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acute abdominal

S Florim, A Almeida, D Rocha, P Portugal
Acute mesenteric ischaemia (AMI) is an uncommon cause of acute hospital admission with high mortality rates (50-90%) that requires early diagnosis and treatment. With the increase in average life expectancy, AMI represents one of the most threatening abdominal conditions in elderly patients. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can reverse this process leading to a full recovery, but the diagnosis of AMI is difficult...
August 17, 2018: Insights Into Imaging
Andrea R G Sheel, Ryan D Baron, Ioannis Sarantitis, Jayapal Ramesh, Paula Ghaneh, Michael G T Raraty, Vincent Yip, Robert Sutton, Michael R Goulden, Fiona Campbell, Ammad Farooq, Priya Healey, Richard Jackson, Christopher M Halloran, John P Neoptolemos
BACKGROUND: Longitudinal data are lacking to support consensus criteria for diagnosing early chronic pancreatitis. METHODS: Retrospective single centre study of the initial evidence for chronic pancreatitis (CP), with reassessment after follow-up (January 2003-November 2016). RESULTS: 807 patients were previously diagnosed with chronic pancreatitis. This diagnosis was rejected in 118 patients: 52 had another pathology altogether, the remaining 66 patients formed the study population...
August 7, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Zhaoyi Chen, Victoria Y Bird, Rupam Ruchi, Mark S Segal, Jiang Bian, Saeed R Khan, Marie-Carmelle Elie, Mattia Prosperi
BACKGROUND: Kidney stone (KS) disease has high, increasing prevalence in the United States and poses a massive economic burden. Diagnostics algorithms of KS only use a few variables with a limited sensitivity and specificity. In this study, we tested a big data approach to infer and validate a 'multi-domain' personalized diagnostic acute care algorithm for KS (DACA-KS), merging demographic, vital signs, clinical, and laboratory information. METHODS: We utilized a large, single-center database of patients admitted to acute care units in a large tertiary care hospital...
August 17, 2018: BMC Medical Informatics and Decision Making
Caroline Linninge, Peter Jönsson, Hans Bolinsson, Gunilla Önning, Joakim Eriksson, Gerd Johansson, Siv Ahrné
The virtual version of the Trier Social Stress Test (V-TSST) is an effective and standardized tool for social stress induction. This study aimed to examine gut permeability and physiological and inflammatory markers of reactivity to acute psychosocial stress. Forty young men were classified as high-stressed (HIGHS) or low-stressed (LOWS) according to the Shirom-Melamed Burnout Questionnaire. Cardiovascular reactivity and gut dysfunction were studied along with cortisol, zonulin and cytokines. Gut permeability was shown to be affected within one hour after the psychosocial stress induction, and shown to be dependent on age...
August 14, 2018: Biological Psychology
Beau M Bailey, Kenneth S Ramos, Alice Johnson, Charlene Mitchell
Systemic lupus erythematosus (SLE) is an autoimmune disease known to affect a variety of organ systems. Patients with SLE are more prone to developing common infections that can mimic the complications of SLE. As such, it is essential to differentiate complications of SLE from infection to ensure appropriate management and to improve morbidity and mortality of this patient population. Here we present a 24-year-old, Hispanic male, with SLE complicated by dialysis-dependent end-stage renal disease and dilated cardiomyopathy...
September 2018: Journal of Clinical Medicine Research
Vijay Gayam, Amrendra Kumar Mandal, Mazin Khalid, Jaspreet Kaler, Shivani Thapa, Pavani Garlapati, Arshpal Gill, Ragin Alex, Binav Shrestha
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which can manifest in many different organ systems. Gastrointestinal (GI) involvement is common in SLE, but the symptoms are usually mild. More severe GI complications including acute pancreatitis and peptic ulcer bleeding are rare but represent a significant risk of morbidity and mortality. We present a case of a 25-year-old Hispanic female with a severe SLE flare. The initial presentation included symptoms of hematemesis and epigastric abdominal pain secondary to both gastric ulceration and acute pancreatitis, an atypical presentation of an SLE flare...
August 2018: Gastroenterology Research
Bryce C Simes, Alozie A Mbanaso, Carlos A Zapata, Chukwuma M Okoroji
Background: The hallmark of gestational trophoblastic disease is the production of human chorionic gonadotropin (hCG) due to the hyperproliferation of extraembryonic trophoblast cells. Previous studies show hCG has thyrotropic action due to its structural similarity with thyroid stimulating hormone (TSH) molecules. Germ cell tumors represent 15-20% of all ovarian tumors and can be malignant or benign. Case presentation: We present a case of a 53-year old African American female with a history of hyperthyroidism secondary to a complete hydatidiform mole and an associated finding of a mature cystic ovarian teratoma...
2018: Thyroid Research
Harsh Sheth, Sadashiv Chaudhari, Yash Sinha, Ramlal Prajapati
An accessory spleen is a rare entity which is usually asymptomatic. When symptomatic, it presents as an acute abdomen, with either torsion, rupture or haemorrhage. We present the case of a 20-year-old man who presented with chronic lower abdominal pain since 3 months and a lump in the left lower quadrant. On clinical examination and investigations, the lump was diagnosed as a mesenteric cyst, and an uncomplicated laparoscopic excision was performed. The postoperative histopathological examination reported it as an infarcted accessory spleen...
August 16, 2018: BMJ Case Reports
Anthony J Ocon, Vivek R Mehta, Ruben Peredo-Wende
Behcet's disease is a multisystemic vasculitis. Arterial involvement in the form of acute dissection is rare. A 42-year-old Lebanese man with Behcet's disease presented with severe abdominal pain. On exam, blood pressure was 162/104 mm Hg, and he exhibited epigastric tenderness. CT angiogram demonstrated an acute dissection of the coeliac artery trunk, common hepatic artery and proper hepatic arteries, with asymmetric thickening of the proximal left subclavian artery and circumferential thickening of the abdominal infrarenal aorta suggestive of vasculitis...
August 16, 2018: BMJ Case Reports
Guntaragorn Hongrattana, Potipong Reungjui, Panaya Tumsatan, Chulee Ubolsakka-Jones
AIM: The aim of the study was to obtain information about the incidence and risk factors for pulmonary atelectasis in mechanically ventilated patients in the trauma ICU (TMICU). Pulmonary atelectasis is a common complication leading to serious lung dysfunction in patients in the TMICU and early identification of patients at risk is important for their effective management. METHODS: All trauma patients admitted to the TMICU with mechanical ventilation for more than 1 day were included in a prospective 12-month study...
August 14, 2018: International Journal of Evidence-based Healthcare
L Creedon, H Boyd-Carson, J Lund
Gallstone ileus is an uncommon cause of bowel obstruction that involves cholecystoenteric fistulation and resultant passage of gallstones into the bowel. In the vast majority of cases, the fistula forms between the gallbladder and duodenum leading to small bowel obstruction. We report a case of cholecystocolic fistulation and subsequent large-bowel obstruction in a 75-year-old woman who presented acutely after taking a bowel preparation for an outpatient colonoscopy during the course of an investigation of anaemia and nonspecific abdominal pain...
August 16, 2018: Annals of the Royal College of Surgeons of England
A Bakopoulos, D I Tsilimigras, M Syriga, N Koliakos, V Ntomi, D Moris, D Bistarakis, D Schizas
The transverse colon is a particularly rare site for a diverticulum to develop, with only few reports of solitary diverticula described in the literature. Among the reported complications, colocutaneous fistulas appear relatively infrequently. We describe the case of an 80-year-old woman with a solitary diverticulum of the transverse colon presenting as acute diverticulitis with abscess formation in the epigastric region. A fistulous tract was found between the inflamed colon and the skin. A wedge resection of the inflamed colon together with the fistula and the solitary diverticulum was performed followed by primary suturing of the healthy colonic tissue...
August 16, 2018: Annals of the Royal College of Surgeons of England
Augusto Zani, Nigel J Hall, Abidur Rahman, Francesco Morini, Alessio Pini Prato, Florian Friedmacher, Antti Koivusalo, Ernest van Heurn, Agostino Pierro
AIM:  To define patterns in the management of pediatric appendicitis. METHODS:  A total of 169 delegates from 42 (24 European) countries completed a validated survey administered at the EUPSA 2017 annual congress. RESULTS:  In the work-up of children with suspected acute appendicitis, most surgeons rely on full blood count (92%), C-reactive protein (82%), and abdominal ultrasonography (76%), but rarely on computed tomography scans or magnetic resonance imaging...
August 15, 2018: European Journal of Pediatric Surgery
Karama Zouari Bouassida, Samar Makni, Amina Tounsi, Lobna Jlaiel, Mohamed Trigui, Slim Tounsi
Juniperus phoenicea ( J. phoenicea ) is a wild tree belonging to the Cupressaceae family, commonly used for the treatment of several disorders. This study aimed to evaluate the potential protective effects of J. phoenicea hydroethanolic extract (EtOH-H2 OE) against oxidation, acute inflammation, and pain in mice models. For the purpose, chemical compounds of J. phoenicea EtOH-H2 OE were also analyzed by GC-MS. The J. phoenicea EtOH-H2 OE showed a potent antioxidant activity in vitro , thanks to its richness in phenolic and flavonoid compounds...
2018: BioMed Research International
Sarang Thaker, Cemal Yazici, Sean Koppe
Pericardial tamponade is a rare cause of acute liver injury due to the compressive effects of an effusion resulting in a poor cardiac output which ultimately leads to ischemia-induced injury. We present a patient with chronic hepatitis C infection and end-stage renal disease who was transferred to our center for further evaluation and management of acute liver injury after presenting to an outside hospital with left upper quadrant abdominal pain, nausea and vomiting. The patient was discovered to have tamponade physiology on transthoracic echocardiogram as an underlying cause of his acute liver injury despite lack of clinical tamponade features...
June 11, 2018: Curēus
James Haug, A S Katkar, James Covelli
Intussusception of the appendix is a relatively rare event that is usually asymptomatic but can present similar to other acute and chronic abdominal conditions. We present two separate cases of suspected appendiceal intussusception mimicking cecal masses. The authors also present a cursory review of the limited number of literatures available concerning this entity to help the radiologist avoid misdiagnosis and potentially unnecessary invasive intervention.
2018: Case Reports in Radiology
Sujen Jayakody, Danette Bianca Wright, Corrina Chiong, Mona Liu, Clare Bouffler, Toufic El-Khoury
BACKGROUND: Paclitaxel is a chemotherapy drug commonly used in the management of ovarian cancer. Colonic perforation is an extremely rare complication of paclitaxel administration with few case reports in the medical literature. We report a case of a patient with advanced ovarian cancer who had a rectal perforation following administration of paclitaxel. There has only been one other case report of rectal perforation in the medical literature following paclitaxel therapy. CASE PRESENTATION: A 55-year-old Caucasian woman with advanced ovarian cancer awaiting elective debulking surgery for her tumor presented to our emergency department with abdominal pain, vomiting, and diarrhea...
August 16, 2018: Journal of Medical Case Reports
Takeshi Urade, Shigeteru Oka, Shinya Iimori, Mariko Man-I, Tomoki Abe, Hidehiro Sawa, Yoshiteru Iwatani, Yukiko Morinaga, Daisuke Kuroda
Gallbladder metastasis from breast cancer, especially from ductal carcinoma, is rare. Herein, we report a rare case of gallbladder metastasis from ductal carcinoma of the breast that was diagnosed after laparoscopic cholecystectomy (LC) for acute cholecystitis. A 78-year-old woman presented with right upper abdominal tenderness and positive Murphy's sign during chemotherapy for advanced multiple metastases of the breast cancer. Abdominal ultrasonography and computed tomography showed a slightly thickened gallbladder wall and two calculi...
August 14, 2018: Clinical Journal of Gastroenterology
Juma Obayashi, Shigeyuki Furuta, Takuya Kawaguchi, Kohei Kawaguchi, Kei Ohyama, Hideki Nagae, Munechika Wakisaka, Hiroaki Kitagawa
BACKGROUND: We investigated the efficacy of broad-spectrum antibiotics for prevention of postoperative intra-abdominal abscess in pediatric acute appendicitis with our 3 risk factors:-WBC > 16.5 (× 103 /µl), CRP > 3.1 (mg/dl) and appendix maximum short diameter on diagnostic imaging > 11.4 mm. METHODS: Four hundred twenty-two patients were reviewed. Patients with 0-1 risk factors were assessed as low-risk and those with 2-3 were high-risk...
August 14, 2018: Pediatric Surgery International
Haichun Zhou, Xiaohui Ma, Meijun Sheng, Can Lai, Junfen Fu
BACKGROUND: The magnetic resonance imaging (MRI) characteristics of evolving duodenal hematomas in children are unknown. OBJECTIVE: To describe the MRI changes exhibited by evolving duodenal hematomas and the likely mechanisms behind these changes. MATERIALS AND METHODS: We retrospectively reviewed the MR features of intramural duodenal hematomas (6 lesions, 10 examinations) studied on a 1.5-T MR unit. All patients had clinical histories of blunt abdominal trauma or endoscopic procedures and we were able to determine the time interval between the onset and MR imaging...
August 14, 2018: Pediatric Radiology
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