment in 10 patients with unresectable tumors involved in the walls of chest and abdomen. Methods: Tumors located in the walls of the chest and abdomen in 10 patients were treated by HIFU, including local recurrence of fibrosarcoma in 1 case and local invasion or metastases in 9 cases. All of the 10 patients had received anti-cancer treatments before HIFU, 3 patients were complicated with intercostal neuralgia. Results: Partial responses were obtained in 2 patients, minor response in 1 patient, stable disease in 4, progressive disease in 2 after HIFU treatments. All the intercostal neuralgia in 3 patients was disappeared after HIFU. Bone scan showed that site of rib metastasis before HIFU became normal after HIFU in one patient. Conclusion: Our preliminary results showed that HIFU could get good results for patients with malignant tumors located in the walls of chest and abdomen if they are focal tumors, even if they are complicated with rib metastasis.

  14. Dose estimation in CT exams of the abdomen based on values of DLP; Estimativa da dose em exames de tomografia de abdome com base nos valores de DLP

    Energy Technology Data Exchange (ETDEWEB)

    Kikuti, C.F.; Medeiros, R.B.; Salvadori, P.S.; Costa, D.M.C; D' lppolito, G., E-mail: kikuticf@gmail.com, E-mail: rbitelli2011@gmail.com [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Coordenadoria de Fisica e Higiene das Radiacoes. Departamento de Diagnostico por Imagem

    2013-10-01

    One of the challenges of multidetector computerized tomography is to minimize the risk of ionizing radiation using optimized protocols since higher doses are necessary to obtain high image quality. It was also noted that, due to the geometry in image acquisition using MDCT becomes necessary to estimate dose values consistent with the hypothesis clinically and with the specificities of the tomographic equipment. The aim of this study was to estimate the doses in abdomen exams from the data recorded on the MDCT console and dimensions obtained from DICOM images of patients undergoing different clinical protocols. Were collected, from the image DICOM of 101 exams, values of the dose length product (DLP) provided by Philips Health Care - Brilliance 64 equipment console, in order to relate them with the dose values obtained by means of thermoluminescent dosimeters ( TLD ) of CasSo{sub 4}:Mn placed on the surface of a cylindrical simulator abdomen acrylic manufactured under the technical - operational conditions for a typical abdomen exam. From the data obtained, it was possible to find a factor of 1.16 ( 5 % ) indicating that the DLP values Brilliance 64 console underestimate the doses and this should be used with correction factor to estimate the total dose of the patient. (author)

  15. Are contrast media required for (68)Ga-DOTATOC PET/CT in patients with neuroendocrine tumours of the abdomen?

    Energy Technology Data Exchange (ETDEWEB)

    Mayerhoefer, Marius E.; Magnaldi, Silvia; Weber, Michael; Trattnig, Siegfried [Medical University of Vienna, Vienna General Hospital, Department of Radiology, PET/CT Center, Vienna (Austria); Schuetz, Matthias; Karanikas, Georgios [Medical University of Vienna, Vienna General Hospital, Department of Nuclear Medicine, PET/CT Center, Vienna (Austria)

    2012-04-15

    To determine the value of intravenous contrast medium in (68)Ga-DOTA-Phe(1)-Tyr(3)-octreotide - (68)Ga-DOTATOC - PET/CT for the detection of abdominal neuroendocrine tumours (NET). In fifty-five patients with known or suspected NETs of the abdomen PET/CT was performed on a 64-row multi-detector hybrid system. For PET, 150 MBq of (68)Ga-DOTATOC were injected intravenously. Full-dose unenhanced, and arterial- and venous-phase contrast-enhanced CT images were obtained. Unenhanced and contrast-enhanced PET/CT images were evaluated separately for the presence of NETs on a per-region basis, by two separate teams with different experience levels. On unenhanced PET/CT, sensitivity and specificity ranged from 89.3% (junior team) to 92% (senior team), and 99.1% (junior team) to 99.2% (senior team), respectively. On contrast-enhanced PET/CT, sensitivity and specificity ranged from 92.3% (junior team) to 98.5% (senior team), and 99.4% (junior team) to 99.5% (senior team), respectively. These increases in sensitivity and specificity, due to the use of contrast-enhanced images, were statistically significant (P < 0.05). Intravenous contrast medium only moderately, aleit significantly, improves the sensitivity of (68)Ga-DOTATOC PET/CT for the detection of abdominal NETs, and hardly affects specificity. Thus, while contrast enhancement is justified to achieve maximum sensitivity, unenhanced images may be sufficient for routine PET/CT in NET patients. (orig.)

  16. Milttorsion kan være årsag til akut abdomen hos børn

    DEFF Research Database (Denmark)

    Helvind, Neel Maria; Gögenur, Ismail; Stadeager, Morten

    2013-01-01

    A six-year-old boy was admitted with symptoms consistent with acute appendicitis. Immediately before placement of the first trocar, a large abdominal mass was observed which on imaging was identified as a torsioned spleen. Due to suboptimal reperfusion and risk of reperfusion-mediated morbidity...

  17. CT -- Abdomen and Pelvis

    Science.gov (United States)

    ... few hours beforehand. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce ... have any allergies. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications ( ...

  18. Appendiceal diverticulitis and acute appendicitis: differences and similarities

    Directory of Open Access Journals (Sweden)

    Irene Lobo-Machín

    2014-08-01

    Full Text Available Introduction: Acute appendiceal diverticulitis is an unusual cause of acute abdomen, considered clinically indistinguishable from acute appendicitis. Material and methods: In a historic cohort study with 27 cases of appendiceal diverticulitis and 54 cases of acute appendicitis, we compared clinical characteristics, diagnostic tests and pathology findings of the two processes. Results: Mean age at presentation was lower in acute appendicitis (37.24 ± 19.98 vs. 54.81 ± 17.55 years, p < 0.001, with significant differences between men (33.33 ± 15.89 vs. 57 ± 18.02 years, p < 0.001 but not between women (41.76 ± 24.87 vs. 50.44 ± 16.69 years, p = 0.34. In the diverticulitis group, 48.15 % had leukocytosis vs. 81.48 % in the appendicitis group (p = 0.02; there was no difference in leukocyte count (13770.37 ± 4382.55 vs. 14279.63 ± 4268.59, p = 0.61. Patients with appendiceal diverticulitis had a higher incidence of appendiceal mucocele (p = 0.01 and a lower proportion of appendiceal gangrene (p = 0.03. There were no differences in appendiceal perforation or ulceration. Symptom duration before emergency department attendance (71.61 ± 85.25 hours vs. 36.84 ± 33.59 hours; Z = -3.1 p = 0.002, duration of surgery (85 ± 40 minutes vs. 60 ± 21 minutes, Z = -3.2, p = 0.001 and the presence of appendicular plastron was higher in patients with diverticulitis vs. appendicitis (8 vs. 5 patients (p = 0.01, Odds ratio 2.2. Conclusions: Appendiceal diverticulitis presents a series of clinical, epidemiological and pathological differences with respect to acute appendicitis. The former shows a more indolent course with delayed diagnosis.

  19. Critique of Sew it Up! A Western Trauma Association Multi-Institutional Study of Enteric Injury Management in the Postinjury Open Abdomen

    Directory of Open Access Journals (Sweden)

    Nuri Abdurraheim

    2013-03-01

    Full Text Available Background: Use of damage control surgery techniques has reduced mortality in critically injured patients but at the cost of the open abdomen. With the option of delayed definitive management of enteric injuries, the question of intestinal repair/anastomosis or definitive stoma creation has been posed with no clear consensus. The purpose of this study was to determine outcomes on the basis of management of enteric injuries in patients relegated to the postinjury open abdomen.Methods: Patients requiring an open abdomen after trauma from January 1, 2002 to December 31, 2007 were reviewed. Type of bowel repair was categorized as immediate repair, immediate anastomosis, delayed anastomosis, stoma and a combination. Logistic regression was used to determine independent effect of risk factors on leak development.Results: During the 6-year study period, 204 patients suffered enteric injuries and were managed with an open abdomen. The majority was men (77% sustaining blunt trauma (66% with a mean age of 37.1 years±1.2 years and median Injury Severity Score of 27 (interquartile range=20-41. Injury patterns included 81 (40% small bowel, 37 (18% colonic, and 86 (42% combined injuries. Enteric injuries were managed with immediate repair (58, immediate anastomosis (15, delayed anastomosis (96, stoma (10, and a combination (22; three patients died before definitive repair. Sixty-one patients suffered intra-abdominal complications: 35 (17% abscesses, 15 (7% leaks, and 11 (5% enterocutaneous fistulas. The majority of patients with leaks had a delayed anastomosis; one patient had a right colon repair. Leak rate increased as one progresses toward the left colon (small bowel anastomoses, 3% leak rate; right colon, 3%; transverse colon, 20%; left colon, 45%. There were no differences in emergency department physiology, injury severity, transfusions, crystalloids, or demographic characteristics between patients with and without leak. Leak cases had higher 12-hour

  20. MRT of the abdomen in combination with enteroclysis in Crohn disease with oral and intravenous Gd-DTPA; MRT des Abdomens in Kombination mit der Enteroklyse bei Morbus Crohn unter Verwendung von oralem und intravenoesem Gd-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Rieber, A.; Wruk, D.; Nuessle, K.; Aschoff, A.J.; Brambs, H.J.; Tomczak, R. [Abt. Roentgendiagnostik, Radiologische Klinik der Univ. Ulm (Germany); Reinshagen, M.; Adler, G. [Abt. fuer Innere Medizin 1 (Gastrenterologie) der Univ. Ulm (Germany)

    1998-01-01

    60 patients between 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The length of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel contrast is optimal. The main prerequisite is a large filling volume of the small bowel to reach a homogeneous contrast and a good distension of the small bowel lumen. (orig./AJ) [Deutsch] 60 Patienten im Alter von 17-72 Jahren wurden untersucht. Zunaechst wurde eine Enteroklyse in konventioneller Technik durchgefuehrt, wobei der Methylzellulose in einer Mischung von 1:10 positives orales MR-Kontrastmittel (Magnevist enteral) zugesetzt wurde. Nach Abschluss der Enteroklyse erfolgte die MRT unter Verwendung T1- und T2-gewichteter Sequenzen (Flash 2D vor und nach i.v. Gd-DTPA bzw. TSE) in Atemanhaltetechnik in koronarer und axialer Schnittffuehrung. Die in der Enteroklyse nachweisbaren Schleimhautveraenderungen und Stenosenlaenge entsprachen einer nachweisbaren Darmwandverdickung bzw. Stenose in der MRT. Mit der MRT konnten bei 28 Patienten Zusatzbefunde wie Fisteln, Abszesse oder Hydronephrosen diagnostiziert werden, oder die Stenose war wegen der ueberlagerungsfreien Darstellung in der MRT besser beurteilbar als mittels Enteroklyse. Mit der MRT kann

  1. Acute chylous peritonitis due to acute pancreatitis

    OpenAIRE

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of “chyle” occurs rapidly, the patient may present with signs of peritonitis. Preoperative...

  2. Multidendritic sensory neurons in the adult Drosophila abdomen: origins, dendritic morphology, and segment- and age-dependent programmed cell death

    Directory of Open Access Journals (Sweden)

    Sugimura Kaoru

    2009-10-01

    Full Text Available Abstract Background For the establishment of functional neural circuits that support a wide range of animal behaviors, initial circuits formed in early development have to be reorganized. One way to achieve this is local remodeling of the circuitry hardwiring. To genetically investigate the underlying mechanisms of this remodeling, one model system employs a major group of Drosophila multidendritic sensory neurons - the dendritic arborization (da neurons - which exhibit dramatic dendritic pruning and subsequent growth during metamorphosis. The 15 da neurons are identified in each larval abdominal hemisegment and are classified into four categories - classes I to IV - in order of increasing size of their receptive fields and/or arbor complexity at the mature larval stage. Our knowledge regarding the anatomy and developmental basis of adult da neurons is still fragmentary. Results We identified multidendritic neurons in the adult Drosophila abdomen, visualized the dendritic arbors of the individual neurons, and traced the origins of those cells back to the larval stage. There were six da neurons in abdominal hemisegment 3 or 4 (A3/4 of the pharate adult and the adult just after eclosion, five of which were persistent larval da neurons. We quantitatively analyzed dendritic arbors of three of the six adult neurons and examined expression in the pharate adult of key transcription factors that result in the larval class-selective dendritic morphologies. The 'baseline design' of A3/4 in the adult was further modified in a segment-dependent and age-dependent manner. One of our notable findings is that a larval class I neuron, ddaE, completed dendritic remodeling in A2 to A4 and then underwent caspase-dependent cell death within 1 week after eclosion, while homologous neurons in A5 and in more posterior segments degenerated at pupal stages. Another finding is that the dendritic arbor of a class IV neuron, v'ada, was immediately reshaped during post

  3. A STUDY OF AETIOLOGY, CLINICAL FEATURES AND MANAGEMENT OF ACUTE PANCREATITIS IN A TERTIARY CARE HOSPITAL IN SOUTHERN ODISHA

    Directory of Open Access Journals (Sweden)

    Rajendra

    2016-05-01

    Full Text Available BACKGROUND Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen in the UK. The hospital admission rate for acute pancreatitis is 9.8/100,000 per year in UK and annual incidence may range from 5-50/100,000 worldwide. Gall stone disease and alcohol account for greater than 80% of all patients with acute pancreatitis, with biliary disease accounting for 45% and alcohol found in 35% of patients. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualised. Patients with mild acute pancreatitis generally can be managed with resuscitation and supportive care. Aetiological factors are sought and treated, if possible, but operative therapy essentially has no role in the care of these patients. Those with severe and necrotising pancreatitis require intensive therapy, which may include wide operative debridement of the infected pancreas or surgical management of local complications of the disease. AIM OF THE STUDY 1. To study the age and sex prevalence of acute pancreatitis. 2. To study the various aetiological factors of acute pancreatitis. 3. To study the clinical presentation and management of acute pancreatitis. MATERIALS AND METHODS Patients admitted to the Department of General Surgery at M.K.C.G Medical College and Hospital, Berhampur were taken up for the study. Totally, 49 patients with 53 episodes of acute pancreatitis were studied from September 2013 to August 2015. RESULTS AND CONCLUSIONS Acute pancreatitis is a common cause of acute abdomen in patients presenting to the surgical emergency department. Alcohol being the most common cause of acute pancreatitis in this part of the country, it has a male preponderance and most commonly presents in the 4th decade of life. It is mainly a clinical diagnosis supplanted with biochemical and radiological findings. The management is mainly conservative, with surgery

  4. Acute pancreatitis with saw palmetto use: a case report

    Directory of Open Access Journals (Sweden)

    Amankona Raymond

    2011-08-01

    Full Text Available Abstract Introduction Saw palmetto is a phytotherapeutic agent commercially marketed for the treatment of benign prostatic hyperplasia. Evidence suggests that saw palmetto is a safe product, and mild gastrointestinal adverse effects have been reported with its use. We report a case of acute pancreatitis, possibly secondary to the use of saw palmetto. Case presentation A 61-year-old Caucasian man with a history of benign prostatic hyperplasia and gastroesophageal reflux disease developed epigastric pain associated with nausea 36 hours prior to presentation. He denied drinking alcohol prior to the development of his symptoms. His home medications included saw palmetto, lansoprazole and multivitamins. Laboratory results revealed elevated lipase and amylase levels. An abdominal ultrasound demonstrated a nondilated common bile duct, without choledocholithiasis. Computed tomography of his abdomen showed the pancreatic tail with peripancreatic inflammatory changes, consistent with acute pancreatitis. Our patient's condition improved with intravenous fluids and pain management. On the fourth day of hospitalization his pancreatic enzymes were within normal limits: he was discharged home and advised to avoid taking saw palmetto. Conclusion It is our opinion that a relationship between saw palmetto and the onset of acute pancreatitis is plausible, and prescribers and users of saw palmetto should be alert to the possibility of such adverse reactions.

  5. Scrotal Swelling as a Complication of Hydrochlorothiazide Induced Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Ivan Nikiforov

    2015-01-01

    Full Text Available Background. Scrotal swelling is a rare complication of acute pancreatitis with few reported cases in the literature. In this case report, we present a 59-year-old male with hydrochlorothiazide induced pancreatitis who developed scrotal swelling. Case Presentation. A 59-year-old male presented to the emergency department with sharp epigastric abdominal pain that radiated to the back and chest. On physical examination, he had abdominal tenderness and distention with hypoactive bowel sounds. Computed tomography (CT scan of the abdomen showed acute pancreatitis. The patient’s condition deteriorated and he was admitted to the intensive care unit (ICU. After he improved and was transferred out of the ICU, the patient developed swelling of the scrotum and penis. Ultrasound (US of the scrotum showed large hydrocele bilaterally with no varicoceles or testicular masses. Good blood flow was observed for both testicles. The swelling diminished over the next eight days with the addition of Lasix and the patient was discharged home in stable condition. Conclusion. Scrotal swelling is a rare complication of acute pancreatitis. It usually resolves spontaneously with conservative medical management such as diuretics and elevation of the legs.

  6. Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report

    Directory of Open Access Journals (Sweden)

    L.F.F. Botelho

    2010-06-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, the patient developed a nosocomial pneumonia and cefepime was initiated. On the fourth day of cephalosporin treatment, he presented with a maculopapular, pruritic eruption affecting the face, neck, abdomen and limbs. One day later he developed disseminated pustular lesions and his temperature was 37°C. Laboratory analysis evidenced leukocytosis and skin biopsy showed subcorneal pustule, edema in the papillary dermis, perivascular inflammatory infiltrate consisting of neutrophils, leukocytoclasia and red cell extravasation in the epidermis. Cefepime was suspended and within 4 days the non-follicular pustules cleared following a desquamation. AGEP is a disease attributed to a variety of causes, but in 90% of the cases it is due to an adverse drug reaction. Antibiotics are implicated in 80% of these cases, mostly penicillins and macrolides. There are few cases associated with cephalosporins. It is very important to consider AGEP in cases of acute pustular rashes and drugs should be investigated as causative agents.

  7. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    Science.gov (United States)

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  8. Pulmonary Thromboembolism Complicating Acute Pancreatitis With Pancreatic Ascites: A Series of 4 cases

    Directory of Open Access Journals (Sweden)

    Ruchir Patel

    2016-05-01

    Full Text Available Acute pancreatitis is an inflammatory disease often associated with local and systemic complications. Portosplenic and splanchnic vascular complications of acute pancreatitis are common, but extrasplanchnic vessel thrombosis is less commonly seen. Among them, pulmonary thromboembolism is a very rare complication to be encountered with. We report four cases of acute pulmonary thromboembolism in patients with acute pancreatitis superimposed on chronic pancreatitis. All the patients had abdominal pain on presentation and distention of abdomen during the course. Dyspnea was present in all the patients. All patients were found to have pancreatic ascites, whose association with pulmonary thromboembolism is reported only in two patients till date upto our knowledge. Two of them had deep vein thrombosis and rest two had no venous thrombosis. All of them were managed conservatively using subcutaneous heparin, intravenous fluids and analgesics. We provide the causative mechanism for occurrence of pulmonary thromboembolism in acute on chronic pancreatitis. We have also hypothesized pancreatic ascites as the possible cause for pulmonary thromboembolism and provide explanation for it. We conclude that pulmonary thromboembolism in acute pancreatitis has good prognosis if diagnosed timely. Whenever patient with pancreatic ascites presents with dyspnea, pulmonary thromboembolism must be ruled out.

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

    Directory of Open Access Journals (Sweden)

    Loste, A.

    2009-05-01

    Full Text Available ResumenUna oveja de raza Rasa Aragonesa, procedente de una explotación de laprovincia de Zaragoza, fue remitida a la Facultad de Veterinaria,presentando un historial de descarga vaginal sanguinolenta, oscura ymaloliente, por lo que se sospechó de un proceso de metritis y seadministró oxitocina para favorecer la eliminación de la secreción. Otros síntomas encontrados tras la exploración fueron caquexia, palidez de mucosas y debilidad. A la palpación del abdomen se detectaron varios nódulos, destacando por su tamaño uno localizado en la región umbilical, que podían corresponder con abscesos.El estado de la oveja empeoró progresivamente, por lo que se decidió su sacrificio humanitario. En la necropsia de observaron múltiples nódulos distribuidos en la zona abdominal (peritoneo, hígado y bazo, y uno de enorme tamaño localizado en el cuello del útero. No se encontraron lesiones en ninguna otra localización. Se tomaron muestras para el estudio anatomopatológico, que dio como resultado un carcinoma de células escamosas. Los carcinomas de células escamosas se han descrito en ganado ovino localizados en cabeza (fosas nasales y tercer párpado, asociados normalmente a una alta exposición a radiaciones solares en zonas desprotegidas de la piel y mucosas. En la bibliografía no se ha encontrado ninguna descripción de carcinoma de células escamosas de localización abdominal en ganado ovino. Dado que no se encontró en la necropsia ningún foco primario de localización típica en esta especie, se especula con el posible origen de la neoplasia a nivel del cuello del útero.SummaryA Rasa Aragonesa sheep from a flock of Zaragoza (Spain, was sent to the Veterinary Faculty with a history of bleeding, dark and smelly vaginal discharge. Metritis was suspected and treated with oxitocina in order to eliminate the secretion. Clinical exploration reveled caquexia, mucous paleness and weakness, and also several nodules were detected by

  10. Acute Pancreatitis in Children

    Science.gov (United States)

    ... a feeding tube or an IV to prevent malnutrition and improve healing. Does my child have to ... intestines. Can my child die from acute pancreatitis? Death from acute pancreatitis is quite rare in children– ...

  11. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis It is important to get your questions about ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  12. Laparoscopic Cholecystectomy for Severe Acute Cholecystitis in a Patient with Situs Inversus Totalis and Posterior Cystic Artery

    Directory of Open Access Journals (Sweden)

    Theodoros E. Pavlidis

    2008-01-01

    Full Text Available Situs inversus totalis is an inherited condition characterized by a mirror-image transposition of thoracic and abdominal organs. It often coexists with other anatomical variations. Transposition of the organs imposes special demands on the diagnostic and surgical skills of the surgeon. We report a case of a 34-year-old female patient presented with left upper quadrant pain, signs of acute abdomen, and unknown situs inversus totalis. Severe acute cholecystitis was diagnosed, and an uneventful laparoscopic cholecystectomy was performed. A posterior cystic artery was identified and ligated. Laparoscopic cholecystectomy is feasible in patients with severe acute calculus cholecystitis and situs inversus totalis; however, the surgeon should be alert of possible anatomic variations.

  13. Beta Lactamase Producing Clostridium perfringens Bacteremia in an Elderly Man with Acute Pancreatitis

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    Rashmi Mishra

    2016-01-01

    Full Text Available Clostridium perfringens bacteremia is associated with adverse outcomes. Known risk factors include chronic kidney disease, malignancy, diabetes mellitus, and gastrointestinal disease. We present a 74-year-old man admitted with confusion, vomiting, and abdominal pain. Exam revealed tachycardia, hypotension, lethargy, distended abdomen, and cold extremities. He required intubation and aggressive resuscitation for septic shock. Laboratory data showed leukocytosis, metabolic acidosis, acute kidney injury, and elevated lipase. CT scan of abdomen revealed acute pancreatitis and small bowel ileus. He was started on vancomycin and piperacillin-tazobactam. Initial blood cultures were positive for C. perfringens on day five. Metronidazole and clindamycin were added to the regimen. Repeat CT (day 7 revealed pancreatic necrosis. The patient developed profound circulatory shock requiring multiple vasopressors, renal failure requiring dialysis, and bacteremia with vancomycin-resistant enterococci. Hemodynamic instability precluded surgical intervention and he succumbed to multiorgan failure. Interestingly, our isolate was beta lactamase producing. We review the epidemiology, risk factors, presentation, and management of C. perfringens bacteremia. This case indicates a need for high clinical suspicion for clostridial sepsis and that extended spectrum beta lactam antibiotic coverage may be inadequate and should be supplemented with use of clindamycin or metronidazole if culture is positive, until sensitivities are known.

  14. Modelo teórico práctico de atención médica al adulto mayor con abdomen agudo quirúrgico

    OpenAIRE

    Rodríguez Pascual, Yazmín

    2011-01-01

    En los 100 últimos años ha transcurrido una revolución silenciosa e inusitada: la de la longevidad. Fenómeno demográfico mundial que provoca un incremento de adultos mayores, eleva la asistencia a los servicios de urgencias hospitalarios de este grupo de edad, aumenta el número de operados de esta afección, aumentan las complicaciones y muertes, es un problema de salud. La investigación tuvo como objetivo un modelo teórico práctico de atención médica al adulto mayor con abdomen ag...

  15. SU-E-P-08: Establishment of Local Diagnostic Reference Levels of Routine Abdomen Exam in Computed Tomography According to Body Weight

    Energy Technology Data Exchange (ETDEWEB)

    Wang, H; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose: The national diagnostic reference levels (NDRLs) is an efficient, concise and powerful standard for optimizing radiation protection of a patient. However, for each hospital the dose-reducing potential of focusing on establishment of local DRLs (LDRLs). A lot of study reported that Computed tomography exam contributed majority radiation dose in different medical modalities, therefore, routine abdomen CT exam was choose in initial pilot study in our study. Besides the mAs of routine abdomen CT exam was decided automatic exposure control by linear attenuation is relate to body shape of patient. In this study we would like to establish the local diagnostic reference levels of routine abdomen exam in computed tomography according to body weight of patient. Methods and Materials: There are two clinical CT scanners (a Toshiba Aquilion and a Siemens Sensation) were performed in this study. For CT examinations the basic recommended dosimetric quantity is the Computed Tomography Dose Index (CTDI). The patient sample involved 82 adult patients of both sexes and divided into three groups by their body weight (50–60 kg, 60–70 kg, 70–80 kg).Carried out the routine abdomen examinations, and all exposure parameters have been collected and the corresponding CTDIv and DLP values have been determined. The average values were compared with the European DRLs. Results: The majority of patients (75%) were between 50–70 Kg of body weight, the numbers of patient in each group of weight were 40–50:7; 50–60:29; 60–70:33; 70–80:13. The LDRLs in each group were 10.81mGy, 14.46mGy, 20.27mGy and 21.04mGy, respectively. The DLP were 477mGy, 630mGy, 887mGy and 959mGy, respectively. No matter which group the LDRLs were lower than European DRLs. Conclusions: We would like to state that this was a pioneer work in local hospital in Chiayi. We hope that this may lead the way to further developments in Taiwan.

  16. Acute mastoiditis in children

    DEFF Research Database (Denmark)

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren;

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute...... otitis media....

  17. Recurrent acute renal failure

    OpenAIRE

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  18. An atypical clinical presentation of acute appendicitis in a young man with midgut malrotation

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Antonio [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy)]. E-mail: pinto@neomedia.it; Di Raimondo, Domenico [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Tuttolomondo, Antonino [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Fernandez, Paola [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Caronia, Aurelio [Dipartimento di Biotecnologie Mediche - Sezione di Radiologia, University of Palermo, Via del Vespro no 129, 90127 Palermo (Italy); Lagalla, Roberto [Dipartimento di Biotecnologie Mediche - Sezione di Radiologia, University of Palermo, Via del Vespro no 129, 90127 Palermo (Italy); Arnao, Valentina [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy); Law, Robert L. [Department of Radiology, Frenchay Hospital, Bristol (United Kingdom); Licata, Giuseppe [Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Piazza delle Cliniche no 2, 90127 Palermo (Italy)

    2007-05-15

    Midgut malrotation occurs as a result of failure in normal intestinal rotation and fixation during early pregnancy. Pathological conditions reported in the literature involving midgut malrotation predominantly relate to infants and children. In adults malrotation is often revealed as an incidental finding on computed tomography (CT), or the associated altered anatomy can be the cause of atypical clinical symptoms of relatively common intestinal disorders. An unusual presentation of acute appendicitis, with fever and recurrent pain in left iliac fossa is reported. Underlying intestinal malrotation delayed the correct clinical diagnosis of acute appendicitis. It was not until a CT scan was performed that a malrotation was identified. The predominant appearances of malrotation are the siting of the ascending colon, caecum (and appendix) in the left side of the abdomen and the right-sided placement of the duodenojejunal junction.

  19. Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Acute pancreatitis (AP) is a common acute abdomen in clinic with a rapid onset and dangerous pathogenetic condition.AP can cause an injury of intestinal mucosa barrier, leading to translocation of bacteria or endotoxin through multiple routes,bacterial translocation (BT), gutorigin endotoxaemia, and secondary infection of pancreatic tissue, and then cause systemic inflammatory response syndrome (SIRS) or multiple organ dysfunction syndrome (MODS), which are important factors influencing AP's severity and mortality. Meanwhile, the injury of intestinal mucosa barrier plays a key role in AP's process. Therefore, it is clinically important to study the relationship between the injury of intestinal mucosa barrier and AP. In addition, many factors such as microcirculation disturbance, ischemical reperfusion injury, excessive release of inflammatory mediators and apoptosis may also play important roles in the damage of intestinal mucosa barrier. In this review, we summarize studies on mechanisms of AP.

  20. Evaluation and management of acute abdominal pain in the emergency department

    Directory of Open Access Journals (Sweden)

    Macaluso CR

    2012-09-01

    Full Text Available Christopher R Macaluso, Robert M McNamaraDepartment of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA, USAAbstract: Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.Keywords: acute abdomen, emergency medicine, peritonitis

  1. Blunt abdominal trauma with handlebar injury: A rare cause of traumatic amputation of the appendix associated with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Amanda Jensen

    2016-04-01

    Full Text Available We describe traumatic appendicitis in a 7-year-old boy who presented after sustaining blunt abdominal trauma to his right lower abdomen secondary to bicycle handlebar injury. With diffuse abdominal pain following injury, he was admitted for observation. Computed axial tomography (CT obtained at an outside hospital demonstrated moderate stranding of the abdomen in the right lower quadrant. The CT was non-contrasted and therefore significant appendiceal distention could not be confirmed. However, there was a calcified structure in the right pelvis with trace amount of free fluid. Patient was observed with conservative management and over the course of 15 h his abdominal pain continued to intensify. With his worsening symptoms, we elected to take him for diagnostic laparoscopy. In the operating room we found an inflamed traumatically amputated appendix with the mesoappendix intact. We therefore proceeded with laparoscopic appendectomy. Pathology demonstrated acute appendicitis with fecalith. It was unclear as to whether the patient's appendicitis and perforation were secondary to fecalith obstruction, his blunt abdominal trauma or if they concurrently caused his appendicitis. Acute appendicitis is a common acute surgical condition in the pediatric population and continues to be a rare and unique cause of operative intervention in the trauma population.

  2. Imaging of Acute Pancreatitis.

    Science.gov (United States)

    Thoeni, Ruedi F

    2015-11-01

    Acute pancreatitis is an acute inflammation of the pancreas. Several classification systems have been used in the past but were considered unsatisfactory. A revised Atlanta classification of acute pancreatitis was published that assessed the clinical course and severity of disease; divided acute pancreatitis into interstitial edematous pancreatitis and necrotizing pancreatitis; discerned an early phase (first week) from a late phase (after the first week); and focused on systemic inflammatory response syndrome and organ failure. This article focuses on the revised classification of acute pancreatitis, with emphasis on imaging features, particularly on newly-termed fluid collections and implications for the radiologist.

  3. Management Of Acute Migraine

    Directory of Open Access Journals (Sweden)

    Mehndiratta M

    2002-01-01

    Full Text Available Pharmacotherapy for migraine involves treatment for the acute attack as well as using long-term prophylaxis in order to reduce the frequency and severity of the attacks. Based on severity, there are a number of drugs available to treat the acute attacks. For mild to moderate attacks, analgesics, NSAIDs and Ergotamine are effective but severe attacks may need Dihydroergotamine (DHE or a triptan. Sumatriptan and the second generation triptans have revolutionized the acute treatment of migraine. Early and appropriate treatment holds the key to successful therapy of the acute attack. This article discusses the various acute treatment options available.

  4. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  5. Acute chylous peritonitis due to acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Georgios K Georgiou; Haralampos Harissis; Michalis Mitsis; Haralampos Batsis; Michalis Fatouros

    2012-01-01

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse.The development of chylous ascites is usually a chronic process mostly involving malignancy,trauma or surgery,and symptoms arise as a result of progressive abdominal distention.However,when accumulation of "chyle" occurs rapidly,the patient may present with signs of peritonitis.Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation,appendicitis or visceral ischemia.Less than 100 cases of acute chylous peritonitis have been reported.Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis.This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis,and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis.The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer,since,due to hypertriglyceridemia,serum amylase values appeared within the normal range.Moreover,abdominal computed tomography imaging was not diagnostic for pancreatitis.Following abdominal lavage and drainage,the patient was successfully treated with total parenteral nutrition and octreotide.

  6. Acute chylous peritonitis due to acute pancreatitis.

    Science.gov (United States)

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide.

  7. Acute pancreatitis in acute viral hepatitis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To elucidate the frequency and characteristics of pancreatic involvement in the course of acute (nonfulminant) viral hepatitis.METHODS: We prospectively assessed the pancreatic involvement in patients with acute viral hepatitis who presented with severe abdomimanl pain.RESULTS: We studied 124 patients with acute viral hepatitis, of whom 24 presented with severe abdominal pain. Seven patients (5.65%) were diagnosed to have acute pancreatitis. All were young males. Five patients had pancreatitis in the first week and two in the fourth week after the onset of jaundice. The pancreatitis was mild and all had uneventful recovery from both pancreatitis and hepatitis on conservative treatment.The etiology of pancreatitis was hepatitis E virus in 4,hepatitis A virus in 2, and hepatitis B virus in 1 patient.One patient had biliary sludge along with HEV infection.The abdominal pain of remaining seventeen patients was attributed to stretching of Glisson's capsule.CONCLUSION: Acute pancreatitis occurs in 5.65% of patients with acute viral hepatitis, it is mild and recovers with conservative management.

  8. Acute chylous peritonitis due to acute pancreatitis.

    Science.gov (United States)

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide. PMID:22563182

  9. CT findings in acute small bowel diverticulitis; Computertomographie bei akuter Duenndarmdivertikulitis

    Energy Technology Data Exchange (ETDEWEB)

    Ferstl, F.J.; Obert, R. [Radiologisch-Nuklearmedizinisches Zentrum (RNZ) am St. Theresienkrankenhaus Nuernberg (Germany)

    2004-02-01

    Small bowel diverticulitis is a rare cause of an acute abdomen. Originating from acquired diverticula of the jejunum, less often of the ileum, or Meckel diverticulum, the symptoms are non-specific, simulating other acute inflammatory disorders, such as appendicitis, cholecystitis or colonic diverticulitis. The diagnosis of small bowel diverticulitis is solely based on radiologic findings, with computed tomography (CT) regarded as the method of choice. In recent years, a number of case reports have described the spectrum of the CT features in acute small bowel diverticulitis and its dependence on the severity of the inflammatory process. Typical findings are an inflamed diverticulum, inflammatory mesenteric infiltration, extraluminal gas collection and mural edema of adjacent small bowel loops with resultant separation of bowel loops. An enterolith is rarely found in an inflamed diverticulum. Complications include abscesses, fistulae, small bowel obstruction and free perforation with peritonitis. Small bowel diverticulitis can be a diagnostic problem if it involves the terminal ileum or Meckel's diverticulum. For preoperative confirmation of the presumed diagnosis of small bowel diverticulitis on CT, an enteroclysis for acquired diverticula or a technetium scan for Meckel's diverticulum should be performed. We present the CT findings in three patients of acute small bowel diverticulitis, two affecting the jejunum and one a Meckel's diverticulum. (orig.) [German] Die akute Duenndarmdivertikulitis ist eine seltene Ursache eines akuten Abdomens. Ausgehend von den erworbenen Divertikeln des Jejunums, seltener des Ileums, oder von einem Meckel-Divertikel, manifestiert sich die Divertikulitis klinisch durch eine unspezifische Symptomatik, die zuerst an die haeufigeren, akutentzuendlichen Erkrankungen des Abdomens wie z. B. Appendizitis, Cholezystitis oder Kolondivertikulitis denken laesst. Die Duenndarmdivertikulitis kann praeoperativ nur durch

  10. The Diagnostic Value of D-dimer, Procalcitonin and CRP in Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Bulent Kaya, Baris Sana, Cengiz Eris, Koray Karabulut, Orhan Bat, Riza Kutanis

    2012-01-01

    Full Text Available BACKGROUND: The early diagnosis of acute abdomen is of great importance. To date, several inflammatory markers have been used for the diagnosis of acute abdominal conditions, including acute appendicitis. The aim of this study was to evaluate the diagnostic utility of D-dimer, Procalcitonin (PCT and C-reactive protein (CRP measurements in the acute appendicitis.METHODS: This prospective study was conducted between March 1st, 2010 and July 1st, 2011. In this period, seventy-eight patients were operated with the diagnosis of acute appendicitis, and D-dimer, PCT and CRP levels of the patients were measured. The patients were grouped as phlegmonous appendicitis (Group 1, gangrenous appendicitis (Group 2, perforated appendicitis (Group 3 and negative appendectomy (Group 4 according to the surgical findings and histopathological results.RESULTS: Of 78 patients, 54 (69.2 % were male and 24 (30.8 % were female, and the mean age was 25.4 ± 11.1 years (range, 18 to 69 years. 66 (84.6 % patients had increased leukocyte count (white blood cell count. The PCT values were higher than the upper normal limit in 20 (25.6% patients, followed by D-dimer in 22 (28.2 % patients and CRP in 54 (69.2 % patients. The diagnostic value of leukocyte count and CRP in acute appendicitis was higher than that of the other markers, whereas leukocyte count showed very low specificity. CRP values were higher in perforated appendicitis when compared with the phlegmonous appendicitis (p<0.05. However, PCT and D-dimer showed lower diagnostic values (26% and 31%, respectively.CONCLUSION: An increase in CRP levels alone is not sufficient to make the diagnosis of acute appendicitis. However, CRP levels may differentiate between phlegmonous appendicitis and perforated appendicitis. Due to their low sensitivity and diagnostic value, PCT and D-dimer are not better markers than CRP for the diagnosis of acute appendicitis.

  11. Clinical Experience of Vibrating Abdomen Therapy for Primary Dysmenorrhea of Qi Stagnation and Blood Stasis Type%振腹法治疗气滞血瘀型原发性痛经的临床运用心得

    Institute of Scientific and Technical Information of China (English)

    李敏; 李迎红; 詹育和; 王德瑜; 曹美琴

    2013-01-01

    Vibrating abdomen therapy is a kind of manipulation technique of traditional Chinese medicine, professor Zang Fuke of Beijing university of Chinese medicine had founded the"pine vibration"and the unique vibrating abdomen therapy. This article would summarize and analyze the expe-rience of vibrating abdomen therapy for primary dysmenorrhea of qi stagnation and blood stasis type.%振腹法是一种传统中医推拿手法,上世纪九十年代北京中医药大学臧福科教授等创立了“松振法”及独特的振腹疗法,本文总结分析振腹法治疗气滞血瘀型原发性痛经的临床运用心得。

  12. Atrial fibrillation (acute onset)

    OpenAIRE

    Lip, Gregory Y. H.; Watson, Timothy

    2008-01-01

    Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of less than 48 hours' duration. It resolves spontaneously within 24 to 48 hours in over 50% of people. In this review we have included studies on patients with onset up to 7 days previously. Risk factors for acute atrial fibrillation include increasing age, CVD, alcohol abuse, diabetes, and lung disease.Acute atrial fibrillation increases the risk of stroke and heart failure.

  13. Acute generalized exanthematous pustulosis

    Directory of Open Access Journals (Sweden)

    K.S. Dhillon

    2012-10-01

    Full Text Available Acute generalized exanthematous pustulosis (AGEP is a rare reaction pattern with a typical morphology and a short clinical course that in majority of cases is related to medication administration. It is an acute pustular eruption with unique clinical features, a rapid clinical course and a typical histopathology. Herein, we report the case of a patient with acute generalized exanthematous pustulosis for its classical presentation.

  14. Streptococcal acute pharyngitis

    OpenAIRE

    2014-01-01

    Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-s...

  15. Imaging of acute pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Merkle, Elmar M.; Goerich, Johannes [Department of Radiology, University Hospitals of Ulm, Steinhoevel Strasse 9, 89075 Ulm (Germany)

    2002-08-01

    Acute pancreatitis is defined as an acute inflammatory process of the pancreas with variable involvement of peripancreatic tissues or remote organ systems. This article reports the current classification, definition and terminology, epidemiology and etiology, pathogenesis and pathological findings, clinical and laboratory findings, and finally imaging findings of acute pancreatitis with emphasis on cross-sectional imaging modalities such as ultrasound, computed tomography, and magnetic resonance imaging. (orig.)

  16. Acute Idiopathic Scrotal Edema

    Directory of Open Access Journals (Sweden)

    Micheál Breen

    2013-01-01

    Full Text Available We report a case of acute idiopathic scrotal edema (AISE in a 4-year-old boy who presented with acute scrotal pain and erythema. The clinical features, ultrasound appearance, and natural history of this rare diagnosis are reviewed. In this report, we highlight the importance of good ultrasound technique in differentiating the etiology of the acute scrotum and demonstrate the color Doppler “Fountain Sign” that is highly suggestive of AISE.

  17. Management Of Acute Migraine

    OpenAIRE

    Mehndiratta M

    2002-01-01

    Pharmacotherapy for migraine involves treatment for the acute attack as well as using long-term prophylaxis in order to reduce the frequency and severity of the attacks. Based on severity, there are a number of drugs available to treat the acute attacks. For mild to moderate attacks, analgesics, NSAIDs and Ergotamine are effective but severe attacks may need Dihydroergotamine (DHE) or a triptan. Sumatriptan and the second generation triptans have revolutionized the acute treatment of migra...

  18. SU-E-I-29: Care KV: Dose It Influence Radiation Dose in Non-Contrast Examination of CT Abdomen/pelvis?

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J; Ganesh, H [University of Kentucky, Lexington, KY (United States); Weir, V [Baylor University Medical Center, Plano, TX (United States)

    2015-06-15

    Purpose: CARE kV is a tool that automatically recommends optimal kV setting for individual patient for specific CT examination. The use of CARE kV depends on topogram and the user-selected contrast behavior. CARE kV is expected to reduce radiation dose while improving image quality. However, this may work only for certain groups of patients and/or certain CT examinations. This study is to investigate the effects of CARE kV on radiation dose of non-contrast examination of CT abdomen/pelvis. Methods: Radiation dose (CTDIvol and DLP) from patients who underwent abdomen/pelvis non-contrast examination with and without CARE kV were retrospectively reviewed. All patients were scanned in the same scanner (Siemens Somatom AS64). To mitigate any possible influences due to technologists’ unfamiliarity with the CARE kV, the data with CARE kV were retrieved 1.5 years after the start of CARE kV usage. T-test was used for significant difference in radiation dose. Results: Volume CTDIs and DLPs from 18 patients before and 24 patients after the use of CARE kV were obtained in a duration of one month. There is a slight increase in both average CTDIvol and average DLP with CARE kV compared to those without CARE kV (25.52 mGy vs. 22.65 mGy for CTDIvol; 1265.81 mGy-cm vs. 1199.19 mGy-cm). Statistically there was no significant difference. Without CARE kV, 140 kV was used in 9 of 18 patients, while with CARE KV, 140 kV was used in 15 of 24 patients. 80kV was not used in either group. Conclusion: The use of CARE kV may save time for protocol optimization and minimize variability among technologists. Radiation dose reduction was not observed in non-contrast examinations of CT abdomen/pelvis. This was partially because our CT protocols were tailored according to patient size before CARE kV and partially because of large size patients.

  19. SU-E-I-29: Care KV: Dose It Influence Radiation Dose in Non-Contrast Examination of CT Abdomen/pelvis?

    International Nuclear Information System (INIS)

    Purpose: CARE kV is a tool that automatically recommends optimal kV setting for individual patient for specific CT examination. The use of CARE kV depends on topogram and the user-selected contrast behavior. CARE kV is expected to reduce radiation dose while improving image quality. However, this may work only for certain groups of patients and/or certain CT examinations. This study is to investigate the effects of CARE kV on radiation dose of non-contrast examination of CT abdomen/pelvis. Methods: Radiation dose (CTDIvol and DLP) from patients who underwent abdomen/pelvis non-contrast examination with and without CARE kV were retrospectively reviewed. All patients were scanned in the same scanner (Siemens Somatom AS64). To mitigate any possible influences due to technologists’ unfamiliarity with the CARE kV, the data with CARE kV were retrieved 1.5 years after the start of CARE kV usage. T-test was used for significant difference in radiation dose. Results: Volume CTDIs and DLPs from 18 patients before and 24 patients after the use of CARE kV were obtained in a duration of one month. There is a slight increase in both average CTDIvol and average DLP with CARE kV compared to those without CARE kV (25.52 mGy vs. 22.65 mGy for CTDIvol; 1265.81 mGy-cm vs. 1199.19 mGy-cm). Statistically there was no significant difference. Without CARE kV, 140 kV was used in 9 of 18 patients, while with CARE KV, 140 kV was used in 15 of 24 patients. 80kV was not used in either group. Conclusion: The use of CARE kV may save time for protocol optimization and minimize variability among technologists. Radiation dose reduction was not observed in non-contrast examinations of CT abdomen/pelvis. This was partially because our CT protocols were tailored according to patient size before CARE kV and partially because of large size patients

  20. Mixed phenotype acute leukemia

    Institute of Scientific and Technical Information of China (English)

    Ye Zixing; Wang Shujie

    2014-01-01

    Objective To highlight the current understanding of mixed phenotype acute leukemia (MPAL).Data sources We collected the relevant articles in PubMed (from 1985 to present),using the terms "mixed phenotype acute leukemia","hybrid acute leukemia","biphenotypic acute leukemia",and "mixed lineage leukemia".We also collected the relevant studies in WanFang Data base (from 2000 to present),using the terms "mixed phenotype acute leukemia" and "hybrid acute leukemia".Study selection We included all relevant studies concerning mixed phenotype acute leukemia in English and Chinese version,with no limitation of research design.The duplicated articles are excluded.Results MPAL is a rare subgroup of acute leukemia which expresses the myeloid and lymphoid markers simultaneously.The clinical manifestations of MPAL are similar to other acute leukemias.The World Health Organization classification and the European Group for Immunological classification of Leukaemias 1998 cdteria are most widely used.MPAL does not have a standard therapy regimen.Its treatment depends mostly on the patient's unique immunophenotypic and cytogenetic features,and also the experience of individual physician.The lack of effective treatment contributes to an undesirable prognosis.Conclusion Our understanding about MPAL is still limited.The diagnostic criteria have not been unified.The treatment of MPAL remains to be investigated.The prognostic factor is largely unclear yet.A better diagnostic cdteria and targeted therapeutics will improve the therapy effect and a subsequently better prognosis.

  1. Clinical evaluation of digital radiography based on a large-area cesium iodide-amorphous silicon flat-panel detector compared with screen-film radiography for skeletal system and abdomen

    International Nuclear Information System (INIS)

    The aim of this clinical study was to compare the image quality of digital radiography using the new digital Bucky system based on a flat-panel detector with that of a conventional screen-film system for the skeletal structure and the abdomen. Fifty patients were examined using digital radiography with a flat-panel detector and screen-film systems, 25 for the skeletal structures and 25 for the abdomen. Six radiologists judged each paired image acquired under the same exposure parameters concerning three observation items for the bone and six items for the abdomen. Digital radiographic images for the bone were evaluated to be similar to screen-film images at the mean of 42.2%, to be superior at 50.2%, and to be inferior at 7.6%. Digital radiographic images for the abdomen were judged to be similar to screen-film images at the mean of 43.4%, superior at 52.4%, and inferior at 4.2%; thus, digital radiographic images were estimated to be either similar as or superior to screen-film images at over 92% for the bone and abdomen. On the statistical analysis, digital radiographic images were also judged to be preferred significantly in the most items for the bone and abdomen. In conclusion, the image quality of digital radiography with a flat-panel detector was superior to that of a screen-film system under the same exposure parameters, suggesting that dose reduction is possible with digital radiography. (orig.)

  2. Función del diafragma durante la colocación de cargas sobre el abdomen en sujetos normales Study of diaphragmatic muscle function during abdominal weight in normal subjects

    OpenAIRE

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

    2012-01-01

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

  3. Cloth Structural Design for Different Raised Abdomen Body%不同凸腹体服装的结构设计

    Institute of Scientific and Technical Information of China (English)

    肖柳庆

    2012-01-01

    根据幼儿、中老年凸腹者、孕妇三种凸腹体的生活和体型特征,运用服装腰节线平衡原理,进行服装结构设计,比较不同凸腹体服装结构设计的异同。%According to the living and body characteristics of three typical raised abdomen grounps including baby,pregnant woman and middle-old aged person,it employed body cloth balance principal to design the structure of cloth,and compared the structural difference of the three different kinds of clothes.

  4. A cross-platform survey of CT image quality and dose from routine abdomen protocols and a method to systematically standardize image quality

    Science.gov (United States)

    Favazza, Christopher P.; Duan, Xinhui; Zhang, Yi; Yu, Lifeng; Leng, Shuai; Kofler, James M.; Bruesewitz, Michael R.; McCollough, Cynthia H.

    2015-11-01

    Through this investigation we developed a methodology to evaluate and standardize CT image quality from routine abdomen protocols across different manufacturers and models. The influence of manufacturer-specific automated exposure control systems on image quality was directly assessed to standardize performance across a range of patient sizes. We evaluated 16 CT scanners across our health system, including Siemens, GE, and Toshiba models. Using each practice’s routine abdomen protocol, we measured spatial resolution, image noise, and scanner radiation output (CTDIvol). Axial and in-plane spatial resolutions were assessed through slice sensitivity profile (SSP) and modulation transfer function (MTF) measurements, respectively. Image noise and CTDIvol values were obtained for three different phantom sizes. SSP measurements demonstrated a bimodal distribution in slice widths: an average of 6.2  ±  0.2 mm using GE’s ‘Plus’ mode reconstruction setting and 5.0  ±  0.1 mm for all other scanners. MTF curves were similar for all scanners. Average spatial frequencies at 50%, 10%, and 2% MTF values were 3.24  ±  0.37, 6.20  ±  0.34, and 7.84  ±  0.70 lp cm-1, respectively. For all phantom sizes, image noise and CTDIvol varied considerably: 6.5-13.3 HU (noise) and 4.8-13.3 mGy (CTDIvol) for the smallest phantom; 9.1-18.4 HU and 9.3-28.8 mGy for the medium phantom; and 7.8-23.4 HU and 16.0-48.1 mGy for the largest phantom. Using these measurements and benchmark SSP, MTF, and image noise targets, CT image quality can be standardized across a range of patient sizes.

  5. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  6. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H;

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  7. [Acute kidney injury

    NARCIS (Netherlands)

    Hageman, D.; Kooman, J.P.; Lance, M.D.; Heurn, L.W. van; 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. Acute dysautonomia following mumps.

    Directory of Open Access Journals (Sweden)

    Mathuranath P

    1999-04-01

    Full Text Available Pure acute or subacute dysautonomia is a rare entity. Its etiology is as yet unknown. However, majority of these cases have a preceding viral infection such as herpes simplex, infectious mononucleosis, rubella or coxsackie B. A unique patient in whom acute dysautonomia followed mumps is reported.

  9. Acute dysautonomia following mumps.

    OpenAIRE

    Mathuranath P; Duralpandian J; Kishore A

    1999-01-01

    Pure acute or subacute dysautonomia is a rare entity. Its etiology is as yet unknown. However, majority of these cases have a preceding viral infection such as herpes simplex, infectious mononucleosis, rubella or coxsackie B. A unique patient in whom acute dysautonomia followed mumps is reported.

  10. Serum amylase and lipase in the evaluation of acute abdominal pain.

    Science.gov (United States)

    Chase, C W; Barker, D E; Russell, W L; Burns, R P

    1996-12-01

    The purpose of this study was to determine 1) the incidence and magnitude of elevation in admission serum amylase and lipase levels in extrapancreatic etiologies of acute abdominal pain, and 2) the test most closely associated with the diagnosis of acute pancreatitis. Serum amylase and lipase levels were obtained in 306 patients admitted for evaluation of acute abdominal pain. Patients were categorized by anatomic location of identified pathology. Logistic regression analysis was used to compare the enzyme levels between patient groups and to determine the correlation between elevation in serum amylase and lipase. Twenty-seven (13%) of 208 patients with an extrapancreatic etiology of acute abdominal pain demonstrated an elevated admission serum amylase level with a maximum value of 385 units (U)/L (normal range 30-110 U/L). Twenty-six (12.5%) of these 208 patients had an elevated admission serum lipase value with a maximum of 3685 U/L (normal range 5-208 U/L). Of 48 patients with abdominal pain resulting from acute pancreatitis, admission serum amylase ranged from 30 to 7680 U/L and lipase ranged from 5 to 90,654 U/L. Both serum amylase and lipase elevations were positively associated with a correct diagnosis of acute pancreatitis (P pancreatic disease processes. Serum amylase and lipase levels may be elevated in nonpancreatic disease processes of the abdomen. Significant elevations (greater than three times upper limit of normal) in either enzyme are uncommon in these disorders. The strong correlation between elevations in the two serum enzymes in both pancreatic and extrapancreatic etiologies of abdominal pain makes them redundant measures. Serum lipase is a better test than serum amylase either to exclude or to support a diagnosis of acute pancreatitis.

  11. Secondary pancreatic involvement by a diffuse large B-cell lymphoma presenting as acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    M Wasif Saif; Sapna Khubchandani; Marek Walczak

    2007-01-01

    Diffuse large B-cell lymphoma is the most common type of non-Hodgkin's lymphoma. More than 50% of patients have some site of extra-nodal involvement at diagnosis,including the gastrointestinal tract and bone marrow.However, a diffuse large B-cell lymphoma presenting as acute pancreatitis is rare. A 57-year-old female presented with abdominal pain and matted lymph nodes in her axilla. She was admitted with a diagnosis of acute pancreatitis. Abdominal computed tomography (CT) scan showed diffusely enlarged pancreas due to infiltrative neoplasm and peripancreatic lymphadenopathy. Biopsy of the axillary mass revealed a large B-cell lymphoma.The patient was classified as stage Ⅳ, based on the Ann Arbor Classification, and as having a high-risk lymphoma,based on the International Prognostic Index. She was started on chemotherapy with CHOP (cyclophosphamide,doxorubicin, vincristine and prednisone). Within a week after chemotherapy, the patient's abdominal pain resolved. Follow-up CT scan of the abdomen revealed a marked decrease in the size of the pancreas and peripancreatic lymphadenopathy. A literature search revealed only seven cases of primary involvement of the pancreas in B-cell lymphoma presenting as acute pancreatitis. However, only one case of secondary pancreatic involvement by B-cell lymphoma presenting as acute pancreatitis has been published. Our case appears to be the second report of such a manifestation.Both cases responded well to chemotherapy.

  12. ACUTE PERFORATED PEPTIC ULCER: A CLINICAL, DIAGNOSTIC AND MANAGEMENT ANALYSIS IN A TERTIARY HOSPITAL OF TELANGANA

    Directory of Open Access Journals (Sweden)

    Boda

    2015-12-01

    Full Text Available Treatment of Peptic Ulcer Disease in major hospitals is now limited to managing their complications like perforations of stomach or duodenum. This is also a common cause of peritonitis and remains a challenge to the surgeon. Diagnosis is based on clinical parameters like pain in the abdomen, shock, abdominal guarding/rigidity and abdominal distension. The diagnosis is confirmed by ultrasound examination of the abdomen, x-ray abdomen in erect posture. The predisposing factors include the age, smoking, alcohol intake, steroids and NSAIDs usage. The risk factors of mortality are presence of shock and pre-existing medical conditions and time of arrival to the casualty. The mortality and morbidity may be predicted using different scoring systems like ASA scoring and Boey’s scoring. AIM To analyze the different risk factors, clinical features and surgical treatment options of Acute Peptic Ulcer perforation in patients attending a Tertiary Hospital. To evaluate the prognostic factors causing death and complications in this condition. MATERIALS AND METHODS One hundred and sixty five patients attending with signs and symptoms of Acute Perforation of Peptic Ulcer were included. Males were predominantly affected than females with a 1.94:1 ratio. The median duration of illness was 9.64 days. History of smoking in 93.5%, NSAIDs in 78%, alcohol intake in 93.8% and steroids in 84% of the patients was present. Previous history of peptic ulcer disease was reported in 90% of the patients. Gastric ulcers were more common than with duodenal ulcer with a ratio of 1.32:1. The mortality rate was 6.66%. Among the complications wound infection was highest with 26% followed by paralytic ileus 23%. ASA and Boey’s scoring showed statistical significance in predicting the mortality with a P value of 0.00003. RESULTS The incidence of APPU was 0.35% of the total 46080 emergency surgical patients in a 4-year period. The incidence was high among the manual laborers and in

  13. ERCP in acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Jijo V Cherian; Joye Varghese Selvaraj; Rajesh Natrayan; Jayanthi Venkataraman

    2007-01-01

    BACKGROUND:The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute pancreatitis has evolved over years since its introduction in 1968. Its importance in diagnosing the etiology of pancreatitis has steadily declined with the advent of less invasive diagnostic tools. The therapeutic implications of ERCP in acute pancreatitis are many fold and are directed towards management of known etiological factors or its related complications. This article highlights the current status of ERCP in acute pancreatitis. DATA SOURCES:An English literature search using PubMed database was conducted on ERCP in acute pancreatitis, the etiologies and complications of pancreatitis amenable to endotherapy and other related subjects, which were reviewed. RESULTS: ERCP serves as a primary therapeutic modality for management of biliary pancreatitis in speciifc situations, pancreatitis due to microlithiasis, speciifc types of sphincter of Oddi dysfunction, pancreas divisum, ascariasis and malignancy. In recurrent acute pancreatitis and smoldering pancreatitis it has a deifnite therapeutic utility. Complications of acute pancreatitis including pancreatic-duct disruptions or leaks, benign pancreatic-lfuid collections and pancreatic necrosis can be beneifcially dealt with. Intraductal ultrasound and pancreatoscopy during ERCP are useful in detecting pancreatic malignancy. CONCLUSIONS:The role of ERCP in acute pancreatitis is predominantly therapeutic and occasionally diagnostic. Its role in the management continues to evolve and advanced invasive procedures should be undertaken only in centers dedicated to pancreatic care.

  14. Informative content of clinical symptoms of acute appendicitis in different terms of pregnancy

    Directory of Open Access Journals (Sweden)

    Kutovoy A.B.

    2015-09-01

    Full Text Available With the purpose to evaluate diagnostic efficacy of some clinical symptoms of acute appendicitis 75 women in different terms of pregnancy were examined. Informative content of such symptoms as Kocher- Volkovich, Rovsing, Bartomje - Michelson, Sitkovsky, Gabay, Brendo, Michelson, Ivanov was studied. Pain syndrome was fixed in all examined women. Pain localization was various and depended on the pregnancy term. During the I trimester of pregnancy the most often pain was manifestated in epigastrium and right lower quadrant, rarely in other abdomen regions. In the II trimester in majority of cases pain occurred in right lower quadrant. During III trimester pain prevailed in right upper quadrant of abdomen. Analyzing informative component of researching symptoms there was noted significant decrease (р<0,05; р<0,01; р<0,001 of their diagnostic value with growth of pregnancy term. Therefore Kocher – Volkovich and Rovsing symptoms were the most informative in the I trimester of pregnancy. Diagnostic efficacy of Brendo(67,3%, Michelson(55,7%, Ivanov(59,6% symptoms was higher than that of Kocher – Volkovich (36,5%, Rovsing (28,8%, Sitkovsky (51,9%, Bartomje – Michelson (55,7% symptoms, their value was diminishing together with increase of pregnancy terms.

  15. Acute Brucella Hepatitis in an Urban Patient

    Directory of Open Access Journals (Sweden)

    Seyed Moayed Alavian

    2009-11-01

    Full Text Available A 35-year-old man was referred to our center because of low grade fever, vomiting, yellow sclera, and tenderness in the upper-right quadrant of his abdomen. Laboratory tests showed a white blood cell (WBC of 7100/µL, a platelet of 184,000/µL, an erythrocyte sedimentation rate (ESR of 4 mm/h, an alanine aminotransferase (ALT of 525 U/L, an aspartate aminotransferase AST of 142 U/L, a total bilirubin level of 4.23 mg/dL, and a direct bilirubin level of 3.16 mg/dL. Viral hepatitis markers, immunoglobuline M antibody to cytomegalovirus (anti-CMV IgM, Ebstein-Barr virus (EBV IgM, and immunologic markers of autoimmune hepatitis were negative. The patient was diagnosed with acute hepatitis. Alkaline phosphatase was in the normal range throughout the course of the disease. Because of the patient's occupation as a butcher and his history of eating semi-cooked sheep testes, serologic tests of brucellosis were conducted; the tests came out positive. We were concerned about the hepatotoxicity of standard regimens; therefore, we started treatment with streptomycin and ciprofloxacin regimens. Although liver enzyme had fallen and fever discontinued, the total and direct bilirubin concentrations in the patient's serum both increased in spite of using 2 weeks of the abovementioned drug regimen. The elevation of bilirubin could have been due to drug hepatotoxicity. Alternatively, a regimen containing ciprofloxacin may have not have been efficient enough and may have had effects on the direct bilirubin concentration. Fortunately, within 8 weeks, progressive recovery was noticed. Brucellosis should be considered in the differential diagnosis of fever and hepatitis for those who live in endemic areas, especially if his/her job was at high risk for acquiring brucellosis. We recommend taking a careful occupational and behavioral history for patients with acute hepatitis syndrome. We assumed that ciprofloxacin was not suitable for brucella hepatitis treatment and

  16. Quantitative analysis of the {sup 18}F-F.D.G. harnessing in the aneurysm walls of abdomen aorta; Analyse quantitative de la captation du 18F-FGD dans les parois d'anevrismes de l'aorte abdominale

    Energy Technology Data Exchange (ETDEWEB)

    Meneroux, B.; Djaballah, W.; Koehl, G.; Olivier, P.; Karcher, G.; Marie, P.Y. [Service de medecine nucleaire, CHU de Nancy, (France); Mandry, D.; Regent, D. [service de radiologie, CHU de Nancy, (France); Veyre, L.; Rossignol, P. [CIC Nancy (France)

    2009-05-15

    The measurements using the maximal parietal activities seem the most reproducible and the most steady when the PET imaging is used to appreciate the inflammatory reaction of abdomen aorta aneurysms treated medically. Preliminary results suggest that an increase of this activity and so, of the inflammatory reaction, accompanies effectively the fast growth of abdomen aorta aneurysms. (N.C.)

  17. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  18. Acute pancreatitis; Pancreatite aigue

    Energy Technology Data Exchange (ETDEWEB)

    Mehdi, M.; Deutsch, J.P.; Arrive, L.; Ayadi, K.; Ladeb, M.F.; Tubiana, J.M. [Centre Hospitalier Universitaire Saint-Antoine, 75 - Paris (France)

    1996-12-31

    The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients. (authors). 20 refs., 12 figs., 4 tabs.

  19. Low back pain (acute)

    OpenAIRE

    Koes, B; Tulder, van, M.W.

    2011-01-01

    Low back pain is pain, muscle tension, or stiffness, localised below the costal margin and above the inferior gluteal folds, with or without referred or radicular leg pain (sciatica), and is defined as acute when pain persists for less than 12 weeks. Low back pain affects about 70% of people in resource-rich countries at some point.Acute low back pain is usually self-limiting, although 2-7% develop chronic pain. Acute low back pain has a high recurrence rate with less-painful symptoms recu...

  20. Acute acalculous cholecystitis complicating chemotherapy for acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Olfa Kassar

    2015-01-01

    Full Text Available Acute acalculous cholecystitis is a rare complication in the treatment of acute myeloblastic leukemia. Diagnosis of acute acalculous cholecystitis remains difficult during neutropenic period. We present two acute myeloblastic leukemia patients that developed acute acalculous cholecystitis during chemotherapy-induced neutropenia. They suffered from fever, vomiting and acute pain in the epigastrium. Ultrasound demonstrated an acalculous gallbladder. Surgical management was required in one patient and conservative treatment was attempted in the other patient. None treatment measures were effective and two patients died. Acute acalculous cholecystitis is a serious complication in neutropenic patients. Earlier diagnosis could have expedited the management of these patients.

  1. Nutrition, Inflammation, and Acute Pancreatitis

    OpenAIRE

    Max Petrov

    2013-01-01

    Acute pancreatitis is acute inflammatory disease of the pancreas. Nutrition has a number of anti-inflammatory effects that could affect outcomes of patients with pancreatitis. Further, it is the most promising nonspecific treatment modality in acute pancreatitis to date. This paper summarizes the best available evidence regarding the use of nutrition with a view of optimising clinical management of patients with acute pancreatitis.

  2. Acute respiratory distress syndrome

    Science.gov (United States)

    ... chap 33. Lee WL, Slutsky AS. Acute hypoxemic respiratory failure and ARDS. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

  3. Treatment of acute gout.

    Science.gov (United States)

    Schlesinger, Naomi

    2014-05-01

    This article presents an overview of the treatment of acute gout. Nonpharmacologic and pharmacologic treatments, monotherapy versus combination therapy, suggested recommendations, guidelines for treatment, and drugs under development are discussed.

  4. Acute genital ulcers.

    Science.gov (United States)

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-28

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers.

  5. Acute respiratory distress syndrome

    Science.gov (United States)

    ... chap 33. Lee WL, Slutsky AS. Acute hypoxemic respiratory failure and ARDS. In: Broaddus VC, Mason RJ, Ernst ... A.M. Editorial team. Related MedlinePlus Health Topics Respiratory Failure Browse the Encyclopedia A.D.A.M., Inc. ...

  6. Acute mountain sickness

    Science.gov (United States)

    High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. The faster you ...

  7. Acute liver failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Bjerring, Peter Nissen

    2011-01-01

    Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these.......Acute liver failure (ALF) results in a multitude of serious complications that often lead to multi-organ failure. This brief review focuses on the pathophysiological processes in ALF and how to manage these....

  8. Acute lymphocytic Leukemia masquerading as acute osteomyelitis

    International Nuclear Information System (INIS)

    Two children each developed a focal destructive bone lesion accompanied by intermittent fever, swelling, tenderness and elevated ESR. Blood counts were normal; bone marrow aspiration showed acute leukemia. The bone lesions healed in both patients after anti-leukemic therapy. We suggest that the similar roentgenographic appearance of osteomyelitis, bone infarction and focal destructive lesions in leukemia probably reflects a common, basically ischemic process of bone. (orig.)

  9. Teníase: uma causa rara de apendicite aguda Taeniasis: a rare cause of acute appendicitis

    Directory of Open Access Journals (Sweden)

    Fábio Vieira Teixeira

    2008-02-01

    Full Text Available Acute appendicitis is the most common surgical condition of acute abdomen. Approximately 7 percent of the population will have appendicitis during their lifetime, with the peak incidence occurring between 10 through 30 years-old. Obstruction of the appendix lumen with subsequent bacterial infection initiates the pathophysiological sequence of acute appendicitis. Obstruction may have multiple causes, including fecalith, lymphoid hyperplasia (related to viral illnesses, including upper respiratory infection, mononucleosis, and gastroenteritis, foreign bodies, carcinoid tumor, and parasites. In Asia, Africa and Latin America, Enterobius vermicularis has been reported as the main parasite that causes appendix obstruction. Rarely, Taenia sp., has been pointed as a cause of parasitic appendicitis. We reported a 30 years-old patient clinically diagnosed with acute appendicitis. The appendectomy was performed through a McBurney incision. The patient's convalescence was uneventful, and he was discharged from hospital 48 hours after operation. Histological examination of the appendix showed acute appendicitis, and it was found a parasite (Taenia sp. lying inside of the appendix lumen at a transverse section. He has received 10 mg/Kg weight of praziquantel for taeniasis treatment.

  10. RETROSPECTIVE AND PROSPECTIVE STUDY OF MANAGEMENT AND OUTCOME OF BLUNT ABDOMEN TRAUMA IN TERTIARY HEALTH CENTER IN LAST 5 - YEAR 2009 - 2014

    Directory of Open Access Journals (Sweden)

    Raikwar

    2015-05-01

    Full Text Available AIMS: 1. To study the incidence of various intra - abdominal and extra - abdominal injuries in blunt abdominal trauma in tertiary health care center in five year (2009 - 14 . 2 . To study the relationship between mode of injury , severity of injury and clinical presentation and its outcome , mortality and morbidity. 3 . To study modalities for evaluating the abdomen after blunt abdominal trauma. 4 . To evaluate the major indication for operation in each cases . 5 . To study of outcome , mortality and morbidity . SETTINGS AND DESIGN: This study carried out in the Department of Surgery , MGM Medical College , M.Y. Hospital Indore and Trauma Department , M.Y. Hospital Indore both retrospectively and prospectively in patients with Blunt abdominal trauma over the period of from 2009 to 2014 with co - operation of the staff of Medicolegal section , Central record room and residents looking after the admitted pat ients. MATERIALS AND METHODS: On admission to hospital patient’s name , age , sex , address , registration number and date and time of admission , length of delay in treatment taken noted and mode of trauma also noted. Patient’s presenting complaint , detail his tory and time of trauma noted. RESULTS: During this study total 250 admission were included 170 ( P rospective and 80 ( R etrospective. There were over all 201 males (80.4% and 49 female (19.6%. Mortality was maximum due to RTA 64.52%. Highest number of ca ses (65 in the third decade i.e. 26%. Among these injuries hemoperitoneum was found in 94 cases i.e.37.6%. Small intestine (ileal>jejunal injury 45 cases i.e. , 18% was most common hollow viscous injury. In solid organ injury there was maximum incidence o f liver injury 34 cases. i.e. , 13.6% . CONCLUSION: This study concludes that young males are more prone to trauma and maximum blunt trauma is asso ciated with RTA. Almost half of patients required laparotomy and found injury to liver and small intestine in max cases. Overall

  11. Acute Myeloid Leukemia Presenting as Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Sherri Rauenzahn

    2013-01-01

    Full Text Available Appendicitis in leukemic patients is uncommon but associated with increased mortality. Additionally, leukemic cell infiltration of the appendix is extremely rare. While appendectomy is the treatment of choice for these patients, diagnosis and management of leukemia have a greater impact on remission and survival. A 59-year-old Caucasian female was admitted to the surgical service with acute right lower quadrant pain, nausea, and anorexia. She was noted to have leukocytosis, anemia, and thrombocytopenia. Abdominal imaging demonstrated appendicitis with retroperitoneal and mesenteric lymphadenopathy for which she underwent laparoscopic appendectomy. Peripheral smear, bone marrow biopsy, and surgical pathology of the appendix demonstrated acute myeloid leukemia (AML with nonsuppurative appendicitis. In the setting of AML, prior cases described the development of appendicitis with active chemotherapy. Of these cases, less than ten patients had leukemic infiltration of the appendix, leading to leukostasis and nonsuppurative appendicitis. Acute appendicitis with leukemic infiltration as the initial manifestation of AML has only been described in two other cases in the literature with an average associated morbidity of 32.6 days. The prompt management in this case of appendicitis and AML resulted in an overall survival of 185 days.

  12. Successful transgastric cytogastrostomy in a dog with acute pancreatitis and pancreatic pseudocyst complications

    International Nuclear Information System (INIS)

    A five-year-old, spayed female mixed breed dog was presented after four weeks of vomiting and anorexia, and was diagnosed with acute pancreatitis. A large, anechoic mass having no blood flow organization was seen adjoining the stomach in an ultrasonic examination of the abdomen. A large ball-like mass protruded from the stomach pylorus under mucous membrane causing stricture of the stomach, and obstructing the transit. A low-density mass of consistent texture extending from the left limb of the main mass was confirmed by CT. A celiotomy was performed and a pancreatic cyst was confirmed. A transgastric cytogastrostomy was performed to treat the pancreatic pseudocyst. Clinical signs resolved following surgery, and 16 months after surgery there have been no complications

  13. Peritonitis Aguda por Diverticulo Apendicular Perforado / Acute perforated diverticulum appendiceal peritonitis

    Directory of Open Access Journals (Sweden)

    Martinez Villalba N

    2015-11-01

    Full Text Available Appendix diverticular disease is a casual finding after appendectomies or pathological studies of surgical samples. Most patients are male adults between the fourth and fifth decade of life. 16 years old male consults for a 48 hours stitch pain in right iliac fossa of moderate intensity radiating to lower abdomen with nausea and fever, without vomiting or diarrhea. Presents lower abdominal pain with muscle guarding and pain on physical examination. Bowel sounds negative. Laboratory routine study shows leukocytosis with neutrophilia. A perforated diverticulum of about 15cm diameter is found during surgery in the middle third of the cecum appendix with 200cc purulent fluid in and multiple adhesions to transverse colon, omentum and small intestine. A conventional appendectomy is performed. Acute appendix diverticulitis is a rare entity and its finding is by casualty. It is important to consider it a differential diagnosis especially in the intraoperative treatment which in most cases does not differ from conventional appendectomy.

  14. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

  15. Perfusion measurement of the whole upper abdomen of patients with and without liver diseases: Initial experience with 320-detector row CT

    International Nuclear Information System (INIS)

    Objectives: To report initial experience of upper abdominal perfusion measurement with 320-detector row CT (CTP) for assessment of liver diseases and therapeutic effects. Materials and methods: Thirty-eight patients who were suspected of having a liver disease underwent CTP. There were two patients with liver metastases, two with hemangiomas, and four with cirrhosis (disease group). CTP was repeated for four patients with cirrhosis or hepatocellular carcinoma (HCC) after therapy. Hepatic arterial and portal perfusion (HAP and HPP) and arterial perfusion fraction (APF), and arterial perfusion (AP) of pancreas, spleen, stomach, and intra-portal HCC were calculated. For disease-free patients (normal group), the values were compared among liver segments and among pancreatic and gastric parts. The values were compared between groups and before and after therapy. Results: No significant differences were found in the normal group except between APFs for liver segments 3 and 5, and fundus and antrum. Mean HAP and APF for the disease group were significantly higher than for the normal group. APF increased after partial splenic embolization or creation of a transjugular intrahepatic portosystemic shunt. HPP increased and AP of intra-portal HCC decreased after successful radiotherapy. Conclusions: 320-Detector row CT makes it possible to conduct perfusion measurements of the whole upper abdomen. Our preliminary results suggested that estimated perfusion values have the potential to be used for evaluation of hepatic diseases and therapeutic effects

  16. Perfusion measurement of the whole upper abdomen of patients with and without liver diseases: Initial experience with 320-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Tomonori, E-mail: k_a@hotmail.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yoshikawa, Takeshi, E-mail: yoshikaw@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Fujisawa, Yasuko, E-mail: yasuko1.fujisawa@toshiba.co.jp [Toshiba Medical Systems Co., 1385 Shimoishigami, Otawara 324-0036 (Japan); Kanata, Naoki, E-mail: takikina12345@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yamaguchi, Masato, E-mail: masato03310402@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Seo, Yasushi, E-mail: yseo@med.kobe-u.ac.jp [Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate, School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yano, Yoshihiko, E-mail: yanoyo@med.kobe-u.ac.jp [Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate, School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Koyama, Hisanobu, E-mail: hkoyama@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Kitajima, Kazuhiro, E-mail: kazu10041976@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Takenaka, Daisuke, E-mail: daisuket@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); and others

    2012-10-15

    Objectives: To report initial experience of upper abdominal perfusion measurement with 320-detector row CT (CTP) for assessment of liver diseases and therapeutic effects. Materials and methods: Thirty-eight patients who were suspected of having a liver disease underwent CTP. There were two patients with liver metastases, two with hemangiomas, and four with cirrhosis (disease group). CTP was repeated for four patients with cirrhosis or hepatocellular carcinoma (HCC) after therapy. Hepatic arterial and portal perfusion (HAP and HPP) and arterial perfusion fraction (APF), and arterial perfusion (AP) of pancreas, spleen, stomach, and intra-portal HCC were calculated. For disease-free patients (normal group), the values were compared among liver segments and among pancreatic and gastric parts. The values were compared between groups and before and after therapy. Results: No significant differences were found in the normal group except between APFs for liver segments 3 and 5, and fundus and antrum. Mean HAP and APF for the disease group were significantly higher than for the normal group. APF increased after partial splenic embolization or creation of a transjugular intrahepatic portosystemic shunt. HPP increased and AP of intra-portal HCC decreased after successful radiotherapy. Conclusions: 320-Detector row CT makes it possible to conduct perfusion measurements of the whole upper abdomen. Our preliminary results suggested that estimated perfusion values have the potential to be used for evaluation of hepatic diseases and therapeutic effects.

  17. Realtime or Delayed Tele-Echography Using (A) a Robotic Arm, ISDN or Satellite Lines, (B) a Volumic Echographic Capture Mode and Internet (Application to Abdomen and Fetus)

    Science.gov (United States)

    Arbeille, Ph.; Cloppet, F.; Boucher, A.; Capri, A.; Vincent, N.

    2008-06-01

    Objective: to test (a) the tele-echography in realtime based on the use of a robotic arm, (b) the delayed tele echography using a volumic echographic capture and delayed processing. Method: A dedicated robotic arm (ESTELE) holding a real ultrasound probe is remotely controlled from the expert site with a fictive probe, and reproduces on the real probe all the movements of the expert hand. A dedicated motorized probe holder (TILTER) was used for tilting a 2D probe from -45 to +45°. Results: During fetal robotized Tele-echography (n=50) the expert was able to visualize and measure the fetal structures in 95% of the cases, while during abdomen echography (n=87) the expert visualized the main organs and lesions in 87% of the cases. The mean duration of the robotized tele echography session for one patient was 20+/-10 min. The delayed echography using the TILTER was tested on 40 patients. The organs were adequately visualized in 85% of the cases after 3 capture per organ. The average time from the first capture until the diagnostic was delivered was 40+/-10 minutes. Conclusion: Realtime or delayed Tele-echography provide similar information as direct examination in at least 85% of the cases. No false diagnostic was reported.

  18. Analysis on theory of treatment from abdomen for athletic injury%运动损伤病症从腹部论治的理论探析

    Institute of Scientific and Technical Information of China (English)

    刘晓亭; 董宝强; 张文静; 王树东

    2013-01-01

    从中医学和现代运动解剖学两方面对循行于腹部的经络及与腹部相关的功能解剖、生物力学进行研究,探讨运动损伤与腹部经络、脏腑、气血及现代解剖生理、病理之间的关系,为运动损伤病症从腹部论治提供理论依据,从而为运动损伤病症的治疗开辟新的思路.%The purpose of this thesis is to work over the abdominal meridian,functional anatomy and biological force line in term of traditional Chinese medicine theory and modern sport anatomy,to discuss the relations of athletic injury with abdominal meridian,Zang-Fu,Qi and blood,and with modern anatomical physiology and pathology.In this way,it provides basis for treating athletic injury from abdomen,thus develops new ways for athletic injury treatment.

  19. Computed tomography of the abdomen of calves during the first 105 days of life: II. Liver, spleen, and small and large intestines.

    Science.gov (United States)

    Braun, U; Schnetzler, C; Augsburger, H; Müller, U; Dicht, S; Ohlerth, S

    2014-05-01

    Computed tomography (CT) findings of the liver, spleen and intestines of five healthy calves during six examinations in the first 105 days of life were compared with corresponding cadaver slices. The liver was located in the right hemiabdomen adjacent to the diaphragm and right abdominal wall. The caudal vena cava was seen dorsomedially and the portal vein further ventrally. The umbilical vein was seen running from the navel to the liver in all calves in the first scan and in four calves in the second scan. The spleen ran dorsoventrally adjacent to the costal part of the left abdominal wall and appeared sickle-shaped on transverse images. Differentiation of small and large intestines was only possible when the former contained fluid content and the latter gaseous content. The small intestine was in the left hemiabdomen dorsal to the abomasum and caudodorsal to the rumen at the first two examinations. Growth of the forestomachs caused displacement of the small intestine to the right and toward the ventral abdomen caudal to the liver and adjacent to the right abdominal wall. The large intestine was located caudodorsally, and the typical features of the spiral colon were apparent in the dorsal plane. The location of the caecum varied from dorsal to the spiral colon to adjacent to the right abdominal wall with the apex always pointing caudally. The rectum was easily identified in the pelvic region. The size, volume and density of the described organs throughout the study are shown in several tables.

  20. Acute bronchial asthma.

    Science.gov (United States)

    Grover, Sudhanshu; Jindal, Atul; Bansal, Arun; Singhi, Sunit C

    2011-11-01

    Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the acute episode of asthma is judged clinically and categorized as mild, moderate and severe. The initial therapy consists of oxygen, inhaled beta-2 agonists (salbutamol or terbutaline), inhaled budesonide (three doses over 1 h, at 20 min interval) in all and ipratropium bromide and systemic steroids (hydrocortisone or methylprednisolone) in acute severe asthma. Other causes of acute onset wheeze and breathing difficulty such as pneumonia, foreign body, cardiac failure etc. should be ruled out with help of chest radiography and appropriate laboratory investigations in first time wheezers and those not responding to 1 h of inhaled therapy. In case of inadequate response or worsening, intravenous infusion of magnesium sulphate, terbutaline or aminophylline may be used. Magnesium sulphate is the safest and most effective alternative among these. Severe cases may need ICU care and rarely, ventilatory support. PMID:21769523

  1. Acute anuria after a family vacation to Corsica/France.

    Science.gov (United States)

    Richter, Joachim; Holtfreter, Martha; Mouahid, Gabriel; Moné, Hélène

    2016-04-01

    A 12-year-old male patient suffered hematuria. Histopathology of a biopsy showed granulomata suspicious for schistosomiasis. The patient had never travelled outside Europe during his entire lifetime. He had taken frequent bathes in various rivers during his last family holidays 5 months earlier in Corsica. Microfiltration of urine revealed viable ova of Schistosoma haematobium with alterated size and shape. Ultrasonography showed a large focal echopoor mass attached to the bladder roof. Four days after antihelminthic therapy, the patient suffered inferior abdominal pain and acute anuria. Ultrasound revealed an approximately 5-cm mass in the bladder lumen suspicious for a large blood clot. After taking non-invasive measures such as drinking high amounts of fluid and treating the lower abdomen with a warm water bag and massage, the clot was excreted with urine and symptoms subsided. The further course was uneventful until 11 months later when hematuria recurred. This time, parasitological urine examination confirmed non-viable schistosome ova. Hematuria was likely due to erosion of the bladder mucosa by calcified non-viable ova. PMID:26852123

  2. Assessment of recovery of the intestine after acute radiation injury

    Energy Technology Data Exchange (ETDEWEB)

    Baer, A.R.; Cheeseman, C.I.; Thomson, A.B.

    1987-02-01

    Several aspects of intestinal function and morphology are affected by acute radiation damage, including changes in the activity of proliferative cells in the crypts, immune cell populations, and the transport of various substrates. This study was designed to compare the time course of the recovery of intestinal proliferation, transport, and leukocyte population following radiation injury. Rats received a single dose of 6 Gy to the abdomen from a /sup 137/Cs source and were studied 3, 7, and 14 days later. No changes in the passive uptake of L-glucose or D-leucine were observed in the jejunum. Active transport of D-glucose and maximal water uptake were reduced at 3 days but had returned to normal by 7 days, whereas L-leucine uptake required more than 7 days to return to control levels. Mucosal permeability, assessed by an in vivo potential difference technique, remained increased 7 days after irradiation. Ornithine decarboxylase, an indicator of DNA synthetic activity, was elevated following radiation treatment and remained so even after 14 days. By comparison, myeloperoxidase activity, used as a quantitative monitor of granulocyte numbers, was still reduced after 7 days. These data indicate that while certain parameters of gut function may return to normal soon after radiation injury, the recovery of other factors is more prolonged. Thus the return of transport function to normal values post irradiation may be viewed as an adaptive change rather than simply the recovery of the tissue.

  3. Systemic tuberculosis presenting with acute transient myopia: a case report

    Directory of Open Access Journals (Sweden)

    Aslam Sher A

    2008-11-01

    Full Text Available Abstract Introduction Transient myopia has been reported to occur in a number of conditions, either ocular in origin or associated with an underlying systemic cause. We present a rare case of this abnormality occurring in the setting of systemic tuberculosis. Case presentation A 29-year-old Indian woman presented with sudden onset blurred distance vision and fever. Examination revealed visual acuity of counting fingers in both eyes improving to 6/9 with pinhole with N5 reading acuity. Anterior segment examination revealed narrow angles on gonioscopy. Posterior segments were normal. Systemic examination revealed a fluctuant mass in her left loin, aspiration of which yielded pus which was culture-positive for Mycobacterium tuberculosis. The Mantoux test elicited a strongly positive reaction. Chest X-ray and magnetic resonance imaging of the brain were unremarkable. Computed tomography scan and magnetic resonance imaging of the spine and abdomen revealed a large psoas abscess communicating with the loin mass. Two vertebrae were involved but not the spinal cord or canal. Conclusion Transient myopia is a rare presenting feature of systemic tuberculosis. A postulated mechanism in this patient is that development of a uveal effusion related to systemic tuberculosis caused anterior rotation of the iris-lens diaphragm, thereby inducing narrowing of the angle and acute myopia.

  4. Acute appendicitis presenting with abdominal wall and right groin abscess: A case report

    Institute of Scientific and Technical Information of China (English)

    Mustafa Yildiz; Ahmet Sevki Karakayali; Saadet Ozer; Hilal Ozer; Aydin Demir; Bugra Kaptanoglu

    2007-01-01

    We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.

  5. The mechanisms in treatment of acute pancreatitis by traditional Chinese medicine

    Institute of Scientific and Technical Information of China (English)

    Xiping Zhang; Ying Wang; Yan Shi

    2006-01-01

    As common acute abdomen, most of acute pancreatitis(AP) are self-restricted. Only a few patients may develop into worse state with local complications or organ failures, and finally neastic acute pancreatitis (NAP). With the change of people's dietaries, cholelithiasis morbidity and popularization of wine in recent years, the number of AP patients has increased.Although people conducted enormous studies on pathogenesis of AP and brought forward many be valuable theories, yet the exact mechanism is still unclear by far. There are many therapies of AP which should be unexceptionally classified as operative therapy and non-operative therapy. With the increasing understanding of the disease in recent years, we found many defects of operation and good therapeutic effects of traditional Chinese medicine in AP. Traditional Chinese medicine as an auxiliary therapy has been generally paid close attention in clinical practices. Traditional Chinese medicine is a treasure-house of China. This article summarizes the main mechanisms of AP treatment by traditional Chinese medicine and the progress of laboratory studies. It aims to help people recognize the multiple-target treatment effects and conspicuous efficacy of traditional Chinese medicine and promote the popularization of traditional Chinese medicine in AP treatment.

  6. Treatment of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Al-Mofleh Ibrahim

    1998-01-01

    Full Text Available There is no specific treatment for acute pancreatitis. Majority of patients with acute pancreatitis respond to medical therapy. Supportive measures and close observations represent the cornerstone of the medical therapy. Failure to respond to medical treatment may indicate choledocholithiasis or infected necrosis. Endoscopic papillotomy with stone retrieval is beneficial in patients with severe biliary pancreatitis. Image-guided fine needle aspiration and bacteriological examination of aspirate is reliable in detecting infection and deliniating causative pathogen. Surgical debridement is the method of choice for treatment of infected necrosis. In contrast, in pancreatic abscess, surgery is preserved for those, who do not respond to percutaneous drainage combined with antibiotics. The benefit of antisecretory and antiproteolytic agents is debatable. A combination of antioxidants, calcium channel antagonists and antibiotics may play a major role in the treatment of acute pancreatitis in the future.

  7. Acute pancreatitis in children

    Directory of Open Access Journals (Sweden)

    Jokić Radoica

    2012-01-01

    Full Text Available Introduction. Acute pancreatitis in children is mostly due to abdominal trauma, diseases or congenital anomalies of the biliary-pancreatic tree. Both exogenous and endogenous functions of the gland could be disturbed by various levels of damage. Clinical Finding and Diagnostics. Acute abdominal pain, gastrointestinal signs and general deterioration are the main clinical findings. The examination can be completed by blood and urine tests of amylase, electrolytes level, and the C-reactive protein. In addition to these tests, ultrasound, computed tomography and endoscopy are required as well. Therapeutic Methods. The therapy of choice is non-operative treatment using medicaments to control the pain, decrease the pancreatic activity and prevent further complications. If the conservative treatment fails, the surgical approach is necessary: drainage, resections, by-pass procedures, etc. Conclusion. Acute pancreatitis is a very serious disease in childhood. Clinical experience and rational approach are very important in the diagnostic and therapeutic methods.

  8. Acute management of stones

    DEFF Research Database (Denmark)

    Jung, Helene; Osther, Palle J S

    2015-01-01

    INTRODUCTION: Stone management is often conservative due to a high spontaneous stone passage rate or non-symptomatic calyceal stones that do not necessarily require active treatment. However, stone disease may cause symptoms and complications requiring urgent intervention. MATERIAL AND METHODS......: In this review, we update latest research and current recommendations regarding acute management of stones, with particular focus on imaging, pain management, active stone interventions, medical expulsive therapy, and urolithiasis in pregnancy and childhood. RESULTS: Acute stone management should be planned...... with careful consideration of stone size and location, symptoms, patient comorbidity and radiation dose. CONCLUSION: In case of infective hydronephrosis, compromised renal function or persistent pain despite adequate analgesic treatment acute intervention is indicated....

  9. Acute acalculous cholecystitis.

    Science.gov (United States)

    Barie, Philip S; Eachempati, Soumitra R

    2003-08-01

    Acute cholecystitis can develop without gallstones in critically ill or injured patients. However, the development of acute acalculous cholecystitis is not limited to surgical or injured patients, or even to the intensive care unit. Diabetes, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, and shock or cardiac arrest have been associated with acute acalculous cholecystitis. Children may also be affected, especially after a viral illness. The pathogenesis of acute acalculous cholecystitis is a paradigm of complexity. Ischemia and reperfusion injury, or the effects of eicosanoid proinflammatory mediators, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and total parenteral nutrition have all been implicated. Ultrasound of the gallbladder is the most accurate diagnostic modality in the critically ill patient, with gallbladder wall thickness of 3.5 mm or greater and pericholecystic fluid being the two most reliable criteria. The historical treatment of choice for acute acalculous cholecystitis has been cholecystectomy, but percutaneous cholecystostomy is now the mainstay of therapy, controlling the disease in about 85% of patients. Rapid improvement can be expected when the procedure is performed properly. The mortality rates (historically about 30%) for percutaneous and open cholecystostomy appear to be similar, reflecting the severity of illness, but improved resuscitation and critical care may portend a decreased risk of death. Interval cholecystectomy is usually not indicated after acute acalculous cholecystitis in survivors; if the absence of gallstones is confirmed and the precipitating disorder has been controlled, the cholecystostomy tube can be pulled out after the patient has recovered. PMID:12864960

  10. Acute pancreatitis: Manifestation of acute HIV infection in an adolescent

    OpenAIRE

    Bitar, Anas; Altaf, Muhammad; Sferra, Thomas J.

    2012-01-01

    Summary Background: Pancreatitis in the pediatric age group is not as common as in adults. Etiologies are various and differ from those in adults. Although infectious etiology accounts for a significant number of cases of pancreatitis, acute infection with Human Immunodeficiency Virus (HIV) was rarely reported as a possible etiology for acute pancreatitis in adults. Acute pancreatitis has never been reported as a presenting manifestation of acute HIV infection in children. Case Report: We des...

  11. Acute acalculous cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Fox, M.S.; Wilk, P.J.; Weissmann, H.S.; Freeman, L.M.; Gliedman, M.L.

    1984-07-01

    Sixty-eight patients with acute acalculous cholecystitis were reviewed. The results of history and physical examinations were usually nondiagnostic. IDA cholescintigraphy (93 per cent accuracy rate) was the only reliable diagnostic modality. The results of oral cholecystography, intravenous cholangiography and ultrasonography were considerably less reliable. One-half of the patients had gangrenous cholecystitis. Cholecystectomy was the preferred operation with an over-all mortality of 9 per cent. IDA cholescintigraphy is an important new modality for the diagnosis of acute acalculous cholecystitis which, in the past, has often been difficult to diagnose.

  12. Congenital acute megakaryocytic leukemia

    Directory of Open Access Journals (Sweden)

    N B Mathur

    2011-01-01

    Full Text Available Congenital leukemia (CL is an extremely rare disorder in the newborn, significant proportion of which is of myeloid origin, primarily of M4 or M5 morphology. As compared to pediatric leukemia, CL is a more aggressive disease. Acute myeloid leukemia (AML-M7 or acute megakaryocytic leukemia is a rare type of AML with an incidence of 0.5 per million per year. Median age of presentation is 6 years, and children may present with a broad variety of symptoms including low-grade fever, diarrhea, easy bruising, failure to gain weight and life-threatening conditions.

  13. Acute myocardial infarct imaging

    International Nuclear Information System (INIS)

    A brief review is presented of radiopharmaceuticals used for imaging acute myocardial infarction and instrumentation using the rectilinear scanner and the scintillation camera. Clinical experience indicates that myocardial imaging with /sup 99 m/Tc pyrophosphate is a useful adjunct to the electrocardiogram and serum enzyme activity in managing patients with myocardial infarction. The technique allows rapid diagnosis, accurate localization, and an estimate of the size of acute infarcts. It can also be used to document infarct extension and in association with myocardial perfusion imaging can help differentiate fresh from old myocardial infarction

  14. Acute Gynecologic Disorders.

    Science.gov (United States)

    Donaldson, Carolyn K

    2015-11-01

    Premenopausal women with acute pelvic pain comprise a significant percentage of patients who present to the emergency room. Etiologies can be gynecologic, urologic, gastrointestinal, or vascular. Signs and symptoms are often nonspecific and overlapping. The choice of imaging modality is determined by the clinically suspected differential diagnosis. Ultrasound (US) is the preferred imaging modality for suspected obstetric or gynecologic disorders. CT is more useful when gastrointestinal or urinary tract pathology is likely. MR imaging is rarely used in the emergent setting, except to exclude appendicitis in pregnant women. This article presents a comprehensive review of imaging of acute gynecologic disorders. PMID:26526439

  15. Impact of the SPECT/T.D.M. with leukocytes labelled with 99mTc-H.M.P.A.O. in the detection of abdomen vascular prosthesis infections

    International Nuclear Information System (INIS)

    Objectives: to enlighten the contribution of specificity of SPECT/T.D.M. with leucocytes labelled with 99mTc-H.M.P.A.O. in the detection of abdomen vascular prosthesis infection and the interest to free oneself of physiological digestive background noise artefacts.Conclusions: The scintigraphy with leukocytes labelled with 99mTc-H.M.P.A.O. is a noticeable examination for the detection of infectious centres. The contribution of the SPECT/T.D.M. at 24 hours in the detection of infectious centres of vascular prosthesis allows to increase the examination specificity, especially for the abdomen vascular prosthesis, by freeing oneself of the physiological digestive background noise able to induce false positives, and allows a precise anatomical location with a therapy impact for the patient. (N.C.)

  16. Malignant schwannoma of the abdomen; Malignes Schwannom des Abdomens

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C. [Abt. fuer Diagnostische Radiologie, Universitaetsklinikum Ulm (Germany); Kolokythas, O. [Abt. fuer Pathologie, Universitaetsklinikum Ulm (Germany); Aschoff, A.J. [Abt. fuer Diagnostische Radiologie, Universitaetsklinikum Ulm (Germany); Merkle, E. [Abt. fuer Diagnostische Radiologie, Universitaetsklinikum Ulm (Germany)

    1996-05-01

    A 63 year-old female patient presented herself because of abdominal distension, without being able to report specific complaints. Clinical examination found a well palpable, elastic and engorged abdominal tumour approximately of the size of a football. Conventional imaging of the small intestine according to Sellink with subsequent delayed film revealed in the first instance a displacement of intestinal loops and of the colon frame, with no signs of an onstruction. A similar diagnosis resulted from intraarterial angiography of the abdominal vessels, showing a displacement of the truncus coeliacus, and the A. mesenterica superior. There were no signs of vascular occlusions or pathologic tumour vessels. Surgery revealed a tumour of about 10 kg, with pathologic vascular connection and a broad area of contact to neighbouring intestinal loops. Control CT performed one year after surgery revealed newly developed, multiple, nodular formations, their structure and contrast signs being similar to those of the primary tumour. (orig./VHE) [Deutsch] Eine 63jaehrige Patientin stellte sich mit einer Zunahme des Bauchumfanges vor. Ausgepraegte Beschwerden waren nicht zu erfragen. Klinisch fiel ein gut palpabler, prall elastischer, etwa fussballgrosser Abdominaltumor auf. Die konventionelle Duenndarmdarstellung nach Sellink mit nachfolgenden Spaetaufnahmen zeigte in erster Linie eine Verlagerung der Darmschlingen und des Kolonrahmens ohne Nachweis einer Obstruktion. Einen aehnlichen Befund ergab die intraarterielle Angiographie der Bauchgefaesse mit einer Verlagerung des Truncus coeliacus und der A. mesenterica superior. Gefaessverschluesse oder pathologische Tumorgefaesse kamen jedoch nicht zur Darstellung. Intraoperativ wurde ein ca. 10 kg schwerer Tumor mit pathologischer Gefaessverbindung und breitem Kontakt zu benachbarten Darmschlingen gefunden. In der ein Jahr nach der Operation durchgefuehrten Kontrollcomputertomographie fanden sich erneut multiple nodulaere Formationen, welche in Struktur und Kontrastmittelverhalten dem Primaertumor glichen. (orig./VHE)

  17. Application of Optical Measurement Techniques During Stages of Pregnancy: Use of Phantom High Speed Cameras for Digital Image Correlation (D.I.C.) During Baby Kicking and Abdomen Movements

    Science.gov (United States)

    Gradl, Paul

    2016-01-01

    Paired images were collected using a projected pattern instead of standard painting of the speckle pattern on her abdomen. High Speed cameras were post triggered after movements felt. Data was collected at 120 fps -limited due to 60hz frequency of projector. To ensure that kicks and movement data was real a background test was conducted with no baby movement (to correct for breathing and body motion).

  18. Loperamide-Induced Acute Pancreatitis

    OpenAIRE

    Halla Vidarsdottir; Hanna Vidarsdottir; Pall Helgi Moller; Einar Stefan Bjornsson

    2013-01-01

    Acute pancreatitis is a common disease leading to hospitalizations, most often caused by gallstones or alcohol. We present a case of a patient diagnosed with acute pancreatitis considered to be due to loperamide treatment for diarrhea.

  19. Causes of acute bronchitis (image)

    Science.gov (United States)

    ... the respiratory system that leads into the lungs. Acute bronchitis has a sudden onset and usually appears after ... and the production of thick yellow mucus. If acute bronchitis occurs because of a bacterial infection antibiotics are ...

  20. The Effectiveness of four Motor Games for the Abdominal Conditioning Eficacia de cuatro juegos motores para el acondicionamiento de los músculos del abdomen

    Directory of Open Access Journals (Sweden)

    B. Flores

    2010-09-01

    Full Text Available

    The purpose of this study was to determine the effectiveness of four traditional motor games (“the tunnel”, “the chicken battle”, “the drunk” and “the wheelbarrow race” for strengthening the abdominal muscles. Electromyography (EMG was collected from rectus abdominis (RA, external oblique (EO, and internal oblique (IO from twelve healthy volunteers during the performance of the games and the trunk curl-up exercise. The EMG amplitude was averaged and normalized using maximal voluntary isometric contractions. A two-way ANOVA (muscle / task was used to compare the level of contraction activity and the way the abdominal muscles co-activated during the different tasks. For EO and IO, the EMG amplitudes during the games were equal or greater than the EMG amplitudes of the curl up. The wheelbarrow race produced the highest intensity of contraction for all muscles. The curl up principally activated RA and IO. On the other hand, the games activated the oblique muscles with higher intensity than RA. On the basis of these results, the motor games are effective for abdominal conditioning.
    KEY WORDS: motor games, exercises, training, abdominal muscles, electromyography.

     

    El objetivo de este estudio fue determinar la eficacia de cuatro juegos motores (“el túnel”, “la pelea de gallinas”, “el tentetieso” y “la carretilla” para el fortalecimiento de los músculos del abdomen. Para ello, se registró la electromiografía de los músculos rectus (RA, obliquus externus (OE y obliquus internus abdominis (OI de 12 voluntarios sanos durante la ejecución de los juegos y del ejercicio de encorvamiento del tronco. La amplitud electromiográfica fue promediada y normalizada respecto a la contracción voluntaria isométrica máxima. Posteriormente, se realizó un ANOVA de dos factores (músculo / tarea para comparar la intensidad de la activación muscular y