1/13. The abdominal compartment syndrome: a report of 3 cases including instance of endocrine induction.Three patients with the abdominal compartment syndrome are presented and discussed. In one of the patients the condition was induced in an endocrine fashion, since trauma was sustained exclusively by the middle third of the left leg. The development of the syndrome as a remote effect of local trauma has never been reported previously. In all three instances only insignificant amounts of intraperitoneal fluid was found and the increase in abdominal pressure was due to severe edema of the mesentery and retroperitoneum. Since the condition is highly lethal, early diagnosis is imperative, and this starts by carrying a high index of suspicion. Measurement of the intraperitoneal pressure easily confirms this diagnosis. It is emphasized that measurements at various sites, like bladder and stomach, in each patient is essential to confirm the diagnosis, since one of the sites may be rendered unreliable due to intraperitoneal processes impinging on the affected site and affecting its distensibility.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/13. 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 = 0.5keywords = pressure (Clic here for more details about this article) |
3/13. Percutaneous removal of retained calculi from the abdomen.With rising pressure placed on health service resources minimally invasive techniques requiring only short hospital admissions are increasing in importance. We describe the techniques used to remove calculi from the peritoneal cavity which had been retained after surgery and continued to cause clinical problems. In both cases described the calculi lay within abscess cavities associated with fistulous tracks to the skin. The fistulae were dilated to allow passage of therapeutic radiologic and endoscopic equipment enabling manipulation and subsequent extraction of the stones. In both cases removal of the calculi allowed complete resolution of the fistulae and the patients made a full clinical recovery. Removal of gallstones which have escaped into the peritoneum at laparoscopic cholecystectomy leading to sepsis has been described; we describe the novel management of a patient in whom extraction had already been attempted, at another hospital, without success. Removal of an appendicolith, described here in another patient, does not appear to have been reported previously.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
4/13. Ruptured phaeochromocytoma--a lesson in acute abdomen.Phaeochromocytoma may present as acute abdomen. This report is of a patient with spontaneous rupture of phaeochromocytoma who presented with abdominal pain and a tender abdominal mass. Ruptured phaeochromocytoma is a rare surgical emergency, with only 30 cases reported in the literature. The classical clinical triad of signs is intense vasoconstriction, tachycardia, and labile blood pressure. Computed tomography scanning of the abdomen is the investigation of choice, and a high index of suspicion is the key to diagnosis. Prompt recognition, appropriate supportive measures, and early surgical intervention can improve the likelihood of survival.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
5/13. Malignant hypertension with intestinal ischemia secondary to juxtaglomerular cell tumor.Malignant hypertension is a well-defined condition associated with high blood pressure and acute target-organ damage. Although 95% of cases are secondary to essential hypertension, its etiological profile is broad. Juxtaglomerular cell tumor is a rare condition, with only approximately 65 cases reported to date. We describe a patient with malignant hypertension with acute renal failure and intestinal ischemia secondary to a juxtaglomerular cell tumor. We believe this is the first case of juxtaglomerular cell tumor causing malignant hypertension. The diagnostic approach and treatment are discussed.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
6/13. Acute abdominal manifestations in patients with ventriculo-peritoneal shunts.Five patients with acute abdominal manifestations after revision of ventriculo-peritoneal shunt were identified. abdominal pain, nausea, vomiting and distention prompted surgical intervention. Clinical evidence of increased intracranial pressure or shunt malfunction were not prominent findings. Exteriorization of the distal (peritoneal) catherer resolved the acute abdominal findings promptly.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
7/13. Repetitive bleeding from a pheochromocytoma presenting as an abdominal emergency. Case report.Recurrent abdominal pain was the only subjective manifestation in a case of pheochromocytoma with retroperitoneal bleeding. At emergency laparotomy the tumor, showing signs of fresh and earlier bleeding, was extirpated. Sinus-type tachycardia was treated with beta-blockade peroperatively, while the diagnosis was still obscure, but hypertension did not follow. Meta-oxedrine and dopamine infusion was continued for 48 hours to sustain the blood pressure. Recovery was uneventful.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
8/13. Abnormal 99mTc-PIPIDA scans mistaken for common duct obstruction.99mTc-PIPIDA scans were obtained in three patients with acute abdominal pain. The appearance of the scans suggested partial common duct obstruction. Two patients underwent surgery. One had acute appendicitis and the second had infarction of the distal ileum. In both cases, the gallbladder and biliary tract were normal. The third patient had been treated with morphine, which is known to increase biliary tract pressure and may cause contraction of the sphincter of oddi. An ultrasound study of the gallbladder was normal and all symptoms resolved within 24 hours. Subsequently, three additional patients without biliary disease have been seen who had similar hepatobiliary scans. All three had received meperidine prior to the study. It is concluded that acute abdominal disease or the administration of morphine sulfate or meperidine can result in a scan pattern suggesting partial distal common duct obstruction in the absence of gallbladder or biliary tract disease.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
9/13. Spontaneous rupture of the cystic duct during pregnancy.A patient with an acute abdomen during pregnancy is reported. It was due to perforation of the cystic duct by a cholesterol gallstone. A cholecystectomy and T-tube drainage resulted in recovery and normal delivery twelve weeks after operation. The presence of gallstones, their location at the weakest point of the cystic duct, and the possible hemodynamic changes (as there is a higher pressure in the vena cava) occurring during pregnancy, are discussed as possible causes of this acute abdominal condition.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
10/13. Ruptured phaeochromocytoma--a rare differential diagnosis of acute abdomen.Ruptured phaeochromocytoma may mimic other cause of acute abdomen and though it is rare, it must be remembered as a possible differential; clinical suspicion should be increased when there is lability in blood pressure. We report a patient whose presentation closely resembles that of a leaking aortic aneurysm. The ultrasound performed was non conclusive and was followed by a computerised axial tomography which showed a retroperitoneal mass. A laparotomy was performed and histology of the mass revealed a haemorrhagic phaeochromocytoma. A computerised axial tomography is a useful investigation to distinguish it from other causes of acute abdomen and in particular a leaking aortic aneurysm.- - - - - - - - - - ranking = 0.5keywords = pressure (Clic here for more details about this article) |
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