Advertisement

Surgery pp 759-769 | Cite as

Assessment of Acute Abdominal Symptoms

  • William P. Schecter

Abstract

The diagnostic evaluation of the patient with acute abdominal pain is one of the most interesting and challenging problems in clinical medicine. Changes in technology in the past 25 years (ultrasonography, computed tomographic [CT] scanning, magnetic resonance imaging [MRI], diagnostic peritoneal lavage, and laparoscopy) have improved our ability to “see” into the abdomen. Nevertheless, the abdomen remains very much a “black box” for the clinician on the front line. Surgery is still awaiting the development of an imaging test of sufficient accuracy to revolutionize the evaluation of the acute abdomen much as the head CT scan changed forever the fields of neurology and neurosurgery. A careful history and physical examination by an experienced surgeon, together with judicious use of laboratory and currently available imaging studies, remain the best method of evaluation at present.

Keywords

Abdominal Aortic Aneurysm Familial Mediterranean Fever Abdominal Aortic Aneurysm Laparoscopic Appendectomy Acute Abdomen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Martin RF, Rossi RL. The acute abdomen: an overview and algorithm. Surg Clin North Am 1997;77:1227.PubMedCrossRefGoogle Scholar
  2. 2.
    Gypta H, Dupuy DE. Advances in imaging the acute abdomen. Surg Clin North Am 1997;77:1245–1283.CrossRefGoogle Scholar
  3. 3.
    Omori H, Asahi H, Inoue Y, et al. Pneumoperitoneum without perforation of the gastrointestinal tract. Dig Surg 2003;20:334–338.PubMedCrossRefGoogle Scholar
  4. 4.
    Ahn SH, Mayo-Smith WW, Murphy BL, et al. Acute non-traumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation. Radiology 2002;225:159–164.PubMedCrossRefGoogle Scholar
  5. 5.
    Fa EM, Cronan EJ. Compression ultrasonography as an aid in the differential diagnosis of appendicitis. Surg Gynecol Obstret 1989;169:290–298.Google Scholar
  6. 6.
    Chen SC, Chen KM, Wang SM, Chang KJ. Abdominal ultrasound screen of clinically diagnosed or suspected appendicitis before surgery. World J Surg 1998;22:449–452.PubMedCrossRefGoogle Scholar
  7. 7.
    Wade DS, Marrow SE, Balsaraza ZN, et al. Accuracy of ultrasound in the diagnosis of acute appendicitis compared with the surgeon’s clinical impression. Arch Surg 1993;128:1039–1044.PubMedGoogle Scholar
  8. 8.
    Carroll BA. Preferred imaging techniques for the diagnosis of cholecystitis and cholelithiasis. Ann Surg 1989;210:1–12.PubMedCrossRefGoogle Scholar
  9. 9.
    Healey MA, Simons RK, Winchell RJ, et al. A prospective evaluation of abdominal ultrasound in blunt trauma: is it useful? J Trauma 1996;40:875–883.PubMedCrossRefGoogle Scholar
  10. 10.
    Goletti O, Lippolis PV, Chiarugi M, et al. Percutaneous ultrasound guided drainage of intra-abdominal abscesses. Br J Surg 1993;80:336–339.PubMedCrossRefGoogle Scholar
  11. 11.
    Livingston DH, Lavery RF, Passannante MR, et al. Admission or observation is not necessary after a negative abdominal computed tomography scan in patients with blunt abdominal trauma: results of a prospective multi-institutional trial. J Trauma 1998;44:273–280.PubMedCrossRefGoogle Scholar
  12. 12.
    Chambers A, Halligan S, Goh V, et al. Therapeutic impact of abdomino-pelvic computed tomography in patients with acute abdominal symptoms. Acta Radiol 2004;45:248–253.PubMedCrossRefGoogle Scholar
  13. 13.
    Esses D, Birnbaum A, Bijur P, et al. Ability of CT to alter decision making in elderly patients with acute abdominal pain. Am J Emerg Med 2004;22:270–272.PubMedCrossRefGoogle Scholar
  14. 14.
    Adam DJ, Bradbury AW, Stuart WP, et al. The value of computed tomography in the assessment of suspected ruptured abdominal aortic aneurysm. J Vasc Surg 1998;27:431–437.PubMedCrossRefGoogle Scholar
  15. 15.
    Schecter W, Rintel T, Slutkin G, et al. Tropical pyomyositis of the iliacus muscle. Am J Trop Med Hyg 1983;34:809–811.Google Scholar
  16. 16.
    Roy S, Weimersheimer P. Non-operative causes of abdominal pain. Surg Clin North Am 1997;77:1433–1454.PubMedCrossRefGoogle Scholar
  17. 17.
    Reissman P, Durst AL, Rivkind A, et al. Elective laparoscopic appendectomy in patients with familial Mediterranean fever. World J Surg 1994;18:139–141.PubMedCrossRefGoogle Scholar
  18. 18.
    Lim H. The porphyrias. Clin Dermatol 1996;14:375–387.PubMedCrossRefGoogle Scholar
  19. 19.
    Cook D, Guyatt G, Marshall J, et al. A comparison of sucralfate and ranitidine for the prevention of upper gastrointestinal bleeding in patient requiring mechanical ventilation. Canadian Critical Care Trials Group. N Engl J Med 1998;338:791–797.PubMedCrossRefGoogle Scholar
  20. 20.
    Montgomery RA, Venbrux AC, Bulkley GB. Mesenteric vascular insufficiency. Curr Probl Surg 1997;34:941–1028.PubMedCrossRefGoogle Scholar
  21. 21.
    Butler JA, Huang J, Wilson SE. Repeated laparotomy for postoperative intra-abdominal sepsis: an analysis of outcome predictors. Arch Surg 1987;122:702–706.PubMedGoogle Scholar
  22. 22.
    Sleeman D, Sosa JL, Gonzalez A, et al. Reclosure of the open abdomen. J Am Coll Surg 1995;180:200–204.PubMedGoogle Scholar
  23. 23.
    Hirschberg A, Wall MJ Jr, Mattox KL. Planned reoperation for trauma: a 2-year experience with 24 consecutive patients. J Trauma 1994;37:365–369.CrossRefGoogle Scholar
  24. 24.
    Mayberry JC, Mullins RJ, Crass RA, Trunkey DD. Prevention of abdominal compartment syndrome by absorbable mesh prosthesis closure. Arch Surg 1997;132:957–961.PubMedGoogle Scholar
  25. 25.
    Whitney TM, Brunell W, Russell TR, et al. Emergent abdominal surgery in AIDS: experience in San Francisco. Am J Surg 1994;168:239–243.PubMedCrossRefGoogle Scholar
  26. 26.
    Schecter WP. Surgical care of the HIV-infected patient: a moral imperative. Camb Q Healthcare Ethics 1992;1:223–228.CrossRefGoogle Scholar
  27. 27.
    Fallon WF, Newman JS, Fallon GL, Malangoni MA. The surgical management of intraabdominal inflammatory conditions during pregnancy. Surg Clin North Am 1995;75:15–31.PubMedGoogle Scholar
  28. 28.
    Pier A, Gotz F, Bacher C, et al. Laparoscopic appendectomy. World J Surg 1993;17:29–33.PubMedCrossRefGoogle Scholar
  29. 29.
    Ortega AE, Hunter JG, Peters JH, et al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic appendectomy study group. Am J Surg 1995;169:208–212.PubMedCrossRefGoogle Scholar
  30. 30.
    Lau WY, Leung KL, Kwong KH, et al. A randomized study comparing laparoscopic versus open repair of perforated peptic ulcer using suture or sutureless technique. Am Surg 1996;224:131–138.Google Scholar
  31. 31.
    Memon MA, Fitzgibbons RJ. The role of minimal access surgery in the acute abdomen. Surg Clin North Am 1997;77:1333–1353.PubMedCrossRefGoogle Scholar
  32. 32.
    Meyers MA, Oliphant M. Pitfalls and pickups in plain-film diagnosis of the abdomen. 1974;4(2):1–37.Google Scholar
  33. 33.
    Meyers MA. Dynamic Radiology of the Abdomen. 4th ed. New York: Springer-Verlag 1994.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • William P. Schecter
    • 1
  1. 1.Department Clinical SurgeryUniversity of California, San FranciscoSan FranciscoUSA

Personalised recommendations