[Fever, hematuria and water-air level in the left hemi-abdomen].
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Objective:To investigate the mechanism and diagnosis of delayed spleen rupture.Methods:The diagnosis of 18 patients with delayed spleen rupture from January,1999 to March,2003 were reviewed.Results:The diagnosis was established by the history of injury,clinical presentations,diagnostic peritoneal puncture,abdominal ultrasonography and/or CT.The accuracy rate of diagnosis was 94.4%.Eighteen patients were treated operatively and cured.One had postoperative complication with effusion in the splenic fossa,and another one with infection of the incision wound.Conclusion:The patients with injury of the chest,back and abdomen should be carefully examined and observed.The diagnostic peritoneal puncture with ultrasonography and CT scan were very valuble in defining delayed spleen rupture.
Peritoneal Effusion
Abdominal ultrasonography
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Objective To explore the diagnosis,treatment,and prevention of delaying enteroparalysis following acute abdomen.Methods Medical records from 160 patients who undertook acute abdomen were analyzed,which included abdominal pain,abdominal distention,recovery time of bowel sounds,clinical diagnosis,therapy,and prevention.Results 11 patients developed delaying enteroparalysis,whereas the patients who undertook laparoscopic procedure did not occur.Conclusions The following measures may lessen significantly symptoms of the disease,including full preoperative preparation,gentle surgical procedure,intraoperative protective management,postoperative effective measures of anti-infection and support,continuous gastrointestinal decompression,the traditional Chinese medicine,and physical therapy.
Acute abdomen
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A geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain and the interval development of epigastric and left upper quadrant abdominal pain. He was admitted to the hospital for evaluation and serial examinations. Mild diffuse abdominal tenderness developed overnight, and computed tomography of the abdomen revealed a perforated appendix with suppuration. An appendectomy was done immediately. The diagnosis of appendicitis in the geriatric patient is occasionally difficult because of atypical and sometimes misleading physical findings.
Epigastric pain
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Objective To explore the method and advantages of laparoscopic surgery in acute abdomen.Methods The clinical data that laparoscopic diagnosis and treatment in 132 cases of acute abdomen was analyzed from March 2004 to July 2011.Results All patients were cured,118 cases(89.4%) were treated by laparoscopic surgery,14 case(10.6%)were conversed to open operation.The average operative time was 55 minutes,the average amount of bleeding was 15 milliliters,the average hospital staye was 5.5 days.Conclusion Compare with open operation,laparoscopic surgery have advantages of less pain,shorter hospital stay,fewer complications,and is a preferred means of diagnosis and treatment in acute abdomen.
Acute abdomen
Open surgery
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We reviewed 1325 cardiovascular surgical cases in our 17-year experience. Seven men and 2 women presented with an acute abdomen between postoperative day 4 and day 26. Intra-abdominal complications included gastroduodenal hemorrhage in 3 men, perforated duodenal ulcer in 1 man, acalculous cholecystitis in 3 patients after 2 to 4 weeks of fasting, intestinal obstruction in 1 woman, and mesenteric artery occlusion in 1 man. Two of these patients (22%) died from subsequent complications and the others recovered after surgical interventions. None of the 633 patients under 50 years old developed an acute abdomen. Complications related to gastroduodenal ulcer were observed only in men. Far advanced heart failure that forced long-term fasting might have been the cause of acalculous cholecystitis. Prompt and appropriate surgical interventions were required to minimize unfavorable consequences.
Acute abdomen
Gastroduodenal artery
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Hemorrhagic complications induced by anticoagulants occur in about 10-20% of patients treated. The bleeding source is found in the gastrointestinal tract in 30%. A careful history and physical examination, in combination with radiologic evaluation, serve to localize the bleeding site and avoid unnecessary surgery. Because anticoagulated patients may have the clinical picture of acute abdomen, it is important to differentiate extra-, intra- and retroperitoneal complications. During the past ten years we have treated 16 patients with acute abdomen under anticoagulation therapy: extra-, intra- and retroperitoneal complications were found in three, nine and four cases respectively. Rectus sheath hematomas, intramural bowel hematomas and retroperitoneal hematomas primarily underwent conservative, symptomatic treatment. Only intraperitoneal hemorrhage and psoas hematomas with neurologic manifestations required early surgical treatment. After successful treatment the indication for anticoagulation therapy should be reevaluated.
Retroperitoneal Hemorrhage
Acute abdomen
Anticoagulant Therapy
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Objective To summarize the clinical manifestations of acute abdomen in gynecology,surgery and non-surgical treatment and prognosis.Methods 100 patients admitted to the clinical manifestations of gynecologic acute abdomen,surgical and non-surgical treatment and prognosis were analyzed.Results 100 cases of gynecologic acute abdomen based on history,clinical symptoms,signs and various laboratory examinations showed that the prognosis showed:surgical treatment of this group of cases in which 73 patients,with no deaths,surgical incisions healed well,the average hospital stay was discharged 7d stitches.Conclusion For patients with gynecological acute abdomen should be carried out detailed history and comprehensive general physical examination,laboratory examinations necessary,reasonable and timely surgery and non-surgical treatment.
Acute abdomen
Clinical history
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Objective To analyze and summarize the clinical diagnosis and treatment of abdominal pain in children. Methods In our hospital from March, 2010 to 2012,a total of 96 cases of abdominal pain children were treated and the clinical data were retrospectively analyzed. Results Through the clinical diagnosis,abdomen internal and surgical diseases could cause abdominal pain,this group of 96 cases,75 cases of internal medicine disease patients,21 cases of surgical patients,all patients were recovered after treatment. Conclusion The causes of abdominal pain in children were correct diagnosed,we could timely and effectivly treat the abdominal pain.
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