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Littérature scientifique sur le sujet « Upper Abdominal Disease »

Auteur : Grafiati

Publié le 9 mars 2023

Mis à jour le 10 mars 2023

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Articles de revues sur le sujet "Upper Abdominal Disease"

Ridha, Ali, Njideka Oguejiofor, Sarah Al-Abayechi et Emmanuel Njoku. « Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease ». Case Reports in Infectious Diseases 2017 (2017) : 1–3. http://dx.doi.org/10.1155/2017/1972023.

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Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.

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Hsu, Hung-Lin, et Wei-Jing Lee. « Man with sudden upper abdominal pain ». Hong Kong Journal of Emergency Medicine 26, n^o 2 (9 juillet 2018) : 130–31. http://dx.doi.org/10.1177/1024907918788221.

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A 52-year-old man without systemic disease presented to the emergency department with sudden-onset epigastric pain for 2 h. He had vomiting for several times without fever, diarrhea, or recent abdominal trauma. Point-of-care ultrasound revealed flap in the superior mesenteric artery. Percutaneous endovascular stent placement was arranged due to refractory upper abdominal pain and poor response to medical treatment.

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Roma, E., J. Panayiotou, Y. Kafritsa, C. Van-Vliet, A. Gianoulia et A. Constantopoulos. « Upper gastrointestinal disease, Helicobacter pylori and recurrent abdominal pain ». Acta Paediatrica 88, n^o 6 (2 janvier 2007) : 598–601. http://dx.doi.org/10.1111/j.1651-2227.1999.tb00006.x.

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Kurth, T., G. Holtmann, J. Neufang-Hüber, G. Gerken et H.-C. Diener. « Prevalence of Unexplained Upper Abdominal Symptoms in Patients with Migraine ». Cephalalgia 26, n^o 5 (mai 2006) : 506–10. http://dx.doi.org/10.1111/j.1468-2982.2005.01076.x.

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Patients with functional gastrointestinal disorders frequently report migraine. We aimed to determine the prevalence of idiopathic upper abdominal symptoms in patients with migraine and compare it with a control population of healthy blood donors. We assessed abdominal symptoms using the Bowel Disease Questionnaire in a series of 488 consecutive blood donors without migraine and 99 patients with migraine. Upper abdominal symptoms were reported by 38% [95% confidence interval (CI) 32, 44] of blood donors compared with 81% (67, 91, P < 0.001) of migraine patients. Of the blood donors, 23% (18, 28) reported frequent dyspepsia compared with 60% (44, 74, P < 0.001) of the migraine patients. Migraine was associated with frequent upper abdominal symptoms (odds ratio 2.7, 95% CI 1.2, 6.1) after adjusting for age, gender, smoking and consumption of analgesics and alcohol. Upper abdominal symptoms are significantly more frequent in patients with migraine compared with healthy controls. The association between migraine and idiopathic upper abdominal symptoms may suggest common pathophysio-logical mechanisms.

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Aiyegbeni, Bibiana, Saleem Jonnalagadda, Lee Creedon et Aija Teibe. « Rare Cause of Left Upper Abdominal Pain ». Prague Medical Report 122, n^o 2 (2021) : 106–11. http://dx.doi.org/10.14712/23362936.2021.11.

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Inflamed diverticular disease of the small bowel is an uncommon cause of acute abdominal pain. Despite its low prevalence rate (0.3–2%), it is associated with a high mortality rate between 20–25% (Fisher and Fortin, 1977; Ferreira-Aparicio et al., 2012). This is due to complications including perforation, bleeding, and obstruction. This case report presents the diagnosis and management of Mr. X, a 70-year-old male with jejunal diverticulitis and a duodenal diverticulum. Mr. X has a background of type 2 diabetes mellitus and sigmoid diverticulosis, he presented with a three-day history of left upper quadrant pain radiating to the left iliac fossa. He was haemodynamically stable despite his elevated inflammatory markers (C-reactive protein 161 mg/l and neutrophils 13.3×109/l) and computerised tomography (CT) of the abdomen and pelvis showing jejunal diverticulitis and a duodenal diverticulum. Mr. X was successfully treated with intravenous antibiotics and analgesia and a follow up CT scan showed that the jejunal diverticulitis had resolved. Previous operative management of the discussed pathology has been reported, the current report is novel as the diagnosis was made early and the case managed conservatively.

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Benny, Bobithamol K., Stephen Daimei, Thouseef Mohammed, Prity Ering et Tatagata Dutta. « Subacute infective endocarditis presenting as upper abdominal pain ». International Journal of Advances in Medicine 7, n^o 10 (22 septembre 2020) : 1588. http://dx.doi.org/10.18203/2349-3933.ijam20204079.

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Splenic abscess develops in 3-5% of patients with infective endocarditis. In more protracted subacute cases of infective endocarditis, symptoms and signs such as anorexia, weight loss, weakness, arthralgia and abdominal pain may occur in 5-30% of patients and thereby misleading the clinician to pursue incorrect diagnosis such as malignancy, connective tissue disease, or other chronic infection or systemic inflammatory disorders. Left upper quadrant pain can be a presenting symptom in a patient with IE, if it is complicated by septic embolization to spleen. Here reported a case of subacute infective endocarditis complicated with splenic embolization in a 34-year-old male with diabetic nephropathy and ischemic dilated cardiomyopathy, presented as acute abdominal pain.

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Md. Hafiz Sardar, Md Hafiz, Mohammad Murad Hossain, Khan Abul Kalam Azad, Md Uzzwal Mallik et Moumita Chakraborty. « Peptic Ulcer Disease and Misuses of Ulcer Healing Drugs in a Tertiary Care Hospital in Dhaka City ». Journal of Medicine 16, n^o 1 (24 février 2015) : 27–34. http://dx.doi.org/10.3329/jom.v16i1.22386.

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This prospective cross sectional study was conducted in Dhaka Medical College Hospital, Dhaka during July, 2013 to December, 2013. Hundred patients were included in this study. Peptic ulcer disease, presented as upper abdominal pain is one of the common disease with a number of underlying causes. Prospective analyses of 100 patients with upper abdominal pain were studied at medicine units of Dhaka Medical College Hospital, Dhaka. Of these 36 patients belonged to peptic ulcer, 20 patients to irritable bowel syndrome and 22 patients to non-ulcer dyspepsia. Next in order were helminthiasis (5 patients), cholelithiasis (4 patients), gastric carcinoma (4 patients), liver abscess (5 patients) chronic pancreatitis (3 patients) and acute pancreatitis (1 patient). Mean age incidence in this series was 39.47 years. Male and female ratio was 1.54:1. Forty patients were smoker with male and female ratio of 3.44:1.All patients had presenting feature of upper abdominal pain. Commonest site of pain was in the epigastrium in 48.08% of cases.Pain was burning in 43.27% cases, periodic pain in 24.03%, and nocturnal hunger pain in 33.65% of cases.Relief of pain after taking food were observed in 38.46%. Epigastric tenderness was present in 56.73% patients.The diagnosis of peptic ulcer disease, irritable bowel syndrome and non-ulcer dyspepsia, the three leading causes of upper abdominal pain, were suspected by history and physical examination but it was difficult to interpret these on clinical ground alone .Some routine and some selected investigation were done for confirmatory diagnosis.In this series, significant disparity detected between clinically diagnosed peptic ulcer diseases 90.38% and endoscopically confirmed peptic ulcer disease, 34.62% cases. As a consequence of wrong diagnosis of PUD, there are huge misuses of ulcer healing drugs and a great economic burden on patients (300 taka per month) and on the nation.DOI: http://dx.doi.org/10.3329/jom.v16i1.22386 J MEDICINE 2015; 16 : 27-34

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Wong, Ching Hin Kevin, Ho Kai Patrick Tsang, Oi Fung Wong, Hing Man Ma et Chau Hung Albert Lit. « A case of rectus sheath haematoma related to severe coughing in a patient with acute exacerbation of chronic obstructive pulmonary disease ». Hong Kong Journal of Emergency Medicine 26, n^o 6 (4 juin 2018) : 371–74. http://dx.doi.org/10.1177/1024907918779525.

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Introduction: Rectus sheath haematoma is a rare condition which is often misdiagnosed. Apart from abdominal trauma and anticoagulation, severe coughing is an uncommon precipitating cause of this rare condition. Case presentation: An elderly gentleman with history of ischaemic heart disease on aspirin developed rectus sheath haematoma due to severe coughing during an episode of acute exacerbation of chronic obstructive pulmonary disease. He developed severe abdominal pain and was noted to have epigastric bruising extending to bilateral loins. Ultrasound abdomen and computed tomography of the abdomen with contrast revealed haematoma over bilateral upper rectus abdominis muscles, which subsided with conservative management. Discussion and conclusion: Rectus sheath haematoma can be related to severe coughing. In patients, especially those with predisposing factors, presenting with abdominal pain and palpable painful abdominal mass, clinicians should raise the suspicion of this uncommon cause so that timely and appropriate management can be provided.

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Freeman, Hugh J. « Nonceliac Diaphragm Disease of the Duodenum ». Canadian Journal of Gastroenterology 14, n^o 5 (2000) : 453–55. http://dx.doi.org/10.1155/2000/365170.

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A 58-year-old, Indo-Canadian man presented with upper abdominal pain and the clinical features of a partial, gastric outlet obstruction. Subsequent studies, including endoscopic examination, revealed diaphragm-like strictures in the descending duodenum. Other reported causes such as celiac disease and drug-induced small bowel diaphragms were excluded. Possibly, the changes seen in this patient were related to ethnic food-induced, mucosal injury to the upper gastrointestinal tract. Further studies are needed to evaluate potential toxicity or protective effects of different ethnic diets and their relationship with the development of different intestinal diseases.

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Gomez, Anthony J., et Robert J. Bailey. « An Unusual Case of Monolobar Caroli’s Disease ». Canadian Journal of Gastroenterology 8, n^o 3 (1994) : 185–88. http://dx.doi.org/10.1155/1994/768974.

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A 27-year-old male with recurrent upper abdominal pain was found to have a suspicious mass in the right hepatic lobe. Right hepatectomy was performed. Pathological examination and further radiological evaluation proved this to be a focal form of Caroli’s disease.

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Thèses sur le sujet "Upper Abdominal Disease"

PEIRETTI, MICHELE. « Role of maximal primary cytoreductive surgery in patients with advanced epithelial ovarian and tubal cancer : surgical and oncological outcomes. single institution experience ». Doctoral thesis, Università degli Studi di Milano-Bicocca, 2010. http://hdl.handle.net/10281/8049.

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Objective. The objective of the present study was to determinate the impact of maximal cytoreductive surgery on progression free survival, overall survival rates and morbidity, in patients with advanced epithelial ovarian or fallopian tube cancer (stage IIIC-IV) treated in a referral cancer center. Methods. After obtaining Institutional Review Board approval, we reviewed all medical records of patients with stage IIIC–IV epithelial ovarian cancer who were managed at our institution between January 2001 and December 2008. Individual records were reviewed and the following information collected: age at surgery, date of surgery, American Society of Anestesiology (ASA) class, primary site of disease, presence of peritoneal carcinomatosis, histologic type and tumor grade, pre-operative serum CA-125 level, location and size of the largest tumor mass, the initial ascites volume (if present), all surgical procedures performed, size of residual disease after surgery. The Kaplan–Meier method was used to estimate survival curves. Cox proportional hazards regression was performed to identify independent prognostic variables for overall survival by univariate and multivariate analysis. Results. A total of 269 patients with advanced epithelial ovarian cancer were referred to our institution between January 2001 and December 2008, and of them 240 consecutive patients met inclusion criteria for the study. The median age was 58 years (range 22 to 77 years). After a median follow up of 29.8 months, the overall median survival (OS) and progression free survival (PFS) were 61.1 and 20.4 months respectively. On univariate analysis, factors significantly associated with decreased survival included: age grater than median (>60 years), presence of ascites >1000 cc, diffuse peritoneal carcinomatosis, omentum as anatomical location of the largest tumor mass, positive lymph-nodes and diameter of residual disease. On multivariate analysis confirmed the independent association of age grater than 60 years and residual disease > 5 mm with worse survival. Conclusion. Our study seems to demonstrate that a more extensive surgical approach is associated with improved survival in patients with stages IIIC-IV epithelial ovarian cancer. Age grater than 60 years and residual tumor grater than 5 mm were independently associated with a worse prognosis.

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Livres sur le sujet "Upper Abdominal Disease"

Fong, Yuman, Pierre A. Clavien et M. G. Sarr. Atlas of Upper Abdominal Surgery. Berlin : Springer-Verlag GmbH & Co. KG, 2004.

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Keshav, Satish, et Alexandra Kent. Alcoholic liver disease. Sous la direction de Patrick Davey et David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0211.

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Alcoholic liver disease develops in excessive drinkers and can manifest in three forms: alcoholic fatty liver (steatosis; >80%), alcoholic hepatitis (10%–35%), and cirrhosis (10%). The more alcohol consumed, the greater the risk of alcoholic liver disease, although other factors may also be involved. Alcohol can cause significant damage without producing any symptoms, and many patients will only have liver dysfunction detected on routine blood tests. Many patients report non-specific symptoms, such as anorexia, morning nausea, diarrhoea, and vague right upper quadrant abdominal pain. The underlying pathogenesis of alcohol-induced injury is not fully understood but is thought to involve various mechanisms. This chapter discusses alcoholic liver disease, focusing on its etiology, symptoms, demographics, natural history, complications, diagnosis, prognosis, and treatment.

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Falk, Stephen. Upper gastrointestinal tract. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199696567.003.0006.

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Chapter 6 discusses the upper gastrointestinal tract, and addresses that the technical challenges of these diseases are considerable related to tumour volumes, anatomical situation, and poor normal tissue tolerance particularly of the intra-abdominal contents. More contemporaneous treatment techniques such as IMRT and IGRT have not currently made significant impact in the routine treatment of upper gastrointestinal tumours in the UK.

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Keshav, Satish, et Alexandra Kent. Dyspepsia. Sous la direction de Patrick Davey et David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0025.

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Dyspepsia is a term encompassing several symptoms of the upper gastrointestinal (GI) tract, including acid reflux, heartburn, nausea, vomiting, and abdominal pain or discomfort. Up to 40% of the population suffer with dyspepsia; 5%–10% will consult their GP, and 1% will undergo endoscopic assessment. Over-the-counter medications cost patients £100 million annually, and prescribed drugs cost the NHS over £463 million annually. There is a steady rise in incidence with increasing age. Helicobacter pylori is present in 40% of the UK population, with many individuals acquiring the infection in childhood and remaining asymptomatic. It has been associated with peptic ulcer disease and distal gastric cancer. This chapter covers the approach to diagnosis, key diagnostic tests, therapies, and prognosis as well as dealing with uncertainty when it comes to the initial diagnosis.

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Orellana, Renán A., et Jorge A. Coss-Bu. Nutrition and Gastrointestinal Emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0014.

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Appropriate nutrition must be tailored to the specific needs of individual patients. Needs depend on the child’s baseline nutritional status, the severity of disease, and specific organ dysfunction. Enteral nutrition is preferable whenever possible. Parenteral nutrition may be necessary when efforts to supply adequate nutrition enterally are contraindicated or unsuccessful. Patients with symptoms of acute abdomen require prompt recognition of surgical and nonsurgical disorders. Upper gastrointestinal hemorrhage may require transfusion of blood products, vasoactive drug infusion to minimize ongoing losses, and endoscopy following stabilization. Pancreatitis typically requires an orogastric/nasogastric tube for decompression, aggressive pain management, and radiological evaluations. Abdominal compartment syndrome needs to be recognized promptly to avoid further injury. Acute liver failure commonly leads to multiorgan system dysfunction and death. Specific therapy is available only in a minority of cases, and outcome depends on excellent supportive care, prompt evaluation by a pediatric gastroenterologist, and referral to a transplant center.

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Chapitres de livres sur le sujet "Upper Abdominal Disease"

Li, Feng, et Cuong C. Nguyen. « Right Upper Quadrant Abdominal Pain ». Dans Practical Gastroenterology and Hepatology : Liver and Biliary Disease, 105–12. Oxford, UK : Wiley-Blackwell, 2010. http://dx.doi.org/10.1002/9781444325249.ch12.

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Gaines, Sara, et John C. Alverdy. « Mesenteric Resection in Upper Abdominal Surgery ». Dans The Mesenteric Organ in Health and Disease, 329–33. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-71963-0_35.

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Monclova, Julio Lopez, Carlos Rodriguez Luppi et Eduardo Mª Targarona Soler. « Minimally Invasive Splenectomy for Oncological Diseases of the Spleen ». Dans Minimally Invasive Surgery for Upper Abdominal Cancer, 345–57. Cham : Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-54301-7_32.

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« Occlusive Disease of the Upper Abdominal Aorta ». Dans Aortic Surgery, 219–32. CRC Press, 2000. http://dx.doi.org/10.1201/9781498712804-22.

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Bahar SEZGIN, Seckin, Ozgur KARCIOGLU, Selman YENİOCAK et Mandana HOSSEINZADEH. « Specific Diagnoses and Management Principles of the Upper Digestive Canal ». Dans Abdominal Pain : Essential Diagnosis and Management in Acute Medicine, 51–105. BENTHAM SCIENCE PUBLISHERS, 2022. http://dx.doi.org/10.2174/9789815051780122010005.

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Acute abdominal conditions which frequently necessitate emergency interventions and/or surgery include visceral perforations i.e., gastric and duodenal ulcer, bleeding and rarely, ingested foreign bodies causing tissue damage, e.g., button batteries. However, the differential diagnosis (DD) of patients presenting with acute abdominal pain is much broader than this, including many benign conditions as well. Acute gastroenteritis, acute gastritis and peptic ulcer disease are benign and mostly temporary diseases which may be relieved with simple treatments and follow-up. Gastrointestinal bleeding (with or without esophageal varices) may cause hemorrhagic shock unless expedient management is pursued. Ingested foreign bodies can constitute emergency conditions with tissue damage, especially when lodged in a specific site. The most important thing about button batteries is the prevention of their ingestion. Complications increase in direct proportion to time wasted.

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« Peripheral vascular disease ». Dans Oxford Handbook of Clinical Surgery, sous la direction de Greg McLatchie, Neil Borley, Anil Agarwal, Santhini Jeyarajah, Rhiannon Harris et Ruwan Weerakkody, 775–808. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198799481.003.0019.

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This chapter assesses peripheral vascular disease. It begins with acute limbic ischaemia; chronic upper limb ischaemia; chronic lower limb ischaemia; intermittent claudication; and critical limb ischaemia. The chapter then turns to aneurysms; ruptured abdominal aortic aneurysm; vascular developmental abnormalities; carotid disease; vasospastic disorders; varicose veins; deep venous thrombosis; and thrombolysis. It also considers the diabetic foot and amputations, as well as complications in vascular surgery. Complications may occur in the perioperative, early, or late post-operative periods. In general, vascular patients are older and have increased cardiac, cerebral, pulmonary, and renal comorbidities. This is due to the associated risk factors of hypertension, diabetes mellitus, hypercholesterolaemia, and smoking.

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Jones, Kelsey D. J. « Gastroenterology ». Dans Oxford Handbook of Tropical Medicine 5e, 223–314. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198810858.003.0006.

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Disorders of the mouth and pharynx?, Dyspepsia, dysphagia and reflux, Upper GI bleeding, Oesophageal varices, Acute abdominal pain, Acute diarrhea, Persistent diarrhea, Compendium of diarrhea-causing pathogens, Travelers’ diarrhea, Food poisoning, Intestinal flukes, Schistosomiasis (bilharzia), Soil-transmitted helminths (STH), Toxocariasis, Perianal complaints, Acute pancreatitis, Biliary disease, Liver flukes, Liver disease, Viral hepatitis, Alcohol and drug-induced hepatitis, Chronic liver disease and cirrhosis, Portal hypertension, Liver failure, Amoebic liver disease, Liver cancer, Hydatid disease

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Adhikari, Sapana P. « Gastrointestinal ». Dans Diagnosketch, 37–54. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/med/9780197636954.003.0004.

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Abstract This chapter includes various images that pertain to the gastrointestinal system. The first images depict the normal digestive system followed by an image depicting the normal structures that are evaluated with a complaints of abdominal pain. The next images depict gastroesophageal reflux disease, gastritis and ulcer, upper and lower gastrointestinal bleeding, hernia, esophageal foreign body, bowel obstruction, gallbladder disease, pancreatitis, diverticular disease, constipation, perirectal abscess, hemorrhoids, and appendicitis.

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Dean, Gillian, et Jonathan Ross. « Pelvic inflammatory disease ». Dans Oxford Textbook of Obstetrics and Gynaecology, sous la direction de Sabaratnam Arulkumaran, William Ledger, Lynette Denny et Stergios Doumouchtsis, 536–49. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198766360.003.0043.

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Pelvic inflammatory disease is a sexually transmitted infection of the female upper genital tract. Rates of pelvic inflammatory disease have fallen in many countries over the last 10 years, at least in part due to increased screening for chlamydial infection. The clinical spectrum ranges from asymptomatic infection through to severe disease requiring hospitalization. Due to the non-specific nature of the condition, diagnosis can be challenging. All sexually active women presenting with acute lower abdominal pain should have a pregnancy test to rule out ectopic pregnancy. Treatment must be initiated as soon as the diagnosis is suspected and include antibiotics covering a broad spectrum of pathogens. Delay in diagnosis increases the risk of adverse sequelae including ectopic pregnancy and infertility. It is recommended that current and recent sexual partners receive empirical treatment, regardless of symptoms or microbiological results, and refrain from sexual contact until completion of therapy. Through better public understanding of the symptoms of pelvic inflammatory disease, women seeking earlier medical attention may reduce the risk of reproductive damage.

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Farne, Hugo, Edward Norris-Cervetto et James Warbrick-Smith. « Right upper quadrant pain ». Dans Oxford Cases in Medicine and Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/oso/9780198716228.003.0021.

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Yes, the likelihood of certain diseases would change considerably. In older patients, certain pathologies are relatively more common, such as pneumonia, cancer (e.g. hepatocellular carcinoma), or vascular disease (aortic dissection, abdominal aortic aneurysm, inferior myocardial infarction). Of course, the differential would still include those diseases seen in a 38-year-old Mrs Cole. Characterize the pain. One useful way is to follow the mnemonic SOCRATES: Site of pain, and has it moved since it began? Onset of pain—was it sudden or gradual, and did something trigger it? Character of pain—stabbing, dull, deep, superficial, gripping, tearing, burning? Radiation of pain—does the patient have pain elsewhere? Attenuating factors—does anything make the pain better (position? medications?) Timing of pain—how long has it gone on for, has it been constant or coming and going? Exacerbating factors—does anything make the pain worse (moving? breathing?) Severity—on a scale of 0–10, where 10 is the worst pain ever (e.g. childbirth). Once you have characterized the pain, you should ask: • Has the patient had any symptoms other than pain? (e.g. fever, weight loss). The reason is that certain other symptoms will help you refine your diagnosis. Thus, fever suggests an infective process and makes a myocardial infarction less likely. Significant weight loss over the preceding months may be due to a cancer, which is a catabolic process (breakdown of tissues for energy). • When did they last open their bowels or pass any flatus (wind)? A patient who hasn’t opened their bowels may be constipated, but a patient who isn’t even managing to pass wind (‘absolute constipation’) may be obstructed—a surgical emergency. • Have they noticed any change in their stool recently? (e.g. colour, floating, smelly). If the common bile duct is obstructed, bilirubin and fat-dissolving bile salts won’t reach the bowel and thus stools will be pale, floating, and smelly (steatorrhoea). If blood is entering the bowel lumen via a bleeding ulcer, the iron (haemoglobin) in the blood will be oxidized, making stools appear very dark, black, tarry, and smelly (melaena).

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Actes de conférences sur le sujet "Upper Abdominal Disease"

Fenner, Fernanda, Francisco José Luis de Sousa, Hilton Mariano da Silva Jr et Andrei Fernandes Joaquim. « Aortic thrombosis presenting with low back pain and paraplegia : a medical alert ». Dans XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.741.

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Context:The importance of a thorough neurological examination of the patient should always include research into differential diagnoses such as vascular syndromes, increasingly common in our population. Case report: A 46-year-old man evaluated and screened by the Neurosurgery’s department team, after an initial complaint of sudden onset low back pain and acute weakness in both lower limbs. The patient was healthy before the event. Patient didn’t have pathological history or use of chronic medications, referring only to use sporadic medication for sexual impotence, approximately 6 months ago. Observation revealed pale cold lower limbs, with livedo reticularis. Pulses of the femoral artery were absent bilaterally. Neurological examination revealed complete flaccid paraplegia with neurological level of L1. Below this level loss of pain, light touch and temperature sensation (0/2 in all dermatomes on both extremities), muscle weakness (0/5 in all neurotomes bilaterally), absent tendon and plantar reflexes. Axial tomography of the lumbar spine didn’t reveal vertebral lesions or pressure within the spinal canal. Consultation of the vascular surgeon confirmed absence of blood flow through femoral arteries and emergency angiotomography of the abdominal aorta showed complete occlusion of the descending aorta, upper renal arteries. Patient underwent percutaneous embolectomy treatment, with successful revascularization of lower extremities; unfortunately died about 10 hours after surgery due the development of revascularization syndrome. Conclusions: Acute aortic occlusion is a catastrophic event and can present itself as flaccid paraplegia, leading to misdiagnosis and loss of valuable time for positive outcome. Vascular examination should always be performed on each patient with neurological deficit in lower limbs, especially patients with clinical history of peripheral vascular disease. Immediate start of treatment is imperative to improve survival rates.

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Maia, Fernanda Pimentel Arraes, Eduarda Sousa Machado, Fabiana Germano Bezerra, Brenda Regio Garcia et Luiz Gonzaga Porto Pinheiro. « LIVER TRANSPLANTATION IN A FEMALE PATIENT WITH PREVIOUS HISTORY OF BREAST CANCER ». Dans XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1052.

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Bile duct injury is a complication of cholecystectomy and may lead the patient to develop secondary biliary cirrhosis (SBC), an irreversible damage to the liver parenchyma caused by the chronic interruption of bile flow. Clinically, cirrhosis manifests when 80% of the liver parenchyma is affected with symptoms like pruritus, jaundice, coagulopathy, and ascites in advanced stages. Liver transplantation is an option of the treatment for SBC, especially when its progression leads to liver failure but there are conditions that strongly contraindicate the procedure, such as an active extrahepatic malignancy. We report a situation in which a patient with breast cancer underwent a liver transplant with good results over 10 years of follow-up. We report a 63-year-old woman, retired, healthy until 2001, when she was submitted for a cholecystectomy. After 15 days, the patient underwent a bile duct reconstruction due to an iatrogenic lesion of the bile duct. After 5 years of asymptomatic, she began to present anorexia, weight loss, jaundice, choluria, and fecal acholia, being diagnosed with SBC. The treatment with endoscopic retrograde cholangiopancreatography and the placement of stents in the bile ducts was initiated with no success. Therefore, she was referred to the liver transplant clinic of the Hospital Universitário Walter Cantídio, placed in Fortaleza-Ceará. On admission, the patient presented a regular general condition, oriented, icteric (++/4), and slimmer. The physical examination showed a symmetric thorax with a palpable lump in the right breast. Cardiac and pulmonary auscultations were normal. The patient had plane, flaccid, painless abdomen, with the presence of incisional hernia with spleen and palpable bowel loops. The laboratory tests showed the following results: creatinine 0.4 mg/dL; international normalized ratio (INR) 1.68; total bilirubin 17.9 mg/dL, being classified as CHILD B MELD 23. The patient also underwent an upper digestive endoscopy that exhibited esophageal varices. The abdominal ultrasound (US) presented signs of chronic liver disease, splenomegaly, and dilated intrahepatic bile ducts. In this case, it was also requested a breast US that revealed a lump on the right breast, measuring 1.5×1.1 cm. Then, she was referred to a mastologist, who requested a mammogram that showed an irregular, spiky, and high-density lump in the upper side quadrant of the right breast, measuring 12 mm. It was requested for a positron emission tomography, whose results excluded the possibility of metastasis. Then, the patient was submitted to a breast quadrantectomy with axillary dissection and removal of five lymph nodes, with freeze biopsy, confirming breast cancer with free margins and sentinel lymph node research. Histopathology of the breast piece revealed grade 2 infiltrating ductal carcinoma of the right breast, measuring 1.8×1.5 cm with angiolymphatic invasion and metastasis to 1 axillary lymph node of 3 mm. Immunohistochemistry examination was positive for estrogen and progesterone receptors, with low Ki-67 and negative HER-2, subtypes of LUMINAL A breast carcinoma. She underwent hormonal treatment, and adjuvant chemotherapy was not indicated. Due to the high risk of mortality associated with SBC, the patient was released by oncology and, in a multidisciplinary meeting with the participation of surgeons, hepatologists, and radiologists, it was decided to include the patient on the liver transplant list, performed 2 months after breast cancer surgery. After 10 years, the patient was monitored by the liver transplant service without recurrence of breast disease and with good liver graft function, using immunosuppressive therapy with everolimus 3.5 mg/day.

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Swillens, Abigail, Lieve Lanoye, Julie De Backer, Nikos Stergiopulos, Frank Vermassen, Pascal Verdonck et Patrick Segers. « The Impact of an Abdominal Aortic Aneurysm on Aortic Wave Reflection ». Dans ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-175514.

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The economical growth and increased welfare in the Western world have a reverse side, with an increased death toll due to cardiovascular diseases. Among these, aortic aneurysms (a local dilation) are particularly lethal as they may grow unnoticed until rupture occurs. In this study, we assessed the impact of the presence of an abdominal aortic aneurysm on arterial hemodynamics and wave reflection in particular. Experimental and numerical methods were applied. Linear wave separation was used to quantify the reflections; wave intensity analysis was applied to assess the nature of the reflected waves. In both the experimental and numerical models, negative reflections were found in the upper aorta corresponding to a backward expansion wave caused by the sudden expansion of the aorta. A numerical parameter study demonstrated that larger diameters and more compliant aneurysms generate stronger negative reflections.

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