1/9. Sigmoid colon rupture secondary to Crede's method in a patient with spinal cord injury.Crede's method is a manual suprapubic pressure exerted with a clenched fist or fingers, used to initiate micturition, in patients with spinal cord injury (SCI) who have neurovesical dysfunction. It is usually a benign maneuver unassociated with any major complications. This paper will illustrate a case report involving a sigmoid colon rupture secondary to Crede's method in a patient with SCI. Various techniques of Crede's method are briefly described. It is recommended that patients with quadriplegia avoid forceful use of Crede's method, as it may cause contusion of the abdominal wall and injuries to internal viscera, possibly leading to colonic rupture. It is believed that this is the first reported case of such an unusual complication of Crede's method in patients with SCI.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/9. Abdominal problems in patients with spinal cord lesions.The physiatrist faces two major difficulties when dealing with abdominal problems in spinal cord-injured patients: (1) realizing when there is a serious problem; and (2) determining the etiology of the problem. patients are presented which demonstrate these difficulties. One patient with a ruptured appendix and the periappendicial abscess had only mild symptoms whereas another patient with severe abdominal pain, rigidity and rebound tenderness had a viral enteritis. The neurologic innervations of the abdomen and the various signs and symptoms appearing in cord-injured patients with abdominal problems are described. A methodical evaluation procedure for acute problems in paraplegic patients is presented.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
3/9. Pain as a presenting feature of acute abdomen in spinal injuries.The diagnosis of acute abdomen can be difficult in patients with spinal injuries. We reviewed all the 1039 case records of patients admitted with spinal injuries to the Queen Elizabeth National spinal injuries Unit, Glasgow over a 7-year-period and found 5 (0.48%) cases of acute abdomen that required surgical intervention and were not caused by original injury. Their presenting signs and symptoms were analysed. Pain was found to be an unreliable symptom in these patients.- - - - - - - - - - ranking = 1.2keywords = spinal (Clic here for more details about this article) |
4/9. diagnosis of the acute abdomen in the neurologically stable spinal cord-injured patient. A case study.The diagnosis of the acute abdomen in the spinal cord injured patient is difficult. Diagnoses are often so delayed that approximately 10% of these patients die of acute abdominal problems. The presentation also varies with the level and duration of injury. An understanding of the functional neuroanatomy of the abdominal wall and viscera aids in timely diagnosis. I present an illustrative case and describe the pertinent functional neuroanatomy.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
5/9. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review.Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.- - - - - - - - - - ranking = 1.2keywords = spinal (Clic here for more details about this article) |
6/9. Acute abdomen in the patient with a ventriculoperitoneal shunt.When patients who have a ventriculoperitoneal shunt present with an acute abdomen, shunt infection may be the cause. The authors relate the cases of three such patients. Two underwent a laparotomy which failed to show any abnormality and which in retrospect might have been avoided. They review the literature and present a systematic approach to the diagnosis and management of this problem. Specific clues from the patient's history, physical examination and further investigation may clarify the diagnosis. When shunt infection cannot be excluded and the clinical setting does not warrant immediate laparotomy, shunt externalization, cerebrospinal fluid culture, empiric antibiotic therapy and close observation of the patient are recommended.- - - - - - - - - - ranking = 0.2keywords = spinal (Clic here for more details about this article) |
7/9. Spinal epidural abscess presenting as acute abdomen in a child.Spinal epidural abscess is seldom encountered in children and rarely occurs in the absence of spinal pain. A case is described in which a child with a thoracic epidural abscess presented with abdominal rather than spinal pain. Thoracolumbar radicular inflammation and visceroparietal reflexes initiated by a s'spinal ileus' probably produced the symptoms and signs of acute intra-abdominal disease. Consideration of intraspinal disease is advisable in all cases of acute abdomen which exhibit atypical features.- - - - - - - - - - ranking = 0.8keywords = spinal (Clic here for more details about this article) |
8/9. ventriculoperitoneal shunt infection masquerading as an acute surgical abdomen.Shunting of cerebrospinal fluid to the peritoneal cavity has brightened the outlook for children with hydrocephalus. Nine hundred sixty-nine primary ventriculoperitoneal shunts were inserted for hydrocephalus between 1970 and 1981. During this same period, 2205 shunt revisions were performed in 847 children, some of whose primary shunt had been inserted prior to 1970 or at other institutions. Nineteen patients with a ventriculoperitoneal shunt infection persented with abdominal pain, fever, and abdominal tenderness; each had acute peritonitis. Three underwent laparotomy with the preoperative diagnosis of appendicitis; however, only infected peritoneal fluid and nonobstructing adhesions were found. A fourth child underwent an unnecessary intestinal resection at another hospital and required prolonged nutritional support and treatment of severe postoperative complications. Fifteen children who presented with an "acute surgical abdomen" were managed with intravenous fluids, gastric decompression, antibiotics, and removal of the intraperitoneal shunt. External ventricular drainage was employed until the cerebrospinal fluid was sterile. The shunt was then internalized in the peritoneal cavity. The abdominal signs and symptoms improved after removing the peritoneal tubing in all children. This plan of therapy has eliminated unnecessary laparotomy in those who may require repeated procedures for control of hydrocephalus.- - - - - - - - - - ranking = 0.4keywords = spinal (Clic here for more details about this article) |
9/9. Acute abdominal pain in the presence of hemi-corporeal neurosensory deficits.Acute abdominal conditions may be extremely difficult to diagnose in patients with spinal cord neurologic deficits. syringomyelia, and the surgical treatment of it, can cause an unusual distribution of neurosensory defects involving primarily pain and temperature sensation, and this can mask occult intraabdominal pathology. We report a case of acute abdominal pain in a patient previously treated with a syringo-pleural shunt for correction of a cervical syringomyelia and the difficulties in diagnosis that this presents.- - - - - - - - - - ranking = 0.2keywords = spinal (Clic here for more details about this article) |