1/13. Acute abdomen in a patient treated with lamprene.patients receiving Lamprene may develop acute abdominal symptoms which simulate an abdominal emergency. Withdrawal of the drug relieves these symptoms. The absorption of Lamprene can be increased and deposition in the reticuloendothelial system as crystals can be avoided if it is administered in an alcoholic medium.- - - - - - - - - - ranking = 1keywords = drug (Clic here for more details about this article) |
2/13. Non-steroidal anti-inflammatory drug (NSAID)-induced colonic strictures and perforation: a case report.Although non-steroidal anti-inflammatory drug-induced colopathy is well described, colonic perforations complicating non-steroidal anti-inflammatory drug intake are rare. We report a patient with rheumatoid arthritis who was on long-term diclofenac and presented with early colonic stricture formation and a caecal perforation, which to the best of our knowledge, has only been reported once before. It is important to suspect this diagnosis in patients on non-steroidal anti-inflammatory drug therapy who present with an acute abdomen.- - - - - - - - - - ranking = 7keywords = drug (Clic here for more details about this article) |
3/13. abdominal pain with rigidity secondary to the anti-emetic drug metoclopramide.We report a case of abdominal pain with rigidity, mimicking an acute abdomen, caused by metoclopramide, a common anti-emetic drug. Extrapyramidal symptoms are commonly reported side-effects of this medication. They generally include involuntary movements of limbs, torticollis, oculogyric crisis, rhythmic protrusion of tongue, trismus, or dystonic reactions resembling tetanus, etc. Abdominal rigidity due to this medication, resembling an acute abdomen, has not been reported previously. This case report illustrates the importance of considering medication side-effects when evaluating a patient with abdominal pain and rigidity.- - - - - - - - - - ranking = 5keywords = drug (Clic here for more details about this article) |
4/13. Paraduodenal hernia evoking intermittent abdominal pain.PURPOSE: Description of a very rare case of internal abdominal hernia, namely herniation of the proximal jejunum in the Landzert fossa, through a hole in the mesocolon transversum. MATERIAL AND methods: Based on preoperative history, clinical state and radiological findings, the diagnosis of internal hernia was strongly suspected. RESULTS: Suspected diagnosis was confirmed during laparotomy. After reduction of the jejunum and closure of the hernia orifice, the patient recovered promptly. CONCLUSION: The diagnosis of internal herniation should always be considered in every patient who presents with an acute abdomen, signs of (sub)obstruction and non-typical history. The most important diagnostic tool is computer tomography, that is accurate in 77%.- - - - - - - - - - ranking = 1.0559983450289keywords = closure (Clic here for more details about this article) |
5/13. Hemorrhagic pancreatitis associated with acetaminophen overdose.A 19-yr-old man ingested 25 g of acetaminophen in a suicide attempt. Twenty-one hours after the ingestion the plasma acetaminophen level was potentially hepatoxic at 62 micrograms/ml. The toxicology screen was negative for all other drugs. Thirty-six hours after admission the patient developed an acute abdomen with a serum amylase of 1500 IU. peritoneal lavage revealed a grossly hemorrhagic fluid. Exploratory laparotomy revealed necrotic pancreatitis. Hepatoxicity with the peak SGOT greater than 2000 IU and a mild renal toxicity with the creatinine of 1.9 mg/dl occurred despite late initiation of treatment with n-acetylcysteine. No other etiology for the pancreatitis was found. Peritoneal irrigation was continuously performed through a surgically placed dialysis catheter. pancreatitis associated with acetaminophen overdose has been reported twice in the past. Although the pathophysiology of the pancreatic injury is obscure, the lack of other etiological factors and temporal association of the pancreatitis with acetaminophen-induced hepatic and renal toxicity suggest a causal relationship.- - - - - - - - - - ranking = 1keywords = drug (Clic here for more details about this article) |
6/13. Tuberculous perforation of the small bowel.Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended.- - - - - - - - - - ranking = 1keywords = drug (Clic here for more details about this article) |
7/13. Acute free perforation as a presenting sign of regional enteritis. Case report and collective review of the literature.Regional enteritis rarely presents as free peritoneal perforation. A case of such a manifestation is described and the literature is reviewed. Resection of the diseased segment is mandatory, for it is associated with the least postoperative morbidity and mortality. Satisfactory results are achieved with cutaneous double-barrel ileotransverse colostomy and subsequent reanastomosis or closure but primary anastomosis can be accomplished safely with construction of a "T-vent" (cutaneous transverse colostomy with ileotransverse colostomy). Perforation of an area of regional enteritis, although uncommon, should be considered in the differential diagnosis of the acute abdomen with peritonitis- - - - - - - - - - ranking = 1.0559983450289keywords = closure (Clic here for more details about this article) |
8/13. Colonic ulceration associated with nonsteroidal anti-inflammatory drugs. Report of three cases.Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a variety of gastrointestinal side effects. Effects on the large intestine have been reported with increasing frequency. Recognition of NSAID-induced colonic lesions has been confounded by variable clinical presentations, variable pathologic findings, and unfamiliarity of this entity among clinicians. We have recently seen three cases of NSAID-induced cecal ulcerations in patients undergoing right colectomy. A correct preoperative diagnosis was not made in our patients, one of whom presented with an acute abdomen and two in whom there was an inability to rule out carcinoma. The gross, radiographic, and histologic findings in each case consisted of a characteristic transverse ulceration with thin diaphragm-like scarring. NSAID-induced cecal ulcers can have a variety of presentations to the general surgeon, are likely to be misdiagnosed preoperatively, but may be recognized based on characteristic gross features evident by radiography and colonoscopy, along with a careful history. review of recent literature suggests that laparotomy can be avoided when diagnosis is considered, but operation is indicated for complications, such as hemorrhage, obstruction, or perforation, and when carcinoma cannot be adequately excluded.- - - - - - - - - - ranking = 5keywords = drug (Clic here for more details about this article) |
9/13. A case presentation and review of neutropenic enterocolitis.Neutropenic enterocolitis (NE) is an unusual complication of neutropenia. Its presentation is dramatic, treatment is controversial, and the outcome may be devastating. The available literature about this entity is mainly case reports and autopsy studies. We have recently performed a celiotomy on a patient who developed sepsis and an acute surgical abdomen three days following chemotherapy and radiotherapy for a metastatic adenocarcinoma with no known primary tumor. At surgery he was found to have a boggy right and recto-sigmoid colon with a grossly normal transverse colon. Intraoperative colonoscopy revealed mucosal ulceration and necrosis extending from the dentate line to the cecum. A total abdominal colectomy, closure of the rectal stump, and an ileostomy was performed. Postoperatively, the patient recovered from the abdominal septic process only to succumb to multiple system organ failure secondary to pulmonary sepsis. Upon review of the literature, we found 65 cases of NE that were suspected or diagnosed in the antemortem state and confirmed at surgery or autopsy. In this review, we intend to analyze these case reports, summarize the salient features of the disease and outline the optimal therapeutic approach.- - - - - - - - - - ranking = 1.0559983450289keywords = closure (Clic here for more details about this article) |
10/13. duodenal obstruction in thyroid storm.A 35-year-old, previously healthy woman, known to be thyrotoxic, was transferred from a community hospital for "acute abdomen." abdominal pain, distention, and hyperemesis resolved with placement of nasogastric tube (NGT) and return of 2,600 mL of bilious fluid. Continued high NGT output made oral or NGT administration of antithyroid drugs impossible. We gave propylthiouracil (PTU) by retention enemas with therapeutic serum levels and sublingual saturated solution of potassium iodide (SSKI) with 70% absorption based on 24-hour free iodine urinary excretion. The patient's thyroxine (T4) and triiodothyronine (T3) radioimmunoassays were normal on hospital days 10 and 12, respectively. However, free T4 and T3 resin uptake did not normalize until hospital day 31. On hospital day 32, she tolerated removal of NGT without nausea and 4 days later was taking a regular diet. We conclude that our patient's gastrointestinal symptoms were a prominent feature of her thyrotoxicosis and that rectal PTU and sublingual SSKI are effective in administration of antithyroid drugs.- - - - - - - - - - ranking = 2keywords = drug (Clic here for more details about this article) |
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