Abdomen, Acute ; etiology ; Child ; Family Health ; Female ; Gastrointestinal Diseases ; etiology ; Genes, Dominant ; genetics ; Humans ; Male ; Nausea ; etiology ; Pedigree ; Telangiectasia, Hereditary Hemorrhagic ; complications ; genetics ; pathology ; Time Factors ; Vomiting ; etiology

Strongyloides stercoralis (SS) is an intestinal nematode that is mainly endemic in tropical and subtropical regions and sporadic in temperate zones. SS infection frequently occurs in people who have hematologic malignancies, HIV infection and in individuals undergoing immunosuppressive therapy. In this study, we report a 12- year-old immunocompetent boy who was admitted to our hospital with acute abdomen. Laboratory evaluation showed strongyloidiasis, amebiasis and giardiasis. Clinical and laboratory findings immediately improved with albendazole therapy. Therefore, when diarrhea with signs of acute abdomen is observed, stool examinations should be done for enteroparasitosis. This approach will prevent misdiagnosis as acute abdomen. Complete clinical improvement is possible by medical therapy without surgical intervention.
Abdomen, Acute/*etiology ; Amebiasis/*complications ; Animals ; Child ; Giardiasis/*complications ; Humans ; Immunocompetence ; Male ; *Strongyloides stercoralis ; Strongyloidiasis/*complications/parasitology

The extravasation of chyle into the peritoneal space usually does not accompany an abrupt onset of abdominal pain with symptoms and signs of peritonitis. The rarity of this condition fails to reach preoperative diagnosis prior to laparotomy. Here, we introduce a case of chylous ascites that presented with acute abdominal pain mimicking peritonitis caused by ovarian torsion in a 41-yr-old female patient with advanced gastric carcinoma. An emergency exploratory laparotomy was performed but revealed no evidence of ovarian torsion. Only chylous ascites was discovered in the operative field. She underwent a complete abdominal hysterectomy and salphingo-oophorectomy. Only saline irrigation and suction-up were performed for the chylous ascites. The postoperative course was uneventful. Her bowel movement was restored within 1 week. She was allowed only a fat-free diet, and no evidence of re-occurrence of ascites was noted on clinical observation. She now remains under consideration for additional chemotherapy.
Abdomen, Acute/etiology ; Adult ; Chylous Ascites/*diagnosis/*etiology ; Diagnosis, Differential ; Female ; Humans ; Ovarian Diseases/*diagnosis ; Stomach Neoplasms/*complications ; Torsion Abnormality/*diagnosis

Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.
Abdomen ; Adult ; Aged ; Compartment Syndromes ; diagnosis ; etiology ; surgery ; Decompression, Surgical ; Female ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; diagnosis ; etiology ; surgery ; Pancreatitis, Acute Necrotizing ; complications ; diagnosis ; surgery

Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.
*Abdomen ; *Compartment Syndromes/diagnosis ; *Compartment Syndromes/etiology ; *Compartment Syndromes/surgery ; Decompression, Surgical ; *Multiple Organ Failure/diagnosis ; *Multiple Organ Failure/etiology ; *Multiple Organ Failure/surgery ; *Pancreatitis, Acute Necrotizing/complications ; *Pancreatitis, Acute Necrotizing/diagnosis ; *Pancreatitis, Acute Necrotizing/surgery

INTRODUCTIONThe number of cases of lead poisoning (LP), a widely known disease with various aetiologies, being reported globally has decreased over the years due to both limited domestic applications of lead and enforcement of stringent safety measures. However, a new presentation of lead poisoning, lead-contaminated opium (LCO), is gradually emerging in our region. This study aimed to determine the prevalence and clinical effects of lead toxicity associated with opium use.

METHODSBetween November 2006 and December 2007, all patients diagnosed with LP at a central laboratory in Tehran, Iran, were assessed for potential causes of poisoning. Patients with a history of LCO abuse were evaluated and recruited for the study.

RESULTSOverall, there were 240 patients with LP, and poisoning from LCO was diagnosed in 25 patients. The duration of addiction was between three months and 40 years, and the duration of symptoms was 28.1 ± 17.7 days. Mean blood lead levels of the patients were 145 ± 61 (range 61-323) μg/dL. The average creatinine and haemoglobin levels were 77.4 ± 8.1 μmol/L and 105 ± 25 g/L, respectively. The association between the duration of addiction and levels of lead in blood was not statistically significant (r = -0.142, p = 0.54). The most common symptoms were gastrointestinal complaints, followed by musculoskeletal complaints with muscle weakness (92%). Anorexia was also a leading complaint.

CONCLUSIONThe results of our study suggest that the possibility of LP should be considered with high suspicion among opium users presenting with acute abdominal symptoms.

Abdomen, Acute ; etiology ; Adult ; Creatinine ; blood ; Cross-Sectional Studies ; Female ; Hemoglobins ; biosynthesis ; Humans ; Iran ; Lead ; blood ; Lead Poisoning ; complications ; diagnosis ; etiology ; Male ; Middle Aged ; Muscle Weakness ; etiology ; Opioid-Related Disorders ; blood ; complications ; Opium ; administration & dosage ; Pain ; etiology ; Prevalence ; Time Factors

OBJECTIVES: To study the etiology and clinical features of children with ascites, so as to provide a basis for the diagnosis and treatment of ascites in children. METHODS: The medical data of the children with ascites, who were hospitalized from January 1, 2010 to December 31, 2019, were retrospectively reviewed. RESULTS: Among the 165 children with ascites, the male/female ratio was 1.53:1, and the mean age of onset was (6±4) years. The causes of ascites included surgical acute abdomen (39 children, 23.6%), infectious diseases (39 children, 23.6%), neoplastic diseases (27 children, 16.4%), hepatogenic diseases (18 children, 10.9%), pancreatitis (10 children, 6.1%), cardiogenic diseases (8 children, 4.8%), rheumatic immune diseases (6 children, 3.6%), and nephrogenic diseases (5 children, 3.0%). According to the age of onset, there were 33 infants, 24 young children, 30 preschool children, 41 school-aged children, and 37 adolescents. Surgical acute abdomen and hepatogenic diseases were the main causes of ascites in infants (P<0.05). Neoplastic disease was the leading cause in young children (P<0.05). Infectious diseases were the most common cause in adolescents (P<0.05). CONCLUSIONS Surgical acute abdomen, infectious diseases, neoplastic diseases, and hepatogenic diseases are the common causes of ascites in children, and there are some differences in the leading cause of ascites between different age groups.
Abdomen, Acute/complications* ; Adolescent ; Ascites/etiology* ; Child ; Child, Preschool ; Communicable Diseases ; Female ; Humans ; Infant ; Male ; Neoplasms/complications* ; Pancreatitis/complications* ; Retrospective Studies