1/24. Endoleaks following conventional open abdominal aortic aneurysm repair.OBJECTIVE: to describe the complication of <<<<endoleak>>>> following conventional open abdominal aortic aneurysm (AAA) repair. DESIGN: prospective case study. SETTING: two specialist vascular surgical centres. patients AND methods: six patients who had successful conventional open AAA repair. RESULTS: six patients presented with back or abdominal pain or hypotension between one and eighteen months later. An endoleak at the distal anastomosis was noted in five of the cases and one endoleak at the proximal anastomosis. All six cases were successfully repaired; two of these patients required Dacron graft replacement, whilst in four cases only direct resuturing was needed. There was no evidence of infection. CONCLUSIONS: an endoleak is not a phenomenon confined to stent grafts. It should be considered in all patients who present with back or abdominal pain within eighteen months of open AAA repair. The combination of computed tomography (CT) scan and digital subtraction angiography is most useful for preoperative diagnosis.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/24. hemoperitoneum following rupture of ectopic varix along splenorenal ligament in extrahepatic portal vein obstruction.A 29-year-old man with extrahepatic portal vein obstruction who underwent variceal eradication by sclerotherapy six years ago, was admitted with hypotension and abdominal pain. Abdominal paracentesis yielded frank blood. laparotomy showed bleeding from a large ectopic vessel along the splenorenal ligament. The vessel was ligated and the patient recovered.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
3/24. Painless acute aortic dissection and rupture presenting as syncope.Acute aortic dissection is an emergency that may not only cause significant morbidity but often results in death. A timely diagnosis can prove difficult in the event of an atypical presentation. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterized as ripping or tearing in nature. This article reports on a case of a completely painless acute dissection and rupture in a middle-aged man who presented with syncope. The diagnosis was made by a combination of clinical suspicion, emergent bedside echocardiography, and computed tomography scan. This patient underwent immediate surgery, and ultimately had a successful outcome.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
4/24. pelvic pain, low blood pressure, and hemolysis after outpatient hysteroscopy in a patient with glucose-6-phosphate dehydrogenase deficiency.OBJECTIVE: To report hemolytic crisis in a woman with glucose-6-phosphate dehydrogenase (G6PD) deficiency who underwent diagnostic hysteroscopy using endoscopic instruments sterilized in gluteraldehyde and phenol disinfectant. DESIGN: Case report. SETTING: Surgical unit of a university hospital. PATIENT(S): A 53 year-old woman with endometrial thickening on ultrasonography. INTERVENTION(S): Diagnostic hysteroscopy. MAIN OUTCOME MEASURES: Laboratory tests. RESULT(S): The patient experienced abdominal pain and acute hypotension 10 minutes after diagnostic hysteroscopy. We attributed this event to the exposure of her genital mucosa caused by the hysteroscopic chemical disinfectant. CONCLUSION(S): Chemical sterilization of endoscopes can cause clinical manifestations in people with G6PD deficiency, a common enzyme abnormality. The phenol content in some chemical disinfectants for endoscopic instruments can also cause hemolytic crisis.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
5/24. An unusual case of an atypical eating disorder masquerading as a serious multi-systemic illness.An early diagnosis and multidisciplinary team approach are mandatory in the management of eating disorders. Serious organic symptoms and nutritional effects can mimic a systemic illness, particularly in those with atypical presentations. A 15-y-old adolescent male presented with poor growth, low weight, abdominal pain and yellow pigmentation. Further bizarre multi-system symptomatology resulted in a protracted admission with multiple investigations. An initial diagnosis of teratoma proved negative on abdominal laparotomy. A multidisciplinary approach followed by a feeding challenge led to the diagnosis of an eating disorder. The disorder, although more common in girls and adolescents, is increasing in incidence in both males and younger children. Conclusion: Atypical eating disorders are potentially serious and life-threatening illnesses, and paediatricians and psychologists should be aware of unusual presentations.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
6/24. Case review: septic shock in the pregnant patient.This case study involves a 36-year-old female at 15 weeks gestation who presented with severe lower abdominal pain post amniocentesis and subsequently deteriorated into a state of septic shock whilst in the ED. The circumstances surrounding this patient's presentation and subsequent clinical course are presented. The assessment and management of septic shock is also described with specific consideration to this patient's pregnant state.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
7/24. Splenic hemorrhage: a complication of tissue plasminogen activator treatment.thrombolytic therapy with tissue plasminogen activator (tPA) for acute myocardial infarction may result in major bleeding complications such as gastrointestinal or intracranial bleeding. A case is described of severe splenic hemorrhage and rupture which developed 3 h after completion of tPA infusion for suspected acute myocardial infarction. The patient developed hypovolemic shock with abdominal pain and distension and further evidence of myocardial necrosis. A computed tomography scan of the abdomen was helpful in elucidating the diagnosis, and surgical splenectomy resulted in a good patient outcome, though the period of hypotension had increased the extent of myocardial necrosis.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
8/24. nifedipine-induced hypotension and mesenteric ischemia.We have presented a case in which nifedipine-induced hypotension in a patient receiving beta blocker and nitrate therapy precipitated mesenteric angina, leading to emergency exploratory celiotomy. Although paradoxic angina is an unusual complication of this antianginal therapy, it should be considered in any patient who has acute abdominal pain and hypotension while receiving this therapeutic regimen.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
9/24. Angiotensin I in peritoneal dialysis fluid improved hypotension: a case report.In a bilateral nephrectomized woman undergoing continuous ambulatory peritoneal dialysis, angiotensin I instilled intraperitoneally with the dialysis fluid prevented the fall in systemic blood pressure at peritoneal dialysis and elevated, in high doses, the systemic blood pressure in a dose-dependent manner over the whole observation period. The blood pressure lowering effect could be completely reversed by infusion of the angiotensin ii receptor antagonist, saralasin. However, some side effects observed, like increased motility of gut, diarrhea and abdominal pain probably will limit the application of the drug in clinical routine.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
10/24. Acute autonomic neuropathy following primary herpes simplex infection.A 13-year-old girl presented with postural hypotension, severe abdominal pain and diarrhoea, parotid pain and a transient encephalopathy. There was evidence of an acute autonomic neuropathy and some electrophysiological evidence of a transient peripheral somatic neuropathy. The likely cause was primary herpes simplex infection.- - - - - - - - - - ranking = 0.5keywords = abdominal pain (Clic here for more details about this article) |
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