Episodes Of Acute Abdominal Pain Research Articles

Large colon strangulation due to a diaphragmatic hernia in a mare: A case report

This report describes a case of diaphragmatic hernia with incarcerated large colon in a 16-year-old Tennessee Walking Horse mare. This mare was presented with an acute episode of abdominal pain that was not responsive to analgesic therapy. Treatment consisted of resection of the devitalized large colon and closure of the rent in the diaphragm.

Dual porphyria of coexisting variegata and cutanea tarda.

While porphyria cutanea tarda and porphyria variegata are independent diseases, we report on seven rare cases with a coincidence of these two different porphyrias in one individuum. The mutual clinical symptom was a cutaneous photosensitivity, which is a major symptom in porphyria cutanea tarda and a facultative one in porphyria variegata. Additionally, five patients had also experienced episodes of acute abdominal pain, which were in three cases accompanied by neurological symptoms, thus offering evidence for an acute hepatic porphyria, such as porphyria variegata. Determination of urinary porphyrin metabolites revealed a porphyria cutanea tarda-like excretion pattern with an elevation of uroporphyrin (mean 1134 nmol/24 h, range 563-4052, normal < or = 30) and heptacarboxyporphyrin (mean 389 nmol/24 h, range 64-830, normal < or = 4). In all patients, however, urinary coproporphyrin was also increased, reaching levels too high for porphyria cutanea tarda but typical for porphyria variegata (mean 1788 nmol/24 h, range 142-4168, normal < or = 120). Fecal porphyrin excretion also resembled the variegate-type with a high concentration especially of protoporphyrin (mean 628 nmol/g dry weight, range 401-1018, normal < or = 151), accompanied by an increase of coproporphyrin (mean 194 nmol/g dry weight, range 75-409, normal < or = 37). The urinary porphyrin precursors 5-aminolaevulinic acid and porphobilinogen were markedly elevated only in one patient, who was in an acute porphyric phase at the time of investigation. The activity of uroporphyrinogen decarboxylase in erythrocytes was considerably decreased in six of our cases (33-64%) and slightly diminished in the other one (83% of normal activity).(ABSTRACT TRUNCATED AT 250 WORDS)

The incidence of cholelithiasis in sickle cell disease.

THE INCIDENCE OF CHOLELITHIASIS IN SICKLE CELL DISEASEJERRY C. PHILLIPS, M.D. and BARRY E. GERALD, M.D.Audio Available | Share

Stool porphyrins in acute intermittent and hereditary coproporphyria. Adverse effect of tranquilizers.

SYMPTOMS of acute intermittent porphyria may be associated with three forms of hepatic porphyria: acute intermittent, variegate, and hereditary coproporphyria. Acute intermittent porphyria (AIP) occurs more frequently in women, with an incidence of approximately 1 per 100,000 and is associated with intermittent episodes of acute abdominal pain, neurological disorders, and psychiatric disturbances. 1 Urinary excretion of aminolevulinic acid (ALA) and porphobilinogen (PBG) is increased during attacks, but may remain normal in remission, and the stool porphyrins are usually normal. 2 Variegate porphyria is more common in South Africa, where more than 5,000 cases have been detected among the Boer population. Variegate porphyria is associated with similar acute intermittent symptoms in addition to clinical features of photosensitivity that are similar to porphyria cutanea tarda, with bullae and ulceration on the sun exposed areas of the skin. Urinary ALA and PBG are increased during acute intermittent episodes but are usually normal