Abdomen, Acute ; diagnosis ; diagnostic imaging ; therapy ; Female ; Humans ; Infant ; Intussusception ; diagnosis ; diagnostic imaging ; therapy ; Ultrasonography

Both malignant tumors derived from gastrointestinal tract and metastasis from peritoneal spread, hematogenous dissemination and lymph node can lead to acute abdomen. Such acute abdomen patients have poor prognosis, high mortality, and complex clinical manifestations. It is difficult to make a correct diagnosis in clinical practice. Recent studies show that gastrointestinal tumors are associated with clinical emergency. Malignant gastrointestinal tumors mostly result in obstruction, so upper gastrointestinal contrast for gastric cancer and post-enhanced CT for colon cancer are recommended; gastrointestinal stromal tumors usually cause bleeding, so computed tomography angiography (CTA) is the first choice for examination; primary gastrointestinal lymphoma tends to cause perforation and usually occurs in small intestine, so CT is the first examination for patients with ischemic acute abdomen, and post-enhanced CT is essential to exclude small intestine carcinoid because of its rising incidence in recent years. The possibility of gastrointestinal metastasis should be kept in mind for patients with cancer presenting acute abdomen. This article focuses on the imaging features of common gastrointestinal tumors and their acute obstruction, perforation, and hemorrhage, and aims to improve the understanding of such symptoms in clinical practice so that correct diagnosis and treatment can be made in time.
Abdomen, Acute ; diagnostic imaging ; Carcinoid Tumor ; diagnostic imaging ; Gastrointestinal Stromal Tumors ; diagnostic imaging ; Humans ; Intestinal Neoplasms ; diagnostic imaging ; Intestines ; diagnostic imaging

Computed tomography (CT) is an imaging modality that provides otherwise unobtainable information in the diagnostic workup for acute abdomen. The patient's clinical history, physical examination, and laboratory findings are essential for a correct diagnosis; however, some diagnoses are difficult to establish. Although contrast-enhanced CT is the preferred diagnostic tool and provides invaluable information, using only post-contrast images can lead to misdiagnoses. Unenhanced CT images are more useful than post-contrast images for detecting high-attenuation lesions or materials because surrounding tissues also show high attenuation on post-contrast images. Unenhanced CT often provides key imaging findings for a correct diagnosis; hence, the purpose of this article is to describe CT findings in acute abdomen with high-attenuation lesions in the gastrointestinal tract.
Adult ; Humans ; Abdomen, Acute/diagnostic imaging* ; Contrast Media ; Tomography, X-Ray Computed/methods* ; Gastrointestinal Tract/diagnostic imaging* ; Retrospective Studies

Bowel injury after laparoscopic gynecologic surgery is a rare but serious complication. In particular, diagnosis of a patient with bowel injury is difficult because of the unusual patient presentation and remaining intraabdominal gas. We report on a case of a sigmoid colon perforation after laparoscopic gynecologic surgery. A 42-year-old woman with abdominal pain and distention underwent exploratory laparotomy. She had undergone laparoscopic gynecologic surgery 6 days ago. During the procedure, a sigmoid colon perforation was found as well as severe inflammation at the pelvic cavity. The patient underwent segmental resection of the sigmoid colon with loop ileostomy. Postoperative acute abdomen did not show classic signs on physical examination and diagnostic imaging. Thus, a more careful approach and interpretation of diagnosis was needed.
Abdomen, Acute ; Abdominal Pain ; Adult ; Colon, Sigmoid* ; Diagnosis ; Diagnostic Imaging ; Female ; Gynecologic Surgical Procedures* ; Humans ; Ileostomy ; Inflammation ; Laparoscopy ; Laparotomy ; Physical Examination

Intestinal torsion and chylous ascites are very rarely associated. We present the case of a 19-year-old man who presented with acute abdomen. Computed tomography of his abdomen showed features suggestive of intestinal torsion. Chylous ascites was incidentally discovered on exploratory laparotomy. The chylous fluid was drained, the small bowel detorted and the coloduodenal adhesion band taken down. The patient's retroperitoneum was explored to exclude occult masses and malformations of the lymphatics. Post surgery, the patient recovered uneventfully. In this case, we postulate that intestinal malrotation had caused the obstruction of the lymphatic flow from the mesenteric lymphatic channels, leading to the exudation of chyle, which then resulted in the accumulation of chylous fluid in the peritoneal cavity. It is important to exclude the more common causes of atraumatic chylous ascites, such as enlarged retroperitoneal lymph nodes or lymphatic malformations.
Abdomen, Acute ; diagnosis ; surgery ; Chylous Ascites ; diagnosis ; diagnostic imaging ; surgery ; Humans ; Intestinal Volvulus ; diagnosis ; diagnostic imaging ; surgery ; Intestines ; abnormalities ; Laparotomy ; Lymph ; metabolism ; Male ; Tomography, X-Ray Computed ; methods ; Young Adult