acute abdomen and lactate level

BACKGROUND: Optimal management following index laparotomy is poorly defined in secondary peritonitis patients. Although "open abdomen" (OA), or temporary abdominal closure with planned relaparotomy, is used to reassess bowel viability or severity of contamination, recent studies demonstrate comparable morbidity and mortality with primary abdominal closure (PC). This study evaluates differences between OA and PC following emergent laparotomy. METHODS: Using the Premier database at a quaternary care center (2012-2016), nontrauma patients with secondary peritonitis requiring emergent laparotomy were identified (N = 534)...

BACKGROUND: Ovarian lymphoma has a varied clinical presentation and rarely presents with heavy menstrual bleeding. It may occur de novo or secondary to systemic disease and macroscopically appear as solid ovarian tumors. CASE PRESENTATION: A 32-year-old Tamil woman presented with heavy menstrual bleeding of 4 months' duration. On examination she was anemic with no lymphadenopathy. A large immobile pelvic mass and three firm nodules were found involving her vaginal walls...

BACKGROUND: Unlike the elective treatment of metastatic colorectal cancer (MCRC), sufficient data and consensual guidelines on acute care are lacking. OBJECTIVES: To analyze a cohort of MCRC patients who required urgent surgery due to acute abdomen and to identify risk factors contributing to the patient's perioperative mortality and morbidity. METHODS: A retrospective analysis was conducted of patients diagnosed with stage IV colorectal cancer who required urgent laparotomy at the Rabin Medical Center...

A 91-year-old female presented to the Emergency Department with a 10-day history of constipation and abdominal pain. Abdominal examination was normal and rectal examination showed faecal loading. A phosphate enema was given and the patient was admitted. Overnight, the patient's GCS dropped from 15/15 to 3/15 and an arterial blood gas showed a lactate of 8 mmol/L (1.5 on admission). Abdomen remained soft throughout. A CT scan showed a large amount of free air and free fluid within the abdomen and pelvis, highly suspicious for perforation...

RATIONALE: We report our experience with 2 patients diagnosed with grey zone lymphoma (GZL). The histopathological characteristics of lymphomatous tissues in these patients ranged between those of diffuse large B-cell lymphoma (DLBCL) and the classical Hodgkin lymphoma. PATIENT CONCERNS: A 52-year-old female presented to the hospital with a history of lower abdominal pain of metastatic origin for 2 days. She was diagnosed with acute appendicitis and had undergone emergency surgery...

BACKGROUND: Data from the trauma patient population suggests handsewn (HS) anastomoses are superior to stapled (ST). A recent retrospective study in emergency general surgery (EGS) patients had similar findings. The aim of the current study was to evaluate HS and ST anastomoses in EGS patients undergoing urgent/emergent operations. METHODS: The study was sponsored by the American Association for the Surgery of Trauma Multi-Institutional Studies Committee. Patients undergoing urgent/emergent bowel resection for EGS pathology were prospectively enrolled from July 22, 2013 to December 31, 2015...

INTRODUCTION: Acute mesenteric ischemia (AMI) is an abdominal-vascular emergency which is rare and has high mortality rates (60-80 %) due to late diagnosis (1-3). Although it is known that extravascular reasons like intestinal intussusception, volvulus, strangulated hernias and obstructions can cause intestinal gangrene, these are rarely the cause of AMI (1). MATERIALS AND METHODS: In this study, we used male Wistar-Albino rats weighing 250-300 grams obtained from Pamukkale University Experimental Research Laboratory...

The patient presented in this study was a 54-year-old woman complaining of nausea and vomiting, onset preceding four days, with no significant past medical history and an unremarkable surgical history. The patient was afebrile and hypertensive. Physical examination revealed a non-tender abdomen, and initial laboratory evaluation revealed elevated blood glucose level, ketonuria, leukocytosis, elevated C-reactive protein, gamma glutamyl transferase, lactate dehydrogenase, and total bilirubin. The patient was admitted to the internal medicine ward due to new onset of diabetes mellitus...

A 52-year-old man presented with acute, sharp chest pain radiating to the back and abdomen after using cocaine 18 hours previously. Computed tomographic angiography revealed a type B aortic dissection that extended to the iliac arteries. The patient underwent balloon fenestration, placement of multiple aortic stents, and bilateral leg fasciotomy. He eventually went into hyperkalemic arrest but was successfully resuscitated, after which his serum lactate and creatine kinase levels peaked at 7.4 mmol/L and 990,400 U/L, respectively...

BACKGROUND AND OBJECTIVE: To evaluate the clinical usefulness of serum intestinal fatty acid binding protein (I-FABP) and D-lactate measurements in the early diagnosis of acute intestinal ischemia. METHODS: A total of 272 patients with a clinical diagnosis of acute abdomen were recruited for this trial over a 24-month period, and 37 healthy people were included in the study as controls. Serum I-FABP and D-lactate levels were measured by an enzyme-linked immunosorbent assay and compared in patients with intestinal ischemia vs...

The supply of oxygen is limited in certain intra abdominal conditions due to direct vascular invasion or inflammatory process, resulting in high lactate levels. Aim of this study was to find the predictive value of lactate levels in the peritoneal fluid (PF) and blood of patients with acute abdomen. The study comprised of fifty patients with acute abdominal conditions, admitted in emergency ward of tertiary care hospital, thirty patients were with surgical abdomen (group I) and twenty patients with non surgical abdomen (group II)...

BACKGROUND: Bedside diagnostic laparoscopy has an important role of diagnosing acute abdomen in critically ill patients hospitalized in the intensive care unit (ICU). Delayed diagnosis of intraabdominal pathology increases the morbidity and mortality rates for these patients, whose clinical signs often are absent due to analgesic medication and sedation. METHODS: In this retrospective study performed from January 2007 to December 2009, 62 consecutive ICU patients whose blood test results showed them to be hemodynamically unstable underwent bedside diagnostic laparoscopy...

CONTEXT: Schistocytes are fragmented red blood cells due to the flow of blood through damaged capillaries and indicate endothelial injury. They are typical of microangiopathic hemolytic anemia seen in life threatening conditions like disseminated intravascular coagulation or thrombotic thrombocytopenic purpura/hemolytic uremic syndrome .We report a rare sub-acute presentation of pernicious anemia with hemolysis, thrombocytopenia and numerous schistocytes that was initially diagnosed as a more serious thrombotic thrombocytopenic purpura...

BACKGROUND: Renal infarction is a condition not known to every physician, with often non-specific symptoms. The diagnosis is therefore often not considered initially in patients with acute abdominal pain. CASE DESCRIPTIONS: In a 77-year-old man a renal infarction was found by chance on a CT-scan performed performed for the evaluation of dyspnoea. Previously he had visited the emergency unit with abdominal pain, in retrospect attributable to renal infarction. A 61-year-old man initially labelled as suffering from gastro-enteritis was diagnosed correctly with renal infarction after his renal function deteriorated and the lactate dehydrogenase (LDH) activity increased...

Clinical diagnosis of acute mesenteric ischemia is difficult. The aim of this review is to provide current status on the search for an accurate plasma biomarker for acute mesenteric ischemia. A search using the medical subject heading terms marker and mesenteric ischemia or intestinal ischemia or superior mesenteric artery occlusion or mesenteric venous thrombosis in the Medline and Embase databases from 1980 to 2011. Studies without a control group or a control group consisted of healthy individuals (human studies), or studies on intestinal reperfusion were excluded...

In the present scenario, doctors have to rely on radiological methods for diagnosis of acute abdomen in addition to their clinical skill. The use of serum markers for assessing the outcome of such patients is still debatable. Our aim was to evaluate whether the combined use of serum lactate, interleukin (IL)-6, and C-reactive protein (CRP) is able to simultaneously establish both the septic status and the prognosis of acute abdomen. Ninety-nine patients undergoing surgery for acute abdomen were taken up for the study...

A 67-year-old man presented to the emergency department with acute abdominal pain, which had started 3 hours earlier. On physical examination, the abdomen was distended and tender to palpation. The levels of serum lipase and lactate were within normal limits, as were the white-cell count and..

BACKGROUND: Intestinal fatty acid-binding protein (I-FABP) is a low-molecular-mass (15 kDa) cytosolic protein found exclusively in the epithelial cells of the small bowel mucosa. We aimed to evaluate the clinical usefulness of serum I-FABP measurement for the diagnosis of ischemic small bowel disease. METHODS: Patients with a clinical diagnosis of acute abdomen were recruited for this multicenter trial at one university hospital and nine city hospitals over a 13-month period...

INTRODUCTION: Early diagnosis of acute appendicitis, known as the most frequent cause of acute surgical abdominal pathologies, dramatically decreases the related complications. D-lactate, produced by intestinal bacteria as a fermentation product, may be useful in diagnosing acute abdominal pathologies. The aim of this study was to investigate whether the presence of d-lactate would be a significant indicator in the early diagnosis of acute appendicitis. METHODS: Eighty consecutive patients were prospectively included in this study...

OBJECTIVE: To evaluate the value of immediate postoperative arterial lactate level to predict morbidity after major abdominal surgery. METHODS: 139 patients, 73 males and 66 females, aged (64 +/- 14) (26 - 87), who underwent major abdominal surgery had their levels of arterial lactate, blood routine, blood gas and electrolytes measured after they were sent to the ICU. The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and the simplified acute physiology score II (SAPSII) levels in the first 24-hour postoperative period were calculated Multivariate logistic regression analysis was utilized to examine the independent relationship of the initial lactate, blood gas values, and anion gap with the morbidity...