Spigelian hernia is an uncommon hernia of the ant. abdominal wall. Because of its insidious nature and nonspecific physical findings, the diagnosis of this hernia is often not made. Typically, the hernia orifice is small, and strangulation of the contents of the hernial sac can occur. Computed tomography permits the distinction between Spigelian hernia and other anterial abdominal wall or intraabdominal masses. Spigelian hernia requires surgical correction to prevent complication of acute abdomen with strangulation or incarceration. The typical site of a Spigelian hernia is at the level of the semicircular fold of Douglas known as the arcuate line. Spigelian hernia can occur above the umbilicus, high Spigelian hernia, but its very unusual site. We report a case of Spigelian hernia on upper abdomen and review the literature.
Abdomen* ; Abdomen, Acute ; Abdominal Wall ; Ants ; Diagnosis ; Hernia* ; Umbilicus

Rupture of ovarian endometrioma is rarely occurred. It causes chemical panperitonitis resulting in low fertility and requiring differential diagnosis of acute abdomen. So it needs fast and accurate diagnosis. We have experienced two cases of chemical panperitonitis due to ruptured ovarian endometrioma managed by pelviscopy with a brief review of the literature.
Abdomen, Acute ; Diagnosis ; Diagnosis, Differential ; Endometriosis* ; Female ; Fertility ; Rupture

Epiploic appendagitis is a relatively rare cause of acute abdominal pain. Usually, epiploic appendagitis is a benign and self-limited condition, but it can be clinically misdiagnosed as acute appendicitis or diverticulitis, so an inaccurate diagnosis may lead to unnecessary treatment. We recently managed 7 cases of epiploic appendagitis during 1 year and review these cases with an emphasis on the clinical diagnostic features. The main pathophysiologic mechanism underlying epiploic appendagitis is thought to be triggered by appendageal torsion and caused by a subsequent blood flow disturbance. This medical condition must be kept in mind when a patient with acute abdominal pain has well-localized pain which is characteristically sharp in nature and a mild systemic inflammatory response compared to the severity of the pain.
Abdomen, Acute ; Abdominal Pain ; Appendicitis ; Diagnosis, Differential ; Diverticulitis ; Humans

While colon perforation as a complication of diseases such as carcinoma, colitis, diverticular disease, or abdominal trauma is not uncommon, spontaneous perforation of the colon is rare. Although spontaneous perforation is classified as either stercoral or idiopathic on the basis of its etiological background, the pathological mechanisms of the lesions have yet to be determined in detail. Stercoral perforation is a very rare cause of acute abdomen, with fewer than 70 cases documented in the literature; and idiopathic perforation is also infrequently reported. Both disease entities have often been grouped together as idiopathic or spontaneous perforation, resulting in confusion. We report herein two cases of stercoral perforation of the sigmoid colon. The clinical features, diagnosis, and treatment of the disease are reviewed. Surgeons should be aware of the possibility of this fatal disease, despite its rare incidence. Furthermore, it is important to recognize the condition at an early stage of the disease because it has significantly high mortality if surgery is delayed.
Abdomen, Acute ; Colitis ; Colon* ; Colon, Sigmoid ; Diagnosis ; Incidence ; Mortality

Intestinal perforation by an ingested foreign body is uncommon, and less than 1% lead to intestinal perforation. The diagnosis of fish-bone-induced intestinal perforation is difficult because of the rare history of foreign body ingestion, various clinical presentations, and the radiolucent character of fish bone. Usually, the correct diagnosis is established after an operation. We experienced a rare case of small bowel perforation induced by a fish bone accompanying an intestinal obstruction due to previous operation. Foreignbody-induced perforation is relatively rare, but it should be considered in the case of an acute abdomen.
Abdomen, Acute ; Diagnosis ; Eating ; Foreign Bodies ; Intestinal Obstruction* ; Intestinal Perforation

Accessory spleen is presence of ectopic splenic sue, which has been found in 10~30% in autopsies series. Commonly accessory spleen have no clinical symptoms so diagnosis is difficult to make. But torsion of an wandering accessory spleen which is very unusual entity can appeared as acute abdominal pain and painful mass on abdomen. We reported case of a 27-years-old-woman with torsion of an wandering accessory spleen presenting as acute abdominal pain and painful mass on abdomen. Abdomino-pelvic CT shows large hypodense mass with peripheral enhancement with inflammatory change in LLQ area. Patient underwent laparoscopic exploration under impression of torsion of mesenteric cyst. During the laparoscopic exploration, we found out the torsion of accessory spleen and it was removed successfully by laparoscopic approach. The diagnosis of torsion of wandering accessory spleen could be considered in acute abdomen with intraabdominal mass with hypodense, peripheral enhancement on CT. Despite of size of mass, laparoscopic approach is one of the treatment method in that case.
Abdomen ; Abdomen, Acute ; Abdominal Pain ; Autopsy ; Diagnosis ; Humans ; Laparoscopy* ; Mesenteric Cyst ; Spleen*

Radiological manifestations on plain films of the abdomen in 75 cases with proven typhoid perforation of distal ileum, in Kyungpook National University Hospital between Oct. 1972 and Sep. 1981, were analyzed and discussed. Some clinical and laboratory findings which may be helpful in diagnosis of this condition were also analyzed. Typhoid perforation was occurred most frequently in those between 2nd and 4th decades, and the male to female ratio was 4:1. Typhoid perforation was occurred most frequently in summer, but was occurred in all seasons. Radiological findings were free intraperitoneal gas (64%), loss of preperitoneal fat line (62.7%), free abdominal fluid (53.3%), distention of gas-filled bowel (94.7%), elevation of diaphragm (8%) and fixation of small bowel segments in right lower abdomen (43.7%). We concluded that a large amount of intraperitoneal gas with gas-filled distention of small bowel and findings of peritonitis are highly suggestive of typhoid perforation when the patient has acute abdomen.
Abdomen ; Abdomen, Acute ; Diagnosis ; Diaphragm ; Female ; Gyeongsangbuk-do ; Humans ; Ileum ; Male ; Peritonitis ; Seasons ; Typhoid Fever

Acute appendicitis is the most common acute surgical condition of the abdomen. when the clinical presentationis atypical, barium enema has proven to be safe and useful in confirming the diagnosis and reducing the negativesurgical exploration. However, the performance of barium enema in acute appendicitis has known contraindicationprimarily because of fear of leakage by perforation of the inflammed appendix. This study using barium enema as adiagnostic aid in acute appendicitis with atypical clinical presentation was performed to further support thepreviously noted efficacy and safety of this procedure. The results were as followings: 1. In case of acuteappendicitis with atypical clinical presentation, the use of barium enema as a diagnostic aid increased theaccuracy of diagnosis and decreased the negative surgical exploration. In women between 11 to 50 years old age,especially, it played important role differentiating appendicitis from nonsurgical acute abdomen. 2. The resultsof the study were 92.31% in sensitivity, 7.69% in false positive, 6.9% in false negative, and 10.26% in negativeappendectomy. 4. A simple partial or nonfilling of appendix without other associated possitive finding could notexclude appendicitis, therefore, close clinial observation was necessary. 5. The positive findings of barium enemaand their sensitivity were as followings: 1. Nonfilling of appendix: 9% 2. Partial filling of appendix: 91.7% 3.Displacement or a local impression on temrinal ileum: 100% *, In all cases, combined with a local impression oncecum and/or irritability of cecum or terminal ileum.
Abdomen ; Abdomen, Acute ; Appendicitis ; Appendix ; Barium ; Cecum ; Diagnosis ; Enema ; Female ; Humans ; Ileum

Abdomen, Acute ; diagnosis ; Adult ; Humans ; Male ; Pancreatic Neoplasms ; diagnosis ; Shock, Hemorrhagic ; diagnosis ; Young Adult

Abdomen, Acute ; diagnosis ; Adult ; Female ; Humans ; Laparoscopy ; methods ; Omentum ; pathology ; surgery ; Torsion Abnormality ; diagnosis ; surgery