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acute abdomen pain guidelines

D Nashan, S Dengler
The spectrum of dermato-oncological emergencies is multifaceted. They are particularly observed in cases with malignant melanoma due to the large number of patients and prolonged survival rates that are associated with new therapies for advanced disease. Dermato-oncological patients present to the hospital with symptoms like nausea and emesis, unexpected neurological deficits, various gastrointestinal problems, and even acute abdomen, acute breathlessness, or hemoptysis. Furthermore, emergencies can be caused by hematological problems like anemia and leukopenia...
May 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Amar H Kelkar, Kavitha S Jacob, Eman B Yousif, John J Farrell
RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job...
December 2017: Medicine (Baltimore)
Bradley Mattson, Kal Dulaimy
With several different imaging options available, it is not surprising that health care providers are unsure which imaging study is most appropriate for evaluating patients who present to the emergency department with abdominal pain. The American College of Radiology, currently, has appropriateness criteria for patients presenting with right upper, right lower, and left lower quadrant pain, and there are different variants for each of these quadrants. Clinicians should be aware of the American College of Radiology appropriateness criteria and, whenever possible, should be using criteria as guide to help them order the most appropriate imaging study...
August 2017: Seminars in Ultrasound, CT, and MR
Zhenjun Yu, Ni Zhou, Ali Li, Jie Chen, Huazhong Chen, Zebao He, Fei Yan, Haihong Zhao, Jiansheng Zhu
BACKGROUND: Hemorrhagic Fever with Renal Syndrome (HFRS), caused by the hantavirus, is a natural infectious disease characterized by fever, hemorrhage and renal damage. China is the most severely endemic area for HFRS in the world. In recent years, critical scoring systems based on quantitative classification have become an important clinical tool for predicting and evaluating the prognosis of critical illness, and provide guidelines for clinical practice. METHODS: The sample comprised 384 patients with HFRS treated in the Taizhou Hospital from January 2006 to February 2017...
October 2017: International Journal of Infectious Diseases: IJID
Iwona Gawron, Lukasz Chmura, Dariusz Adamek, Krzysztof Skotniczny, Kazimierz Pityński, Artur Ludwin
Crohn's disease (CD) is a chronic inflammatory disorder that may involve any part of the gastrointestinal tract. Acute manifestations in female internal reproductive organs are rare and have been described in only a few cases. A 27-year-old nulligravida woman diagnosed with CD presented with pelvic pain, fever, and a palpable mass (confirmed by ultrasound) in the right lower quadrant of the abdomen. She underwent diagnostic laparoscopy because of worsening symptoms suggestive of a tubo-ovarian abscess. The right adnexa were excised after adhesiolysis...
September 2017: Journal of Minimally Invasive Gynecology
O Ahmed, A C Rogers, P Balfe, B M Waldron, F Pretorius, M P McMonagle
BACKGROUND: Ultrasound (US) is often the imaging modality of choice in women with acute right iliac fossa (RIF) pain, identifying the appendix in up to 99% of patients. The literature, however, lacks clear guidelines on how ultrasonography should be performed to maximise sensitivity and specificity in such patients. Many centres perform untargeted abdomino-pelvic scans, including organs such as the liver and spleen, which unlikely contribute to the presenting complaint. AIMS: We aimed to evaluate the clinical utility of unfocussed abdominal and pelvic US in women of reproductive age with acute RIF pain...
August 2017: Irish Journal of Medical Science
Marlene Aagaard Hansen, Helle Ø Kristensen, Lars Maagaard Andersen
A 60-year-old male was admitted with acute abdominal pain and fever. Computed tomography (CT) of the abdomen revealed free air. Diagnostic laparoscopy showed a toothpick perforating the ventricle, and the toothpick was removed successfully. This condition is severe with a reported mortality of 9.6%. A practical guideline based on 136 cases was presented in 2014. Endoscopy was found to be superior to CT in identifying toothpicks as well as offering therapeutic intervention, rendering endoscopy the first choice in diagnostic and treatment...
October 17, 2016: Ugeskrift for Laeger
Sriram Pothapregada, Banupriya Kamalakannan, Mahalaskhmy Thulasingham, Srinivasan Sampath
OBJECTIVE: To study the clinical profile and outcome of dengue fever in children at a tertiary care hospital in Puducherry. MATERIALS AND METHODS: All children (0-12 years of age) diagnosed and confirmed as dengue fever from August 2012 to January 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization guidelines for dengue fever. The diagnosis was confirmed by NS1 antigen-based ELISA test or dengue serology for IgM and IgG antibodies, and the data were analyzed using SPSS 16...
July 2016: Journal of Global Infectious Diseases
Åsa Muntlin Athlin, Claes Juhlin, Eva Jangland
RATIONALE, AIMS AND OBJECTIVES: Evidence-informed healthcare is the fundament for practice, whereby guidelines based on the best available evidence should assist health professionals in managing patients. Patients seeking care for acute abdominal pain form a common group in acute care settings worldwide, for whom decision-making and timely treatment are of paramount importance. There is ambiguity about the existence, use and content of guidelines for patients with acute abdomen. The objective was to describe and compare guidelines and management of patients with acute abdomen in different settings across the acute care delivery chain in Sweden...
February 2017: Journal of Evaluation in Clinical Practice
Ania Z Kielar, Michael N Patlas, Douglas S Katz
Positive oral contrast agents, including barium suspensions and water-soluble iodinated solutions, have traditionally been used in conjunction with the CT evaluation of patients with abdominal and pelvic pain. Due to continued advancements in CT technology, and due to increasing obesity and correspondingly a general increase in the intra-abdominal and intra-pelvic fat separating bowel loops in North American patients and in patients in other parts of the world over the past few decades, the ability of radiologists to accurately evaluate the cause of acute symptoms has substantially improved...
October 2016: Emergency Radiology
Udo Hoffmann, Scott R Akers, Richard K J Brown, Kristopher W Cummings, Ricardo C Cury, S Bruce Greenberg, Vincent B Ho, Joe Y Hsu, James K Min, Kalpesh K Panchal, Arthur E Stillman, Pamela K Woodard, Jill E Jacobs
Primary imaging options in patients at low risk for coronary artery disease (CAD) who present with undifferentiated chest pain and without signs of ischemia are functional testing with exercise or pharmacologic stress-based electrocardiography, echocardiography, or myocardial perfusion imaging to exclude myocardial ischemia after rule-out of myocardial infarction and early cardiac CT because of its high negative predictive value to exclude CAD. Although possible, is not conclusive whether triple-rule-out CT (CAD, pulmonary embolism, and aortic dissection) might improve the efficiency of patient management...
December 2015: Journal of the American College of Radiology: JACR
Pawel Zwolak, Markus Kröber
INTRODUCTION: Cervical spine metastases are relatively rare entities. Only about 10 % of all spinal metastases can be found in this localization. Magnetic resonance imaging and computed tomography are routinely used for early detection. The initial, clinical examination and patients' complaints may not always be very prominent. Treatment of such lesions is very challenging and needs to consider patient's comorbidities, quality of life and life expectation. Surgery for these lesions should always be performed in specialized spine units...
September 2015: Archives of Orthopaedic and Trauma Surgery
Edoardo Guida, Federica Pederiva, Massimo Di Grazia, Daniela Codrich, Maria Antonietta Lembo, Maria Grazia Scarpa, Waifro Rigamonti
INTRODUCTION: There are no clear guidelines in the treatment of a perforated appendicitis associated with periappendiceal abscess without generalized peritonitis. PRESENTATION OF CASES: We retrospectively studied six examples of treated children in order to discuss the reasons of our team's therapeutic approach. Some children were treated with a conservative antibiotic therapy to solve acute abdomen pain, planning a routine interval appendectomy after some months...
2015: International Journal of Surgery Case Reports
Geoffrey D Rubin
Computed tomography (CT) has had a profound effect on the practice of medicine. Both the spectrum of clinical applications and the role that CT has played in enhancing the depth of our understanding of disease have been profound. Although almost 90 000 articles on CT have been published in peer-reviewed journals over the past 40 years, fewer than 5% of these have been published in Radiology. Nevertheless, these almost 4000 articles have provided a basis for many important medical advances. By enabling a deepened understanding of anatomy, physiology, and pathology, CT has facilitated key advances in the detection and management of disease...
November 2014: Radiology
Anil Kumar Pillai, Shams I Iqbal, Raymond W Liu, Niranjan Rachamreddy, Sanjeeva P Kalva
Segmental arterial mediolysis (SAM) is an uncommon, nonatherosclerotic, noninflammatory, large- to medium-sized arteriopathy first described in 1976. It is characterized histologically by vacuolization and lysis of the outer arterial media leading to dissecting aneurysms and vessel rupture presenting clinically with self-limiting abdominal pain or catastrophic hemorrhages in the abdomen. Patients of all ages are affected with a greater incidence at the fifth and sixth decades. There is a slight male predominance...
June 2014: Cardiovascular and Interventional Radiology
Gail M Yarmish, Martin P Smith, Max P Rosen, Mark E Baker, Michael A Blake, Brooks D Cash, Nicole M Hindman, Ihab R Kamel, Harmeet Kaur, Rendon C Nelson, Robert J Piorkowski, Aliya Qayyum, Mark Tulchinsky
Acute right upper quadrant pain is a common presenting symptom in patients with acute cholecystitis. When acute cholecystitis is suspected in patients with right upper quadrant pain, in most clinical scenarios, the initial imaging modality of choice is ultrasound. Although cholescintigraphy has been shown to have slightly higher sensitivity and specificity for diagnosis, ultrasound is preferred as the initial study for a variety of reasons, including greater availability, shorter examination time, lack of ionizing radiation, morphologic evaluation, confirmation of the presence or absence of gallstones, evaluation of bile ducts, and identification or exclusion of alternative diagnoses...
March 2014: Journal of the American College of Radiology: JACR
Catherine Steinbach, Martin Stockmann, Maximilian Jara, Jan Bednarsch, Johan Friso Lock
BACKGROUND: Ingested toothpicks are a relatively rare event, but may cause serious gut injuries with peritonitis, sepsis, or death. Numerous case reports describing the clinical course in this setting are available but there is no concise guideline. The aim of the present study was to develop practical guidelines to aid clinicians in the diagnosis and management of acute tooth pick ingestion. METHOD: Our Medline search identified 116 publications containing case reports of ingested toothpicks...
February 2014: World Journal of Surgery
Scott J Saccomano, Lucille R Ferrara
Abdominal pain is a common complaint encountered in primary care and in the ED. Varying levels of pain dictate the immediacy of the intervention. Time is vital when making the decision to initiate therapeutic interventions. A comprehensive assessment with physical exam and diagnostic studies is required.
November 10, 2013: Nurse Practitioner
Gabriele Masselli, Lorenzo Derchi, Josephine McHugo, Andrea Rockall, Peter Vock, Michael Weston, John Spencer
Acute abdominal pain in pregnancy presents diagnostic and therapeutic challenges. Standard imaging techniques need to be adapted to reduce harm to the fetus from X-rays due to their teratogenic and carcinogenic potential. Ultrasound remains the primary imaging investigation of the pregnant abdomen. Magnetic resonance imaging (MRI) has been shown to be useful in the diagnosis of gynaecological and obstetric problems during pregnancy and in the setting of acute abdomen during pregnancy. MRI overcomes some of the limitations of ultrasound, mainly the size of the gravid uterus...
December 2013: European Radiology
Caroline S Andeweg, Irene M Mulder, Richelle J F Felt-Bersma, Annelies Verbon, Gert Jan van der Wilt, Harry van Goor, Johan F Lange, Jaap Stoker, Marja A Boermeester, Robert P Bleichrodt
BACKGROUND: The incidence of acute left-sided colonic diverticulitis (ACD) is increasing in the Western world. To improve the quality of patient care, a guideline for diagnosis and treatment of diverticulitis is needed. METHODS: A multidisciplinary working group, representing experts of relevant specialties, was involved in the guideline development. A systematic literature search was conducted to collect scientific evidence on epidemiology, classification, diagnostics and treatment of diverticulitis...
2013: Digestive Surgery
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