Acute Abdomen Syndrome Research Articles

Acute abdomen syndrome and radial nerve compression correlated with diffuse metastatic melanoma in the lymphatic system and skeletal muscle: case report

Acute abdomen syndrome and radial nerve compression correlated with diffuse metastatic melanoma in the lymphatic system and skeletal muscle: case report

Abdominal pain in pregnant women: modern possibilities differential diagnosis and relief

The article shows the main causes of functional and organic abdominal pain and its specific types during pregnancy. The author presents the tactics of patient management, the peculiarities of the interpretation of laboratory data in case of suspected acute surgical pathology and “alarm symptoms” in case of abdominal pain in pregnant women. She emphasized the importance of imaging techniques in the differential diagnosis of acute abdomen syndrome in the gestational period. Article also substantiates safety and the need for magnetic resonance imaging in patients with persistent abdominal pain. It discusses a clinical case of paralytic intestinal obstruction in a pregnant woman. It analyzes the drug therapy for abdominal pain, taking into account the prevalence of the expected benefit to the mother over the potential risk to the fetus. The author demonstrates that the management of abdominal pain relies on a conservative approach due to the lack of evidence base on the safety of drugs for the fetus and clinical guidelines for the management of pregnant women with abdominal pathology. Author also emphasizes the need for legal registration of the appointment of magnetic resonance imaging and computed tomography, as well as off-label pharmacotherapy the instructions during gestation.

C-REACTIVE PROTEIN AS AN EFFICIENT INDICATOR MONITORING AND PROGNOSING CANINE INFLAMMATORY DISEASES

C-reactive protein (CRP) is an acute phase protein that may increase in response to various inflammatory conditions or infections in human and animals. It has been suggestive to use CRP levels to diagnose, monitor and prognose canine inflammatory diseases; however, its practical uses remain obscure. We have comparatively demonstrated the use of CRP, total white blood cell (WBC) counts and neutrophil counts to monitor the progression of four canine common disorders, including acute pancreatitis, acute abdomen syndrome, neoplastic diseases and pyometra. A total of 52 cases were included in this study. The CRP concentration, complete blood count and protein profile were measured before and on days 1, 2 of hospitalization, day of discharge and the day of follow-up visit. Statistical analyses indicated that CRP is the only parameter with elevated concentrations significantly differ among different days. None of the clinicopathological variables correlated well with serum CRP concentrations except for visual negative correlation to albumin. Differential efficiencies were observed when using CRP and total WBC counts to monitor the four disorders. The CRP and total WBC counts were equally efficient in monitoring pyometra and neoplastic disease patients, while in acute pancreatitis and acute abdomen syndrome, the use of CRP was clearly advantageous. Overall, CRP is a more sensitive marker showing an evident up-and-down trend and with greater degree of responses than total WBC and neutrophil counts, which enable CRP a better quantitative analysis of disease progression. In conclusion, CRP levels exhibit various degrees of clinical potential to monitor the development and treatment progress of canine diseases with inflammatory components. The inclusion of other inflammatory biomarkers and the study of CRP isoforms warrant further investigation.

Gynecological diseases in children and adolescents with the acute abdomen syndrome

Objective. The differential diagnostics of gynecological diseases with a picture of acute abdomen and acute appendicitis may be challenging and can cause a variety of complications, impaired reproductive function and infertility.Purpose. To assess outcomes after diagnosing and treating girls with the syndrome of “acute abdomen” in whom an acute gynecological pathology was revealed.Material and methods. Case histories of 85 girls with gynecological diseases who were hospitalized to the emergency surgical department of Children City Clinical Hospital No 9 in Yekaterinburg are analyzed. All children were admitted to the emergency department with a picture of “acute abdomen”.Results. All children were operated on laparoscopically, and the cause of their acute abdominal syndrome was clarified. Acute inflammatory diseases of the uterine adnexa prevailed in the structure of causes (59%). In 21% of cases, there was uterine adnexa torsion . The rest of children had apoplexy (11%) and ovarian cysts (9%).Conclusion. The differential diagnostics of acute appendicitis and acute gynecological pathologies is difficult due to various and similar clinical symptoms. Laparoscopy can not only identify the cause of pain syndrome, but also can help to chose a future curative tactics .

Proteomic analysis of therapeutic effects of Qingyi pellet on rodent severe acute pancreatitis-associated lung injury

Severe acute pancreatitis (SAP) is a common acute clinical abdomen syndrome which is characterized by pancreatic self-digestion. As one of the major complication of SAP, acute lung injury is the main reason of high mortality. The traditional Chinese medicine Qingyi pellet (QYT) has been widely used for SAP in clinic. In our study, we constructed the severe acute pancreatitis-associated lung injury (SAP-ALI) rat model and treated with QYT, then characterized the protein from the lung tissue by using a mass spectrometry-based proteomic strategy. Our results showed that, in the SAP group, 9 proteins exhibited obvious changes according to the proteomic analysis. Among the 9 proteins, 7 proteins (alpha-2-macroglobulin, Cathepsin S, ras-related protein RAP-1A, integrin beta, protein phosphatase 2A, Intercellular adhesion molecule 1 and p38) were up-regulated, and 2 proteins (adapter molecule Crk and stathmin) were down-regulated. Interestingly, the data of the QYT group showed that adapter molecule Crk and stathmin were up-regulated, but the other 7 proteins were down-regulated. The kyoto encyclopedia of genes shows that the proteins act on PI3K-AKT, chemokine signaling pathways, apoptosis, leukocyte transendothelial migration and focal adhesion. Therefore, the therapeutic effects of QYT on SAP-ALI are potentially through the additive and/or synergistic interactions of numerous components.

The performance of the specialists working in a big clinical facility of Saint Petersburg in the field of «urgent abdominal surgery» from the standpoints of medical quality assessment and its administrative monitoring

In this topic the role and place of experts work in the area of health care quality control for patients with an acute surgical disease of abdominal cavity in the big multi-profile medical clinic in St. Petersburg were reviewed. There was an analysis of some data of 2155 patients who were urgently taken to the hospital in 2017. As a result surgical care analysis of diseases included in "acute abdomen syndrome" we found the correlation between negative outcomes caused by defects in diagnostics and treatment and insufficiency of activity in experts work in surgery. In these study groups increasing cases of post-operative mortality, delaying of surgical intervention without strong argumentation in all diseases included in "acute abdomen syndrome" were found. Nowadays there is no opportunity to change the balance between acute and planning hospitalization of patients who have abdominal cavity diseases in positive way. Some paths of improving the quality of medical assessment to patients who has abdominal surgery diseases were discussed. In average, the example of positive improvement the abdominal surgery could be given speaking about the importance of systematically estimation of results some of the surgery teams activity and managerial decisions which could be made in time.

Widespread intraperitoneal hydatid cysts presenting with acute abdomen syndrome.

Widespread intraperitoneal hydatid cysts presenting with acute abdomen syndrome.

Abdominal cocoon syndrome: A rare cause of acute abdomen syndrome.

A rare cause of acute abdomen or intestinal obstruction, the abdominal cocoon syndrome is also described in the literature as sclerosing peritonitis or sclerosing encapsulating peritonitis. Abdominal cocoon is characterized by the total or partial wrapping of the abdominal organs by a fibrous membrane. Although it is usually observed in young women, the etiology is unknown. The diagnosis is usually made during laparotomy. In this case series, we aimed to present seven patients diagnosed with abdominal cocoon syndrome during operation. The records of patients who underwent laparotomy for abdominal pain and/or intestinal obstruction in our hospital and diagnosed as abdominal cocoon during operation between January 2012 and November 2018 were retrospectively reviewed. The demographic characteristics of the patients, etiologic factors, surgical procedures, operative findings and follow-up of the patients were recorded. Four out of seven patients who were operated for abdominal cocoon were male and 3 of them were female. The median age of patients was 61 (57-63) years in male and 39.6 (28-49) years in female. Six of the patients were operated in emergency conditions with the diagnosis of an acute abdomen or ileus. One of the patients was operated with the diagnosis of an intra-abdominal mass in elective conditions. In five out of seven patients, all of the small intestines were wrapped with a fibrous collagen capsule, while two of the patient intestines were partially wrapped with a fibrous collagen capsule. Four of the patients had no underlying disease, while one of the patients had Familial Mediterranean Fever (FMF), one had Endometriosis and one had beta-blocker medication. One patient who had small bowel necrosis and septic peritonitis were observed during the operation and died post operative 6th days. Postoperative complications were not observed in the follow-up of other patients and reoperation was not required due to recurrence. Abdominal cocoon is a condition that is usually diagnosed during operation in patients that were operated for reasons, such as the acute abdomen or intestinal obstruction. When the diagnose delayed, death can be seen due to small bowel necrosis and septic complications. High clinical suspicion and radiological imaging are important in the preoperative diagnosis. Treatment is required adhesiolysis and excision of the fibrous membranes.

Salivary alpha-amylase activity and cortisol in horses with acute abdominal disease: a pilot study

BackgroundThe aim of this study was to evaluate salivary alpha-amylase (sAA), considered a non-invasive biomarker for sympathetic nervous system (SNS) activity, and salivary cortisol as possible pain-induced stress biomarker, in horses with acute abdominal disease. Therefore, a prospective observational study was performed in which both biomarkers were analyzed in a group of horses with acute abdomen syndrome, and compared with a group of healthy control horses by an unpaired Student’s t-test. In addition, the possible relationship between both biomarkers, the score in Equine Acute Abdominal Pain scales version 1 (EAAPS-1 scale), Heart Rate (HR) and Respiratory Rate (RR), plasma lactate, the systemic inflammatory response syndrome (SIRS) score and serum amyloid A (SAA) concentration was assessed by a Spearman correlation test.ResultsA total of 30 horses were included in the study, 19 with acute abdominal disease diagnosed as large colon displacements, simple impactions of the pelvic flexure, spasmodic colics and enteritis and 11 healthy ones. sAA activity (24.5 median-fold, P < 0.0001) and salivary cortisol (1.7 median-fold, P < 0.01) were significantly higher in horses with acute abdomen than in healthy horses. sAA activity was significantly correlated with EAAPS-1 scale (r = 0.78, 95% confidence interval [CI] 0.38–0.89, P < 0.001) and SIRS score (r = 0.49, 95% CI 0.03–0.78, P < 0.05). Neither sAA nor salivary cortisol correlated with HR, RR, plasma lactate and SAA.ConclusionsAlthough this study should be considered as preliminary one, alpha-amylase measurements in saliva could be a biomarker of pain-induced stress in horses with acute abdominal disease.

Correlation between Preoperative Ultrasonographic Findings and Clinical, Intraoperative, Cytopathological, and Histopathological Diagnosis of Acute Abdomen Syndrome in 50 Dogs and Cats

Acute abdomen syndrome is an emergency in small animal practice that requires rapid diagnosis to determine the appropriate treatment. No studies have correlated the preoperative abdominal ultrasonography (US) findings with the clinical, surgical, cytopathologic, and histopathologic findings. This retrospective study was designed to evaluate abdominal US in the diagnosis of acute abdomen syndrome using surgery as a “criterion standard”. The most frequently misinterpreted lesions with US were also identified. The study included 50 dogs and cats with physical examination, an US diagnosis, US guided fine-needle aspiration cytology, intraoperative findings, and histopathology. Intraoperatively, 49 primary and 43 secondary lesions were identified. The sensitivity, specificity, and positive and negative predictive values for US were calculated. There was a good agreement between the US diagnosis and intraoperative findings of 86.9% (80/92), for both primary and secondary lesions (p < 0.0001). Cytology and histopathology examinations corroborated the US in 86.4% (n = 64/74) of primary and 66.2% of secondary (n = 49/79) lesions. Using US as the “criterion standard”, the sensitivity of abdominal palpation for identification of ascites and masses was 32.4% and 43.7%, respectively, while the specificity was 93.7% and 94.4%, respectively. Abdominal US is a useful preoperative modality for diagnosing acute abdominal diseases in dogs and cats. Care should be taken with interpretation of gastrointestinal perforation, omental tumors, and common bile duct rupture, as these lesions are frequently misinterpreted with US.

Prognostic value of Tissue Transition Projection 3D transparent wall CT reconstructions in bowel ischemia

BackgroundMulti-detector computed tomography (MDCT) represents the gold standard in patients with acute abdomen syndrome and suspected bowel ischemia. It provides a correct diagnosis and contributes to appropriate treatment planning. This study aims to evaluate the role of 3D Tissue Transition Projection (TTP) transparent wall CT reconstruction for detecting the degree of bowel dilatation and to correlate this finding with the aetiology and prognosis in patients affected by mesenteric infarction. Materials and methodsForty-seven patients affected by bowel infarction due to vascular obstruction (arterial in 66% of cases, venous in 34%) were assessed by MDCT examination searching for the degree of bowel dilatation (subdivided into 4 groups: entire small bowel (SB); ≥50% of SB; < 50% of SB; large bowel only). Two blinded radiologists evaluated TTP 3D transparent wall and multi-planar reconstructions. Chi square test was used to correlate CT findings with the disease course and the mortality rate. Cohen's kappa statistics was used in order to assess inter-observer agreement. ResultsThe overall mortality rate was 64%, with a 90% value for arterial forms and 10% in case of venous infarctions. The entire SB (n = 10) or a ≥50% SB dilatation (n = 16) correlated with poor prognosis in all cases (p < 0.05); a <50% SB dilatation (n = 16) correlated with good prognosis in 87.5% of cases (p < 0.05). A large bowel only dilatation (n = 5) did not show a significant prognostic value (p = 0.13). Almost perfect agreement between the two readers was found (k = 0.84). ConclusionMDCT offers different reconstruction software for diagnosing bowel ischemia. 3D TTP transparent wall reconstructions represent a rapid and automatic tool for identifying loop dilatation, which significantly correlates with an arterial aetiology and poor prognosis.

Risks of tubo-ovarian abscess in cases of endometrioma and assisted reproductive technologies are both under- and overreported

To study possible associations among endometriosis, pelvic infectious disease, and ART. Retrospective cohort analysis over 4 consecutive years, based on medical records and insurance coding in a tertiary endometriosis reference center. Tertiary university-based reference center for endometriosis. We retrieved all charts carrying the diagnoses infectious process and endometriosis in 2009-2012. Each chart was individually analyzed for categorization of the infectious episode and determining whether ART had been performed. Hospitalization for acute infection in women with known endometriosis and possible past ART. Retrospective insurance codes-triggered chart analysis. Ten patients were admitted for an acute infection with fever, acute abdomen syndrome, elevated white blood cell count, and adnexal mass. Three women had oocyte retrieval, and an endometrioma was present 16, 57, and 102days earlier. In one patient, the complication occurred 37days after a cesarean section without prior ART. In the remaining six cases tubo-ovarian abscesses (TOAs) occurred spontaneously in endometriosis women who never had ART. Medical treatment succeeded in only two patients, and the remaining eight needed laparoscopic drainage. In 6 out of those 8 cases, laparoscopic drainage was a second-stage measure justified by failure to respond to antibiotic therapy. Our data indicate that some putative complications of ART and endometrioma may actually not be linked to ART, but rather constitute sporadic occurrences in endometriosis. Furthermore, TOAs occurring in women with endometriosis are best treated by early surgical drainage together with intravenous antibiotics.

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

Acute abdomen syndrome is a frequently encountered clinical condition in emergency departments and includes a wide spectrum of surgical diagnoses. On the other hand, gallbladder torsion is a very rarely seen cause of the acute abdomen syndrome. A 74-year-old male patient admitted to the emergency department with abdominal pain present for two days, with gradually increasing intensity. Diffuse tenderness and guarding was present in the abdominal examination with positive Murphy sign. According to the radiologic evaluation, the patient was taken to the operation room under emergency condition with the preliminary diagnosis of gallbladder perforation. Total gallbladder necrosis due to torsion was detected in operation and cholecystectomy was performed. This case has been presented because of its rare incidence and emphasize that its preoperative diagnosis is very difficult. doi: http://dx.doi.org/10.4021/jmc1293e

Acute Abdomen Syndrome Caused by a Perforated Gastrointestinal Stromal Tumor - A Case Report

Gastrointestinal stromal tumors (GIST) are frequently observed in the stomach and intestines. Although they may be presented with various symptoms depending on their location and diameter, acute abdomen syndrome is a rare presentation form for GIST. A 54-year-old male patient was evaluated with the complaint of sudden onset abdominal pain at the urology clinic. In examination; fever (38.5 ̊C), abdominal distension and peritoneum irritation signs were detected. A mass that contained localized necrotic areas thought to have mesentery origins and intraabdominal free-fluid were detected on abdominal computed tomography. The patient was operated with the diagnosis of acute abdomen syndome. In operation; extensive intestinal content in the abdomen, a perforated tumoral mass which was 7x5 cm in diameter, and anti-mesenterically localized at the ileum segment were detected. Segmental ileum resection-end ileostomy operation was performed, and the patient was discharged as uneventful on post-operative tenth day. As a result of a histopathological analysis, a GIST (&lt;5/50 mitotic growth) was detected. By means of this finding, we want to remind that GISTs may be presented with acute abdomen symptoms due to perforation, though rarely.

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

A Rare Etiology of Acute Abdomen Syndrome: Gallbladder Torsion

Obstrução intestinal por melanoma metastático: relato de caso

Melanoma is a highly malignant tumor and represents 3% of all cancers. Malignant melanoma is the most common metastatic tumor involving the gastrointestinal tract, the small bowel being the localization most frequently involved. Its clinical presentation is inespecific and an obstructive acute abdomen syndrome could be its first manifestation. The article is about a case of a 36 years-old patient, which had been submitted to resection of melanoma in the dorsal region in 2009. The patient developed acute intestinal obstruction and laparotomy showed intestinal intussusceptions caused by metastatic melanoma at 50 cm from the angle of Treitz. The specimen was sent for pathological, which confirmed the presence of metastatic melanoma in the small bowel. The treatment of metastatic melanoma involves systemic treatment and treatment of complications. Intestinal metastasis must be considered in any patient with gastrointestinal symptoms and previous history of melanoma and the surgical treatment should always be considered because it can occasionally provide long-term survival. Key-words: Melanoma. Metastasis. Intestinal obstruction. Intussesception. Surgery.

Idiopathic gastric volvulus: an uncommon etiology of acute abdomen syndrome – a case report

GIRIS Mide volvulusu nadir gorulen ve sikligi tam olarak bilinmeyen bir klinik tablodur (1). Midenin 180 dereceden fazla rotasyonu sonucu olusur. Klinik olarak strangulasyon, inkarserasyon ve perforasyon asamalari hizla gelisip akut karin tablosu seklinde ortaya cikabilir (2). Spesifik bir klinik veya laboratuar bulgusu yoktur. Tani genellikle operasyon esnasinda konulur. Ameliyat oncesi donemde radyolojik olarak mide volvulusu tanisi koymak da oldukca guctur ve ileri derecede radyolojik deneyim gerektirir. Bu yazida volvulus nedeniyle mide perforasyonu gelisen bir olguyu sunma ve mide volvulusunun tanitedavi seceneklerini tartisma amaclanmistir.

A rare ethiology of acute abdomen syndrome: perforation of the small intestinal lymphoma

Gastrointestinal sistem primer ekstranodal lenfomalarin en sik goruldugu yer olmasina ragmen primer intestinal lenfomalar nadir karsilasilan klinik durumlardir. Intestinal lenfomalar genellikle non-spesifik ve kronik abdominal sikayetlerle ortaya cikarlar. Bu yazida acil servise ani baslayan siddetli karin agrisi sikâyeti ile basvuran perfore olmus ince barsak lenfoma olgusunu sunmayi amacladik.

The Use of Ultrasound Imaging For Acute Appendicitis

Acute appendicitis is the most common ethiology of the acute abdomen syndrome. Diagnose may be difficult for atipical cases. Some imaging methots may be helpful to diagnose for these type of cases. We aimed to evaluate the use of ultrasound for 287 acute appendicitis cases in our hospital emergency service retrospectively in this study.

A Rare eth�ology of acute abdomen syndrome �n ch�ldhood: Pr�mary Tors�on of the Greater Omentum � A Case Report

Primary torsion of the greater omentum is a rare ethiology of acute abdomen syndrome in children. An eight year old boy was admitted to our clinic with the complaints of sudden onset abdominal pain and vomiting. The patient was urgently operated because of acute abdomen syndrome diagnosis. Torsion of the omentum majus identified as the primary etiology of the patient underwent excision of the omentum. This case has been reported because of its rare incidance.